Institut National de la Santé et de la Recherche Médicale U872, Team 17, Physiopathology of Ocular Diseases: Therapeutic Innovations, Paris, France.
Invest Ophthalmol Vis Sci. 2011 Aug 11;52(9):6340-7. doi: 10.1167/iovs.11-7675.
Glucocorticoids are used to treat macular edema, although the mechanisms underlying this effect remain largely unknown. The authors have evaluated in the normal and endotoxin-induced uveitis (EIU) rats, the effects of dexamethasone (dex) and triamcinolone acetonide (TA) on potassium channel Kir4.1 and aquaporin-4 (AQP4), the two main retinal Müller glial (RMG) channels controlling retinal fluid movement.
Clinical as well as relatively low doses of dex and TA were injected in the vitreous of normal rats to evaluate their influence on Kir4.1 and AQP4 expression 24 hours later. The dose-dependent effects of the two glucocorticoids were investigated using rat neuroretinal organotypic cultures. EIU was induced by footpad lipopolysaccharide injection, without or with 100 nM intraocular dex or TA. Glucocorticoid receptor and channel expression levels were measured by quantitative PCR, Western blot, and immunohistochemistry.
The authors found that dex and TA exert distinct and specific channel regulations at 24 hours after intravitreous injection. Dex selectively upregulated Kir4.1 (not AQP4) in healthy and inflamed retinas, whereas TA induced AQP4 (not Kir4.1) downregulation in normal retina and upregulation in EIU. The lower concentration (100 nM) efficiently regulated the channels. Moreover, in EIU, an inflammatory condition, the glucocorticoid receptor was downregulated in the retina, which was prevented by intravitreous injections of the low concentration of dex or TA.
The results show that dex and TA are far from being equivalent to modulate RMG channels. Furthermore, the authors suggest that low doses of glucocorticoids may have antiedematous effects on the retina with reduced toxicity.
糖皮质激素被用于治疗黄斑水肿,尽管其作用机制仍知之甚少。作者在正常和内毒素诱导的葡萄膜炎(EIU)大鼠中评估了地塞米松(dex)和曲安奈德(TA)对钾通道 Kir4.1 和水通道蛋白-4(AQP4)的影响,这两种主要的视网膜 Müller 胶质(RMG)通道控制视网膜液体运动。
在正常大鼠的玻璃体内注射临床和相对低剂量的 dex 和 TA,以评估它们对 Kir4.1 和 AQP4 表达的影响 24 小时后。使用大鼠神经视网膜器官型培养物研究了两种糖皮质激素的剂量依赖性作用。通过足底注射脂多糖诱导 EIU,不或用 100 nM 眼内 dex 或 TA 处理。通过定量 PCR、Western blot 和免疫组织化学测量糖皮质激素受体和通道表达水平。
作者发现 dex 和 TA 在玻璃体内注射后 24 小时对通道有不同和特异的调节作用。地塞米松选择性地上调健康和炎症视网膜中的 Kir4.1(而不是 AQP4),而 TA 诱导正常视网膜中的 AQP4(而不是 Kir4.1)下调和 EIU 中的上调。较低浓度(100 nM)有效地调节了通道。此外,在炎症状态下的 EIU 中,视网膜中的糖皮质激素受体下调,这可以通过玻璃体内注射低浓度的 dex 或 TA 来预防。
结果表明 dex 和 TA 在调节 RMG 通道方面远非等效。此外,作者提出低剂量的糖皮质激素可能具有减轻毒性的抗水肿作用。