This study shows that TGFβ2 induces similar cataractous changes
in lenses from weanling, adult, and senile rats. These include
opacification due to the formation of anterior subcapsular plaques. As
noted in our previous studies,
5 13 these plaques contain
type I collagen and α-smooth muscle actin, suggesting that epithelial
cells have undergone a transition into a fibroblastic or
myofibroblastic cell phenotype. These morphologic and molecular changes
are characteristic of anterior subcapsular cataract and aftercataract
in humans.
18 19 20 21 22 23 24 25 They are also reminiscent of the changes
that occur in other biologic systems when TGFβ is activated during
wound healing.
26
A major finding of the present study was that, although lenses from
weanling, adult, and senile rats were all susceptible to the
cataractogenic influence of TGFβ, lenses from older animals were more
responsive than lenses from younger animals. This result was
demonstrated by their response to lower concentrations of TGFβ and
also by the greater extent of the opacification that occurred in
response to a given concentration of TGFβ. The increased
opacification was most pronounced in the lenses from senile rats, a
finding that reveals yet another important similarity between
TGFβ-induced cataract in rats and cataract in humans. The present
finding that rat lenses became more responsive to TGFβ with aging is
consistent with the knowledge that age is the single most significant
risk factor for cataract in humans.
8 It is not clear how
such increased sensitivity to TGFβ arises. However, it is noteworthy
that this behavior is in contrast to the generally decreased activity
of lens cells with age. For example, proliferation of lens epithelial
cells in vivo rapidly decreases with aging.
24 Furthermore,
the rate of fiber differentiation in vivo decreases within the first
month after birth.
28 Similarly, studies with rat and chick
epithelial explants show that the ability to undergo fiber
differentiation in response to fibroblast growth factor
(FGF)
29 30 or insulin-like growth factor
(IGF),
31 respectively, is reduced with aging. In rats, the
age-related reduction in responsiveness of lens epithelial cells to the
fiber differentiating activities of FGF correlates with an age-related
reduction in expression of FGF receptors in the lens.
32 At
present, there is no information on the expression of TGFβ receptors
in lenses from adult rats. Immunolocalization studies have shown,
however, that reactivity for type I and type II TGFβ receptors in the
lens increases between the neonatal and weanling stages.
33
Increased sensitivity of lens cells to TGFβ could occur in two main
ways. First, the level of a factor that promotes sensitivity of lens
cells to TGFβ could increase with age. Alternatively, the level of a
factor that desensitizes and therefore protects lens cells from TGFβ
could decrease with age. Although there are no known examples of the
former possibility, there is an example of the latter. Recently, we
showed that estrogen can desensitize lens cells to TGFβ when
administered both in vivo and in vitro.
13 The mechanism
involved is not yet understood. However, it is a particularly important
finding, because it mimics a major trend shown in humans. Epidemiologic
studies indicate that the prevalence of cataract in women after
menopause increases much more sharply than for men of comparable age.
There are also reports of a lower prevalence of some forms of cataract
in women who are undergoing hormone replacement
therapy.
34 35 36 37 Therefore, during aging there is evidence
that female hormones protect lenses from development of cataract. The
parallel between the protective effects of estrogen in the TGFβ rat
model and trends in epidemiologic studies raises the possibility that
in humans, estrogen may provide protection against cataract by
influencing a TGFβ-mediated mechanism.
Another important feature of the present study is that it gives
information about the effects of different TGFβ exposure regimens. Of
note, a low dose of TGFβ administered over a prolonged period can
have an effect similar to a higher dose administered over a short
period. For example, maintenance of a low concentration of TGFβ (25
pg/ml), which induces minimal opacity formation with a 2-day exposure,
results in the formation of distinct anterior opacities when maintained
over a 6-day period. These opacities are comparable to those induced by
a 40-fold higher concentration of TGFβ applied for a shorter period
(see
Table 2 ). In humans, the former scenario may arise during the
progression of a chronic condition that is associated with even a
marginally elevated level of TGFβ. Glaucoma may conform to this
model; elevated TGFβ levels in the aqueous humor of glaucoma
patients have been reported,
38 and glaucoma is also a
known risk factor for cataract.
39 The ocular inflammatory
condition uveitis may mimic the latter scenario; a brief but
substantial (fourfold) increase in TGFβ levels in the ocular media
has been reported during the early stages of this disease in an
experimental rabbit model.
40 Uveitis is also a risk factor
for cataract.
8
All three mammalian isoforms of TGFβ are known to be present in the
ocular environment. The proteins and corresponding mRNAs have both been
detected in embryonic mouse, rat, and adult human
eye.
41 42 43 TGFβ is generally synthesized as a latent
complex that is activated by cleavage of the latency-associated protein
to release the 25-kDa TGFβ homodimer.
44 45 Activation of
TGFβ can occur in a variety of conditions—for example, by
proteolysis or at extremes of pH or temperature.
46 47 48 Once activated, TGFβ may bind to cell surface receptors that promote
signal transduction or, alternatively, may be bound by several
different binding proteins that further modulate TGFβ bioactivity.
TGFβ-binding proteins include a soluble form of the TGFβ type III
receptor, α-2-macroglobulin, decorin, biglycan, and certain other
extracellular matrix proteins.
44 These molecules may
promote or inhibit TGFβ activity. Work in this laboratory has shown
that the ocular media, particularly the vitreous, have TGFβ
inhibitory properties.
9 α-2-Macroglobulin is present in
vitreous and has been shown to prevent cataractous changes induced by
TGFβ2 in lens epithelial explants
9 and also in whole
lenses (Hales et al., unpublished data, 1996).
Although such inhibitory molecules may normally be effective in
protecting lens cells from the damaging effects of any TGFβ that is
present in the ocular environment, there is evidence that they can be
rendered ineffective in the presence of excess active TGFβ. Anterior
subcapsular cataracts, with morphologic and molecular changes
consistent with those described in human studies, develop in a
transgenic mouse line that overexpresses a constitutively active form
of TGFβ1 in a lens-specific manner.
49 Furthermore,
subcapsular and cortical cataracts develop in adult male rats given a
high dose of TGFβ2 by intravitreal injection.
7 There is
evidence of a similar phenomenon in humans. Patients who receive
intravitreal TGFβ2, to promote the closure of holes in the retina
exhibit an unusually high incidence of cataract.
50
These studies indicate that the mechanisms that normally regulate
TGFβ availability to lens cells can be overcome by swamping the cells
with large amounts of TGFβ. The present study, however, shows that
lens cells can be extremely sensitive to the cataractogenic effects of
TGFβ, indicating the exquisite control of TGFβ bioactivity that
must be exercised in situ. Exposure to as little as 25 pg/ml TGFβ2
for 2 days or to 1 ng/ml for only 8 hours was sufficient to induce
opacification and associated cataractous changes in the rat model.
Therefore, in the human many factors may contribute to the development
of TGFβ-induced cataracts. These may include the status of the TGFβ
(i.e., whether it is active or inactive due to latency or binding to
inhibitory molecules), the concentration of TGFβ in the cellular
microenvironment and the isoform(s) present,
10 and the
gender and hormonal status of the individual.
13 The
present study emphasizes that increased sensitivity of the lens cells
to TGFβ with aging is a major factor that must also be taken into
account.
In conclusion, this study further emphasizes the usefulness of
TGFβ-induced cataract in rats as a model for studying human
cataractogenesis. Not only did TGFβ induce lens cells from rats of
the major age groups (weanling, adult, and senile) to undergo
morphologic and molecular changes that mimic those of the human
condition, but also the lens cells showed increased susceptibility to
the cataractogenic effects of TGFβ with age. These results emphasize
the need for greater understanding not only of how TGFβ bioactivity
is regulated, but also of the factors that modulate the responsiveness
of lens cells to TGFβ and how these aspects of lens biology are
influenced by aging. The results suggest that at least some forms of
cataract may arise from an elevation in the level of TGFβ activity,
of either short or long duration, or from an age-related increase in
lens cell responsiveness to TGFβ. The etiology of cataract during
aging or otherwise, however, is likely to be multifactorial, including
both the direct effects of TGFβ on lens cells and/or as yet
undetermined cellular influences related to other known risk factors.
The authors thank Cedric Shorey and Arthur Everitt, Department of
Anatomy and Histology, The University of Sydney, for the generous
donation of senile rats, which came from an aged colony housed at
Concord Repatriation Hospital, Sydney, and Roland Smith for assistance
with photography.