In this in vivo study, we clearly demonstrate that there is a significant upregulation of activated NF-κB in the iris/ciliary body during the ocular inflammation that occurs during EAAU. Inhibition of this in vivo activation by PDTC ameliorates the clinical signs of EAAU. These results are entirely consistent with the suggestion that the activation of NF-κB is a critical participant in the pathogenesis of EAAU.
We have also clearly shown that the NF-κB inhibitor PDTC effectively suppresses the expression of the chemokine genes encoding MCP-1, RANTES, and IL-8 and the expression of the chemokine receptors genes encoding CCR2, CCR5, and CXCR3. These proteins collectively contribute to the recruitment of leukocytes during inflammation. The findings indicate that NF-κB modulates inflammatory responses through its ability to induce transcription of these proinflammatory genes during the EAAU disease process.
It is now widely accepted that the synthesis and secretion of inflammatory chemokines play important roles in the pathophysiology of ocular inflammation.
26 The expression of inducible genes leading to the formation of these proteins relies on transcription factors. NF-κB plays a central role in the regulation of many genes responsible for the generation of mediators or proteins in inflammation. There is increasing evidence that NF-κB involves in the regulation of chemokine gene expression.
13 However, the exact chemokines controlled by NF-κB in EAAU have remained unknown. Our results demonstrate that PDTC inhibits MCP-1, RANTES, and IL-8 gene expression, consistent with an NF-κB-dependent transcriptional regulation of these genes. It is possible that MCP-1, RANTES, and IL-8 proteins are the main chemokines involved in the pathogenesis of EAAU. MCP-1 and RANTES are potent chemoattractants for T lymphocytes, monocytes, and NK cells, all of which are the infiltrating cells observed in the iris/ciliary body in rats with EAAU.
27 28 29 Il-8 not only is a potent chemoattractant for neutrophils but also is critically involved in firm cellular adhesion on endothelium, which is a necessary prerequisite for transmigration of the vessel wall.
8 9 30 31 Therefore, inhibition of MCP-1, RANTES, and IL-8 production by PDTC may significantly block monocyte/lymphocyte infiltration and subsequent inflammatory reactions in EAAU.
The finding that PDTC suppresses the induction of MCP-1, RANTES, and IL-8 confirms previous reports regarding the importance of NF-κB sequences in mediating the transcriptional activities of specific chemokine promoters including those of MCP-1 and RANTES.
32 33 Consensus binding sequences for NF-κB have been identified in the promoter regions of human and rat genes encoding MCP-1, RANTES, and IL-8.
32 34 Similarly, the lack of suppression of MIP-1 by PDTC observed in the present study is consistent with the absence of consensus NF-κB-binding sites in the 5′ untranslated region of genes and favors the suggestion that the transcriptional regulation of the MIP-1 gene is entirely independent of NF-κB.
35 36 In contrast, the lack of suppression of IP-10 by PDTC observed in the present study was surprising, since IP-10 appears to be an NF-κB regulated chemokine.
37 This discrepancy occurred because the transcriptional control of IP-10 varies depending on both the stimulus and the cell type. It is likely that other non-NF-κB enhancer sequences are sufficient for induction of the IP-10 gene in EAAU.
38
Chemokines interact with respective G-protein-coupled receptors possessing a seven-transmembrane domain. Chemokine receptors are differentially expressed on Th1 and Th2 effector cells, resulting in the distribution of these cells in the specified environments.
39 40 CCR2 is the primary receptor of chemokine MCP-1 and is critical in the induction of experimental autoimmune encephalomyelitis. Mice with a CCR2 deletion are protected from dextran sodium sulfate-mediated colitis.
41 42 CCR5 and CXCR3 are the primary receptors of RANTES and IP-10, respectively, and are predominantly found on Th1 cells. T lymphocytes expressing CCR5 and CXCR3 are enriched in rheumatoid arthritis synovial tissue, active lesions in multiple sclerosis, and the conjunctiva in vernal keratoconjunctivitis.
43 44 45 Quantitative analysis of the chemokine receptor expression pattern in this study revealed significantly decreased expression of CCR2, CCR5, and CXCR3 mRNA in the iris/ciliary body after PDTC treatment. This finding probably reflects a reduced number of monocytes and T lymphocytes invading the iris/ciliary body during the acute immune-mediated inflammatory process. However, it is still possible that the CCR2, CCR5, and CXCR3 distributed on the surface of monocytes/macrophages decreased after PTDC treatment. This notion is supported by Saccani et al.,
47 who found that PDTC inhibited CCR2, CCR5, and CXCR4 expression in human monocytes.
46 Chemokine receptors are expressed in a dynamic fashion and can be modulated by cytokines and redox status at the inflammatory sites. The control of chemokine receptor expression is a decisive mechanism for regulating chemokine action.
48 Selective downregulation of specific chemokine receptors on a given subset of leukocytes may reduce ligand binding, ultimately contributing to the decreased recruitment of these cells to the inflammatory sites. However, further studies are warranted to elucidate this possibility in greater detail.
In this study, with the increase of IL-8 mRNA, the IL-8 receptors CXCR1 and -2 were undetectable 14 days after immunization. Because CXCR1 and -2 are mainly distributed on the surface of neutrophils, there are two possible explanations for these observations: First, the lack of expression may be due to the decreased accumulation of neutrophils. It is possible that the accumulation and disappearance of neutrophils occurs early in the course of EAAU, therefore, on day 14 after immunization, the number of neutrophils had already decreased so that only a minimal amount of CXCR1 and -2 mRNA was detected. Second, downregulation of CXCR1 and -2 on neutrophils may account for this reduction. It can be assumed that the decrease in CXCR1 and -2 may make neutrophils unresponsive to IL-8 causing fewer of them to be attracted to the iris/ciliary body. Further study with flow cytometry and early detection in the course of EAAU is needed to clarify this question.
PDTC represents a class of antioxidants reported to be a potent inhibitor of NF-κB.
49 50 51 In addition, PTDC blocks IκB-α phosphorylation, precluding the dissociation of NF-κB from IκB-α and subsequent NF-κB translocation from the nucleus in response to inflammatory stimulation.
24 The potential for modulating cell activation suggests that PDTC and its analogues may offer therapeutic benefit in inflammatory conditions in which activation of NF-κB plays a major role. Despite the successful alleviation of the clinical signs of EAAU by PDTC, PDTC-treated rats display retarded body weight gain, suggesting the presence of a toxic action of PDTC.
52 The ultimate benefit of such targeted therapy depends on the delicate balance between inflammation suppression and interference with normal cellular functions. By selectively targeting specific NF-κB subunits that have a degree of tissue specificity, one might attain therapeutic efficacy and minimize systemic toxicity.
In conclusion, the present study demonstrated that the activation of NF-κB is markedly induced in the iris/ciliary bodies of rats during EAAU, and that this induction plays an important role in the pathogenesis of EAAU. Inhibition of NF-κB by PDTC may prevent the activation of NF-κB and the subsequent expression of chemokines and clinical signs of inflammation.