The lens is a naturally hypoxic tissue.
1 2 3 4 Many studies have demonstrated that oxygen concentration in the lens is below 5% in the cortical region and around (or below) 1% in the nucleus.
2 3 5 6 7 The existence of these hypoxic conditions, which are pathologic for any other tissue brings up many questions about possible mechanisms by which the lens is able to accommodate hypoxia and maintain the subtle balance between apoptosis and differentiation. The lens has very low energy requirements, utilizes anaerobic glycolysis, and has a very low oxygen consumption rate (0.5 mL O
2/mg tissue dry weight/h) when compared to the cornea (2 mL), heart (5 mL), and retina (31 mL).
8 9 But the very low-energy requirement of the lens does not explain how the hypoxic lens overcomes all adverse affects of hypoxia. A partial answer may be found by drawing a comparison between lens and the well-known phenomenon of hypoxic preconditioning in the heart. In the heart, as has been shown many times, one of the mechanisms of cardiac protection against ischemia/hypoxia is based on stress-sensing PKC isoforms, including PKCε.
10 During myocardial ischemia connexin-43 (Cx43) is dephosphorylated,
11 12 13 14 15 16 17 18 19 and this is believed to allow gap junctions to be opened and to convey the propagation of ischemia injury.
20 21 22 23 Such adverse propagation of the ischemia signal can be mollified by many factors that specifically activate PKCε in the heart, such as ischemic preconditioning, FGF-2,
24 25 26 exogenous addition of TPA,
25 27 28 29 or hydrogen peroxide.
30 During ischemic preconditioning, PKCε plays a cardioprotective role through several mechanisms, such as: reduction of the intracellular Ca
2+,
31 activation of the mitochondrial cytochrome
c oxidase,
32 33 34 and phosphorylation of Cx43.
13 16 35 In the heart, in hypoxic conditions, PKCε is activated and migrates to membrane Cx43 gap junctions as well as to mitochondria, and, this process is essential for protection from ischemia.
36 The activated PKCε interacts with and phosphorylates Cx43, which aids in the propagation of ischemic injury.
21 25 35 In the mitochondria, PKCε interacts with mitochondrial cytochrome
c oxidase (CytCOxIV), reduces the loss of CytCOxIV,
27 37 38 and helps prevent mitochondria-induced apoptosis.
39 40 41 In general, all these mechanisms inhibit ischemia–reperfusion damage
33 and are associated with cardioprotective effects of ischemic preconditioning on infarct size.
42 43