A variety of factors trigger PAD2 expression. Calcium imbalance has been implicated in eliciting PAD2 activity,
19 and perhaps calcium influences the increased PAD2 observed in myelinating immature oligodendrocytes.
33 Increased IOP in glaucoma often is associated with influx of calcium (e.g., from ischemia), resulting in increased intracellular calcium.
34 Notably in myelin, calcium concentration plays an important role in modulating several protein interactions,
28 35 including for example MBP interaction with calmodulin, which citrullination can disrupt.
36 In POAG, events triggered by intraocular pressure, including fluctuations in optic nerve intracellular calcium concentration, may increase the level of PAD2 and citrullination. Indeed, our in vivo results from POAG donors
(Fig. 5A)and the DBA/2J glaucomatous mouse model
(Fig. 2)support elevated IOP as a possible contributing factor to PAD2 expression. Our in vitro results
(Fig. 5B)also suggest that pressure induces PAD2 expression in astrocytes; however, competing factors in the pressure treated astrocyte model may contribute to the observed results. Others have shown in astrocytes that hypoxia induces PAD2 expression, citrullination, and elevated intracellular calcium concentration.
34 37 Accordingly, fluctuations in gas composition during the 5-hour astrocyte pressure treatment used in the present study may have altered O
2 and CO
2 concentrations, resulting in hypoxia and/or media pH changes that impacted PAD2 expression.