Abstract
purpose. Water channel aquaporin (AQP)-4 is expressed in Müller cells in retina, which are similar to astroglial cells in the central nervous system, where AQP4 deletion protects against cytotoxic brain edema after cerebral ischemia. A transient ischemia–reperfusion model was used to determine whether AQP4 deletion in mice protects the retina.
methods. Retinal function and morphology were assessed in wild-type versus AQP4-deficient mice after ischemic damage produced by a 45- to 60-minute elevation of intraocular pressure to 120 mm Hg. Retinal function was assessed by electroretinography, and retinal structure by light microscopy. Extracellular space (ECS) size in fluorescently stained retinal slices was assessed by fluorescence recovery after photobleaching.
results. Retinal function and cell survival were significantly improved in AQP4-deficient mice in both inbred (C57/bl6) and outbred (CD1) genetic backgrounds. By electroretinography, b-wave amplitude was reduced by 75% to 83% at 1 to 4 days after ischemia in wild-type mice versus 48% to 51% in AQP4-null CD1 mice. Reductions were 53% to 72% versus <34% in C57/bl6 mice. Retinal structure and cell count were preserved in AQP4-null mice, particularly in the inner nuclear and plexiform layers of the retina, where Müller cells are concentrated. At 4 days after ischemia, inner retinal thickness was thinned by 43% in wild-type mice versus 11% in AQP4-null mice. Several mechanisms for retinal protection were investigated, including ECS expansion, reduced early swelling, and altered Kir4.1 K+ channel expression.
conclusions. AQP4 deletion in mice is neuroprotective in a transient ischemia model of retinal injury, suggesting the possible use of AQP4 inhibitors in retinal vascular occlusive and ischemic diseases.
Diseases of the retina associated with ischemia, such as vascular occlusion, glaucoma, and diabetic retinopathy, can produce retinal edema and ganglion cell death leading to visual impairment and blindness.
1 2 3 4 Transient elevation of intraocular pressure is a well-established animal model of retinal ischemia that has been used to study molecular mechanisms of retinal neuronal death involving excitatory amino acids, free radicals, and cellular release of calcium, glutamate, and inflammatory mediators,
5 6 7 8 and to evaluate putative neuroprotective agents.
9 10 11 The Müller cell is the major glial-type cell in mouse retina.
12 As do the glial cells in the central nervous system, Müller cells in the retina modulate neuronal activity by regulating extracellular space (ECS) concentrations of neuroactive substances (K
+, glutamate, γ-aminobutyric acid [GABA], and H
+) and removing neurotransmitters from the ECS after their release from synaptic terminals.
13 14 15 16 Several studies have implicated Müller cells in the pathogenesis of retinal injury after ischemia and other insults.
17 18 19 20 21 22
Indirect evidence suggests the involvement of aquaporin (AQP)-4 in the pathophysiology of retinal injury. AQP4 is a water-selective membrane transport protein, cloned originally from lung
23 and has been shown to be expressed in a variety of epithelial and neurosupportive cells.
24 25 26 In the retina, AQP4 is expressed in the Müller cells, which support electrically excitable bipolar and ganglion cells; in glial cells in the central nervous system, which support neurons; and in Clausius and Hensen cells in the inner ear, which support the sound-transducing hair cells.
27 28 29 Distinct roles for AQP4 in neural signal transduction and cellular swelling have been proposed. AQP4 deletion in mice is associated with impaired auditory brain-stem–evoked potentials,
30 altered seizure threshold,
31 and mildly impaired light-induced retinal potentials.
32 Altered K
+ recycling by AQP4-associated Kir4.1 K
+ channels may be responsible for these abnormalities,
33 34 as well as ECS expansion in AQP4 deficiency.
35 Brain swelling and neurologic deterioration in AQP4-deficient mice are reduced in cytotoxic (cellular) brain injury caused by acute water intoxication and ischemic stroke.
36 Reduced glial cell water permeability in AQP4 deficiency may in part be responsible for brain protection in cytotoxic edema. Also, recent studies in aquaporin-transfected cells have suggested that aquaporins have a role in apoptotic cell death,
37 although the mechanism(s) linking reduced cell membrane water permeability and cell death are unclear.
Motivated by this body of indirect evidence, we tested the hypothesis that AQP4 in retinal Müller cells is involved in the pathophysiology of ischemic retinal injury. Transient retinal ischemia was produced by elevating intraocular pressure to a level greater than mean arterial pressure. We found substantial protection against retinal injury in AQP4-deficient mice, when assessed functionally by electroretinography and morphologically by light microscopy of fixed retina. Our studies thus define a novel phenotype produced by AQP4 gene disruption in mice and suggest the use of AQP4 inhibitors in protecting the retina against ischemic damage.
After anesthesia with intraperitoneal ketamine (80 mg/kg) and xylazine (16 mg/kg), pupils were dilated with 1% tropicamide and 2.5% phenylephrine applied topically. Retinal ischemia in one eye was produced by increasing intraocular pressure to 120 mm Hg for 45 or 60 minutes by introducing into the anterior chamber a micropipette containing an isotonic salt solution (Cytosol Ophthalmics, Inc., Braintree, MA) connected to a reservoir situated at an appropriate height. Retinal ischemia was verified by whitening of the anterior segment of the globe and blanching of episcleral veins, as viewed by stereo light microscopy. Body temperature was maintained at 37 ± 0.5°C with a heating pad. The opposite eye served as the nonischemia control. At the end of the period of ischemia, the micropipette was removed and 0.3% tobramycin ointment (Alcon, Fort Worth, TX) was applied to the conjunctival sac.
After mice were killed by cervical dislocation, eyes were enucleated and frozen in optimal cutting temperature (OCT) compound (Tissue-Tek; Sakura Finetek, Torrance, CA) on dry ice. Cryostat sections were cut sagittally through the optic nerve at 7 μm thickness and fixed in 4% paraformaldehyde in PBS for staining by hematoxylin and eosin and immunocytochemistry. Thicknesses of the inner nuclear layer (INL) and the inner plexiform layer (IPL) were measured, as well as the internal retinal layer (IRL), bounded by the internal limiting membrane (ILM) and the interface between the ONL and outer plexiform layer (OPL), and the outer retinal layer (ORL), bounded by the RRE layer and the interface between the ONL and OPL. Layer thicknesses were measured in three cryostat sections per retina of at least three mice at a distance of 300 μm from the optic nerve. The number of cells in the INL and ganglion cell layer (GCL) were counted over a 100-μm length at a distance of 300 μm from the optic nerve. Immunocytochemistry was performed with a polyclonal anti-AQP4 antibody raised against the AQP4 C terminus (Chemicon, Temecula, CA) or an anti-Kir4.1 antibody (Alomone Laboratories, Jerusalem, Israel), with Cy3-coupled secondary antibody (Sigma-Aldrich, St. Louis, MO). Retinal sections were photographed with a fluorescence microscope (model DS5000; Leica Microsystems, Bannockburn, IL).
We found significant retinal protection after ischemia in mice deficient in the Müller cell water channel AQP4. Retinal ischemia results in irreversible morphologic and functional changes due to the deprivation of glucose and oxygen, followed by a cascade of biochemical responses involving glutamate release, water and ion transport, and activation of apoptosis-signaling pathways.
44 45 46 47 As discussed in the introduction, the rationale for study of retinal neuroprotection in AQP4 deficiency was protection of brain tissue in AQP4 deficiency after ischemic stroke produced by middle cerebral artery occlusion.
36 AQP4-expressing glial cells in brain have a similar supportive relationship to neurons as do the AQP4-expressing Müller cells in retina to ganglion cells and bipolar cells. The ECS in retina contains ions, neurotransmitters, and various matrix macromolecules, forming the microenvironment bathing Müller cells, bipolar cells, and ganglion cells, and facilitating cell–cell communication by diffusible solutes. On theoretical grounds, AQP4 deletion in Müller cells and reduced Müller cell water permeability and K
+ transport could reduce initial cell swelling after ischemic damage, as well as alter ECS volume and composition after ischemia. As in other electrically excitable tissues, cell swelling and altered ECS homeostasis may be important early determinants of retinal neuronal cell injury and apoptotic cell death. We used a well-established model of retinal ischemia-reperfusion produced by transient elevation of intraocular pressure. The principal finding was significant protection of the retina after ischemic damage in AQP4 deficiency as assessed functionally, by electroretinography, and morphologically, by retinal thickness and cell survival.
A small baseline reduction in amplitudes of b-waves and OPs was found in ERG measurements in C57/bl6 but not CD1 mice. The b-wave is believed to arise from bipolar cell depolarization and K
+ channel activation in Müller cells.
42 43 Current source-density analysis has suggested that the b-wave source is at the IPL and the sink in the OPL.
48 The OPs are believed to arise from the IPL
49 and are dependent on the retinal microcirculation.
50 AQP4 deficiency did not reduce the amplitude of a-waves, which are produced primarily by the photoreceptors.
Transient retinal ischemia produced retinal swelling in the first 6 to 12 hours, primarily in the IPL. However, the extent of initial retinal swelling was not significantly different in wild-type versus AQP4-null mice. Although Müller cell osmotic water permeability is likely to be reduced by AQP4 deletion as found for brain astroglia,
51 the similar retinal swelling in wild-type and AQP4-null mice is not surprising because cellular osmotic equilibration even in the absence of aquaporins occurs in <1 minute, a time scale much shorter than that for the ionic–solute movements responsible for cell swelling and volume regulatory phenomena. Retinal architecture was disrupted at later times with preferential thinning of the INL and IPL. The thinning and loss of cellularity in the internal retina was significantly reduced in AQP4 deficiency, with corresponding preservation of retinal function, as quantified from b-wave and oscillatory potential amplitudes.
As mentioned in the introduction, ECS expansion in brain in AQP4 deficiency has been proposed as a potential mechanism for abnormalities in neural signal transduction such as increased seizure threshold and duration. ECS expansion could result from an altered dynamic balance of cellular water and K
+ efflux and recycling (influx), in which reduced glial cell water permeability and water uptake in AQP4 deficiency increase relative ECS-to-cellular volume. As a sensitive test of ECS expansion in retina, we developed a photobleaching method to quantify diffusion of a fluorescent probe in the ECS of retinal slices. However, in contrast to results in cerebral cortex showing ECS expansion in AQP4 deficiency,
35 we found no difference in fluorescent probe diffusion in the ECS of retinal cellular layers. Thus, altered basal ECS properties are unlikely to be involved in the mechanism of retinal protection after ischemia in AQP4-null mice. There are many possible explanations for altered ECS volume in AQP4 deficiency in cerebral cortex but not in retina, such as differences in cell transport mechanisms, and tissue architecture, and compliance.
The molecular-level mechanism by which AQP4 deficiency in mice protects the retina against ischemic damage thus remains unclear. As mentioned above, neither altered Müller cell swelling nor differences in baseline ECS properties were found in AQP4 deficiency. Although differences in the ECS response may occur after ischemia, it would be difficult to determine whether such differences are primary or secondary. A recent study by Dalloz et al.
52 showed that targeted disruption of the dystrophin gene in mice results in greater ganglion cell death after transient ischemia, as well as altered cellular distribution of AQP4 and Kir4.1. The mechanisms responsible for their observation are probably very different from the opposite finding in the current study of retinal protection in AQP4 deficiency, where no impairment of Kir4.1 cellular expression or membrane targeting was found. Based on recent literature, other possible explanations for the retinal protection found in the present study include altered glutamate release and reuptake after ischemia,
53 or altered expression and function of clusterin,
17 18 components of the mitogen-activated protein (MAP) kinase signaling cascade,
19 heat shock proteins,
20 ciliary neurotrophic factor (CNTF),
21 and proliferating cell nuclear antigen (PCNA).
22 When available, AQP4 inhibitors will be useful to evaluate whether the retinal neuroprotective phenotype found in the present study is related to altered gene expression in AQP4 null mice or to altered Müller cell water permeability.
In conclusion, AQP4 deletion in mice conferred significant preservation of retinal function and architecture after retinal ischemia. The neuroprotective effect of AQP4 gene disruption suggests the possibility of AQP4 inhibition as a novel approach to limit retinal injury after ischemia produced by vascular occlusive and ischemic diseases.
Supported by National Eye Institute Grant EY13574, National Institute of Diabetes and Digestive and Kidney Diseases Grant DK35124, National Heart, Lung, and Blood Institute Grants HL73856 and HL59198, and National Institute for Biomedical Imaging and Bioengineering Grant EB00415; and Research Development Program Grant R613 from the Cystic Fibrosis Foundation.
Submitted for publication August 4, 2004; accepted August 25, 2004.
Disclosure:
T. Da, None;
A.S. Verkman, None
The publication costs of this article were defrayed in part by page charge payment. This article must therefore be marked “
advertisement” in accordance with 18 U.S.C. §1734 solely to indicate this fact.
Corresponding author: Alan S. Verkman, 1246 Health Sciences East Tower, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94143-0521;
[email protected].
The authors thank Liman Qian for mouse breeding and genotype analysis, and Yuanlin Song, Devin Binder, and Marios Papadopolous for advice in preparing retinal slices and photobleaching measurements.
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