This study provides evidence that the process by which TJ claudin-1 and occludin decrease in ARPE-19 cell and primary pRPE monolayers exposed to DM milieu conditions is through the CAV-1 endocytosis associated with a profound imbalance in paracellular resistance and permeability. An increase in ZO-1 expression and ECM accumulation also was observed in the HG condition. The CAV-1 endocytosis process is dependent on stimulation by TNF-α, which in turn upregulates iNOS expression. The increased NO production then results in S-nitrosylation of CAV-1. Treatment with HPC or EC abolished all these effects through direct interaction with the DOR of the ARPE-19 cells. These results are the first, to the best of our knowledge, to show a protective role for EC in preventing nitrosative posttranslational modification of CAV-1 in ARPE-19 and pRPE cells and maintenance of the RPE barrier properties following exposure to HG conditions.
Most of the research on the physiopathology of DR has focused on the impairment of the neuroretina and the breakdown of the inner BRB. By contrast, the effects of DM on the RPE, and in particular on its secretory and transport activity, have received less attention. In one direction, the RPE transports electrolytes and water from the subretinal space to the choroid, and in the opposite direction, it transports glucose, retinol, ascorbic acid, and fatty acids from the choriocapillaris to the photoreceptors. Transport in both directions was changed under HG conditions.
2 Glucose transport by the RPE is conducted via the large numbers of glucose transporters in the apical and basolateral membranes. Both GLUT1 and GLUT3 are highly expressed in the RPE.
44–46 Recently, HG has been shown to promote alterations in transport by downregulation of GLUT-1
47 ; alterations in transport of retinol due to a downregulation of the interstitial retinol binding protein; and impairment of the transport of ascorbic acid, thereby limiting the antioxidant defenses of the RPE.
48,49
A large amount of water is produced in the retinal tissue, mainly as a consequence of the large metabolic turnover in neurons and photoreceptors. The Na
+-K
+-ATPase, located in the apical membrane, provides energy for the transepithelial transport.
50 Constant elimination of water from the subretinal space produces an adhesive force between the retina and the RPE that is lost by inhibition of Na
+-K
+-ATPase (e.g., by ouabain).
51 Cultured bovine RPE cells exposed to high glucose conditions show a loss of Na
+/K
+ ATPase function, which in turn decreases the permeability.
52
The TJs constitute the barrier between the subretinal space and the choriocapillaris. The literature contains contradictory data concerning the TER of ARPE-19 cells under high glucose conditions. For example, Villarroel and colleagues
53 reported that 3 weeks of exposure to high glucose increased the TER and decreased the permeability of ARPE-19 cells. In addition, this reduction in permeability was unrelated to claudin-1 mRNA overexpression. On the other hand, Trudeau et al.
54 showed increased permeability of ARPE-19 cells exposed for 18 days to 25 mM glucose when treated with IL-1β. This in vitro model indicates that inflammation is playing a pivotal role in the increasing permeability of the RPE barrier. However, ARPE-19 cells exposed to endoplasmic reticulum stress induced by tunicamycin or thapsigargin showed a significant increase in ZO-1, occludin, and claudin-1 associated with an increase in TER.
55 In addition, hyperglycemia could impair the transport of water from the subretinal space to the choriocapillaris and, consequently, might contribute to diabetic macular edema development.
2 On the other hand, the direct visualization of macromolecules leaked through the outer BRB by a microscopic imaging assay demonstrated the importance of outer BRB breakdown in rats made diabetic by streptozotocin treatment.
3
Nitrosative stress is an early event in the pathogenesis of DR.
56 In this present work, the iNOS activation increased NO levels and posttranslationally altered CAV-1 molecules, thereby increasing the communication with claudin-1 and occludin. Recently, a pivotal role for CAV-1–dependent occludin endocytosis induced by TNF-α has been proposed for the regulation of TJs in intestine epithelial cells.
13 Other work showed that phosphorylation of CAV-1 increases its association with vascular endothelial (VE)-cadherin/catenin complexes in response to the proinflammatory mediator thrombin. This weakens the association of catenin with VE-cadherin and the junction-associated actin filaments are lost, thereby compromising the barrier function.
57
Abnormalities in gene expression of CAV-1 have been linked to DR,
58 but the possible involvement of the CAV-1/caveolae in the outer retina needs to be better understood. The caveolae of RPE cells have a unique bipolar distribution,
59 but their functions in either the apical or basolateral RPE membrane domains have not been elucidated. Previous work showed that ablation of CAV-1 resulted in reduced inner and outer retinal functions, whereas
Cav-1 knockout retinas also displayed unusually tight adhesion with the RPE, suggesting alterations in outer retinal fluid homeostasis. These findings demonstrate that the reduced retinal function resulting from CAV-1 ablation involves impairment of subretinal and/or RPE ion/fluid homeostasis.
60 Posttranslational modifications of CAV-1, such as ubiquitination
61 and phosphorylation
33 of the N-terminal near the scaffolding domain, resulted in exacerbated trafficking. In line with our present data, these authors demonstrated that CAV-1 SNO is an important regulatory mechanism controlling caveolar trafficking in endothelial cells.
The opioid receptor family comprises three members, the μ-, δ-, and k-opioid receptors, which respond to classical opioid alkaloids, such as morphine and heroin, as well as to endogenous peptide ligands like endorphins. They belong to the G-protein-coupled receptor superfamily, and are recognized as excellent therapeutic targets for pain control.
62 Activation of one or more opioid receptors by morphine can reduce ischemic/reperfusion injury by the suppression of TNF-α production in the retina. Naloxone, an opioid antagonist, can reverse the morphine-induced suppression of TNF-α production in vitro.
23 Epicatechin, the predominant flavonoid component present in cocoa and dark chocolate, is a well-known antioxidant associated with a lower risk of stroke and heart failure.
63–65 Moreover, EC-induced cardiac protection has shown a dependence on DOR stimulation.
26 In the present study, we demonstrated that the increase in TNF-α levels in ARPE-19 cells exposed to HG is abolished when the cells were treated with HPC or the corresponding amount of EC, which effectively neutralized the HG effect; this action was abrogated in the presence of Nalt, a DOR blocker. This set of experiments clearly demonstrated that EC protects the ARPE-19 monolayer barrier/permeability through stimulation of DOR, thereby modulating TNF-α action. The crystal structure of the mouse DOR, bound to the subtype-selective antagonist Nalt,
66 has indicated that blocking the DOR with oral administration of Nalt resulted in a decrease of the cardiac protective effect of EC on mitochondrial structure in mice.
67
In conclusion, we identified EC as a negative regulator of the CAV-1 nitrosylation that occurs in retinal pigmented epithelium cells under DM milieu conditions due to activation of DOR. Caveolin-1 plays an important role in major diseases, such as cancer,
68 atherosclerosis,
69 DM complications,
70 and inflammation
71 ; therefore, our findings might provide insights into the regulation of claudin-1 and occludin by CAV-1 internalization in RPE cells exposed to HG conditions, as well as in other pathological conditions.