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Suppression of Ocular Inflammation in Endotoxin-Induced Uveitis By

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Suppression of Ocular Inflammation in Endotoxin-Induced Uveitis By Suppression of Ocular Inflammation in Endotoxin-Induced Uveitis by Blocking the Angiotensin II Type 1 Receptor Norihiro Nagai,1,2,3 Yuichi Oike,1,3 Kousuke Noda,2 Takashi Urano,3 Yoshiaki Kubota,3 Yoko Ozawa,1,2 Hajime Shinoda,2 Takashi Koto,1 Kei Shinoda,2 Makoto Inoue,2 Kazuo Tsubota,2 Kenji Yamashiro,4 Toshio Suda,3 and Susumu Ishida1,2 PURPOSE. To examine whether the angiotensin II type 1 recep- ndotoxin-induced uveitis (EIU) is an animal model of acute tor (AT1-R) signaling plays a role in ocular inflammation in Eocular inflammation induced by the administration of lipo- endotoxin-induced uveitis (EIU). polysaccharide (LPS), a component of Gram-negative bacterial 1–3 METHODS. EIU was induced in C57BL/6 mice by a single intra- outer membranes. Because uveitis frequently leads to severe peritoneal injection of 150 ␮g lipopolysaccharide (LPS). Tissue vision loss and blindness with retinal vasculitis, retinal detach- localization, mRNA expression, and protein levels of AT1-R in ment, and glaucoma, it is important to elucidate further the murine retinas were examined by immunohistochemistry, RT- mechanisms in the development of ocular inflammation. LPS PCR, and Western blot analyses, respectively. Telmisartan, an enhances the expression of various inflammatory mediators, 3,4 ␣ 5 AT1-R antagonist widely used as an antihypertensive agent, was such as interleukin (IL)-6, tumor necrosis factor (TNF)- , prostaglandin E2,6 and monocyte chemotactic protein (MCP)- administered intraperitoneally at a dose of 10 mg/kg daily for 5 7 6 days until the injection of LPS. Twenty-four hours after admin- 1, as well as the production of nitric oxide, all of which istration, leukocyte adhesion to the retinal vasculature was contribute to the development of EIU, resulting in the break- evaluated with a concanavalin A lectin perfusion-labeling tech- down of the blood–ocular barrier and in the infiltration of nique. Retinal mRNA and protein levels of intercellular adhe- leukocytes. For the first phase of leukocyte infiltration, cell adhesion to vascular endothelium is essential, in which adhe- sion molecule (ICAM)-1 were examined by RT-PCR and ELISA, 8 respectively. Protein concentration and inflammatory cells in sion molecules play major roles. Among various adhesion the aqueous humor were also measured. molecules, intercellular adhesion molecule (ICAM)-1 and its receptor, lymphocyte function-associated antigen (LFA)-1, are RESULTS. Retinal vessels were positive for AT1-R. In mice with necessary for the development of EIU.8–10 Although EIU was EIU, retinal AT1-R mRNA and protein levels were significantly originally used as a model of anterior uveitis, increasing evi- increased when compared to the normal control. EIU animals dence shows that it also involves inflammation in the posterior also showed significant increases in the number of inflamma- segment of the eye with recruitment of leukocytes that adhere tory cells infiltrating the anterior chamber and adhering to the to the retinal vasculature and infiltrate the vitreous cavity.11,12 retinal vessels and in retinal ICAM-1 levels. Administration of The renin–angiotensin system is a major controller of sys- telmisartan to EIU mice resulted in significant suppression of temic blood pressure. Angiotensin II, the effector molecule of retinal ICAM-1 expression and leukocyte adhesion and infiltra- the system, has two cognate receptors: angiotensin II type 1 tion compared with vehicle treatment. Protein concentration receptor (AT1-R) and AT2-R.13,14 Because major functions of in the aqueous humor of telmisartan-treated EIU mice tended angiotensin II are mediated by AT1-R, its antagonists are widely to be lower than that of vehicle-treated EIU mice, but the used to treat patients with hypertension and cardiovascular difference was not statistically significant. diseases. Recently, several studies have demonstrated the di- CONCLUSIONS. AT1-R signaling blockade inhibited retinal ICAM-1 verse biological functions of angiotensin II as a modulator of upregulation and leukocyte adhesion and infiltration in the EIU angiogenesis, vascular remodeling, and inflammation.15–20 As model. These results suggest the potential use of an AT1-R antag- an inflammatory mediator, angiotensin II enhances vascular onist as a therapeutic agent to reduce ocular inflammation. (In- permeability through prostaglandins and vascular endothelial vest Ophthalmol Vis Sci. 2005;46:2925–2931) DOI:10.1167/ growth factor,17 and contributes to the recruitment of inflam- iovs.04-1476 matory cells by inducing chemokines and adhesion mole- cules.18,19 Moreover, angiotensin II directly induces the prolif- eration and differentiation of inflammatory cells per se.20 From the 1Laboratory of Retinal Cell Biology and the Departments AT1-R blockade is reported to attenuate such inflammatory of 2Ophthalmology and 3Cell Differentiation, Keio University School of processes effectively.17–19 Recent studies have demonstrated Medicine, Tokyo, Japan; and the 4Department of Ophthalmology, Kobe the prevention of EIU by suppressing inflammatory mediators City General Hospital, Kobe, Japan. including IL-6, TNF-␣, cyclooxygenase (COX)-2, inducible ni- Submitted for publication December 15, 2004; revised March 30, tric oxide synthase (iNOS), and MCP-1.5–7,21–24 However, it is 2005; accepted April 19, 2005. Disclosure: N. Nagai, Boehringer Ingelheim (F); Y. Oike, None; K. not clear whether AT1-R blockade is effective in reducing Noda, None; T. Urano, None; Y. Kubota, None; Y. Ozawa, Boehringer ocular inflammation. In the current study we show for the first Ingelheim (F); H. Shinoda, None; T. Koto, Boehringer Ingelheim (F); K. time the anti-inflammatory effects of an AT1-R antagonist, telm- Shinoda, None; M. Inoue, None; K. Tsubota, None; K. Yamashiro, isartan, on ocular inflammation in a murine model of EIU. None; T. Suda, None; S. Ishida, Boehringer Ingelheim (F) The publication costs of this article were defrayed in part by page charge payment. This article must therefore be marked “advertise- METHODS ment” in accordance with 18 U.S.C. §1734 solely to indicate this fact. Corresponding author: Susumu Ishida, Laboratory of Retinal Cell Animals and Induction of EIU Biology, Department of Ophthalmology, Keio University School of Medicine; 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; C57BL/6 mice (7–10 weeks old; SLC, Shizuoka, Japan) were used. All [email protected]. animal experiments were conducted in accordance with the ARVO Investigative Ophthalmology & Visual Science, August 2005, Vol. 46, No. 8 Copyright © Association for Research in Vision and Ophthalmology 2925 Downloaded from jov.arvojournals.org on 10/02/2021 2926 Nagai et al. IOVS, August 2005, Vol. 46, No. 8 Statement for the Use of Animals in Ophthalmic and Vision Research. and reverse-transcribed with a cDNA synthesis kit (First-Strand; Amer- The ethics committee of our institution approved all surgical interven- sham Biosciences, Inc., Piscataway, NJ) according to the manufactur- tions and animal care procedures, which were in accordance with the er’s protocols. PCR was performed with Taq DNA polymerase Guidelines and Policies for Animal Surgery provided by the Animal (Toyobo, Tokyo, Japan) in a thermal controller (MiniCycler; MJ Re- Study Committees of the Central Institute for Experimental Animals of search, Watertown, MA). The primer sequences were as follows: 5Ј- Keio University. Animals received a single intraperitoneal injection of ATG TGG CAC CAC ACC TTC TAC AAT GAG CTG CG-3Ј (sense) and 0.15 mg LPS from Escherichia coli (Sigma-Aldrich, St. Louis, MO) in 5Ј-CGT CAT ACT CCT GCT TGC TGA TCC ACA TCT GC-3Ј (antisense; 0.15 mL phosphate-buffered saline (PBS). 837 bp) for ␤-actin; 5Ј-TCA CCT GCA TCA TCA TCT GG-3Ј (sense) and Ј Ј Pretreatment with Telmisartan 5 -AGC TGG TAA GAA TGA TTA GG-3 (antisense; 204 bp) for mouse AT1-R; 5Ј-GTG TCG AGC TTT GGG ATG GTA-3Ј (sense) and 5Ј-CTG Telmisartan was a gift of Boehringer Ingelheim, Ingelheim, Germany. GGC TTG GAG ACT CAG TG-3Ј (antisense; 505 bp) for ICAM-1; 5Ј-TTC Animals were pretreated with 0.15-mL intraperitoneal injections of CTC TCT GCA AGA GAC T-3Ј (sense) and 5Ј-TGT ATC TCT CTG AAG vehicle (0.25% dimethylsulfoxide [DMSO] in PBS) or telmisartan daily GAC T-3Ј (antisense; 430 bp) for IL-6; 5Ј-AGC CCA CGT CGT AGC AAA for 5 days until the injection of LPS. LPS was injected immediately after CCA CCA A-3Ј (sense) and 5Ј-ACA CCC ATT CCC TTC ACA GAG CAA the fifth telmisartan injection. We dissolved the telmisartan in in 30 T-3Ј (antisense; 446 bp) for TNF-␣;5Ј-TGC ATG TGG CTG TGG ATG mM DMSO, diluted to 60 ␮M with PBS and injected into mice at a dose TCA TCA A-3Ј (sense) and 5Ј-CAC TAA GAC AGA CCC GTC ATC TCC of 10 mg/kg body weight. This dose was sufficient to block AT1-R A-3Ј (antisense; 449 bp) for COX-2; 5Ј-TCA CGC TTG GGT CTT GTT signaling to decrease systemic blood pressure in rats.25 The effects of CAC T-3Ј (sense) and 5Ј-TTG TCT CTG GGT CCT CTG GTC A-3Ј telmisartan pretreatment on ocular inflammation were evaluated 24 (antisense; 472 bp) for iNOS; and 5Ј-ATC CCA ATG AGT AGG CTG hours after LPS injection. GAG AG-3Ј (sense) and 5Ј-CAG AAG TGC TTG AGG TGG TTG TG-3Ј Lectin Labeling of Retinal Vasculature and (antisense; 617 bp) for MCP-1. Adherent Leukocytes The retina-adherent leukocytes were imaged by perfusion labeling Western Blot Analysis for AT1-R with fluorescein-isothiocyanate (FITC)-coupled concanavalin A lectin (con A; Vector, Burlingame, CA), as described previously.26 In mice The animals were killed with an overdose of anesthesia, and the eyes under deep anesthesia, the chest cavity was opened and a 27-gauge were immediately enucleated. The retina and the iris–ciliary body ␮ cannula was introduced into the left ventricle.
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