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Published in: Acta Diabetologica 9/2019

01-09-2019 | Diabetic Retinopathy | Original Article

Pharmacological blockade of the P2X7 receptor reverses retinal damage in a rat model of type 1 diabetes

Authors: Carmen Clapp, Nundehui Diaz-Lezama, Elva Adan-Castro, Gabriela Ramirez-Hernandez, Bibiana Moreno-Carranza, Alba Clara Sarti, Simonetta Falzoni, Anna Solini, Francesco Di Virgilio

Published in: Acta Diabetologica | Issue 9/2019

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Abstract

Aims

Retinopathy is a leading cause of vision impairment in diabetes. Its pathogenesis involves inflammation, pathological angiogenesis, neuronal and glial dysfunction. The purinergic P2X7 receptor (P2X7R) has a leading role in inflammation and angiogenesis. Potent and selective P2X7R blockers have been synthesized and tested in Phase I/II clinical studies. We hypothesize that P2X7R blockade will ameliorate diabetes-related pathological retinal changes.

Methods

Streptozotocin (STZ)-treated rats were intraperitoneally inoculated with either of two small molecule P2X7R receptor inhibitors, A740003 and AZ10606120, and after blood glucose levels increased to above 400 mg/dL, retinae were analyzed for P2X7R expression, vascular permeability, VEGF, and IL-6 expression.

Results

STZ administration caused a near fourfold increase in blood glucose, a large increase in retinal microvasculature permeability, as well as in retinal P2X7R, VEGF, and IL-6 expression. P2X7R blockade fully reversed retinal vascular permeability increase, VEGF accumulation, and IL-6 expression, with no effect on blood glucose.

Conclusion

P2X7R blockade might be promising strategy for the treatment of microvascular changes observed in the early phases of diabetic retinopathy.
Literature
1.
go back to reference Barrett EJ, Liu Z, Khamaisi M et al (2017) Diabetic microvascular disease: an endocrine society scientific statement. J Clin Endocrinol Metab 102:4343–4410CrossRef Barrett EJ, Liu Z, Khamaisi M et al (2017) Diabetic microvascular disease: an endocrine society scientific statement. J Clin Endocrinol Metab 102:4343–4410CrossRef
2.
go back to reference Klein BE (2007) Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic Epidemiol 14:179–183CrossRef Klein BE (2007) Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic Epidemiol 14:179–183CrossRef
3.
go back to reference Altmann C, Schmidt MHH (2018) The role of microglia in diabetic retinopathy: inflammation. Microvasc Defects Neurodegener Int J Mol Sci 19:e110 Altmann C, Schmidt MHH (2018) The role of microglia in diabetic retinopathy: inflammation. Microvasc Defects Neurodegener Int J Mol Sci 19:e110
4.
go back to reference Wang W, Lo ACY (2018) Diabetic retinopathy: pathophysiology and treatments. Int J Mol Sci 19:e1816CrossRef Wang W, Lo ACY (2018) Diabetic retinopathy: pathophysiology and treatments. Int J Mol Sci 19:e1816CrossRef
5.
go back to reference Mehta H, Hennings C, Gillies MC, Nguyen V, Campain A, Fraser-Bell S (2018) Anti-vascular endothelial growth factor combined with intravitreal steroids for diabetic macular oedema. Cochrane Database Syst Rev 4:CD011599PubMed Mehta H, Hennings C, Gillies MC, Nguyen V, Campain A, Fraser-Bell S (2018) Anti-vascular endothelial growth factor combined with intravitreal steroids for diabetic macular oedema. Cochrane Database Syst Rev 4:CD011599PubMed
6.
go back to reference Coope A, Torsoni AS, Velloso LA (2016) Mechanisms in endocrinology: metabolic and inflammatory pathways on the pathogenesis of type 2 diabetes. Eur J Endocrinol 174:R175–R187CrossRef Coope A, Torsoni AS, Velloso LA (2016) Mechanisms in endocrinology: metabolic and inflammatory pathways on the pathogenesis of type 2 diabetes. Eur J Endocrinol 174:R175–R187CrossRef
7.
go back to reference Burnstock G (2006) Pathophysiology and therapeutic potential of purinergic signaling. Pharmacol Rev 58:58–86CrossRef Burnstock G (2006) Pathophysiology and therapeutic potential of purinergic signaling. Pharmacol Rev 58:58–86CrossRef
8.
go back to reference Novak I, Solini A (2018) P2X receptor-ion channels in the inflammatory response in adipose tissue and pancreas-potential triggers in onset of type 2 diabetes? Curr Opin Immunol 52:1–7CrossRef Novak I, Solini A (2018) P2X receptor-ion channels in the inflammatory response in adipose tissue and pancreas-potential triggers in onset of type 2 diabetes? Curr Opin Immunol 52:1–7CrossRef
9.
go back to reference Di Virgilio F, Dal Ben D, Sarti AC, Giuliani AL, Falzoni S (2017) The P2X7 receptor in infection and inflammation. Immunity 47:15–31CrossRef Di Virgilio F, Dal Ben D, Sarti AC, Giuliani AL, Falzoni S (2017) The P2X7 receptor in infection and inflammation. Immunity 47:15–31CrossRef
10.
go back to reference Adinolfi E, Raffaghello L, Giuliani AL et al (2012) Expression of P2X7 receptor increases in vivo tumor growth. Cancer Res 72:2957–2969CrossRef Adinolfi E, Raffaghello L, Giuliani AL et al (2012) Expression of P2X7 receptor increases in vivo tumor growth. Cancer Res 72:2957–2969CrossRef
11.
go back to reference Amoroso F, Capece M, Rotondo A et al (2015) The P2X7 receptor is a key modulator of the PI3 K/GSK3beta/VEGF signaling network: evidence in experimental neuroblastoma. Oncogene 34:5240–5251CrossRef Amoroso F, Capece M, Rotondo A et al (2015) The P2X7 receptor is a key modulator of the PI3 K/GSK3beta/VEGF signaling network: evidence in experimental neuroblastoma. Oncogene 34:5240–5251CrossRef
12.
go back to reference Bringmann A, Pannicke T, Uhlmann S, Kohen L, Wiedemann P, Reichenbach A (2002) Membrane conductance of Muller glial cells in proliferative diabetic retinopathy. Can J Ophthalmol 37:221–227CrossRef Bringmann A, Pannicke T, Uhlmann S, Kohen L, Wiedemann P, Reichenbach A (2002) Membrane conductance of Muller glial cells in proliferative diabetic retinopathy. Can J Ophthalmol 37:221–227CrossRef
13.
go back to reference Portillo JC, Lopez CY, Miao Y et al (2017) CD40 in retinal muller cells induces P2X7-dependent cytokine expression in macrophages/microglia in diabetic mice and development of early experimental diabetic retinopathy. Diabetes 66:483–493CrossRef Portillo JC, Lopez CY, Miao Y et al (2017) CD40 in retinal muller cells induces P2X7-dependent cytokine expression in macrophages/microglia in diabetic mice and development of early experimental diabetic retinopathy. Diabetes 66:483–493CrossRef
14.
go back to reference Diaz-Lezama N, Wu Z, Adan-Castro E et al (2016) Diabetes enhances the efficacy of AAV2 vectors in the retina: therapeutic effect of AAV2 encoding vasoinhibin and soluble VEGF receptor 1. Lab Invest 96:283–295CrossRef Diaz-Lezama N, Wu Z, Adan-Castro E et al (2016) Diabetes enhances the efficacy of AAV2 vectors in the retina: therapeutic effect of AAV2 encoding vasoinhibin and soluble VEGF receptor 1. Lab Invest 96:283–295CrossRef
15.
go back to reference Fong DS, Aiello LP, Ferris FL III, Klein R (2004) Diabetic retinopathy. Diabetes Care 27:2540–2553CrossRef Fong DS, Aiello LP, Ferris FL III, Klein R (2004) Diabetic retinopathy. Diabetes Care 27:2540–2553CrossRef
16.
go back to reference Lim LS, Liew G, Cheung N, Mitchell P, Wong TY (2010) Mixed messages on systemic therapies for diabetic retinopathy. Lancet 376:1461CrossRef Lim LS, Liew G, Cheung N, Mitchell P, Wong TY (2010) Mixed messages on systemic therapies for diabetic retinopathy. Lancet 376:1461CrossRef
17.
go back to reference Cai S, Bressler NM (2017) Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T. Curr Opin Ophthalmol 28:636–643CrossRef Cai S, Bressler NM (2017) Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T. Curr Opin Ophthalmol 28:636–643CrossRef
18.
go back to reference Morciano G, Sarti AC, Marchi S et al (2017) Use of luciferase probes to measure ATP in living cells and animals. Nat Protoc 12:1542–1562CrossRef Morciano G, Sarti AC, Marchi S et al (2017) Use of luciferase probes to measure ATP in living cells and animals. Nat Protoc 12:1542–1562CrossRef
19.
go back to reference Chaurasia SS, Lim RR, Parikh BH et al (2018) The NLRP3 inflammasome may contribute to pathologic neovascularization in the advanced stages of diabetic retinopathy. Sci Rep 8:2847CrossRef Chaurasia SS, Lim RR, Parikh BH et al (2018) The NLRP3 inflammasome may contribute to pathologic neovascularization in the advanced stages of diabetic retinopathy. Sci Rep 8:2847CrossRef
20.
go back to reference Brandle U, Kohler K, Wheeler-Schilling TH (1998) Expression of the P2X7-receptor subunit in neurons of the rat retina. Brain Res Mol Brain Res 62:106–109CrossRef Brandle U, Kohler K, Wheeler-Schilling TH (1998) Expression of the P2X7-receptor subunit in neurons of the rat retina. Brain Res Mol Brain Res 62:106–109CrossRef
21.
go back to reference Hu H, Lu W, Zhang M et al (2010) Stimulation of the P2X7 receptor kills rat retinal ganglion cells in vivo. Exp Eye Res 91:425–432CrossRef Hu H, Lu W, Zhang M et al (2010) Stimulation of the P2X7 receptor kills rat retinal ganglion cells in vivo. Exp Eye Res 91:425–432CrossRef
22.
go back to reference Pannicke T, Fischer W, Biedermann B et al (2000) P2X7 receptors in Muller glial cells from the human retina. J Neurosci 20:5965–5972CrossRef Pannicke T, Fischer W, Biedermann B et al (2000) P2X7 receptors in Muller glial cells from the human retina. J Neurosci 20:5965–5972CrossRef
23.
go back to reference Sanderson J, Dartt DA, Trinkaus-Randall V et al (2014) Purines in the eye: recent evidence for the physiological and pathological role of purines in the RPE, retinal neurons, astrocytes, Muller cells, lens, trabecular meshwork, cornea and lacrimal gland. Exp Eye Res 127:270–279CrossRef Sanderson J, Dartt DA, Trinkaus-Randall V et al (2014) Purines in the eye: recent evidence for the physiological and pathological role of purines in the RPE, retinal neurons, astrocytes, Muller cells, lens, trabecular meshwork, cornea and lacrimal gland. Exp Eye Res 127:270–279CrossRef
24.
go back to reference Kaczmarek-Hajek K, Zhang J, Kopp R et al (2018) Re-evaluation of neuronal P2X7 expression using novel mouse models and a P2X7-specific nanobody. Elife 7:e36217CrossRef Kaczmarek-Hajek K, Zhang J, Kopp R et al (2018) Re-evaluation of neuronal P2X7 expression using novel mouse models and a P2X7-specific nanobody. Elife 7:e36217CrossRef
25.
go back to reference Resta V, Novelli E, Vozzi G et al (2007) Acute retinal ganglion cell injury caused by intraocular pressure spikes is mediated by endogenous extracellular ATP. Eur J Neurosci 25:2741–2754CrossRef Resta V, Novelli E, Vozzi G et al (2007) Acute retinal ganglion cell injury caused by intraocular pressure spikes is mediated by endogenous extracellular ATP. Eur J Neurosci 25:2741–2754CrossRef
26.
go back to reference Hu SJ, Calippe B, Lavalette S et al (2015) Upregulation of P2RX7 in Cx3cr1-deficient mononuclear phagocytes leads to increased interleukin-1beta secretion and photoreceptor neurodegeneration. J Neurosci 35:6987–6996CrossRef Hu SJ, Calippe B, Lavalette S et al (2015) Upregulation of P2RX7 in Cx3cr1-deficient mononuclear phagocytes leads to increased interleukin-1beta secretion and photoreceptor neurodegeneration. J Neurosci 35:6987–6996CrossRef
27.
go back to reference Solini A, Menini S, Rossi C et al (2013) The purinergic 2X7 receptor participates in renal inflammation and injury induced by high-fat diet: possible role of NLRP3 inflammasome activation. J Pathol 231:342–353CrossRef Solini A, Menini S, Rossi C et al (2013) The purinergic 2X7 receptor participates in renal inflammation and injury induced by high-fat diet: possible role of NLRP3 inflammasome activation. J Pathol 231:342–353CrossRef
28.
go back to reference Di Virgilio F, Sarti AC, Falzoni S, De Marchi E, Adinolfi E (2018) Extracellular ATP and P2 purinergic signalling in the tumour microenvironment. Nat Rev Cancer 18:601–618CrossRef Di Virgilio F, Sarti AC, Falzoni S, De Marchi E, Adinolfi E (2018) Extracellular ATP and P2 purinergic signalling in the tumour microenvironment. Nat Rev Cancer 18:601–618CrossRef
29.
go back to reference Vessey KA, Gu BJ, Jobling AI et al (2017) Loss of function of P2X7 receptor scavenger activity in aging mice: a novel model for investigating the early pathogenesis of age-related macular degeneration. Am J Pathol 187:1670–1685CrossRef Vessey KA, Gu BJ, Jobling AI et al (2017) Loss of function of P2X7 receptor scavenger activity in aging mice: a novel model for investigating the early pathogenesis of age-related macular degeneration. Am J Pathol 187:1670–1685CrossRef
30.
go back to reference Joussen AM, Poulaki V, Le ML et al (2004) A central role for inflammation in the pathogenesis of diabetic retinopathy. FASEB J 18:1450–1452CrossRef Joussen AM, Poulaki V, Le ML et al (2004) A central role for inflammation in the pathogenesis of diabetic retinopathy. FASEB J 18:1450–1452CrossRef
31.
go back to reference Tang J, Kern TS (2011) Inflammation in diabetic retinopathy. Prog Retin Eye Res 30:343–358CrossRef Tang J, Kern TS (2011) Inflammation in diabetic retinopathy. Prog Retin Eye Res 30:343–358CrossRef
Metadata
Title
Pharmacological blockade of the P2X7 receptor reverses retinal damage in a rat model of type 1 diabetes
Authors
Carmen Clapp
Nundehui Diaz-Lezama
Elva Adan-Castro
Gabriela Ramirez-Hernandez
Bibiana Moreno-Carranza
Alba Clara Sarti
Simonetta Falzoni
Anna Solini
Francesco Di Virgilio
Publication date
01-09-2019
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 9/2019
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-019-01343-4

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