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PROX1 loss in adult mouse Schlemm’s canal causes permanent ocular hypertension
Sofia Lara Ochoa, Hoi-Lam Li, Hyeohn Kim, Zihang Yan, Natalia C. Mendonca, Pan Liu, Hyunjoo J. Lee, Michael P. Vincent, Sultan Almunif, Hao F. Zhang, Haiyan Gong, Evan A. Scott, Mark Johnson, Benjamin R. Thomson
Sofia Lara Ochoa, Hoi-Lam Li, Hyeohn Kim, Zihang Yan, Natalia C. Mendonca, Pan Liu, Hyunjoo J. Lee, Michael P. Vincent, Sultan Almunif, Hao F. Zhang, Haiyan Gong, Evan A. Scott, Mark Johnson, Benjamin R. Thomson
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Research Article Ophthalmology Vascular biology

PROX1 loss in adult mouse Schlemm’s canal causes permanent ocular hypertension

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Abstract

Glaucoma is associated with ocular hypertension, and lowering intraocular pressure is the primary objective of current therapies. Recent studies have established a key role for Schlemm’s canal endothelium in this pressure increase and have shown that it has a unique, lymphatic-like hybrid phenotype characterized by expression of the lymphatic transcription factor PROX1. However, the functional importance of this hybrid phenotype in the adult canal remains unclear, as long-term studies have been limited by systemic requirements for lymphatic gene expression and a lack of Schlemm’s canal–specific animal models. Here, we designed and validated a strategy using 4OH-tamoxifen-loaded nanocarriers to generate targeted, Schlemm’s canal specific Prox1 knockout mice that specifically lacked lymphatic characteristics in the canal endothelium. Within 4 weeks, intraocular pressure was significantly elevated, and ocular hypertension was maintained for at least 24 weeks. Unlike lymphatic vessels, which degenerate following Prox1 deletion, Schlemm’s canal persisted but reverted to a less functional vein-like phenotype with no change in size or morphology. Together, these findings demonstrate the utility of nanocarrier-mediated tamoxifen delivery and establish the importance of the Schlemm’s canal lymphatic-like phenotype in intraocular pressure regulation, providing targets for future glaucoma therapies and a mouse model of adult-onset ocular hypertension.

Authors

Sofia Lara Ochoa, Hoi-Lam Li, Hyeohn Kim, Zihang Yan, Natalia C. Mendonca, Pan Liu, Hyunjoo J. Lee, Michael P. Vincent, Sultan Almunif, Hao F. Zhang, Haiyan Gong, Evan A. Scott, Mark Johnson, Benjamin R. Thomson

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Figure 4

Schlemm’s canal–specific Prox1 deletion leads to ocular hypertension.

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Schlemm’s canal–specific Prox1 deletion leads to ocular hypertension.
(A...
(A) Schematic of experimental timeline used for targeted nanocarrier induction of Prox1 deletion. (B and C) Four weeks after targeted nanocarrier induction, IOP elevation was observed in eyes of Prox1fl/fl Cdh5-CreERT2 mice receiving targeted 4OHT nanocarriers in comparison with contralateral eyes receiving identical targeted empty (blank) nanocarriers. IOP elevation persisted throughout the duration of the experiment. No IOP elevation was seen in identically treated Cre-negative mice (Cre+, n = 8; Cre–, n = 8). NC, nanocarrier. (D and E) In vivo visible-light OCT imaging 12 weeks after nanocarrier-mediated Prox1 deletion revealed no change in canal size on B-scans (D) or longitudinal reconstructions (pseudo-colored in yellow) of Schlemm’s canal (E). Scale bars: 100 μm (D), 250 μm (E). (F) Comparison of luminal area by 16 individual OCT B-scans captured around the circumference of Schlemm’s canal showed no difference in canal size between matched 4OHT- and blank nanocarrier–treated eyes of Cdh5-CreERT2–positive mice. (G) PROX1 expression and canal morphology were examined in Schlemm’s canal flat mounts collected 6 months after nanocarrier induction by confocal microscopy. Dashed lines in PROX1 panels indicate the outline of PECAM1-positive Schlemm’s canal. Scale bar: 100 μm. (H) Compared with contralateral control eyes, PROX1 expression was significantly reduced in eyes treated with 4OHT nanocarriers. BG, background; AFU, arbitrary fluorescence units. (I) No significant change in Schlemm’s canal (SC) size was observed in 4OHT nanocarrier–treated eyes (n = 6). *P < 0.05, **P < 0.01, ****P < 0.0001 as determined by 2-way ANOVA followed by Bonferroni’s post-tests (B, C and F) or 2-tailed paired Student’s t test (H and I). Error bars in B, C, H, and I indicate ± SEM, while each point represents an independent biological replicate. Each point in F represents a single measurement captured along the length of Schlemm’s canal, while each violin represents a single eye.

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