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Sustained inflammation after pericyte depletion induces irreversible blood-retina barrier breakdown
Shuntaro Ogura, … , Yuichiro Ogura, Akiyoshi Uemura
Shuntaro Ogura, … , Yuichiro Ogura, Akiyoshi Uemura
Published February 9, 2017
Citation Information: JCI Insight. 2017;2(3):e90905. https://doi.org/10.1172/jci.insight.90905.
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Research Article Ophthalmology Vascular biology

Sustained inflammation after pericyte depletion induces irreversible blood-retina barrier breakdown

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Abstract

In the central nervous system, endothelial cells (ECs) and pericytes (PCs) of blood vessel walls cooperatively form a physical and chemical barrier to maintain neural homeostasis. However, in diabetic retinopathy (DR), the loss of PCs from vessel walls is assumed to cause breakdown of the blood-retina barrier (BRB) and subsequent vision-threatening vascular dysfunctions. Nonetheless, the lack of adequate DR animal models has precluded disease understanding and drug discovery. Here, by using an anti-PDGFRβ antibody, we show that transient inhibition of the PC recruitment to developing retinal vessels sustained EC-PC dissociations and BRB breakdown in adult mouse retinas, reproducing characteristic features of DR such as hyperpermeability, hypoperfusion, and neoangiogenesis. Notably, PC depletion directly induced inflammatory responses in ECs and perivascular infiltration of macrophages, whereby macrophage-derived VEGF and placental growth factor (PlGF) activated VEGFR1 in macrophages and VEGFR2 in ECs. Moreover, angiopoietin-2 (Angpt2) upregulation and Tie1 downregulation activated FOXO1 in PC-free ECs locally at the leaky aneurysms. This cycle of vessel damage was shut down by simultaneously blocking VEGF, PlGF, and Angpt2, thus restoring the BRB integrity. Together, our model provides new opportunities for identifying the sequential events triggered by PC deficiency, not only in DR, but also in various neurological disorders.

Authors

Shuntaro Ogura, Kaori Kurata, Yuki Hattori, Hiroshi Takase, Toshina Ishiguro-Oonuma, Yoonha Hwang, Soyeon Ahn, Inwon Park, Wataru Ikeda, Sentaro Kusuhara, Yoko Fukushima, Hiromi Nara, Hideto Sakai, Takashi Fujiwara, Jun Matsushita, Masatsugu Ema, Masanori Hirashima, Takashi Minami, Masabumi Shibuya, Nobuyuki Takakura, Pilhan Kim, Takaki Miyata, Yuichiro Ogura, Akiyoshi Uemura

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Figure 9

Schematic diagram of irreversible blood-retina barrier (BRB) breakdown in pericyte-free retinal vessels.

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Schematic diagram of irreversible blood-retina barrier (BRB) breakdown i...
In the presence of pericytes (PCs), angiopoietin-1 (Angpt1)-induced Tie2 activation phosphorylates FOXO1 and inhibits its nuclear translocation in endothelial cells (ECs). After PC depletion, endothelial NFAT activation upregulates inflammatory chemokines, leukocyte adhesion molecules, and Angpt2, which together promote the influx of circulating monocytes into retinas. The infiltrating macrophages (MPs) secrete VEGF and placental growth factor (PlGF), which activate VEGFR1 in MPs and VEGFR2 in ECs. The VEGF/VEGFR2 signal further activates NFAT and upregulates Angpt2. MP-derived VEGF and TNF-α facilitate Tie1 cleavage and Angpt2 conversion from a Tie2 agonist into an antagonist, which then activates FOXO1 and upregulates its target genes including Angpt2. This positive feedback loop renders ECs more sensitive to VEGF and TNF-α, and sustains inflammation and vascular dysfunction. The resulting hypoxia further upregulates VEGF and Angpt2, leading to the irreversible BRB breakdown with paracellular and transcellular leakage and RBC extravasation.

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