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Purinergic dysregulation causes hypertensive glaucoma–like optic neuropathy
Youichi Shinozaki, … , Takeshi Iwata, Schuichi Koizumi
Youichi Shinozaki, … , Takeshi Iwata, Schuichi Koizumi
Published October 5, 2017
Citation Information: JCI Insight. 2017;2(19):e93456. https://doi.org/10.1172/jci.insight.93456.
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Research Article Neuroscience Ophthalmology

Purinergic dysregulation causes hypertensive glaucoma–like optic neuropathy

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Abstract

Glaucoma is an optic neuropathy characterized by progressive degeneration of retinal ganglion cells (RGCs) and visual loss. Although one of the highest risk factors for glaucoma is elevated intraocular pressure (IOP) and reduction in IOP is the only proven treatment, the mechanism of IOP regulation is poorly understood. We report that the P2Y6 receptor is critical for lowering IOP and that ablation of the P2Y6 gene in mice (P2Y6KO) results in hypertensive glaucoma–like optic neuropathy. Topically applied uridine diphosphate, an endogenous selective agonist for the P2Y6 receptor, decreases IOP. The P2Y6 receptor was expressed in nonpigmented epithelial cells of the ciliary body and controlled aqueous humor dynamics. P2Y6KO mice exhibited sustained elevation of IOP, age-dependent damage to the optic nerve, thinning of ganglion cell plus inner plexiform layers, and a reduction of RGC numbers. These changes in P2Y6KO mice were attenuated by an IOP lowering agent. Consistent with RGC damage, visual functions were impaired in middle-aged P2Y6KO mice. We also found that expression and function of P2Y6 receptors in WT mice were significantly reduced by aging, another important risk factor for glaucoma. In summary, our data show that dysfunctional purinergic signaling causes IOP dysregulation, resulting in glaucomatous optic neuropathy.

Authors

Youichi Shinozaki, Kenji Kashiwagi, Kazuhiko Namekata, Akiko Takeda, Nobuhiko Ohno, Bernard Robaye, Takayuki Harada, Takeshi Iwata, Schuichi Koizumi

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Figure 1

P2Y6 receptor activation reduces intraocular pressure.

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P2Y6 receptor activation reduces intraocular pressure.
(A) Concentration...
(A) Concentration dependency of the intraocular pressure (IOP) lowering effect by instillation of uridine diphosphate (UDP) in 3-month-old WT mice. UDP (1.5 h) showed a concentration-dependent IOP lowering effect, and the maximum effect was obtained at 500 μM (n = 20, **P < 0.01 and *P < 0.05 vs. saline-treated eyes, 1-way ANOVA followed by Fisher’s least significant difference [LSD] test). (B) Time dependency of the effect of UDP on WT mice. UDP (500 μM) showed no IOP changes at 30 min but induced a maximum IOP changes at 1.5 hours, followed by gradual recovery. Statistically significant effects were obtained at 1.5–6.0 hours (n = 20, **P < 0.01 and *P < 0.05 vs. initial IOP value, 1-way ANOVA followed by Fisher’s LSD test). The IOP at 24 hours showed a tendency to be elevated and recovered to the initial level at 48 hours. (C) The effect of an antagonist for P2Y6 receptor on IOP of WT mice. MRS2578 (30 μM, 1.5 h), a selective antagonist for P2Y6 receptors, increased the IOP (n = 10, *P < 0.05, Mann-Whitney U test). (D) The UDP effect in 3-month-old P2Y6 receptor–deficient (P2Y6KO) mice. UDP (500 μM, 1.5 h) did not change the IOP in P2Y6KO mice (n = 20, P = 0.801, Mann-Whitney U test). Data are shown as means ± SEM.

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