The NLRP3 Inflammasome May Contribute to Pathologic Neovascularization in the Advanced Stages of Diabetic Retinopathy

Diabetic retinopathy (DR) is a retinal microvascular disease characterized by inflammatory and angiogenic pathways. In this study, we evaluated NLRP3 inflammasome in a double transgenic mouse model, Akimba (Ins2AkitaxVEGF+/−), which demonstrates hyperglycemia, vascular hyperpermeability and neovascularization seen in the proliferative DR. Retinal structural integrity, vascular leakage and function were examined by fundus photography, fluorescein angiography, optical coherence tomography, retinal flat mounts, laser speckle flowgraphy (LSFG), and electroretinography in Akimba and its parental strains, Akita (Ins2Akita) and Kimba (trVEGF029) mice. Inflammatory mechanisms involving NLRP3 inflammasome were investigated using real time-PCR, immunohistochemistry, ELISA and western blots. We observed an increased vascular leakage, reduced retinal thickness, and function in Akimba retina. Also, Akimba retina depicts decreased relative flow volume measured by LSFG. Most importantly, high levels of IL-1β along with increased NLRP3, ASC, and Caspase-1 at mRNA and protein levels were observed in Akimba retina. However, the in vivo functional role remains undefined. In conclusion, increased activation of macroglia (GFAP), microglia (Iba-1 and OX-42) and perivascular macrophages (F4/80 and CD14) together with pro-inflammatory (IL-1β and IL-6) and pro-angiogenic markers (PECAM-1, ICAM-1, VEGF, Flt-1, and Flk-1), suggested a critical role for NLRP3 inflammasome in the Akimba mouse model depicting advanced stages of DR pathogenesis.

[1]  W. Hauswirth,et al.  DICER1 Loss and Alu RNA Induce Age-Related Macular Degeneration via the NLRP3 Inflammasome and MyD88 , 2012, Cell.

[2]  S. Mohr,et al.  Inhibition of Caspase-1/Interleukin-1β Signaling Prevents Degeneration of Retinal Capillaries in Diabetes and Galactosemia , 2007, Diabetes.

[3]  K. Noda,et al.  Pulse Waveform Changes in Macular Choroidal Hemodynamics With Regression of Acute Central Serous Chorioretinopathy. , 2015, Investigative ophthalmology & visual science.

[4]  Tien Yin Wong,et al.  Diabetic macular oedema. , 2017, The lancet. Diabetes & endocrinology.

[5]  T. Nakazawa,et al.  The effect of intravitreal bevacizumab on ocular blood flow in diabetic retinopathy and branch retinal vein occlusion as measured by laser speckle flowgraphy , 2014, Clinical ophthalmology.

[6]  C. Gerhardinger,et al.  IL-1\(\beta\) Is Upregulated in the Diabetic Retina and Retinal Vessels: Cell-Specific Effect of High Glucose and IL-1\(\beta\) Autostimulation available. Please share how this access benefits you. Your story matters , 2012 .

[7]  E. Rakoczy,et al.  Characterization of a mouse model of hyperglycemia and retinal neovascularization. , 2010, The American journal of pathology.

[8]  L. Schmetterer,et al.  Reduced response of retinal vessel diameters to flicker stimulation in patients with diabetes , 2004, British Journal of Ophthalmology.

[9]  S. Vannucci,et al.  Advanced glycation end products and RAGE: a common thread in aging, diabetes, neurodegeneration, and inflammation. , 2005, Glycobiology.

[10]  K. Moore,et al.  The NALP3 inflammasome is involved in the innate immune response to amyloid-β , 2008, Nature Immunology.

[11]  R. Flavell,et al.  Molecular Mechanism of NLRP3 Inflammasome Activation , 2010, Journal of Clinical Immunology.

[12]  A. Kauppinen,et al.  NLRP3 inflammasome activation is associated with proliferative diabetic retinopathy , 2017, Acta ophthalmologica.

[13]  B. Song,et al.  Mechanistic Insights into Pathological Changes in the Diabetic Retina: Implications for Targeting Diabetic Retinopathy. , 2017, The American journal of pathology.

[14]  T. Wong,et al.  Characterization of Fatty Acid Binding Protein 7 (FABP7) in the Murine Retina. , 2016, Investigative ophthalmology & visual science.

[15]  J. J. Wang,et al.  Circulating markers of inflammation and endothelial function, and their relationship to diabetic retinopathy , 2015, Diabetic medicine : a journal of the British Diabetic Association.

[16]  Milos Pekny,et al.  Glia in the pathogenesis of neurodegenerative diseases. , 2014, Biochemical Society transactions.

[17]  P. Wiedemann,et al.  Macrophages in proliferative vitreoretinopathy and proliferative diabetic retinopathy: differentiation of subpopulations. , 1993, The British journal of ophthalmology.

[18]  T. Sano,et al.  [Diabetic retinopathy]. , 2001, Nihon rinsho. Japanese journal of clinical medicine.

[19]  Mei Chen,et al.  Parainflammation, chronic inflammation, and age‐related macular degeneration , 2015, Journal of leukocyte biology.

[20]  R. Kowluru,et al.  Role of interleukin-1beta in the development of retinopathy in rats: effect of antioxidants. , 2004, Investigative ophthalmology & visual science.

[21]  Elisabetta Dejana,et al.  The control of vascular integrity by endothelial cell junctions: molecular basis and pathological implications. , 2009, Developmental cell.

[22]  Noemi Lois,et al.  The progress in understanding and treatment of diabetic retinopathy , 2016, Progress in Retinal and Eye Research.

[23]  Masataka Mori,et al.  Targeted disruption of the Chop gene delays endoplasmic reticulum stress-mediated diabetes. , 2002, The Journal of clinical investigation.

[24]  Leila Mobasheri,et al.  The Association of Major Depressive Disorder with Activation of NLRP3 Inflammasome, Lipid Peroxidation, and Total Antioxidant Capacity , 2019, Journal of Molecular Neuroscience.

[25]  D. Cheţa,et al.  Animal Models of Type I (Insulin-Dependent) Diabetes Mellitus , 1998, Journal of pediatric endocrinology & metabolism : JPEM.

[26]  J. Tschopp,et al.  From inflammasomes to fevers, crystals and hypertension: how basic research explains inflammatory diseases. , 2007, Trends in molecular medicine.

[27]  A. Dick,et al.  Flow cytometric identification of a minority population of MHC class II positive cells in the normal rat retina distinct from CD45lowCD11b/c+CD4low parenchymal microglia. , 1995, The British journal of ophthalmology.

[28]  M. Wolzt,et al.  Reduced retinal vessel response to flicker stimulation but not to exogenous nitric oxide in type 1 diabetes. , 2009, Investigative ophthalmology & visual science.

[29]  E. Newman,et al.  Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease , 2012, Progress in Retinal and Eye Research.

[30]  C. Gerhardinger,et al.  IL-1β Is Upregulated in the Diabetic Retina and Retinal Vessels: Cell-Specific Effect of High Glucose and IL-1β Autostimulation , 2012, PloS one.

[31]  T. Kern In vivo Models of Diabetic Retinopathy , 2008 .

[32]  L. Wen,et al.  NLRP3 deficiency protects from type 1 diabetes through the regulation of chemotaxis into the pancreatic islets , 2015, Proceedings of the National Academy of Sciences.

[33]  S. Abcouwer Müller Cell–Microglia Cross Talk Drives Neuroinflammation in Diabetic Retinopathy , 2017, Diabetes.

[34]  Si Ming Man,et al.  IL-1 Family Members Mediate Cell Death, Inflammation and Angiogenesis in Retinal Degenerative Diseases , 2019, Front. Immunol..

[35]  G. Wu,et al.  Expression of major histocompatibility complex molecules in rodent retina. Immunohistochemical study. , 1997, Investigative ophthalmology & visual science.

[36]  B. Klein,et al.  Global Prevalence and Major Risk Factors of Diabetic Retinopathy , 2012, Diabetes Care.

[37]  A. Keech,et al.  Biomarkers in Diabetic Retinopathy. , 2015, The review of diabetic studies : RDS.

[38]  Jens Dawczynski,et al.  Influence of Flickering Light on the Retinal Vessels in Diabetic Patients , 2008, Diabetes Care.

[39]  S. Malozowski,et al.  Interleukin-1-receptor antagonist in type 2 diabetes mellitus. , 2007, The New England journal of medicine.

[40]  Mei Chen,et al.  Diabetic retinopathy and dysregulated innate immunity , 2017, Vision Research.

[41]  R. Schlingemann,et al.  Molecular basis of the inner blood-retinal barrier and its breakdown in diabetic macular edema and other pathological conditions , 2013, Progress in Retinal and Eye Research.

[42]  K Miyamoto,et al.  Vascular endothelial growth factor (VEGF)-induced retinal vascular permeability is mediated by intercellular adhesion molecule-1 (ICAM-1). , 2000, The American journal of pathology.

[43]  Prahalathan Pichavaram,et al.  Targeting Polyamine Oxidase to Prevent Excitotoxicity-Induced Retinal Neurodegeneration , 2019, Front. Neurosci..

[44]  T. Nakazawa,et al.  Relative flow volume, a novel blood flow index in the human retina derived from laser speckle flowgraphy. , 2014, Investigative ophthalmology & visual science.

[45]  Spencer J. Williams,et al.  MCL and Mincle: C-Type Lectin Receptors That Sense Damaged Self and Pathogen-Associated Molecular Patterns , 2014, Front. Immunol..

[46]  E. Newman,et al.  Signalling within the neurovascular unit in the mammalian retina , 2007, Experimental physiology.

[47]  Kate Schroder,et al.  The NLRP3 Inflammasome: A Sensor for Metabolic Danger? , 2010, Science.

[48]  S. Mohr,et al.  Topical Administration of Nepafenac Inhibits Diabetes-Induced Retinal Microvascular Disease and Underlying Abnormalities of Retinal Metabolism and Physiology , 2007, Diabetes.

[49]  E. Rakoczy,et al.  Molecular analysis of blood-retinal barrier loss in the Akimba mouse, a model of advanced diabetic retinopathy. , 2014, Experimental eye research.

[50]  J. Tschopp,et al.  A pilot study of IL-1 inhibition by anakinra in acute gout , 2007, Arthritis research & therapy.

[51]  J. Ting,et al.  The pathogenic role of the inflammasome in neurodegenerative diseases , 2016, Journal of neurochemistry.

[52]  W. Shen,et al.  Generation of transgenic mice with mild and severe retinal neovascularisation , 2005, British Journal of Ophthalmology.

[53]  S. Mohr,et al.  Caspase activation in retinas of diabetic and galactosemic mice and diabetic patients. , 2002, Diabetes.

[54]  F. Behar-Cohen,et al.  Microglia/macrophages migrate through retinal epithelium barrier by a transcellular route in diabetic retinopathy: role of PKCζ in the Goto Kakizaki rat model. , 2011, The American journal of pathology.

[55]  Walter T Ambrosius,et al.  The effects of medical management on the progression of diabetic retinopathy in persons with type 2 diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study. , 2014, Ophthalmology.

[56]  Joan W. Miller,et al.  Vascular endothelial growth factor/vascular permeability factor is temporally and spatially correlated with ocular angiogenesis in a primate model. , 1994, The American journal of pathology.

[57]  Dhanesh Amarnani,et al.  Oxidized Lipoprotein Uptake Through the CD36 Receptor Activates the NLRP3 Inflammasome in Human Retinal Pigment Epithelial Cells , 2016, Investigative ophthalmology & visual science.

[58]  T. Kern,et al.  Inflammation in diabetic retinopathy , 2011, Progress in Retinal and Eye Research.

[59]  Joan W. Miller,et al.  Programmed necrosis, not apoptosis, is a key mediator of cell loss and DAMP-mediated inflammation in dsRNA-induced retinal degeneration , 2013, Cell Death and Differentiation.

[60]  Ulrich Schraermeyer,et al.  A central role for inflammation in the pathogenesis of diabetic retinopathy , 2004, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[61]  T. Wong,et al.  Update on animal models of diabetic retinopathy: from molecular approaches to mice and higher mammals , 2012, Disease Models & Mechanisms.

[62]  Akiyoshi Uemura,et al.  Sustained inflammation after pericyte depletion induces irreversible blood-retina barrier breakdown. , 2017, JCI insight.

[63]  E. Kohner,et al.  Leukocytes in diabetic retinopathy. , 2007, Current diabetes reviews.