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1 From the Sumitomo Pharmaceuticals Research Center, Osaka Japan; and the 2 Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Abstract
PURPOSE. To investigate the neuroprotective effects of brain-derived neurotrophic factor (BDNF) against potassium cyanide (KCN)induced retinal damage.
METHODS. Rats were injected intravitreally with iodinated BDNF. Two days later, eyeballs were dissected into various parts, and the level of radioactivity in each part was measured. Retinal damage was induced by incubating rat eyeballs with 5 mM KCN. BDNF was injected intravitreally 2 days before KCN treatment, and subsequent morphometric analysis was carried out to evaluate the retinal cell damage. To elucidate the mechanisms of BDNFs neuroprotective effects, the intravitreal concentrations of amino acids and the expression of calretinin were investigated.
RESULTS. Intravitreally injected BDNF was distributed evenly throughout the eyes, and the incorporation of iodinated BDNF into the retina was three times higher than in other ocular tissues. Immunohistochemical analysis demonstrated that exogenous BDNF diffused throughout the retina and was especially concentrated in the inner (INL) and outer nuclear layer. Morphometric analysis showed that the number of INL cells of the posterior area, 880 µm from the optic nerve head, was 190 ± 4 with KCN treatment and 284 ± 9 in control animals. Cell death appeared to be necrotic. When eyes injected with either phosphate-buffered saline (PBS) or BDNF were subjected to treatment with KCN, the number of INL cells was 186 ± 5 in the PBS-treated controls and 253 ± 8 in eyes treated with BDNF. Also, BDNF increased the number of calretinin-positive cells in the INL and reduced the KCN-induced elevation of intravitreal glutamate levels.
CONCLUSIONS. BDNF injected intravitreally reaches the retina and attenuates the INL cell death caused by KCN-induced metabolic insult. The neuroprotective effects of BDNF are partly ascribed to the upregulation of a calcium-binding protein and the attenuation of glutamate release into the vitreous body.
Neurotrophic agents have the potential to provide new therapies for neurodegenerative diseases such as Alzheimers disease, Parkinsons disease, peripheral neuropathy, and optic neuropathy. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin (NT) family, which includes nerve growth factor (NGF), NT-3, NT-4/5, and NT-6. Neurotrophins are known to have survival and neurite outgrowth-promoting activity in the central and peripheral nervous systems.1
TrkB, the high-affinity receptor for BDNF (and NT-4/5), is present in developing and adult retinas2 3 4 5 6 7 8 9 10 and in the retinal pigment epithelium (RPE).11 Retinal ganglion cells can upregulate BDNF mRNA expression after optic nerve injury.12 13 These findings indicate that BDNF may play an important role in the development, maturation, and maintenance of various neuronal networks. Indeed, BDNF can support the survival of chick14 and rat15 16 retinal ganglion cells in vitro. In vivo, BDNF has been shown to support cell survival and to enhance the axonal regeneration of axotomized retinal ganglion cells.17 18 19 20 21 22 BDNF also protects the rat retina from ischemic injury,23 light damage,24 and photoreceptor degeneration.25 Possible therapeutic roles have been described for calcium-channel blockers, glutamate antagonists, antioxidants, anti-apoptotic agents, and neurotrophic factors in the treatment of ischemic injury, ischemic degeneration, and glaucoma.26 27 28 These findings imply a therapeutic potential for BDNF as a neuroprotective agent in the treatment of ocular diseases and prompted us to investigate its efficacy in blocking retinal damage using animal models of retinal metabolic insult.
Retinal cell death is seen in many ocular diseases, and a number of different stimuli (such as high intraocular pressure, blockage of axonal flow, and retinal ischemia) may cause cellular damage in the retina.26 29 Ischemic damage can be mimicked by hypoglycemia and anoxia, or by chemically inducing a metabolic blockade of either glycolysis or electron transport.30 31 32 Cyanide is known to block the mitochondrial respiratory chain and to produce neurotoxicity.33 In embryonic chick eyes, potassium cyanide (KCN) treatment results in the death of inner nuclear layer (INL) cells via excitotoxicity associated with metabolic inhibition.30 31 In this study, we investigated the distribution of intravitreally injected BDNF and the neuroprotective effect of BDNF on KCN-induced retinal damage in adult rat eyes ex vivo. Our results showed that KCN-induced cell death in the INL was necrotic in nature and that BDNF attenuated INL cell death by regulating the expression of a calcium-binding protein and by limiting the KCN-induced release of intravitreal glutamate.
Methods
Animals
Male Wistar rats were obtained at 250 to 300 g (Charles
River, Yokohama, Japan) and maintained in a cyclic light environment
(12 hour light/12 hour dark) for 7 or more days before experiments. All
the animal experiments were carried out according to the guidelines of
the Sumitomo Pharmaceuticals Committee on Animal Research and ARVO
Statement for the Use of Animals in Ophthalmic and Vision Research.
Preparation of 125IBDNF and Determination of
125IBDNF Radioactivity
Human recombinant BDNF (N-terminal methionine-free) was supplied
from Regeneron Pharmaceuticals (Tarrytown, NY). Iodination and
isolation of 125IBDNF was performed in a
similar manner to that of Rosenfeld et al. (1993).34
The
specific activity of 125IBDNF was 1.07 x
107 cpm/µg. Rats were anesthetized with ether
and injected intravitreally with 1 µl of sterilized
125IBDNF (1 µg). The injection was performed
with a 33-gauge needle, according to the method of Faktorovich et
al.35
Two days after intravitreal injection of
125I-labeled BDNF, rats were killed with
pentobarbital and the eyeballs removed. The cornea, lens, iris, ciliary
body, retina, and sclera (including the choroid) were dissected from
the eyeballs under a dissecting microscope. The radioactivity in each
section was measured using a scintillation gamma counter. The data are
shown as the radioactivity per microgram of tissue wet weight.
Preparation of Anti-BDNF Antibody and Preabsorption of Anti-BDNF
Anti-BDNF antiserum was produced by immunizing rabbits with
Escherichia coliderived recombinant BDNF. Anti-BDNF
antiserum was loaded onto a BDNF affinity column, which had been
prepared by coupling BDNF to CNBr-activated Sepharose 4B (Amersham
Pharmacia Biotech, Tokyo, Japan). After extensive washing with affinity
column loading buffer (Pierce, Rockford, IL), bound anti-BDNF antibody
was eluted with ImmunoPure Gentle Ag/Ab Elution Buffer (Pierce). To
assess the specificity of western blot analysis and immunohistochemical
staining with anti-BDNF, anti-BDNF was incubated with an excess of BDNF
affinity resin, overnight at 4°C, on a rotary shaker. The suspension
was spun, and the supernatant fraction was used as preabsorbed
anti-BDNF.
Western Blot Analysis
Purified BDNF, NGF (Serotec, Oxford, UK), NT-3 (Peprotec, Rocky
Hill, NJ), and NT-4 (Regeneron, Tarrytown, NY) were used as NT
standards, and rainbow markers (Amersham Pharmacia Biotech) were used
as the molecular weight markers. The electrophoresis samples were
prepared as follows. The retinas were removed from the posterior halves
of the eyeballs under a dissecting microscope. They were then washed
twice with ice-cold phosphate-buffered saline (PBS) and immediately
homogenized in lysis buffer (50 mM TrisHCl, pH 7.5, containing 1%
NP-40, 150 mM sodium chloride, 2.5 mM ethyleneglycol bis
[2-aminoethylether] tetraacetic acid [EGTA], 0.14 U/ml aprotinin, 1
mM phenylmethylsulfonyl fluoride, 2 mM sodium vanadate, and 50 mM
sodium fluoride). Homogenates were spun at 10,000g for 10
minutes, and the supernatant fractions were collected. Electrophoresis
was performed on 12.5% sodium dodecyl sulfatepolyacrylamide gels
(12.5 µg protein/lane) and blotted on HybondECL filters (Amersham
Pharmacia Biotech). The membranes were incubated for 48 hours at 4°C
with the anti-BDNF antibody diluted 1:500 in 0.1% Tween-20PBS
(TPBS) or 24 hours at 4°C with a polyclonal antibody against
calretinin (Chemicon International, Temecula, CA) diluted 1:3000 in
TPBS. After washing with TPBS, the membranes were incubated with
horseradish peroxidaselinked anti-rabbit immunoglobulins (Amersham
Pharmacia Biotech) diluted 1:500, for 60 minutes at room temperature.
After washing with TPBS, the bands were visualized using
chemiluminescence according to the manufacturers protocol (ECL
detection kits; Amersham Pharmacia Biotech). To assess the specificity
of the anti-BDNF antibody, neurotrophic factors (0.1 µg) were loaded
onto duplicate sodium dodecyl sulfatepolyacrylamide gels. One gel was
subjected to western blot analysis, and the other was silver stained
(Daiichi Kagaku, Tokyo, Japan) to visualize the loaded proteins.
Immunohistochemistry
Two days after the intravitreal injection of BDNF, rats were
killed and the eyeballs were enucleated in preparation for the analysis
of BDNF distribution and calretinin expression. The eyes were fixed
with 10% formalinPBS, embedded in paraffin, and sectioned at 4-µm
thickness for immunohistochemical analysis. Sections were incubated for
2 days at 4°C with anti-BDNF antibody diluted 1:300. The specificity
of this antibody was confirmed by incubating control sections in the
preabsorbed anti-BDNF diluted 1:300. Calretinin was detected with the
anti-calretinin antibody diluted 1:3000 (Chemicon International,
Temecule, CA), overnight at 4°C. After washing in PBS, sections were
incubated in fluorescein isothiocyanatelinked anti-rabbit
immunoglobulins (Cappel Research Products, Durham, NC) diluted 1:500 or
horseradish peroxidase-linked anti-rabbit immunoglobulins (Amersham
Pharmacia Biotech) diluted 1:500, for 60 minutes at room temperature.
The distribution of intravitreally injected BDNF was analyzed under a
microscope equipped for fluorescence imaging. All the
calretinin-positive INL cells were counted in all the retinal sections
containing the optic nerve head.
Intravitreal Injection of BDNF and KCN Treatment
BDNF was diluted in PBS to a final concentration of 0.1 to 10
mg/ml and intravitreally injected into the eyes of rats anesthetized
with ether, 2 days before ex vivo KCN treatment. Intact eyes were
removed immediately after death, and each eye was incubated in 3 ml
bicarbonate-buffered KrebsRinger solution (KR), which was kept at
37°C and equilibrated with 5% CO2/95%
O2. After preincubation in KR for 10 minutes,
KCN was added to the medium to a final concentration of 5 mM, and the
eyes were incubated for 5, 30, and 60 minutes.
Ca2+ chelaters and glutamate receptor antagonists
were added to the incubation medium 10 minutes before KCN treatment.
TdT-Mediated dUTP Nick-End Labeling Method
After 30 minutes of incubation with KCN, eyes were fixed in 10%
formalinPBS. TdT-mediated dUTP nick-end labeling (TUNEL) analysis was
performed on 4-µmthick paraffin sections using the TUNEL kit (Apop
Taq; Oncor, Gaithersburg, MD). Eyes prepared from rats exposed to
fluorescent light at 190 foot-candles for 48 hours were used as a
positive control for apoptosis.
Retinal Cell Counts
After incubation in KR with 5 mM KCN, eyeballs were immediately
fixed in a solution of 2.5% formalin1% glutaraldehyde in PBS.
Samples were embedded in Thechnovit 7100 (Heraeus Kulzer,
Zweigniederlassung, Germany) and sectioned at 2-µm thickness. The
sections containing the optic nerve head were stained with 0.1% cresyl
violet for 1 minute (Nissl staining) and observed under the microscope.
In our study, the KCN-induced cell loss in the INL and the attenuation
of INL cell death by BDNF treatment were similar in all regions of the
superior and inferior retina from the center to the periphery.
Therefore, for the quantitative analysis, the numbers of Nissl
stainpositive cells were counted in four microscopic fields, each 220
µm in length, of the posterior portions of the retina lying 880 and
1320 µm away from the optic nerve head in the superior and inferior
regions. The total number of positive cells in the four regions was
used for the evaluation of INL degeneration and rescue.
Amino Acid Analysis
After incubating the eyeball in KR, the vitreous humor was
collected by cutting the eye. The humor was acidified with a one-tenth
volume of 4 N perchloric acid. Before performing amino acid analysis,
the medium was neutralized with 2.5 M potassium carbonate. It was then
spun at 10,000g for 10 minutes at 4°C, and the supernatant
fraction was analyzed by a microhigh performance liquid
chromatography system for automated analysis of amino acids using
precolumn o-phthalaldehyde derivatization and fluorescence
detection (CMA 1200 refrigerated Microsampler, CMA/280 Fluorescence
Detector; BAS, Tokyo, Japan).
Results
Distribution of Intravitreally Injected BDNF
Two days after intravitreal injection of
125IBDNF, the levels of radioactivity in the
cornea, iris, ciliary body, lens, retina, and sclera containing the
choroid were determined. As shown in Figure 1
, the incorporation of 125IBDNF into the retina
was three times higher than into the other regions. The measured
radioactivity levels were as follows (cpm/mg wet-weight tissue):
cornea, 10.7 ± 3.7; iris, 41.9 ± 41.9; ciliary body,
81.7 ± 53.5; lens, 65.1 ± 25.1; retina, 287.4 ± 97.9;
and sclera, 95.7 ± 14.1. The radioactivity in the retina was
competed by a 100-fold excess of cold BDNF. The amount of BDNF
incorporated into the retina was calculated to be approximately 0.3%
of the total injected. Thus, we found that intravitreally injected BDNF
reached the retina and remained there even 2 days after administration.
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Protective Effect of BDNF on KCN-Induced Cell Death
BDNF (0.1, 1, and 10 µg) was injected intravitreally 2 days
before KCN treatment, to examine the efficacy of BDNF in preventing
KCN-induced cell death. After a 30-minute incubation with KCN,
intravitreal BDNF protected INL cells in a dose-dependent manner,
whereas the injection of PBS had no effect (Fig. 5)
. Although only four regions of the posterior retina were analyzed for
the quantitative evaluation, a similar protective effect of BDNF was
observed in the other parts of the retinal sections as well. Compared
with the PBS treatment (186 ± 5/880 µm), 1 and 10 µg of BDNF
produced a statistically significant reduction in KCN-induced INL cell
death, by 28.6% (214 ± 6/880 µm) and 68.4% (253 ± 8/880
µm), respectively (Fig. 6)
. Interestingly, a lag time after BDNF treatment appeared to be
required for neuroprotection to occur, because 10 µg of BDNF showed
no protection when it was injected 1 hour instead of 2 days before KCN
treatment (Fig. 6) .
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Mechanism of BDNF Action
Western blot analysis showed that retinas from BDNF (1 or 10
µg)-injected eyes expressed 1.5 times more calretinin than did
PBS-injected eyes (Fig. 8)
. In an immunohistochemical study, calretinin was detected in retinal
ganglion cells and in the INL cells and was especially strong in
amacrine cells and in the inner plexiform layer (Figs. 9
A, 9B). Intravitreal injection of BDNF increased the number of
calretinin-positive cells in the INL. In contrast, we observed very
little increase in the calretinin signal in the ganglion cell layer
after BDNF treatment, probably because the normal level of calretinin
expression in ganglion cells, as seen in the PBS-treated control
retina, was high, which obscured any increase. The numbers of
calretinin-positive cells in the INL were 33 ± 5, 64 ± 7,
and 69 ± 11 (mean ± SEM/1000 µm) in PBS-treated and
1-µg and 10-µgBDNFtreated eyes, respectively (Fig. 9C)
.
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Distribution of Exogenously Administered BDNF in Ocular Tissues
Intravitreal injection of BDNF has been shown to have a protective
effect on retinal cells.17
18
19
20
21
22
23
24
25
The distribution of
injected BDNF, however, has not been clarified. In this study, we
examined the tissue distribution of intravitreally administered
125I-labeled BDNF. Our results showed that more
radioactivity was detected in the retinal tissue than in the cornea,
iris, ciliary body, lens, or sclera 2 days after the intravitreal
injection of radiolabeled BDNF. Furthermore, our immunohistochemical
study showed that exogenous BDNF was extensively distributed throughout
the retina. Because TrkB, the high-affinity receptor for BDNF, is
expressed in the retina,2
3
4
5
6
7
8
9
10
11
we assume that BDNFs
biological effect occurs in the cells that express TrkB on their
surfaces.
KCN-Induced Retinal Damage by Necrosis
Previous reports showed that the INL cells from chick embryo
retinas were selectively damaged by KCN. In the embryonic retina, the
INL cells showed edema and degeneration after approximately 30 minutes
of treatment with KCN.30
In contrast, it was reported that
cyanide induced apoptotic cell death in PC12 cells.36
In
our adult rat retinal system, we observed swelling and acute cell loss
in the retina after KCN treatment (Figs. 3B
3C)
. This damage was
partially dependent on extracellular Ca2+, and it
was sensitive to AMPA/kainate glutamate receptor blockage (Table 1)
, in
agreement with a previous report.31
Furthermore, chromatin
condensation was not observed by ethidium bromide staining (data not
shown), and there were no positive cells in the TUNEL analysis (Fig. 4C) . These lines of evidence suggest that the cell death in the
KCN-treated adult rat retinas in our system was necrosis rather than
apoptosis. The differences between apoptotic and necrotic cell death in
retinas treated with KCN can be attributed to differences in the
severity of the damage, as reported for glutamate
toxicity.37
Neuroprotective Effects of BDNF on the INL
BDNF attenuated the cell loss in the INLs of retinas treated with
KCN for 30 minutes. The effect of BDNF was transient, and the
attenuation of the cell loss was not observed with a longer KCN
treatment (60 minutes, Fig. 7
). Thus, BDNF showed its protective
effects on retinas that were lightly damaged but did not prevent cell
death in cases of severe injury. BDNF exerts its trophic effects on
neurons by several mechanisms. Among these actions, it prevents an
overload of free Ca2+ by elevating a
Ca2+-binding protein, it reduces the elevation of
glutamate levels, and it enhances cellular resistance to antioxidative
stress by elevating glutathione peroxidase activity, as discussed
below. It seems that the cell death signal cannot be blocked by BDNF in
conditions in which severe cell damage occurs.
The protective effect of BDNF against KCN-induced INL cell damage in this study is consistent with a previous study that demonstrated that BDNF attenuated ischemic damage to INL cells induced by raising the pressure in the anterior chamber of the eye.23 Although ganglion and INL cell death in the ischemic injury model was caused by apoptosis or necrosis, our result at least indicates that BDNF attenuates the nonapoptotic INL cell death induced by KCN treatment.
Neuronal apoptosis has been suggested to be widely involved in the various types of injury against which BDNF shows protective effects, as described previously.17 38 In contrast, Koh et al.39 demonstrated that BDNF enhanced acute necrotic neuronal cell damage induced by oxygen-glucose deprivation in cortical cell cultures, although BDNF also attenuated the apoptotic death induced by serum deprivation in the same cells. Although their result is not consistent with ours, the differences in our experimental systems and in the severity of injury may account for this discrepancy.
BDNF Enhanced Calretinin Expression and Reduced Glutamate Levels
When BDNF was administered intravitreally 1 hour before KCN
treatment instead of 2 days before, no protective effect of BDNF was
observed (Fig. 6)
. This result implies that the induction of some
substance, other changes in retinal tissue, or both are required for
BDNF to show its protective effect. We observed the involvement of
Ca2+ influx and glutamate in the KCN-induced INL
cell damage. Therefore, to understand the mechanism of the protective
effect of BDNF, we investigated the influence of BDNF on the regulation
of intracellular Ca2+ and on the levels of
intravitreal glutamate.
First, we examined the possibility that BDNF blocked Ca2+ influx. In the central nervous system, BDNF is known to enhance the expression of the Ca2+-binding protein calbindin.40 41 42 43 This protein chelates free Ca2+ within cells. Previous studies of hippocampal neurons have shown that NGF, basic fibroblast growth factor, and BDNF prevent the increase in intracellular Ca2+ and the subsequent cell damage induced by hypoglycemia.44 45 46 These findings prompted us to investigate whether BDNF upregulates a Ca2+ -binding protein in our system. In the retina, there are several kinds of Ca2+-binding proteins.47 48 49 50 51 52 Among them, calretinin is known to be expressed in the amacrine cells of the rat INL,50 where TrkB receptors are highly expressed.5 10 Therefore, we examined the change in the expression pattern of calretinin after the intravitreal injection of BDNF in naive adult rats. Two days after the injection of BDNF, the number of calretinin-positive INL cells increased (Figs. 9B 9C) . Because ganglion cells also express TrkB and INL cells,2 3 4 5 6 7 8 9 10 ganglion cells should have responded to exogenous BDNF. However, we did not observe this increase in our study. This result could be ascribed to the fact that the preexisting expression level of calretinin in ganglion cells is already quite high, thus obscuring any increase in the signal (Fig. 9A) . Our finding suggests that the upregulation of the Ca2+-chelating system in the INL is one mechanism by which BDNF acts to protect the INL against KCN-induced insult.
In our study, there was no obvious increase in calretinin expression in the 10-µg BDNFinjected group compared with the 1-µg BDNFtreated group. However, there was clearly more cell survival from KCN injury in the retinas treated with 10 µg BDNF than in those treated with 1 µg BDNF (Fig. 6) . This observation implied that an additional mechanism of protection by BDNF treatment exists. Therefore, we next focused on the levels of glutamate in the vitreous body (Table 2) , because a glutamate receptor antagonist partially reduced the INL cell damage in our system. BDNF treatment attenuated the release of glutamate from retinal tissue into the vitreous body after KCN treatment, and the rate of suppression by 10 µg BDNF was higher than that by 1 µg BDNF. This result coincides with the dose-dependency of the protective action of BDNF against KCN-induced cell damage, suggesting that the efficacy of BDNF could be ascribed to the reduction of the elevation of glutamate levels in the vitreous body rather than to the upregulation of a Ca2+-binding protein in the cytoplasm. Because INL cells use glutamate as a neurotransmitter, a possible interpretation is that the attenuation of the rise in intravitreous glutamate levels is a secondary effect of BDNFs preventing cell death. This is unlikely, however, because BDNF did not prevent the concomitant increase in GABA concentration that was caused by the damage to the INL by KCN treatment. Thus, our results suggest that BDNF shows a specific effect on glutamate. It is well known that the glutamate uptake system is ubiquitous in INL cells and that INL cells express the TrkB receptor.53 Therefore, BDNF might have an effect on the glutamate uptake system in the retina, as has been reported for GABA uptake in the cerebral cortex.41 43
It has been reported that nitric oxide and reactive oxygen species are involved in cyanide-induced neurotoxicity.36 54 BDNF is known to enhance the activity of the antioxidant system by elevating glutathione peroxidase activity,46 55 56 and this enhancement may provide protection from toxicity.
BDNF as an Optic Neuroprotective Agent
Retinal damage can have various causes. Ischemic insults cause
ocular damage and lead to glaucoma, retinal ischemic disease, retinal
degeneration, and optic neuropathy. Many ocular diseases are treated
preliminarily by removing the source of the insult. However,
application of a new approach, neuroprotection therapy, which can
enhance the resistance to disease, is now
anticipated.26
27
28
29
57
Our present results show that BDNF
has a protective effect when KCN-induced energy depletion in the retina
is used to mimic ischemia. Our results and previous reports clearly
demonstrate that exogenously administered BDNF shows a therapeutic
potential for many retinal injuries. Thus, as a neuroprotectant, BDNF
can be expected to provide new strategies for treating retinal ischemic
diseases.
Acknowledgements
The authors thank Akiyoshi Kishino, Hirohsi Ogo, Osamu Konishi, and Shigeyuki Honda for their valuable technical advice concerning the immunohistochemical and TUNEL methods; Akira Itoh for providing valuable comments on the manuscript; and Mutsuko Sakai for technical assistance.
Footnotes
Reprint requests: Chikao Nakayama, Sumitomo Pharmaceuticals Research Center, 3-1-98 Kasugadenaka, Konohanaku, Osaka 554-0022, Japan.
Submitted for publication July 29, 1998; revised January 28, 1999; accepted March 2, 1999.
Proprietary interest category: EN.
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