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1 From the Department of Anatomy and Cell Biology, University of North Dakota School of Medicine and Health Sciences, Grand Forks; and the 2 Department of Biological Science and Disease, New England College of Optometry, Boston, Massachusetts.
| Abstract |
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METHODS. Form deprivation myopia was induced in adolescent marmosets by unilateral lid suture for an average of 108 days. After the lids were reopened, the axial lengths and refractions were measured at intervals for up to 39 weeks. At the end of the study period, sclera were isolated and immediately radiolabeled with 35SO4 in organ culture. Proteoglycan synthesis rates were determined by measurement of 35SO4 incorporation into cetylpyridinium chlorideprecipitable glycosaminoglycans after digestion of the scleral samples with proteinase K. Collagen content was determined by measurement of total hydroxyproline in scleral digests. Newly synthesized proteoglycans were separated on a Sepharose CL-4B molecular sieve column and identified by their core proteins by Western blot analyses.
RESULTS. Lid suture resulted in myopia due to a significant increase in vitreous
chamber depth. After Sepharose CL-4B chromatography, newly synthesized
scleral proteoglycans isolated from normal, form-deprived, and
contralateral control eyes, resolved into one major peak that eluted in
the position of decorin, a small chondroitin-dermatan sulfate
proteoglycan. After digestion of the major peak with chondroitinase
ABC, an approximately 45-kDa core protein was detected by Western blot
analyses, confirming the presence of decorin. Form deprivation resulted
in a significant reduction in the rate of proteoglycan synthesis in the
posterior sclera (-43.55%, P
0.001).
Proteoglycan synthesis was also significantly reduced in the posterior
sclera of form-deprived eyes relative to total collagen content
(-36.19%, P
0.01) and was negatively
correlated with the rate of vitreous chamber elongation in the deprived
eye (r2 = 0.779, P
0.05).
CONCLUSIONS. Significant extracellular matrix remodeling occurs in the posterior sclera of the adolescent primate eye during vitreous chamber elongation and myopia development. The negative correlation between vitreous chamber elongation rates and the synthesis rates of decorin in form-deprived eyes suggests that proteoglycan synthesis within the posterior sclera plays a role in the regulation of ocular size and refraction in the adolescent marmoset.
| Introduction |
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There is much evidence for the existence of a vision-dependent emmetropization process that regulates the coordinated growth of the separate tissues of the eye to minimize refractive error.1 2 3 Deprivation of form vision, either experimentally induced in young animals4 5 6 7 8 9 10 11 12 13 14 or occurring in humans as a result of scarring or disease to the anterior ocular segment15 16 17 18 has been shown to result in elongation of the vitreous chamber and the development of myopia, presumably by interfering with the normal emmetropization process. Form deprivation has been widely used in studies on birds,4 5 6 7 mammals,8 9 10 11 12 and primates13 14 19 20 to study the ocular changes associated with vitreous chamber elongation and the development of myopia.
Significant changes in scleral extracellular matrix synthesis, accumulation, and turnover are associated with vitreous chamber elongation during the development of experimentally induced myopia in a variety of animals.21 22 23 24 25 26 27 In chicks, the development of myopia is associated with increased growth of the cartilaginous scleral layer at the posterior pole of the eye, as evidenced by increases in thickness,28 total protein accumulation,29 proteoglycan synthesis,22 23 and proteoglycan accumulation.21 In contrast, the outer fibrous layer of the chick sclera undergoes increased catabolism during the development of myopia, as evidenced by an increased expression of gelatinase, A30 31 ; decreased expression of tissue inhibitor of metalloproteinase (TIMP)-2, an endogenous inhibitor of gelatinase A31 ; decreased rate of proteoglycan synthesis23 32 ; and overall thinning of the fibrous layer.28 Similar to the fibrous sclera of the chick eye, the sclera of form vision-deprived tree shrew eyes exhibits thinning33 and has a reduced rate of proteoglycan24 and collagen24 34 accumulation at the posterior pole, as well as an increase in the ratio of active-to-latent gelatinase A, compared with control eyes.35 Furthermore, decreases in glycosaminoglycan and collagen concentration have also been identified in the posterior sclera of eyes from highly myopic human donors,36 suggesting that the changes observed in the fibrous sclera of chicks and tree shrews model the changes that occur in the human sclera during the development of myopia.
Nearly all experimental studies examining scleral extracellular matrix changes associated with myopia development have been performed in neonatal or young juvenile subjects whose eyes are still undergoing significant growth and elongation. Because the onset of myopia in humans most commonly occurs in late childhood or early adolescence,37 an age when the eye has grown to nearly adult dimensions,38 it is of much interest to examine the extracellular matrix changes associated with vitreous chamber elongation in adolescent primates. Results obtained from these studies may be used to predict the scleral changes associated with the development of myopia in humans during the teenage years.
| Materials and Methods |
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Treatments and Measurements
In five animals, form deprivation by lid suture was introduced
between 299 and 315 days of age (mean, 306 days). This age was selected
because it is comparable to puberty in humans,40
when
axial eye growth has slowed, and axial length has
stabilized.39
The duration of lid suture in the present
experiment was between 79 and 133 days (mean, 108 days). After the lids
were reopened, refractive error and axial dimensions were measured at
intervals between 14 and 78 days.
Two additional marmosets used in the present study underwent unilateral lid suture at 10 and 17 days of age for a period of 3 weeks. These marmosets were euthanatized by an overdose of pentobarbital sodium at the ages of 529 and 538 days, respectively, and the scleras were used for proteoglycan characterization (described later). One untreated marmoset (248 days old) was used as a normal control for proteoglycan characterization. Vitreous chamber depths of treated and control eyes were measured in vivo using a-scan ultrasonography. Complete optometric data are presented in Troilo et al.39 and are summarized in Table 1 .
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Chromatography
The sclera from two marmosets, with lids sutured at 10 and 17 days
of age for a period of 3 weeks, and one untreated marmoset (248 days
old) were used for proteoglycan characterization. To characterize newly
synthesized proteoglycans, radiolabeled sclera from control and
form-deprived eyes were minced into small
(<2-mm3) pieces with a razor blade. The minced
tissue was extracted in 4 M guanidine-HCl containing 0.01 M sodium
acetate, 0.01 M sodium EDTA, 0.005 M benzamidine-HCl, and 0.1 M
-amino-n-caproic acid at 4°C overnight, followed by
re-extraction in the same solvent for 2 to 4 hours at 4°C. The two
extracts were combined for each tissue and were dialyzed exhaustively
in 0.01 M Na2SO4, followed
by exhaustive dialysis in distilled water and lyophilization.
Lyophilized scleral extracts were reconstituted into column buffer (4 M
guanidine-HCl containing 0.02 M Tris [pH 6.8] and 0.1% CHAPS) and
applied to a Sepharose CL-4B column (100 x 1.6 cm;
Pharmacia Uppsala, Sweden) and eluted with the same buffer at a flow
rate of 0.2 ml/min.42
An aliquot from each fraction was
measured for the presence of radioactivity by liquid scintillation
counting, and tubes containing the peak fractions were pooled,
dialyzed, and lyophilized. Measurements of the areas under each peak of
each chromatographic profile were used to calculate the relative
amounts of newly synthesized proteoglycans present in scleral extracts.
Quantification of Proteoglycan Synthesis
The sclera of five animals, form deprived between 299 and 315 days
of age were used to quantify the rate of proteoglycan synthesis and
collagen accumulation in different regions of control and form-deprived
eyes. After radiolabeling, 3-mm punches were excised from the anterior,
equatorial, and posterior scleral regions of both eyes using a surgical
trephine (Storz Ophthalmics, St. Louis, MO). Scleral punches were
digested with proteinase K (protease type XXVIII; Sigma, St. Louis,
MO), 0.05% wt/vol in 10 mM EDTA, and 0.1 M sodium phosphate (pH 6.5)
overnight at 60°C. This treatment resulted in complete digestion of
the tissue. 35SO4-labeled
glycosaminoglycans were precipitated by the addition of 0.5%
cetylpyridinium chloride (CPC) in 0.002 M
Na2SO4 in the presence of
unlabeled carrier chondroitin sulfate (1 mg/ml in
dH20), as previously described.22
Briefly, the samples were incubated for 30 minutes at 37°C and
precipitated glycosaminoglycans were collected on Whatman filters
(GF/F; Fisher Scientific, Pittsburgh, PA) using a 12 port sampling
manifold (Millipore, Bedford, MA) The filters were rinsed with 0.1%
CPC containing 0.05 M NaCl and with dH2O.
Radioactivity was measured directly on the filters by liquid
scintillation counting in 10 ml of scintillation fluid (Ready Safe;
Beckman Instruments, Fullerton, CA). The remainder of the proteinase K
digests was used for determining the hydroxyproline concentration in
each scleral punch.
Determination of Collagen Concentration
To estimate collagen content, hydroxyproline concentration was
measured on an aliquot of each proteinase K digest. Proteinase K
digests were placed in hydrolysis vials (microflex; Kontes, Vineland,
NJ) and subjected to acid hydrolysis at 110°C overnight.
Hydroxyproline was quantified to the nearest nanogram using chloramine
T.43
Electrophoretic Techniques
To survey the marmoset sclera for proteoglycan content, the sclera
that remained after 3-mm punches were obtained for proteoglycan
synthesis quantification was extracted, and proteoglycans were analyzed
by sodium dodecyl sulfatepolyacrylamide gel electrophoresis
(SDS-PAGE) without purification. Approximately 50 mg of tissue was
extracted in a gel sample buffer composed of 3.3% SDS and 16%
glycerol in 0.1 M Tris-HCl (pH 6.8; 1 ml/100 mg tissue wet weight in
screw-cap microcentrifuge tubes). Extraction was continued for at least
48 hours and included heating to 60°C for 5 hours. This method has
previously been shown to extract 90% of tendon
proteoglycans.44
Scleral extracts were electrophoresed on
linear 3% to 15% gradient SDS-polyacrylamide gels with a 3% stacking
gel with doubled concentrations of Tris and glycine in the electrode
buffer (Tris, 0.05 M; glycine, 0.38 M) and run at 6 mA/gel at
15°C.44
After electrophoresis, the gels were fixed in
numerous changes of 35% methanol:5% acetic acid over a 3-day period,
stained for 3 hours with 0.5% alcian blue in 7% acetic acid and
destained overnight in 7% acetic acid.
Proteoglycans previously separated by Sepharose CL-4B chromatography were characterized by Western blot analyses using antisera generated against a synthetic peptide containing the exon 5 sequence of human decorin (generously supplied by David McQuillan, Center for Extracellular Matrix Biology, Texas A & M University, Houston). Proteoglycan fractions were digested with chondroitinase ABC (Seikagaku America, Ijamsville, MD) in 0.1 M Tris (pH 7.4) containing 500 mM phenylmethylsulfonyl fluoride, 100 mM N-ethylmaleimide, 100 mM EDTA, and 36 mM pepstatin A overnight at 37°C, and digested and undigested samples were electrophoresed on 10% SDS-polyacrylamide gels. Proteoglycans were transferred to nitrocellulose, reacted with antibodies, and detected with a chemiluminescent substrate (Western Star; Tropix, Bedford, MA).
Statistical Analyses
Regression lines were fitted to the data using a simple linear
model (Statview Student; Abacus Concepts, Berkeley, CA). Comparisons
between control and lid-sutured eyes were made using analysis of
variance and post hoc t-tests.
| Results |
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0.05) due to significant
vitreous chamber elongation (+178 ± 0.05567 µm,
P
0.05) compared with the contralateral untreated
control eyes (Table 1
; for complete details see Troilo et
al.39
). During the period after the deprivation, the
vitreous chamber of experimental eyes continued to elongate relative to
the control eyes (mean rate, 12.5 mm/d in deprived eyes versus 6 mm/d
in control eyes). Of the two marmosets deprived early in life (used for proteoglycan characterization), one (marmoset C) showed development of myopia that persisted throughout its life. The experimental eye was 0.4 mm longer and 3.6 D more myopic than the fellow eye at the time of death. The other ( marmoset D) did not become myopic, although the experimental eye was 0.1 mm longer than the fellow eye (the experimental eye had a flatter cornea than the control eye).
Characterization of Marmoset Scleral Proteoglycans
The major proteoglycan extracted from control and deprived
marmoset sclera migrated on SDS-polyacrylamide gels as a single broad
band with a molecular weight of approximately 70 to 100 kDa (Fig. 1) consistent with the migration position of the small chondroitin
sulfate proteoglycan decorin.45
46
A lighter staining
band, migrating at 190 to 220 kDa could be seen in some samples, which
corresponds to the migration position for biglycan.45
46
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0.01) or equatorial sclera (+229.24%,
P
0.01) of control eyes. In contrast, regional
differences were largely absent in form-deprived eyes. The rate of
proteoglycan synthesis was significantly higher only in the anterior
sclera than in the equatorial sclera (+155.16%, P
0.05) of form-deprived eyes. Comparison of proteoglycan synthesis rates
in different regions of control and form-deprived eyes indicated that
the rate of proteoglycan synthesis was significantly lower in the
posterior sclera of form-deprived eyes, compared with the posterior
sclera of control eyes (-43.55%, P
0.001). No
significant differences were detected in proteoglycan synthesis rates
in the anterior or equatorial sclera between form-deprived and control
eyes.
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0.05). Hydroxyproline levels were also lower in
the equatorial sclera than in the posterior sclera, although these
differences did not reach statistical significance (P =
0.0847). A similar regional variation in hydroxyproline content was
observed in form-deprived eyes, with hydroxyproline concentration
significantly lower in the equatorial sclera than in the anterior
sclera (-70.44%, P
0.01) and the posterior sclera
(-43.61%, P
0.05). When control and form-deprived
eyes were compared, no significant differences were detected in
hydroxyproline concentration in anterior, equatorial, or posterior
sclera.
When normalized to collagen content, the rate of proteoglycan synthesis
per microgram hydroxyproline was significantly higher in the posterior
sclera of control eyes than in the anterior sclera (+129.15%,
P
0.01) or equatorial sclera (+92.41%,
P
0.05). In contrast, no significant regional
differences were detected in the rates of proteoglycan synthesis per
microgram hydroxyproline in the sclera of deprived eyes. When scleras
of form-deprived eyes were compared with those of control eyes, the
rates of proteoglycan synthesis relative to hydroxyproline
concentration were significantly lower in the posterior sclera of
deprived eyes than in the same region of control eyes (-36.19%,
P
0.01) (Fig. 5C)
, suggesting that the decrease in
proteoglycan synthesis rates observed in deprived eyes is not simply a
reflection of a generalized loss of scleral extracellular matrix.
The decrease in the rate of proteoglycan synthesis observed in
experimental eyes relative to the fellow control eye was compared with
the average rate of vitreous chamber elongation in the experimental eye
during the period after the end of form deprivation. We found that
there was a significant negative correlation between the mean daily
growth rate of experimental eyes during the period after lid-opening
and the interocular difference in proteoglycan synthesis
(r2 = 0.779, P
0.05; Fig. 6 ). Specifically, the scleras of the fastest growing eyes showed larger
decreases in proteoglycan synthesis (measured as counts per minute of
35SO4) relative to that of
the scleras of their slower growing fellow control eyes.
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| Discussion |
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The human sclera is thickest at the posterior pole and thinnest at the equator; it thickens again at the corneal limbus.48 Although no comprehensive histologic studies have been performed on the marmoset sclera, if the regional differences in scleral thickness are similar in the marmoset, it may account for the regional differences in proteoglycan synthesis and collagen accumulation observed in control eyes. When normalized to collagen content, the posterior sclera exhibited the highest rate of proteoglycan synthesis compared with the anterior and equatorial regions. The higher rate of proteoglycan synthesis in the posterior sclera may be a related to the anteroposterior developmental pattern in the primate sclera49 resulting in the most immature and biosynthetically active cells being located at the posterior pole. Of note, proteoglycan synthesis was significantly reduced in form-deprived eyes only in the posterior sclera. This localized response in the posterior sclera may be related to regional differences in the growth states of the scleral fibroblasts or may be a reflection of a concentration of deprivation-induced changes in the retina, choroid, and sclera along the visual axis.50
A similar reduction in proteoglycan synthesis and accumulation has been reported to occur in the sclera of the juvenile tree shrew,24 suggesting that cellular responses to form deprivation are similar between the two species. A small but statistically significant reduction in collagen accumulation (-11.9%) was also reported in the posterior sclera of the deprived tree shrew eyes.24 In the present study, no significant differences were detected in collagen accumulation in the marmoset sclera, although a trend toward reduced collagen at the posterior pole was observed in deprived eyes. It is possible that a marmoset sample size comparable to that used in the tree shrew study (n = 10) would also show similar decreases in collagen accumulation at the posterior pole. We cannot, however, exclude the possibility that species and age differences may be related to the differences in collagen accumulation between the two studies.
Results of SDS-PAGE, Sepharose CL-4B chromatography, and Western blot
analysis indicated that the major proteoglycan of the marmoset sclera
is decorin, a small chondroitin-dermatan sulfate proteoglycan with a
core protein of approximately 45 kDa. Decorin has been shown to be
present in close association with collagen fibrils of many, if not all,
connective tissues, where it regulates collagen fibril
formation51
and organization in the extracellular
matrix.52
Decorin has also been identified in the human
sclera where it makes up approximately 74% of the total sulfated
proteoglycans.41
Additionally, the human sclera has been
shown to contain biglycan (
20%), another chondroitin-dermatan
proteoglycan, and a small amount (
6%) of aggrecan, the
chondroitin-keratan sulfate proteoglycan typically found in
cartilage.41
With increasing age in humans, the amounts of
aggrecan increase and the amounts of decorin and biglycan decrease,
relative to total sulfated proteoglycans.47
It is
speculated that decorin and biglycan function to maintain collagen
fibril organization within the scleral extracellular matrix and
stabilize intermolecular collagen interactions, whereas aggrecan may
function to maintain scleral hydration and pliancy at the posterior
pole.47
In addition, decorin has been shown to suppress
cell growth by upregulating the cell cycle inhibitory protein
p21,53
as well as by binding to transforming growth
factor-ß, thereby neutralizing its growth-promoting activity in
Chinese hamster ovary cells.54
Based on the interactions
of decorin with cells and the extracellular matrix characterized in the
current study, a decrease in decorin synthesis and reduced accumulation
in the scleral stroma of marmosets would be expected to significantly
alter the metabolism and organization of the scleral extracellular
matrix, which may result in decreased mechanical strength and
subsequent ocular elongation.
Changes in scleral creep rates (time-dependent changes in length under constant force) have been reported to correspond to changes in axial elongation rates during the induction and recovery from deprivation-induced and negative lens-induced myopia.54 It has been speculated that alterations in the levels of the noncollagenous components, such as proteoglycans may affect the structural integrity of the sclera and thereby influence the creep rate of the sclera. The significant changes observed in proteoglycan synthesis rates in form-deprived primate eyes, and the negative correlation of these changes with the rate of vitreous chamber elongation observed in the present study, suggest that the synthesis and accumulation of decorin in the posterior sclera influences scleral distensibility and the rate of ocular elongation in the eyes of adolescent primates.
In the present study, we found that the rate of proteoglycan synthesis in the sclera of the experimental eye relative to the fellow control eye was inversely correlated with the rate of growth: Faster growing eyes had relatively larger decreases in proteoglycan synthesis than slower growing eyes. These changes are presumably related to a restructuring of the extracellular matrix of the sclera. The tissue used in this part of the study (in vitro analysis of synthesis rates) was from animals with previously lid-sutured eyes that had been open for several weeks (211 weeks), and the rate of growth used for this analysis was taken as a mean over this period, which differed in different animals. It is known that in marmosets, lid suture produces axial elongation that continues well after the lids are opened and vision is restored.14 In fact, in these five animals, the myopia and axial elongation progressed after lid opening, and the rates of growth remained higher than normal over this postdeprivation period (see Troilo et al.39 ). If, as we speculate, the decrease in proteoglycan synthesis is a component of the restructuring of the matrix necessary for eye enlargement, then this negative correlation implies that this component of the restructuring mechanism is directly related to the rate of ocular enlargement.
Because the changes in proteoglycan synthesis occurred in mature marmosets, weeks after late-onset deprivation was discontinued, it is unclear whether the decreased rate of proteoglycan synthesis was responsible for vitreous chamber elongation, or were secondary to another, unidentified scleral response related to the rate of vitreous chamber elongation. The normal postnatal growth of the human eye has been described as having an "early" rapid elongation phase followed by a later "juvenile" slow-elongation phase.56 57 Although the human eye reaches adult size by 10 to 15 years,38 58 the concentration of scleral proteoglycans continues to increase significantly in the sclera through the fourth decade of life.47 Therefore, defects in the regulation of scleral proteoglycan synthesis and/or accumulation appearing in childhood, adolescence, and young adulthood may be expected to cause significant structural abnormalities in the scleral matrix. The results of the present study show that scleral proteoglycan synthesis can be altered in adolescent primates by changes in the visual environment. It is therefore likely that changes in visual experience during adolescence may affect eye growth in humans through alterations in proteoglycan synthesis and extracellular matrix organization in the sclera.
| Acknowledgements |
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| Footnotes |
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Submitted for publication November 2, 1999; revised January 24, 2000; accepted February 7, 2000.
Commercial relationships policy: N.
Corresponding author: Jody A. Rada, Department of Anatomy and Cell Biology, University of North Dakota School of Medicine and Health Sciences, Box 9037, Grand Forks, ND 58202-9037. jarada{at}medicine.nodak.edu
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