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1 From the Institut für Klinische Physiologie, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Germany; the 2 Universitäts-Augenklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Germany; 3 Novartis Ophthalmics AG, Basel, Switzerland; and 4 Novartis Ophthalmics AG, Strasbourg, France.
| Abstract |
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METHODS. The effects of unoprostone (M1 metabolite = free acid, 10-5 M) and endothelin (ET)-1 (10-9 M) on bovine TM (BTM) and ciliary muscle (CM) strips were investigated, by using a custom-made force-length transducer system. The effects of unoprostone and ET-1 (5 x 10-8 M) on intracellular Ca2+ mobilization in cultured human TM (HTM) were measured using fura-2AM as a fluorescent probe. Patchclamp experiments were performed on HTM and BTM cells to investigate the unoprostone-dependent modulation of membrane currents.
RESULTS. In isolated TM and CM strips, unoprostone almost completely inhibited ET-induced contractions (TM: 2.9% ± 4.3% vs. 19.6% ± 5.7%, P < 0.05, n = 6; CM: 1.4% ± 1.6% vs. 30.1% ± 5.3%, P < 0.01, n = 6; 100% = maximal carbachol-induced (10-6 M) contraction). However, neither carbachol-induced contraction nor baseline tension was affected by unoprostone. Furthermore, unoprostone had no effect on baseline intracellular calcium levels (baseline: 126 ± 45 nM versus unoprostone: 132 ± 42 nM, n = 8) in HTM cells. The endothelin-induced increase (679 ± 102 nM), however, was almost completely (P < 0.01) blocked by unoprostone (178 ± 40 nM). In patchclamp recordings, unoprostone could be shown to double the amplitude of outward current (HTM: 200% ± 33%; n = 6; BTM: 179% ± 20%; n = 8). This effect was blocked by the specific inhibitor of maxi-K channels, iberiotoxin.
CONCLUSIONS. This study presents evidence for direct interaction of unoprostone with the contractility of the TM and CM. This compound may lower IOP by affecting aqueous outflow, most probably conventional outflow pathways (i.e., TM) through inhibition of ET-dependent mechanisms. In addition, unoprostone interacts with the maxi-K channel. Although primarily Ca2+-sensitive signal-transduction pathways seem to be involved, effects of unoprostone on Ca2+-independent pathways and uveoscleral outflow cannot be excluded.
| Introduction |
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-3, polyunsaturated fatty acid abundantly
located in the neural tissues of the retina and brain.1
2
Topical application of unoprostone isopropyl ophthalmic solution
(Rescula; Novartis Ophthalmics AG, Basel, Switzerland) decreases IOP in
rabbits, monkeys,3
4
5
and humans.6
7
Furthermore, the compound has been shown to positively affect optic
nerve head circulation in rabbits8
and
humans9
and appears to have retinal neuroprotective
properties in rats.10
There is a debate about whether IOP
reduction in humans induced by unoprostone results from increased
conventional outflow through the TM or primarily from enhanced
uveoscleral flow,5
as it does in primates.
The ciliary muscle (CM) and the trabecular meshwork (TM) have
been shown to be contractile elements in the conventional outflow
pathway that contribute to the regulation of outflow facility (for
review see Ref. 11
). Because DHA, as a parent
unoprostone molecule, has been shown to exert vasorelaxing
effects,12
13
14
15
16
we attempted to identify whether
unoprostone has similar effects and what the molecular mechanisms are.
DHAs smooth musclerelaxing properties have been suggested to be
caused by suppressing receptor-mediated Ca2+
influx in vascular smooth muscle cells.17
Improved
endothelium-dependent relaxation and inhibition of
endothelium-dependent contraction was demonstrated in a coronary
artery model using normal animals fed a diet rich in
-3 fatty
acids.18
19
A similar enhancement of endothelium-mediated
vasodilation in atherosclerotic human coronary arteries was later
demonstrated after only 3 weeks of treatment with fish oil rich in
-3 fatty acids (among which DHA is the most
abundant).14
To clarify the ocular hypotensive effects of unoprostone, contractility measurements of bovine TM (BTM) and CM strips were performed. We attempted to clarify the signal-transduction pathways affected by unoprostone within these smooth musclelike tissues, by using functional contractility measurements, measurements of intracellular calcium [Ca2+]i, and patchclamp recordings.
| Materials and Methods |
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Cell Cultures
Human TM (HTM) cells were isolated by methods based on those of
Grierson et al.21
and Siegner et al.22
Human
eyes were obtained from multiorgan donors of our hospital who were
identified according to age, gender, and time of death. Donor ages
ranged from 20 to 68 years, and a history of glaucoma was ruled out by
screening patients histories. The tenets of the Declaration of
Helsinki were followed, informed consent obtained, and institutional
human experimentation committee approval granted for the studies. BTM
cells were obtained in a similar fashion with methods previously
described.23
HTM and BTM cells were cultured in Dulbeccos modified Eagles minimum essential medium (DMEM) supplemented with 20% fetal calf serum (FCS), 100 U/ml penicillin, and 100 µg/ml streptomycin (all cell culture material was obtained from Biochrom, Berlin, Germany). The cells were kept in an atmosphere containing 95% air-5% CO2 at 37C° temperature and were passaged using the trypsin-EGTA method. Only well characterized, normal HTM cells from early passages (24) were used for patchclamp recordings and fura-2AM dye calcium measurements.11
Measurement of [Ca2+]i
Measurements of
[Ca2+]i were performed
using the Ca2+-sensitive dye fura-2AM (Sigma,
Deisenhofen, Germany) based on methods described by Grynkiewicz et
al.24
Cells were trypsinized as described earlier and
remained on coverslips in culture medium for at least 1 week. Before
each experiment, the semiconfluent cells were incubated in control
solution and 10 mM fura-2AM for 20 minutes at room temperature. The dye
was loaded by diffusion and intracellular cleavage of fura-2AM to
fura-2. The coverslip was then placed in a perfusion chamber on the
stage of the inverted microscope, which was also used for the
patchclamp recordings. Cells were perfused with control solution for
at least 30 minutes to wash out extracellular dye. The excitation light
was generated by a xenon lamp (XPO 75 W/2; Osram, Carl Zeiss,
Oberkochen, Germany) filtered by two rotating filters (six per
second) at 340 nm and 380 nm. Relative fluorescence of the dye
after excitation was registered at 510 nm by means of a photomultiplier
(928 SF; Hamamatsu, Hamamatsu City, Japan) with consequent signal
detection with a patchclamp amplifier (EPC-9; Heka Electronics,
Lambrecht, Germany). Data storage and data processing were performed on
computer (TIDA for Windows; Heka Electronics). Changes in the
340:380-nm fluorescence ratio represent relative changes in
[Ca2+]i. Absolute
[Ca2+]i was calculated
using the equation and dissociation constant of Grynkiewicz et
al.24
PatchClamp Recordings
The patchclamp experiments were performed at 37°C, as
previously described.25
26
A coverslip with trypsinized
cells was introduced into a perfusion chamber on the stage of an
inverted microscope (Axiovert 35; Carl Zeiss) and superfused
continuously with variable solutions. Borosilicate patch pipettes
(Clark GC 150T-15; Harvard Apparatus, Kent, UK) were pulled and
polished using a universal puller (DMZ; Zeitz, Augsburg, Germany). The
input resistance of the pipette filled with the standard solution was 4
to 5 M
. Nystatin (150 µg/ml) in the patch pipette was used to
obtain perforated patches. Membrane currents were recorded using a
patchclamp amplifier (EPC-9; Heka Electronics) patchclamp
amplifier. Electrical stimulation, data storage, and processing were
performed on computer (TIDA for Windows; Heka Electronics). The same
software was used to automatically calculate membrane capacitance and
access resistance. Potentials were referenced to the bath, by using an
Ag-AgCl electrode connected to the bath solution by an agar bridge
electrode, so that a negative potential corresponded to a negative
pipette potential. Liquid junction potentials were determined and
corrected according to the method described by Neher.27
Unless indicated otherwise, positive ions flowing into the pipette correspond to a negative current and are depicted in figures as going downward, whereas positive ions flowing out of the pipette are designated by a positive current in the upward direction. Currents were monitored using a protocol that generated steps of 200-msec duration to various voltages between -80 and 100 mV. After each step, the voltage returned to a holding potential of -40 mV for 200 msec. Currents were continuously sampled at 100 Hz throughout the entire duration of this protocol. Control perfusion solution (Ringers) contained (in millimolar): 151 NaCl, 4 KCl, 1.7 CaCl2, 1 KH2PO4, 0.9 MgSO4, 10 HEPES, and 5 glucose adjusted to pH 7.4 (NaOH). Standard pipette solution contained (in millimolar): 119 potassium glutamate, 10 NaCl, 1 KH2PO4, 0.9 MgSO4, 3.3 EGTA, 6.6 CaEGTA, and 10 HEPES, adjusted to pH 7.2 with NaOH.
Chemicals and Solution
The following reagents were used for the experiments: ET-1,
(Alexis Deutschland GmbH, Grünberg, Germany) and unoprostone
isopropyl (unoprostone free acid, stock solution of the M1 metabolite
dissolved in dimethyl sulfoxide; Novartis). All other chemicals were
purchased from Merck (Darmstadt, Germany), Sigma, and Serva
(Heidelberg, Germany).
Calculations and Statistical Analysis
Data are presented as mean ± SEM and were analyzed for
significance using the paired Students t-test.
Significance was assumed at the following probabilities, as shown in
the figures and table: *P < 0.05, **P < 0.01, ***P < 0.001, on computer (Sigma Plot
Scientific Graph System, ver. 1.02, SPSS Science, San Rafael, CA).
| Results |
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In all cases studied, addition of unoprostone resulted in a highly significant increase (P < 0.001) in outward current to almost twice the original level (Fig. 8) . Conversely, addition of unoprostone in the presence of iberiotoxin (10-7 M) resulted in only an insignificant increase (Fig. 9) . No species-dependent differences could be found in the response to unoprostone (see Table 1 for details).
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| Discussion |
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receptor (FP)
agonists (latanoprost) have recently become commercially available as
antiglaucoma drugs, but despite good IOP control, they appear to be
prone to ophthalmic side effects, such as increased iris pigmentation,
excessive eyelash growth or macular edema.30
31
Unoprostone isopropyl (Rescula; Novartis) is the first synthetic
docosanoid introduced for the treatment of glaucoma. The substance has
been in clinical use as an antiglaucoma drug in Japan for several years
and appears to be well tolerated.6
There is still some
debate concerning how this compound lowers IOP. Although some
investigators suggest a modulation of conventional outflow facility,
others see the primary target site in the uveoscleral outflow
pathway.3
4
5
6
7
8
9
10 The TM has smooth musclelike properties and is actively involved in aqueous humor dynamics through contractile mechanisms. We have described a functional antagonism between TM and CM (for review see Ref. 11 ) with CM contraction leading to a distension of the TM with subsequent reduction in IOP, and with TM contraction leading to the opposite effect. Furthermore contractility appears to be differently regulated in TM and CM in respect to various signal transduction pathways involved in the regulation of smooth muscle contractility.11 32 33 To investigate the mode of action of a compound that lowers IOP, the effects on the modulation of contractility within the major outflow pathway must be determined.11 This study presents evidence for the modulation of TM and CM contractility through unoprostone. This is in line with investigations on the effects of unoprostone on the conventional outflow facility in rabbits,34 primates, and humans.6 7 The fact that unoprostone was not able to influence baseline contractility or pathways that involve G-proteinlinked acetylcholine receptors (Gq) suggests involvement of different G-proteins (perhaps Gi) or additional G-proteinindependent pathways in mediating the relaxing effects of unoprostone. This compound does not bind to known prostaglandin receptors35 where it would have induced relaxation in TM and CM, as has been demonstrated with various prostaglandin agonists.36
As mentioned before, unoprostone is not a prostanoid but represents a
new docosanoid. Concerning prostanoids we recently tested the effects
of various agonists as well as antagonists on TM contraction and found
virtually no effect of PGF2
on TM
contractility. However, EP2 agonists relaxed the
TM, whereas a thromboxane agonist contracted it.36
ETs represent a group of 21-amino-acidcontaining peptides and were first described by Yanagisawa et al.37 ET-1 mediates contraction in various smooth muscle systems, such as ocular vasculature, as well as the TM and CM.38 39 40 Using RT-PCR-techniques the ET-A but not ET-B receptor was found to be expressed in human CM and TM cells.28 Here, an involvement in the mobilization of internal calcium28 40 and an activation of phospholipase C could be demonstrated.28 41 Levels of ET-1 were found to be increased in the aqueous humor of patients with primary open-angle glaucoma (pooled samples).42 The role of ET in the pathogenesis of glaucoma remains unclear; however, it can be speculated that this vasoactive compound may influence aqueous humor outflow by mediating contractility in the conventional outflow pathway. It is interesting to note that unoprostone was able to inhibit ET-induced contraction but not the contraction induced by another G-proteinlinked receptor agonist (carbachol), suggesting a distinct modulation of contractility by these two receptor agonists. Similar results of a unoprostone-mediated ET antagonist (ET-1) were detected in perfused pig retinal arteries43 as well as in the choroid of humans in a dose-dependent manner.44
Changes in internal calcium mediate contraction and relaxation in TM and CM through L-type calcium channels29 and maxi-K channels.25 26 In TM, contractility is partly dependent and partly independent of calcium and uses PKC and rho-A/ROCK-mediated pathways based on pharmacomechanical coupling events.29 39 45 In our studies, unoprostone almost completely inhibited the ET-induced increase in [Ca2+]i. There was no statistically significant effect on [Ca2+]i in HTM cells through unoprostone alone, which underlines the absence of effect of the compound on baseline contractility.
In patchclamp experiments, we were able to show that unoprostone stimulates maxi-K channelsthat is, high-conductance, calcium-activated potassium channels in TM cells of both bovine and human origin. In previous publications,25 26 we have shown that the stimulation of potassium efflux through maxi-K channels leads to hyperpolarization with subsequent closure of L-type calcium channels in TM.29 This should lead to lowered values of cytosolic calcium, explaining the relaxation of TM in response to unoprostone in strips of BTM precontracted by ET. According to this hypothesis, an effect of unoprostone on contractility can only be expected in situations in which L-type calcium channels are open before the administration of the substance. In unstimulated tissue with physiological membrane voltage, maxi-K and L-type channels show only minimal activity.25 26 29 Correspondingly, we were unable to observe any effect of unoprostone on unstimulated TM cells. Even if unoprostone opens maxi-K channels in this situation, hyperpolarizing the tissue, no effect can be expected on L-type channels, because these are already closed.
In contrast to experiments of contractility in which an effect of unoprostone could only be observed when the tissue was precontracted by ET, in patchclamp experiments, the maxi-K channel was also stimulated when the cells were pretreated with acetylcholine or ET. As mentioned, there appear to be marked differences in the signaling pathways (perhaps through different G-protein receptors) leading to the contraction of TM after stimulation of either muscarinic or ET receptors. Thus, we were able to show that, although 42% of carbachol-mediated contraction is dependent on the presence of external calcium, only 23% of ET-mediated contraction depends on the influx of calcium into the tissue.39 Carbachol-mediated contraction does not appear to involve calcium influx to the degree observable in ET-mediated responses.
In summary, this study suggests that the ocular hypotensive effects of unoprostone appear to be the result of a direct relaxation of TM, a smooth musclelike tissue in the outflow pathway. However, effects of this compound on uveoscleral outflow cannot be excluded from our studies. Our studies show that the CM is also affected by unoprostone, suggesting a possible influence on uveoscleral outflow. This relaxation is probably mediated by a stimulation of maxi-K channels involving changes in cytosolic calcium in tissues of both human and bovine origin. In addition, the involvement of ET-dependent pathways in Ca2+-sensitive mechanisms seems to play a major role. The possibility of involvement of Ca2+-independent pathways in the regulation of contractility cannot be excluded.
| Acknowledgements |
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| Footnotes |
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Commercial relationships policy: Commercial relationship policy: C (AO, CLP, GNL); N (all others).
The publication costs of this article were defrayed in part by page
charge payment. This article must therefore be marked
"advertisement" in accordance with 18 U.S.C.
1734
solely to indicate this fact.
Corresponding author: Hagen Thieme, Institut für Klinische Physiologie, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. thieme{at}ukbf.fu-berlin.de
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