|
|
||||||||
1 From the Department of Pharmacology and Toxicology and the 2 Department of Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, Milwaukee.
| Abstract |
|---|
|
|
|---|
METHODS. Rats were intoxicated with methanol, and retinal function was assessed by electroretinography 72 hours after the initial dose of methanol and after a 72-hour recovery period. Retinal energy metabolites, glutathione (GSH) concentrations, and histology were determined at the same time points.
RESULTS. Both rod-dominated and UV-conemediated electroretinogram responses were profoundly attenuated in methanol-intoxicated rats. In rats allowed to recover from methanol intoxication, there was significant, although incomplete, recovery of rod-dominated retinal function. However, there was no demonstrable improvement in UV-conemediated responses. Retinal adenosine triphosphate (ATP), adenosine diphosphate (ADP), and GSH concentrations were significantly reduced after intoxication. Although retinal energy metabolites returned to control values after the recovery period, retinal GSH remained significantly depleted. Histopathologic changes were apparent in the photoreceptors after methanol intoxication, with evidence of inner segment swelling and mitochondrial disruption. In animals allowed to recover from methanol intoxication, there was no evidence of histopathology at the light microscopic level; however, ultrastructural studies revealed subtle photoreceptor mitochondrial alterations.
CONCLUSIONS. These findings support the hypothesis that formate inhibits retinal mitochondrial function and increases oxidative stress. They also provide evidence for a differential sensitivity of photoreceptors to the cytotoxic actions of formic acid, with a partial recovery of rod-dominated responses and no recovery of UV-conemediated responses.
| Introduction |
|---|
|
|
|---|
Methanol toxicity is primarily attributable to its metabolite, formic acid. Formic acid is the toxic metabolite responsible for the metabolic acidosis and visual toxicity observed in human methanol poisoning.5 6 9 Formate has been hypothesized to produce retinal and optic nerve toxicity by disrupting mitochondrial energy production.10 11 In vitro studies have shown that formate inhibits the activity of cytochrome oxidase, the terminal electron acceptor of the mitochondrial electron transport chain involved in adenosine triphosphate (ATP) synthesis.12 13 Inhibition occurs subsequent to the binding of formic acid to the ferric heme iron in cytochrome oxidase, with inhibition constants between 5 and 30 mM.12 13 Permanent visual damage in methanol-intoxicated humans5 and nonhuman primates10 14 has been associated with prolonged exposures (usually longer than 24 hours) to blood formate concentrations in excess of 7 mM. However, very little information is available on the potential for recovery of retinal function after toxic exposure to methanol-derived formate.
Our laboratory has developed a rodent model of methanol intoxication in which formate oxidation is selectively inhibited by treatment with nitrous oxide (N2O). Subanesthetic concentrations of nitrous oxide inactivate the enzyme methionine synthetase, reducing the production of tetrahydrofolate, a necessary cofactor for formate oxidation.14 15 16 17 18 19 This allows formate to accumulate to toxic concentrations after methanol administration.14 15 16 17 18 19 In methanol-intoxicated rats, formic acidemia, metabolic acidosis, and visual toxicity develop, analogous to the toxicity seen in methanol intoxicated humans. Previous studies in our laboratory have established this rodent model of methanol-induced visual toxicity and have documented abnormalities in the flash-evoked visual potential and electroretinogram (ERG).16 17 18 19
The clinical features of methanol intoxication are remarkably similar to those of Lebers hereditary optic neuropathy, nutritional amblyopia, and the recent Cuban epidemic of optic neuropathy. In each case, there is evidence that a common pathophysiological mechanism involving mitochondrial dysfunction contributes to the retinal and optic nerve dysfunction characteristic of the disease.20 21 We hypothesize that the retinal pathophysiology of methanol intoxication is a consequence of formate-induced mitochondrial dysfunction. In this study, we examined the effect of methanol intoxication on retinal function and retinal energy metabolism and assessed the potential for recovery of retinal function after intoxication. Our findings indicate that formate accumulation after methanol intoxication inhibited retinal energy metabolism, increased oxidative stress in the retina, and profoundly attenuated retinal function. These studies also provide evidence for a complete recovery of retinal energy metabolites and a partial recovery of retinal glutathione (GSH) and retinal function in animals allowed to recover for 72 hours from methanol intoxication. Furthermore, our results are indicative of a differential sensitivity of photoreceptors to the cytotoxic actions of formic acid with a partial recovery of rod-dominated responses and no recovery of UV-conemediated responses.
| Methods |
|---|
|
|
|---|
Animals
Adult (250350 g) male LongEvans rats (Harlan
SpragueDawley, Madison, WI) were used throughout the experiments.
Animals were supplied food and water ad libitum and maintained on a
12-hour lightdark schedule in a temperature- and humidity-controlled
environment. All animal experiments were performed in accordance with
the ARVO Statement for the Use of Animals in Ophthalmic and Vision
Research.
Methanol Intoxication Protocol
Rats were placed in a thermostatically controlled plexiglas
chamber (22 x 55 x 22 cm; maintained at 2223°C) and
exposed to a mixture of
N2O/O2 (1:1; flow rate, 2
l/min) for 4 hours before the administration of methanol or saline.
N2O/O2 exposure was
continued for 72 hours after the initial dose of methanol. Two
treatment protocols were used. In the first protocol (intoxication),
rats were intoxicated with methanol (25% wt/vol in saline, 4 g/kg,
intraperitoneally, followed by 2-g/kg supplemental doses at 24 and 48
hours) in the presence of
N2O/O2 for 72 hours. At 72
hours, ERG analysis was performed, animals were killed, and retinal
tissue was prepared for biochemical and histologic analysis. In the
second protocol (recovery), rats were intoxicated with methanol (same
dosage regimen as above) for 72 hours in the presence of
N2O/O2 and allowed to
recover from methanol intoxication for an additional 72 hours in the
absence of N2O/O2. At 144
hours, ERG analysis was performed, animals were killed, and retinal
tissue was prepared for biochemical and histologic analysis. Controls
for these experiments included groups of rats treated with saline and
exposed to N2O/O2 (nitrous
oxide-control), rats treated with methanol, but not exposed to
N2O/O2 (methanol-control),
and untreated rats (untreated-control). Formate concentrations were
determined from tail vein blood samples by fluorometric analysis as
previously described.17
18
ERG Procedures and Analyses
ERG experiments were performed as previously
described.18
The light-stimulation apparatus consisted of
a three-beam optical system.22
All three beams were
derived from tungsten-halide lamps (50 W, 12 V), and beam intensity was
controlled by using neutral-density step filters. Each of the beams
contained a high-speed, computer-driven shutter (Uniblitz; Vincent
Associates, Rochester, NY). One beam had a wavelength computer
controlled by a tunable band-pass filter (Varispec; Cambridge Research
Instruments, Wilmington, DE; half-energy pass-band, 7 nm). The second
beam was used with a short-pass UV filter (half pass, 380 nm) in
experiments designed to isolate UV-cones. The third beam was used as a
chromatic adapting light to suppress responses from rods and M-cones in
the UV-cone isolation experiments. For this purpose, a glass
long-wavelength pass filter (half pass, 590 nm) was used. The three
beams were optically superimposed and focused on the lens to illuminate
a 70° patch of retina in Maxwellian view. Light calibrations were
made with a silicon photodiode (PIN 10 DF; United Detector Technology,
Hawthorne, CA).
ERG recordings were differentially amplified and computer averaged. The amplified signal was processed through a two-stage active narrow band-pass filter, the half voltage of which was 0.2 times the center frequency. To ensure that any transients in the response that occur at the onset of the stimulus pulses were not included in the average, the initiation of signal averaging was delayed by a preset number of stimulus cycles (typically a minimum of 20). The resultant ERG is a noise-free, single-cycle, sinusoidal waveform. The averaged responses were measured (peak-to-trough amplitude) from a calibrated digital oscilloscope display.22
Before ERG analysis, ophthalmoscopic examination confirmed that all eyes were free of lenticular opacities or other gross anomalies. Rats were anesthetized with thiobutabarbital sodium (100 mg/kg, intraperitoneally), positioned in a stereotaxic apparatus (David Kopf, Tujunga, CA), and placed on a heating pad to maintain core body temperature at 37°C. Atropine sulfate (0.05 mg/kg, subcutaneously) was administered to inhibit respiratory tract secretions. The pupil of the eye to be tested was dilated by topical application of 1% atropine sulfate. Methylcellulose was topically applied as a lubricant and to enhance electrical conduction. A circular, silver wire recording electrode was positioned on the cornea, a reference electrode was placed above the eye, and a ground electrode was placed on the tongue. Recordings were obtained under ambient light conditions from cool white fluorescent room lights approximately 100 candelas [cd]/m2 at the rats eye. Flickering stimuli (lightdark ratio, 0.25:0.75) were presented. Responses to 60 successive flashes were averaged for each stimulus condition. At each test wavelength, a minimum of four stimulus intensities, spaced at intervals of 0.3 log units, were presented. The stimulus intensity yielding a 5-µV criterion response was determined by extrapolating between the two intensity points that bracketed the 5-µV response for each animal. All sensitivity measures were made in triplicate. After ERG analysis, anesthetized rats were killed by decapitation, and retinal tissue was prepared for histologic and biochemical analysis. One retina from each animal was prepared for histology, and the other retina was prepared for analysis of retinal energy metabolites and GSH concentrations.
Two experimental protocols were used to evaluate retinal function. (1) The 15-Hz/510-nm ERG response: ERGs were recorded in response to a 15-Hz flickering light at a wavelength of 510 nm over a 3-log-unit range of light intensity. For these studies the unattenuated stimulus (log relative retinal illumination [LRRI], 0) had an irradiance of 25 µW distributed over the 70° patch of illuminated retina. This can be calculated to produce retinal illumination equivalent to approximately 104 scotopic trolands (scot td). These recording conditions disadvantage rods; however, because at least 97% of rat photoreceptors are rods and ERGs are recorded at luminance intensities ranging from 101 to 104 scot td, it is likely that the responses to the 15-Hz/510-nm light are drawn from both rods and medium-wavelength cones (M-cones).23 24 25 (2) 25-Hz/UV ERG response: Cone responses were elicited by a 25-Hz flickering UV light (380-nm cutoff) in the presence of an intense chromatic adapting light (445 µW), which eliminated responses mediated by rods and M-cones.26 Recording conditions were the same as those used by Jacobs et al.26 (except that the intensity of the chromatic adapting light was lower in our studies). In Jacobs et al.,26 complete spectral sensitivity functions were measured in the rat, and it was demonstrated that UV-cone responses are separated from rod and M-cone responses. The 25-Hz/UV ERG responses were recorded over a 1-log-unit range of light intensity. For these studies, the unattenuated stimulus (LRRI, 0) had an irradiance of 12.5 µW distributed over the 70° patch of illuminated retina. By equating the effectiveness of this light to the 510-nm stimulus, we estimate that the unattenuated light produced the equivalent of 102.5 scot td in the rat eye.
Determination of Retinal Energy Metabolites
Retinas were rapidly dissected and frozen in liquid nitrogen.
Frozen retinas were extracted in 2.5% trichloroacetic acid (TCA), the
suspension centrifuged, and the supernatant neutralized with 1.0 M Tris
base. Protein concentrations in the pellet were determined using a
modification of the dye-binding method of Bradford.27
The
neutralized supernatant was assayed for ATP, adenosine diphosphate
(ADP), and adenosine monophosphate (AMP) by the high-performance liquid
chromatography (HPLC) method of Bernocchi et al.,28
using
a system (1090L; Hewlett Packard, Palo Alto, CA) with a diode array
detector and a 3-µm reversed-phase column (15 cm x 4.6 mm;
Supelcosil LC-18; Supelco, Bellefonte, PA). Peak identities were
confirmed by comparison of the peak retention time and peak spectral
characteristics of samples with those of known standards. Quantitative
measurements were made on the basis of the injection of standard
solutions in known concentrations. Metabolite concentrations are
expressed per milligram of protein.
Determination of Retinal GSH Concentrations
Retinas were rapidly dissected and frozen in liquid nitrogen.
Frozen retinas were extracted in 2.5% TCA, the suspension centrifuged,
and the supernatant assayed for GSH. Protein concentrations in the
pellet were determined using a modification of the dye-binding method
of Bradford.27
GSH was assayed by the fluorometric method
of Morkrasch and Teschke,29
using
o-phthalaldehyde. Fluorescence was measured at an excitation
wavelength of 345 nm and an emission wavelength of 425 nm. GSH
concentrations are expressed per milligram of protein.
Histopathologic Analysis
Retinal tissue was prepared for histology as previously
described.18
19
Briefly, eyes were enucleated, hemisected,
and immersed in fixative (2.67% glutaraldehyde in 0.1 M phosphate
buffer at 4°C [pH 7.3]) for 72 hours, then transferred to 4%
sucrose. The anterior segment and vitreous were removed and
full-thickness pieces of eye wall were dissected from the posterior
pole, including the optic nerve. Tissues were postfixed in
phosphate-buffered 2% osmium tetroxide (OsO4),
dehydrated in a graded ethanol series, and embedded in epoxy resin.
Thick sections (1 µm) for light microscopy were stained with
toluidine blue; thin sections for electron microscopy were stained with
uranyl acetate-lead citrate.18
19
Statistical Analysis
All values are expressed as means ± SEM. A one-way
analysis of variance (ANOVA) with Bonferronis test was used to
determine significant differences among groups for blood formate
concentrations, energy metabolites, and GSH concentrations. For ERG
studies, a one-way ANOVA with repeated measures was performed, followed
by Scheffés F procedure. In all cases, the minimum level of
significance was taken as P < 0.05.
| Results |
|---|
|
|
|---|
|
The effects of methanol intoxication and recovery on the 15-Hz/510-nm ERG responses are shown in Figure 2 . In the control group, 15-Hz/510-nm ERG amplitude increased linearly over the 3-log-unit range of retinal illumination intensities, achieving a maximal amplitude of 57.1 ± 3.1 µV at maximal retinal illumination (0 LRRI, equivalent to 104 scot td). A consistent 5-µV criterion threshold response was obtained in control animals at -2.7 ± 0.1 LRRI. We observed a decrease in retinal responsiveness and attenuation of maximal ERG amplitude in both the intoxicated and the recovery groups in comparison with untreated control animals. In intoxicated animals, ERG responses were at or below the 5-µV threshold response over the entire range of luminance intensities, indicative of a severe deficit in retinal function. In animals allowed to recover from intoxication for 72 hours, the 5-µV threshold response was not different from the control group; however, the ERG intensity response curve was significantly attenuated at all light intensities of more than -2.1 LRRI, and the maximal response to light stimulation was reduced to 33.9 ± 5.4 µV. These data are indicative of a partial recovery of this component of retinal function.
|
|
|
|
|
|
| Discussion |
|---|
|
|
|---|
Formic acid has been hypothesized to produce ocular toxicity by a disruption of mitochondrial energy production in the retina and optic nerve.10 11 39 40 In vitro studies in our laboratory and by other investigators have shown that formate inhibits cytochrome oxidase, the terminal electron acceptor of the mitochondrial electron transport chain involved in ATP synthesis.12 13 37 38 Inhibition occurs subsequent to the binding of formic acid with the ferric heme iron of cytochrome oxidase, and the apparent inhibition constant is between 5 to 30 mM.12 13 Blood formate concentrations in methanol-intoxicated rats in the present study fall within this range, as do blood formate concentrations in methanol-poisoned humans and monkeys.5 9 10 Moreover, retinal and vitreous humor formate concentrations closely parallel blood formate concentrations.16 17 Additional in vitro studies in isolated mitochondria and cultured neuronal cells have shown that formate inhibits mitochondrial ATP synthesis and decreases cellular ATP content.36 38 The present studies provide evidence that formate inhibits mitochondrial energy metabolism in vivo. These studies document formate-induced depletion of retinal ATP and ADP and a corresponding increase in retinal AMP after methanol intoxication. After recovery, energy metabolites returned to control concentrations, providing evidence of bioenergetic recovery. These findings strongly support the hypothesis that formate inhibits retinal mitochondrial energy metabolism and oxidative phosphorylation in methanol intoxication and are consistent with the documented actions of formate in isolated mitochondria.12 13 38
The vertebrate retina has several features that render it vulnerable to damage from reactive oxygen species, including abundant mitochondria and a high percentage of polyunsaturated fatty acids in photoreceptor membranes that are susceptible to lipid peroxidation.34 35 Because of its constant exposure to irradiation and high metabolic activity, the retina has a great need for antioxidant protection.34 35 Reduced GSH is one of the most abundant intracellular thiols in the central nervous system and acts as a major cellular antioxidant by supporting GSH peroxidase-dependent reduction of hydrogen peroxide and organic peroxides.31 32 33 GSH is normally present in high concentration in the retina and has been shown to play a key role in antioxidant defenses in the retina.34 35 Studies have shown that retinal GSH may be depleted during periods of oxidative stress.34 35 In the present studies, we observed a significant reduction in retinal GSH concentrations after methanol intoxication. Moreover, in contrast to our findings with energy metabolites, GSH concentrations did not return to control concentrations after recovery. We hypothesize that the observed depletion of retinal GSH is a consequence of formate-induced mitochondrial inhibition. Depletion of GSH by formate could result directly from formate-induced peroxidative stress, because inhibition of mitochondrial electron transport has been shown to profoundly increase the production of reactive oxygen species including superoxide and hydrogen peroxide.31 32 33 Alternatively, GSH depletion could occur as a consequence of formate-induced ATP depletion, because GSH synthesis is ATP dependent.31 32 33 In support of the latter mechanism, studies in cultured hepatocytes have shown that inhibition of cellular energy metabolism and ATP synthesis by mitochondrial poisons lead to a rapid decline in GSH content that precedes cell death by several hours.31
Additional studies are under way to determine the mechanism of formate-induced GSH depletion. Because of the critical involvement of GSH in cellular defense mechanisms, depletion of intracellular GSH under conditions of mitochondrial impairment may augment the susceptibility of the retina to oxidative stress. Thus, formate-induced mitochondrial inhibition may not only increase the production of reactive oxygen species, but may also predispose the retina to increased oxidative stress through a perturbation of GSH status. A similar mechanism of tissue injury has been proposed to lead to neuronal degeneration in Parkinsons disease.31
The morphologic changes in the present study are also consistent with formate-induced inhibition of photoreceptor energy metabolism, GSH depletion, and increased oxidative stress. The most profound ultrastructural alterations observed in methanol-intoxicated rats were mitochondrial swelling and disruption in the inner segments of the photoreceptor cells. Similar mitochondrial changes have been associated with the production of GSH deficiency after inhibition of GSH synthesis with buthionine sulfoximine.32 GSH plays a major role in the maintenance of mitochondrial function.31 32 33 Reduction in cytosolic and mitochondrial GSH has been shown to increase mitochondrial susceptibility to oxidative stress, disrupt mitochondrial structure and function, and promote cytotoxicity.32 33 In addition, mitochondrial disruption has also been reported in the retinas of patients with mitochondrial diseases that inhibit electron transport41 42 43 and in certain forms of light-induced retinal degeneration in which inactivation of cytochrome oxidase is postulated to play a role in the disease.44 45 46
The present studies confirm and extend our previous investigations that showed that rod- and cone-mediated ERG responses were profoundly attenuated in rats intoxicated with methanol for 72 hours.14 We also observed a differential recovery of retinal function after methanol intoxication. In rats allowed to recover for 72 hours from methanol intoxication, there was a significant, although incomplete recovery of the 15-Hz/510-nm ERG response. In contrast, there was no evidence of recovery of UV-conemediated function. The rat retina contains three types of photoreceptors, rods, M-cones, and UV-cones.24 25 26 Rods comprise approximately 97% of rat photoreceptors.24 25 26 Although our recording conditions can clearly discriminate UV-cone function, the 15-Hz/510-nm ERG measurements cannot discriminate between rod and M-cone function. In the absence of a definitive assessment of M-cone function, it is unknown whether the observed sensitivity to the cytotoxic actions of formate is specific for UV-cones or reflects a general property of cones. However, it is clear that UV-cone responses are more severely affected after methanol intoxication than rod and M-cone responses.
Previous studies have shown that rod-dominated retinal responses are affected earlier in the course of intoxication and at lower formate concentrations than the UV-conemediated responses. Taken together, these data suggest that although UV-cones may be resistant to the initial cytotoxic actions of formate,18 once poisoned, they do not recover, or their recovery is delayed. These findings have important implications. In cases of human methanol intoxication, the most common outcome is loss of central, but not peripheral, vision. This has been attributed to the loss of central fibers in the optic nerve.10 11 However, the present findings raise the possibility that the loss of central vision may also involve the loss of cone function, because the density of cones is greatest in the central retina. One potential explanation for the initial resistance and subsequent vulnerability of UV-cone photoreceptors to the toxic actions of formate may be the greater numbers of mitochondria present in cones in comparison with rods.47 We have previously postulated that cones have a greater metabolic reserve, allowing them to continue to function for a longer period in the presence of a metabolic toxin, to explain the delayed attenuation of UV-cone function relative to rod-dominated function.18 It is also likely that prolonged metabolic inhibition in cells containing many mitochondria could generate excessive amounts of reactive oxygen species, overwhelming antioxidant protection systems and resulting in cell death.48 Of importance, because decrements in retinal energy production and oxidative stress have been postulated to be involved in the pathogenesis of numerous retinal diseases including age-related macular degeneration and diabetic retinopathy, studies of formate-induced retinal dysfunction may provide valuable insight into the pathogenesis of other acquired and genetic retinal disorders.
| Acknowledgements |
|---|
| Footnotes |
|---|
Submitted for publication April 17, 2000; revised October 2, 2000; accepted October 26, 2000.
Commercial relationships policy: N.
Corresponding author: Janis T. Eells, Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226. jeells{at}mcw.edu
| References |
|---|
|
|
|---|
B: studies with isolated mitochondria and rat hepatocytes Mol Pharmacol 48,825-834[Abstract]
This article has been cited by other articles:
![]() |
R. P. Hanzlik, S. C. Fowler, and J. T. Eells ABSORPTION AND ELIMINATION OF FORMATE FOLLOWING ORAL ADMINISTRATION OF CALCIUM FORMATE IN FEMALE HUMAN SUBJECTS Drug Metab. Dispos., February 1, 2005; 33(2): 282 - 286. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. L. Treichel, M. M. Henry, C. M. B. Skumatz, J. T. Eells, and J. M. Burke Antioxidants and Ocular Cell Type Differences in Cytoprotection from Formic Acid Toxicity in Vitro Toxicol. Sci., November 1, 2004; 82(1): 183 - 192. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. P. Vrabec, C. J. Lieven, and L. A. Levin Cell-Type-Specific Opening of the Retinal Ganglion Cell Mitochondrial Permeability Transition Pore Invest. Ophthalmol. Vis. Sci., June 1, 2003; 44(6): 2774 - 2782. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. T. Eells, M. M. Henry, P. Summerfelt, M. T. T. Wong-Riley, E. V. Buchmann, M. Kane, N. T. Whelan, and H. T. Whelan Therapeutic photobiomodulation for methanol-induced retinal toxicity PNAS, March 18, 2003; 100(6): 3439 - 3444. [Abstract] [Full Text] [PDF] |
||||
![]() |
C Cursiefen and A Bergua Acute bilateral blindness caused by accidental methanol intoxication during fire "eating" Br. J. Ophthalmol., September 1, 2002; 86(9): 1064 - 1065. [Full Text] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |