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1From the Departments of Pathology, and 3Ophthalmology and 2The Arnold and Mabel Beckman Macular Research Center at the Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California; and the 4Mt. Zion Cancer Research Institute, University of California San Francisco, San Francisco, California.
| Abstract |
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METHODS. Resting limbal vessel surface area and density and extent of bFGF-induced corneal angiogenesis were determined in C57BL/6J, BALB/cJ, F1 intercross
C57BL/6J X 129S3/SvIM, and 129S3/SvIM mouse strains by quantitative three-dimensional reconstruction confocal microscopy. Strain-related influences on pro- and antiangiogenic gene expression in naïve cornea were determined by quantitative real-time RT-PCR.
RESULTS. The strain-dependent rank order of resting limbal vessel surface area and resting vessel density paralleled bFGF-induced neovascularization: 129S3/SvIM > BALB/cJ, F1 > C57BL/6J (P < 0.0006). Pigment epitheliumderived factor (PEDF) was increased more than 67-fold compared to Ang-2 in resting cornea of both C57BL/6J and 129S3/SvIM strains (P < 0.0001; P < 0.0001), suggesting a strongly antiangiogenic environment. The corneas of the C57BL/6J mice demonstrated 1.8-, 1.5-, and 1.7-fold increased mRNA levels for Flt-1, VEGF, and bFGF, respectively (P < 0.02; P < 0.04; P < 0.02); however, TSP-1 expression was increased 2.4-fold compared with 129S3/SvIM (P < 0.0004).
CONCLUSIONS. Strain-dependent differences in the resting limbal vessel surface area and density correlated with heterogeneity in the extent of bFGF-induced angiogenesis. Differences in pro- and antiangiogenic gene expression levels in resting cornea may influence vascular limbal phenotype during quiescence and may predict susceptibility to angiogenesis-dependent diseases.
Genetic factors have been implicated in the progression of many angiogenesis-dependent diseases. In patients with diabetes, Mexican American populations have increased risk for PDR compared with non-Hispanic whites after controlling for duration and management of diabetes.7 Among those with AMD, vision loss due to choroidal neovascularization is more prevalent in white than in black populations, suggesting a genetic component.8 Experiments using inbred mouse strains in a corneal micropocket assay indicate that the heterogeneity in the extent of angiogenesis in response to exogenous growth factor may be determined by genetic factors.9 10
Angiogenesis is defined as the growth of new vessels from preexisting ones. Thus, genetic factors that determine strain-dependent differences in angiogenic vessels may also influence differences in the resting vasculature from which new vessels are derived. The normally avascular cornea provides an ideal environment to study strain-related influences in the resting limbal vessels and to correlate findings with strain-related differences after angiogenic stimuli. Normally confined to the circumferential periphery to maintain optical clarity, the blood supply to the cornea arises from the ciliary arteries that divide and terminate in the pericorneal plexus in the limbal area.1 When corneal neovascularization occurs, new vessels form from capillaries and venules of the limbal plexus.11 12 We evaluated the strain dependence of resting vessel surface area and resting vessel density in the normal limbus of naïve mice previously reported to have divergent responses to VEGF- and bFGF-induced angiogenesis.9 10 Strain-related influences on gene expression were then determined in naïve cornea from mouse strains with low (C57BL/6J) and high (129S3/SvIM) resting vessel surface area and density.
| Methods |
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C57BL/6J X 129S3/SvIM (F1 cross, pigmented: dark brown). All experiments were performed in accordance with the USC Animal Care and Use Committee and the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research.
Corneal Angiogenesis Assay
A murine corneal neovascularization assay was used to assess in vivo angiogenesis, as described previously.13 In this model, the normally avascular cornea is vascularized from the adjacent limbal vessels when stimulated by bFGF. Briefly, weight- and age-matched adult male mice were anesthetized with ketamine (160 mg/kg) and xylazine (8 mg/kg). A midline keratotomy was made with a breakable surgical blade (Electron Microscopy Sciences, Fort Washington, PA) and a corneal pocket dissected out toward the limbal vessels using an angled corneal knife (Surgical Specialties Corp., Reading, PA). A slow-release sucralfate-hydron polymer NCC (Hydro Med Sciences, Cranbury, NJ) pellet (0.4 x 0.4 mm) containing 75 ng bFGF or saline was implanted 1.0 mm from the limbus. A polymyxin B-bacitracin ointment (Akorn, Inc., Buffalo Grove, IL) was immediately applied to the eye after the procedure. Periodic corneal examinations and photography was performed using a slit lamp (Carl Zeiss Meditec, Oberkochen, Germany) with an attached 35-mm camera (Contax; Kyocera, Meerbusch, Germany). On postoperative day 7, mice were prepared for quantification of corneal neovascularization.
Confocal Microscopic Quantification of Integrated Intravascular Surface Area
Resting limbal vessels and bFGF-induced corneal neovascularization were quantified in the same manner by confocal microscopy. Mice (both nonsurgical and postprocedure day 7) were anesthetized and the femoral vein dissected and injected intravenously with 200 µg endothelium-specific, FITC-conjugated Griffonia simplicifolia lectin I (GSLI; Vector Laboratories, Burlingame, CA).14 After 30 minutes, the mice were killed and the eyes enucleated and fixed in 4% paraformaldehyde overnight at 4°C. The conjunctiva, iris, and ciliary body were dissected from the cornea. Radial incisions were made to facilitate flatmounting of the specimens. Confocal microscopy scanning (2.5x objective) was performed through the entire thickness of the vascularized cornea at 10-µm scanning plane intervals (Carl Zeiss Meditec). Integrated vascular surface area to determine implicit vascular volume was obtained by three-dimensional (3-D) reconstruction and analysis of planar confocal visual slices (LSM 510) using the microscopes 3D software (3D for LSM510; Carl Zeiss Meditec). Units for implicit volume were designated "volsurfarea" (in square micrometers) by the microscopes software and were reported as the mean ± SEM.
Limbal Vessel Density Quantification
To determine limbal vessel density in the resting, unstimulated vasculature, nonsurgically altered corneas were evaluated by fluorescence microscopy after they were labeled with endothelium-specific, FITC-conjugated GSLI. For each cornea, the number of primary and secondary vessel branches was summed for three random fields of view (10x objective, 0.8-mm2 area). Values reported represent the mean number of vessel branches ± SEM.
Relative Quantitative Real-Time RT-PCR
Relative quantitative expression of mRNA in the normal naïve adult cornea was evaluated using real-time RT-PCR. Both corneas from each animal were pooled to isolate total RNA. RNA extraction reagent (TRIzol; Invitrogen Life Technologies, Carlsbad, CA) was used to isolate RNA, and the contaminating genomic DNA was removed with a kit (DNA-free; Ambion, Austin, TX). Reverse transcription was performed using 1 µg total RNA, oligo(dT)15 primer (Promega Corp., Madison, WI), and AMV reverse transcriptase (Promega). Real-time PCR reactions were performed in triplicate with a sequence detection system (GeneAmp 5700; Applied Biosystems, Foster City, CA). Each 25
PCR reaction contained cDNA template, SYBR Green PCR Master Mix (Applied Biosystems), and 167 nM gene-specific primers. Reaction conditions were as follows: 50°C for 2 minutes, 95°C for 10 minutes, and 40 cycles of denaturation at 95°C for 15 seconds with annealing and extension at 60°C for 1 minute. Ribosomal L-32 was used as a reference (housekeeping) gene.
Angiogenic factors studied were vascular endothelial growth factor (VEGF), VEGF receptors Flt-1 and Flk-1, and VEGF coreceptor neuropilin-1 (NPL); angiopoietin-1 (Ang-1) and -2 (Ang-2) and Ang receptor Tie-2; and basic fibroblast growth factor (bFGF). The antiangiogenic growth factors studied were pigment epitheliumderived factor (PEDF) and thrombospondin-1 (TSP-1). The following primer sets were designed on computer (Primer Express software; Applied Biosystems): L-32 5'-TGGTTTTCTTGTTGCTCCCATA-3' and 5'-GGGTGCGGAGAAGGTTCAA-3'; VEGF 5'-CATCTTCAAGCCGTCCTGTGT-3' and 5'-CTCCAG-GGCTTCATCGTTACA-3'; NRP 5'-CAGAGTTCCCGACATACGGTTT-3' and 5'-TCCCAGTGGCAGAATGTCTTG-3'; Flt-1 5'-CGGCTGTCCATGAAAGTGAA-3' and 5'- TTGCAGGCGAGCCATCTT-3'; Flk-1 5'-ACTGCAGTGATTGCCATGTTCT-3' and 5'- CCTTCATTGGCCCGCTTAA-3'; Ang-1 5'-CAGCAGCAAGTGGTTATGTCATG-3' and 5'-TTGACCTCAGAAGGCTCCAAA-3'; Ang-2 5'-GACTTCCAGAGGACGTGGAAAG-3' and 5'-CTCATTGCCCAGCCAGTACTC-3'; Tie2 5'-CATCCCTCACCTG-CATTGC-3' and 5'-GCTTCAAAGTCCCTTCCTATGGT-3'; bFGF 5'-CCCACCAGGCCACTTCAA-3' and 5'-GATGGATGCGCAGGAAGAA-3'; PEDF 5'-CACCCGACTTCAGCAAGATTACT-3' and 5'-TCGAAAGCAGCCCTGTGTT-3'; and TSP-1 5'-ACTACGCTGGCTTTGTATTC-3' and 5'-GGACT-GGGTGACTTGTTTCC-3'. Detection of product formation was set in the center of the linear portion of PCR amplification. The cycle at which each reaction reached the set threshold (CT) was determined. Amplification efficiencies between primer pairs for genes of interest compared with that for the L-32 reference gene was evaluated by amplifying a dilution range of cDNA template. A plot of
CT on the y-axis and log (cDNA) on the abscissa generated a linear curve with slope < 0.01, verifying comparable primer pair amplification efficiencies between L-32 and genes of interest. To assess relative abundance of genes expressed in the cornea, comparable primer pair efficiencies were also determined for all permutations between genes of interest in comparison with each other. Relative multiples of change in mRNA expression were determined by calculation of 
CT.15 Results are reported as mean difference in relative multiples of change in mRNA expression ± SEM.
Statistical Analysis
All statistical analyses were performed using SAS (SAS Institute, Cary, NC). Values reported in figures represent mean ± SEM. Each eye was treated as an independent event for statistical analysis of corneal vessels. The Shapiro-Wilk statistic was used to test for normality of the measurements within each group. If one or more of the groups were found to follow a non-normal distribution, nonparametric statistics were used. For nonparametric distributions, The Kruskal-Wallis test was used to determine overall differences between groups, and Wilcoxon rank sum was used to test for differences between two groups. For normal distributions, parametric tests used were analysis of variance and paired t-tests. For gene expression data, comparisons between groups were made using independent t-tests for equal or unequal variances. Accepted level of significance for all tests was
= 0.05.
| Results |
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C57BL/6J X 129S3/SvIM; n = 8) mice. Inbred mouse strains were chosen to represent previously reported similarly divergent responders to both bFGF and VEGF.9 10 A dose of 75 ng bFGF was used because data produced in our laboratory (not shown) and those reported by others showed a maximum neovascular response in the C57BL/6J strain (a low angiogenic responder) at this dose.9 On day 7 after bFGF pellet implantation, strain-dependent induction of angiogenesis from the limbus across a previously avascular cornea toward the bFGF pellet was assessed (Fig. 1) . All eyes implanted with bFGF pellets demonstrated a neovascular response. For all eyes implanted with saline pellets, no angiogenic response was observed (data not shown). Among animals evaluated, the most exuberant neovascular response was observed in the 129S3/SvIM strain and the least extensive in C57BL/6J (Fig. 1A) mice. Intermediate responses were seen in BALB/cJ and F1 cross-bred animals. Vessels induced in the 129S3/SvIM strain were longer and more dense and formed a more extensive network across the cornea that those in C57BL/6J mice. Neovascularization in the C57BL/6J and F1 genetic backgrounds was decreased 1.7- and 1.4-fold, respectively, compared with the 129S3/SvIM strain (P < 0.01; P < 0.009); BALB/cJ was increased 1.4-fold compared with C57BL/6J (P < 0.02). Overall, bFGF-induced angiogenesis resulted in the following strain-dependent rank order: 129S3/SvIM > BALB/cJ, F1 > C57BL/6J (Kruskal-Wallis, P < 0.0002).
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In contrast, the proangiogenic genes were expressed at relatively lower levels. Both inbred strains demonstrated low expression of Ang-1 and -2 and their receptor Tie2; however, no strain-related differences were seen. When members of this group were compared, Ang-1 and Tie2 decreased more than 5- and 27-fold, respectively, compared with Ang-2 in both inbred strains (P < 0.0001; P < 0.0001). Similarly, bFGF was expressed at extremely low levels in both C57BL/6J and 129S3/SvIM; however, when compared, expression was increased 1.7-fold in C57BL/6J compared with 129S3/SvIM (P < 0.02). VEGF was expressed in resting limbal vessels at levels similar to those in Ang-2; however, VEGF was increased 1.5-fold in C57BL/6J compared with 129S3/SvIM (P < 0.04). The VEGF receptor Flt-1 was also increased 1.8-fold in C57BL/6J compared with 129S3/SvIM (P < 0.02). No strain-related differences in gene expression were observed in NRP or Flk-1.
| Discussion |
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We then demonstrated that the strain-related rank order for summed vascular surface area of resting limbal vessels (129S3/SvIM > BALB/cJ, F1 > C57BL/6J; P < 0.0002) was identical with the strain-related rank order found for bFGF- or VEGF-induced corneal neovascularization reported herein for bFGF and previously for both growth factors.9 10 These results suggest that the heterogeneity in the extent of resting vessels is associated with, and may potentially predict, the heterogeneity of the extent of angiogenic vessels.
An interesting finding was that C57BL/6J (36.5) had a higher ratio of angiogenic-to-resting vessel surface area than did 129S3/SvIM (5.5; P < 0.01). However, the total vessel surface area after stimulation with bFGF remained lower than that in the 129S3/SvIM strain before normalization for resting vessel surface area. This suggests that the amount of preexisting resting vessels before angiogenic stimuli may be a factor that limits new vessel formation but remains an important contribution to the extent of angiogenesis produced.
The low variation in phenotype for resting vessels and vessel density observed in the F1
C57BL/6J X 129S3/SvIM intercross suggests that genetic influences on the extent of resting vessels (as with other complex physiologic and pathologic processes) likely follow polygenic inheritance patterns.10 Characterization of gene expression in naïve corneas revealed a prominent expression of antiangiogenic genes. Whereas no strain-related differences were observed in PEDF expression in naïve cornea specimens, mRNA levels were increased more than 67-fold compared with Ang-2 in both C57BL/6J and 129S3/SvIM mice (P < 0.0001; P < 0.0001). In addition, TSP-1 expression was increased more than 15.8- and 6.6-fold in C57BL/6J and 129S3/SvIM compared with Ang-2 (P < 0.0001). High expression of angiogenic inhibitors is consistent with the primarily avascular phenotype in the cornea. Moreover, TSP-1 mRNA levels were increased 2.4-fold in C57BL/6J compared with 129S3/SvIM mice (P < 0.0004). Resting vessels in the 129S3/SvIM strain demonstrated decreased levels of TSP-1 expression compared with C57BL/6J, consistent with observations that TSP-1 null mice showed increased vessel densities in both the dermis and pancreatic islets.16 Thus, the decreased expression of TSP-1 in 129S3/SvIM mice may explain their higher resting vascular densities and the greater extent of angiogenesis that follows after exogenous proangiogenic growth factor stimulation. Clinical observations have reported that decreased levels of angiogenic inhibitors in aqueous humor of diabetic patients is predictive of progression of diabetic retinopathy.17
Proangiogenic growth factors were expressed at much lower levels in both strains than were PEDF or TSP-1. Ang-1 and -2 and their receptor Tie-2 were all expressed at low levels and no strain-related differences were seen. The relative level of Ang-1 (5-fold; P < 0.0001) and Tie2 (>27-fold; P < 0.0001) was decreased compared with Ang-2 in both strains, consistent with similar relative expression levels reported in normal prostate.18 The proangiogenic factor bFGF, also expressed at very low levels, increased (1.5-fold, P < 0.04) in resting vessels of C57BL/6J compared with 129S3/SvIM mice. In addition, expression of both VEGF and its receptor Flt-1 were increased in C57BL/6J compared with 129S3/SvIM mice (P < 0.02), whereas no differences were seen in expression of Flk-1 or neuropilin. The relatively increased but low expression of several proangiogenic growth factors in C57BL/6J resting vessels may explain why this less-vascular strain showed a higher change in neovascular area after angiogenic stimulation (although it never achieved the extent of angiogenesis found in 129S3/SvIM mice). During angiogenesis, bFGF-induced upregulation of Flk-1 protein, and mRNA expression has been reported.19 After angiogenic stimuli, already elevated levels of bFGF and VEGF in resting vessels of C57BL/6J mice may potentiate synergistic effects between bFGF and VEGF signaling, resulting in an increased ratio of angiogenic-to-resting vessel surface area formation compared with 129S3/SvIM.
TSP-1 expression is found in corneal endothelium, whereas PEDF is expressed in both normal corneal epithelium and endothelium.20 21 The relative abundance of angiogenic inhibitors compared with proangiogenic factors is consistent with the fact that the cornea is largely avascular. Very high levels of PEDF expression compared with angiogenic stimulators (>67-fold) in the normal cornea may explain the permissive effects on angiogenesis with inhibition of PEDF in the cornea.22 Because TSP-1 levels were also highly increased compared with those of all angiogenic stimulators evaluated in the naïve cornea (although not as elevated as those of PEDF levels), inhibition of TSP-1 expression may also provide a permissive environment for angiogenesis.
Identification of single nucleotide polymorphisms (SNPs) which correlate with functional differences in gene expression and or vessel phenotype may provide valuable insight toward predicting susceptibility to a spectrum of angiogenesis-dependent diseases. Studies have reported SNPs in PEDF and TSP-1 genes that have been implicated in increased risk for ocular and coronary disease.23 24 Among healthy individuals, differences in VEGF mRNA expression and protein levels have been associated with SNPs in the 3' untranslated region of the VEGF gene.25 26
This study presents evidence that genetic influences may determine both phenotype of resting vessels and molecular equilibrium between angiogenic stimulators and inhibitors in their environment that could provide a blueprint for prognostic and preventive therapies toward angiogenesis-dependent diseases.
| Acknowledgements |
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| Footnotes |
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Submitted for publication August 11, 2003; revised October 7, 2003; accepted October 17, 2003.
Disclosure: C.K. Chan, None; L.N. Pham, None; C. Chinn, None; C. Spee, None; S.J. Ryan, None; R.J. Akhurst, None; D.R. Hinton, None
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: David R. Hinton, Departments of Pathology and Ophthalmology, University of Southern California, Keck School of Medicine, 2011 Zonal Avenue, HMR 209, Los Angeles, CA 90033; dhinton{at}usc.edu.
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