Ocular-specific ER stress reduction rescues glaucoma in murine glucocorticoid-induced glaucoma

J Clin Invest. 2014 May;124(5):1956-65. doi: 10.1172/JCI69774. Epub 2014 Apr 1.

Abstract

Administration of glucocorticoids induces ocular hypertension in some patients. If untreated, these patients can develop a secondary glaucoma that resembles primary open-angle glaucoma (POAG). The underlying pathology of glucocorticoid-induced glaucoma is not fully understood, due in part to lack of an appropriate animal model. Here, we developed a murine model of glucocorticoid-induced glaucoma that exhibits glaucoma features that are observed in patients. Treatment of WT mice with topical ocular 0.1% dexamethasone led to elevation of intraocular pressure (IOP), functional and structural loss of retinal ganglion cells, and axonal degeneration, resembling glucocorticoid-induced glaucoma in human patients. Furthermore, dexamethasone-induced ocular hypertension was associated with chronic ER stress of the trabecular meshwork (TM). Similar to patients, withdrawal of dexamethasone treatment reduced elevated IOP and ER stress in this animal model. Dexamethasone induced the transcriptional factor CHOP, a marker for chronic ER stress, in the anterior segment tissues, and Chop deletion reduced ER stress in these tissues and prevented dexamethasone-induced ocular hypertension. Furthermore, reduction of ER stress in the TM with sodium 4-phenylbutyrate prevented dexamethasone-induced ocular hypertension in WT mice. Our data indicate that ER stress contributes to glucocorticoid-induced ocular hypertension and suggest that reducing ER stress has potential as a therapeutic strategy for treating glucocorticoid-induced glaucoma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology
  • Dexamethasone / adverse effects*
  • Dexamethasone / pharmacology
  • Disease Models, Animal
  • Endoplasmic Reticulum Stress / drug effects*
  • Endoplasmic Reticulum Stress / genetics
  • Gene Deletion
  • Glaucoma, Open-Angle / chemically induced
  • Glaucoma, Open-Angle / genetics
  • Glaucoma, Open-Angle / metabolism*
  • Glaucoma, Open-Angle / pathology
  • Glaucoma, Open-Angle / prevention & control
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / pharmacology
  • Humans
  • Mice
  • Mice, Transgenic
  • Phenylbutyrates / pharmacology
  • Trabecular Meshwork / metabolism*
  • Trabecular Meshwork / pathology
  • Transcription Factor CHOP / genetics
  • Transcription Factor CHOP / metabolism

Substances

  • Antineoplastic Agents
  • Ddit3 protein, mouse
  • Glucocorticoids
  • Phenylbutyrates
  • Transcription Factor CHOP
  • Dexamethasone
  • 4-phenylbutyric acid