Estrés oxidativo en el glaucoma primario de ángulo abierto. Prevención de la ceguera por glaucoma.

RESUMEN Con este estudio hemos pretendido demostrar que los mecanismos de estrés oxidativo y nitrosativo están relacionados con el glaucoma primario de ángulo abierto (GPAA), y que los neurotransmisores están implicados en las señales que relacionan la hipertensión ocular (HTO) con la muerte por apoptosis de las células ganglionares de la retina y la pérdida subsecuente de las fibras del nervio óptico, lo que conduce a la atrofia óptica y a la ceguera glaucomatosa. Este estudio de casos y controles lo hemos realizado en muestras de humor acuoso y plasma de sujetos con glaucoma primario de ángulo abierto y sujetos con cataratas no patológicas (grupo comparativo), seleccionados de entre aquellos que acudieron a las consultas de oftalmología del Hospital Universitario Dr. Peset (Valencia), Centro de Especialidades de Monteolivete (Valencia) y Hospital Punta de Europa (Algeciras). A cada individuo se le realizó un examen oftalmológico completo (presión intraocular, agudeza visual, fondo de ojo, campo visual y análisis de fibras nerviosas por GDx). Se evaluó el estrés oxidativo mediante la determinación del malonildialdehído (MDA, producto de la peroxidación lipídica), la determinación de la actividad antioxidante de las enzimas superóxido dismutasa (SOD) y glutation peroxidasa (GPx) y la determinación del estado antioxidante total (AOXT). El estrés nitrosativo mediante la determinación de la concentración total de óxido nítrico (ON). Los niveles de serotonina (5-HT) y su principal metabolito (ácido 5-hidroxiindolacético, 5-HIAA) se determinaron por HPLC; y la expresión de la proteína poli (ADP-ribosa) polimerasa-1 (PARP1) mediante western blot e immunoblotting. Los niveles de MDA, SOD, GPx y ON resultaron superiores significativamente en el grupo de sujetos con glaucoma respecto al grupo de cataratas. El estado antioxidante total observado en el grupo glaucoma fue significativamente inferior al observado en el grupo cataratas. Se observó una disminución en los niveles de 5-HT en los sujetos con glaucoma frente a los sujetos con cataratas, aunque la diferencia no fue significativa; y un aumento significativo en los niveles de 5-HIAA en el grupo glaucoma frente al grupo cataratas. Por último, la expresión de PARP1 resultó significativamente superior en el grupo de sujetos con glaucoma respecto al de sujetos con cataratas. Hemos demostrado un aumento del estrés oxidativo y del estrés nitrosativo en el glaucoma primario de ángulo abierto frente a las cataratas. La serotonina y su metabolito actúan facilitando la alteración de la homeostasis del humor acuoso en pacientes con glaucoma, permitiendo el aumento de la presión intraocular. El aumento de la expresión de la proteína poli (ADP-ribosa) polimerasa-1 demuestra que en el glaucoma se produce un aumento de la muerte por apoptosis de las células, tanto de las células de la malla trabecular y de las células ganglionares de la retina. Las moléculas analizadas en el presente estudio podrían ser utilizadas como marcadores de la progresión de la enfermedad glaucomatosa, facilitando el control de la misma y, de este modo, frenando la progresión hacia la ceguera irreversible. __________________________________________________________________________________________________The aim of this study is to demonstrate that oxidative and nitrosative stress mechanisms are related to primary open-angle glaucoma (POAG) and that neurotransmitters are involved with the signals that linked the ocular hypertension (OHT) with the retinal ganglion cell death by apoptosis and the loss of optic nerve fibers, which lead to optic atrophy and glaucomatous blindness. This case-control study has been carried out in aqueous humor and plasma samples of subjects with POAG and subjects with non-pathological cataracts (comparative group), selected from Dr. Peset University Hospital (Valencia), Monteolivete Specialities Centre (Valencia) and Punta de Europa Hospital (Algeciras). Oxidative stress has been tested by means the malodialdehyde determination (MDA, a product of lipid peroxidation), the antioxidant activity determination of superoxide dismutase (SOD) and glutatión peroxidase (GPx) enzymes and the total antioxidant status assay (TAS). Nitrosative stress has been evaluated by analyzing the total nitric oxide concentration (ON). Serotonin (5-HT) and hydroxiindolacetic acid (5-HIAA) levels have been determined by HPLC. Finally, the expression of poly (ADP-ribose) polymerase-1 (PARP1) has been tested by western blot and immunoblotting. We have demonstrated with this study an increase of oxidative and nitrosative stress in POAG subjects with respect to cataracts subjects. Serotonin and its metabolite act facilitating the alteration of the homeostasis of the aqueous humor in glaucoma patients, leading to an increase in intraocular pressure. Results of PARP1 expression prove that there is an increase of cell death by apoptosis in primary open-angle glaucoma. The molecules tested in this study may be used as markers of glaucoma progression and might help us to prevent the glaucomatous blindness

Efficacy and safety study of an eyelid gel after repeated nocturnal application in healthy contact lens users and non-users

Purpose: To evaluate skin biocompatibility of a nighttime hydrating eyelid gel and possible ocular surface effects in contact lens users (CLU) and non-contact lens users (NCLU). The formulation is registered as a medical device as Tridocosahexaenoine-AOX® (TDHA-AOX) (a concentrated DHA triglyceride), containing also hyaluronic acid (HA). Methods: A prospective, randomized, masked clinical trial was performed with 62 participants of both sexes, aged 20–70 years, split into: (1) CLU (n = 30) and (2) NCLU (n = 32). All participants were instructed to apply a single dose of the moisturizing gel (containing TDHA-AOX and HA) nightly to the upper and inner eyelids of their right eye (RE) only, and during 2 consecutive weeks. Personal interviews, questionnaires, ophthalmic examinations and reflex tear collection were performed. Ophthalmological parameters included ocular surface response and contact lens status. Levels of satisfaction/adverse events were also recorded. Biochemical parameters included basal and final determination of pro-inflammatory mediator molecules in tear samples by multiplex analyses. Statistics were done by the SPSS 24.0 program. Results: The CLU group had higher OS dysfunction than NCLU, but overall clinical parameters (corneal staining, and Schirmer/FBUT tests) and OSDI scores showed significant improvement in CLU individuals as compared to the NCLU participants, at the end of study. CLDEQ-8 scores pinpointed significant amelioration in initial risk of developing DEs by applying eyelid gel. Multiplex analyses demonstrated significantly lower VEGF expression levels (p < 0,05) in tears among the CLU compared to NCLU after nightly application of eyelid gel. Conclusions: Eyelid gel appeared to safely and efficiently provide hydration and decongestion of the skin and amelioration of the ocular surface during sleep

Computational analysis of clinical and molecular markers and new theranostic possibilities in primary open-angle glaucoma

Primary open-angle glaucoma (POAG) is a paramount cause of irreversible visual disability worldwide. We focus on identifying clinical and molecular facts that may help elucidating the pathogenic mechanisms of the disease. By using ophthalmological approaches (biomicroscopy, ocular fundus, optical coherence tomography, and perimetry) and experimental tests (enzyme-linked immunosorbent assay (ELISA), high performance liquid chromatography (HPLC), and Western blot/immunoblotting) directed to evaluate the oxidative stress, inflammation, apoptosis, and neurodegeneration processes, we gather information to build a network of data to perform a computational bioinformatics analysis. Our results showed strong interaction of the above players and its downstream effectors in POAG pathogenesis. In conclusion, specific risk factors were identified, and molecules involved in multiple pathways were found in relation to anterior and posterior eye segment glaucoma changes, pointing to new theranostic challenges for better managing POAG progression

Genome-Wide Association Study for Serum Omega-3 and Omega-6 Polyunsaturated Fatty Acids: Exploratory Analysis of the Sex-Specific Effects and Dietary Modulation in Mediterranean Subjects with Metabolic Syndrome.

Many early studies presented beneficial effects of polyunsaturated fatty acids (PUFA) on cardiovascular risk factors and disease. However, results from recent meta-analyses indicate that this effect would be very low or nil. One of the factors that may contribute to the inconsistency of the results is that, in most studies, genetic factors have not been taken into consideration. It is known that fatty acid desaturase (FADS) gene cluster in chromosome 11 is a very important determinant of plasma PUFA, and that the prevalence of the single nucleotide polymorphisms (SNPs) varies greatly between populations and may constitute a bias in meta-analyses. Previous genome-wide association studies (GWAS) have been carried out in other populations and none of them have investigated sex and Mediterranean dietary pattern interactions at the genome-wide level. Our aims were to undertake a GWAS to discover the genes most associated with serum PUFA concentrations (omega-3, omega-6, and some fatty acids) in a scarcely studied Mediterranean population with metabolic syndrome, and to explore sex and adherence to Mediterranean diet (MedDiet) interactions at the genome-wide level. Serum PUFA were determined by NMR spectroscopy. We found strong robust associations between various SNPs in the FADS cluster and omega-3 concentrations (top-ranked in the adjusted model: FADS1-rs174547, p = 3.34 × 10-14; FADS1-rs174550, p = 5.35 × 10-14; FADS2-rs1535, p = 5.85 × 10-14; FADS1-rs174546, p = 6.72 × 10-14; FADS2-rs174546, p = 9.75 × 10-14; FADS2- rs174576, p = 1.17 × 10-13; FADS2-rs174577, p = 1.12 × 10-12, among others). We also detected a genome-wide significant association with other genes in chromosome 11: MYRF (myelin regulatory factor)-rs174535, p = 1.49 × 10-12; TMEM258 (transmembrane protein 258)-rs102275, p = 2.43 × 10-12; FEN1 (flap structure-specific endonuclease 1)-rs174538, p = 1.96 × 10-11). Similar genome-wide statistically significant results were found for docosahexaenoic fatty acid (DHA). However, no such associations were detected for omega-6 PUFAs or linoleic acid (LA). For total PUFA, we observed a consistent gene*sex interaction with the DNTTIP2 (deoxynucleotidyl transferase terminal interacting protein 2)-rs3747965 p = 1.36 × 10-8. For adherence to MedDiet, we obtained a relevant interaction with the ME1 (malic enzyme 1) gene (a gene strongly regulated by fat) in determining serum omega-3. The top-ranked SNP for this interaction was ME1-rs3798890 (p = 2.15 × 10-7). In the regional-wide association study, specifically focused on the FADS1/FASD2/FADS3 and ELOVL (fatty acid elongase) 2/ELOVL 5 regions, we detected several statistically significant associations at p < 0.05. In conclusion, our results confirm a robust role of the FADS cluster on serum PUFA in this population, but the associations vary depending on the PUFA. Moreover, the detection of some sex and diet interactions underlines the need for these associations/interactions to be studied in all specific populations so as to better understand the complex metabolism of PUFA.This study was partially funded, by the Spanish Ministry of Health (Instituto de Salud Carlos III) and the Ministerio de Economía y Competitividad-Fondo Europeo de Desarrollo Regional (FEDER) (grants CIBER 06/03, PI06/1326, PI13/00728, PI16/00366, SAF2016–80532-R and FPU 18/01703); the University Jaume I (grants P1–1B2013–54 and COGRUP/2016/06); the Rei Jaume I Award for Medical Research 2018; the Fundació La Marató de TV3 (grant 538/U/2016); and the Generalitat Valenciana (grants PROMETEO2017/017, AEST/2018/044 and APOSTD/2019/136) and the US Department of Agriculture, Agriculture Research Service (grant 8050–51000--098--00D).N

Genome-Wide Association Study for Serum Omega-3 and Omega-6 Polyunsaturated Fatty Acids: Exploratory Analysis of the Sex-Specific Effects and Dietary Modulation in Mediterranean Subjects with Metabolic Syndrome

Many early studies presented beneficial effects of polyunsaturated fatty acids (PUFA) on cardiovascular risk factors and disease. However, results from recent meta-analyses indicate that this effect would be very low or nil. One of the factors that may contribute to the inconsistency of the results is that, in most studies, genetic factors have not been taken into consideration. It is known that fatty acid desaturase (FADS) gene cluster in chromosome 11 is a very important determinant of plasma PUFA, and that the prevalence of the single nucleotide polymorphisms (SNPs) varies greatly between populations and may constitute a bias in meta-analyses. Previous genome-wide association studies (GWAS) have been carried out in other populations and none of them have investigated sex and Mediterranean dietary pattern interactions at the genome-wide level. Our aims were to undertake a GWAS to discover the genes most associated with serum PUFA concentrations (omega-3, omega-6, and some fatty acids) in a scarcely studied Mediterranean population with metabolic syndrome, and to explore sex and adherence to Mediterranean diet (MedDiet) interactions at the genome-wide level. Serum PUFA were determined by NMR spectroscopy. We found strong robust associations between various SNPs in the FADS cluster and omega-3 concentrations (top-ranked in the adjusted model: FADS1-rs174547, p = 3.34 × 10-14; FADS1-rs174550, p = 5.35 × 10-14; FADS2-rs1535, p = 5.85 × 10-14; FADS1-rs174546, p = 6.72 × 10-14; FADS2-rs174546, p = 9.75 × 10-14; FADS2- rs174576, p = 1.17 × 10-13; FADS2-rs174577, p = 1.12 × 10-12, among others). We also detected a genome-wide significant association with other genes in chromosome 11: MYRF (myelin regulatory factor)-rs174535, p = 1.49 × 10-12; TMEM258 (transmembrane protein 258)-rs102275, p = 2.43 × 10-12; FEN1 (flap structure-specific endonuclease 1)-rs174538, p = 1.96 × 10-11). Similar genome-wide statistically significant results were found for docosahexaenoic fatty acid (DHA). However, no such associations were detected for omega-6 PUFAs or linoleic acid (LA). For total PUFA, we observed a consistent gene*sex interaction with the DNTTIP2 (deoxynucleotidyl transferase terminal interacting protein 2)-rs3747965 p = 1.36 × 10-8. For adherence to MedDiet, we obtained a relevant interaction with the ME1 (malic enzyme 1) gene (a gene strongly regulated by fat) in determining serum omega-3. The top-ranked SNP for this interaction was ME1-rs3798890 (p = 2.15 × 10-7). In the regional-wide association study, specifically focused on the FADS1/FASD2/FADS3 and ELOVL (fatty acid elongase) 2/ELOVL 5 regions, we detected several statistically significant associations at p < 0.05. In conclusion, our results confirm a robust role of the FADS cluster on serum PUFA in this population, but the associations vary depending on the PUFA. Moreover, the detection of some sex and diet interactions underlines the need for these associations/interactions to be studied in all specific populations so as to better understand the complex metabolism of PUFA

Clinical and Molecular-Genetic Insights into the Role of Oxidative Stress in Diabetic Retinopathy: Antioxidant Strategies and Future Avenues

Reactive oxygen species (ROS) overproduction and ROS-signaling pathways activation attack the eyes. We evaluated the oxidative stress (OS) and the effects of a daily, core nutritional supplement regimen containing antioxidants and omega 3 fatty acids (A/ω3) in type 2 diabetics (T2DM). A case-control study was carried out in 480 participants [287 T2DM patients with (+)/without (−) diabetic retinopathy (DR) and 193 healthy controls (CG)], randomly assigned to a daily pill of A/ω3. Periodic evaluation through 38 months allowed to outline patient characteristics, DR features, and classic/OS blood parameters. Statistics were performed by the SPSS 24.0 program. Diabetics displayed significantly higher circulating pro-oxidants (p = 0.001) and lower antioxidants (p = 0.0001) than the controls. Significantly higher plasma malondialdehyde/thiobarbituric acid reactive substances (MDA/TBARS; p = 0.006) and lower plasma total antioxidant capacity (TAC; p = 0.042) and vitamin C (0.020) was found in T2DM + DR versus T2DM-DR. The differential expression profile of solute carrier family 23 member 2 (SLC23A2) gene was seen in diabetics versus the CG (p = 0.001), and in T2DM + DR versus T2DM − DR (p < 0.05). The A/ω3 regime significantly reduced the pro-oxidants (p < 0.05) and augmented the antioxidants (p < 0.05). This follow-up study supports that a regular A/ω3 supplementation reduces the oxidative load and may serve as a dietary prophylaxis/adjunctive intervention for patients at risk of diabetic blindness

DNA Methylomes Reveal Biological Networks Involved in Human Eye Development, Functions and Associated Disorders

This work provides a comprehensive CpG methylation landscape of the different layers of the human eye that unveils the gene networks associated with their biological functions and how these are disrupted in common visual disorders. Herein, we firstly determined the role of CpG methylation in the regulation of ocular tissue-specification and described hypermethylation of retinal transcription factors (i.e., PAX6, RAX, SIX6) in a tissue-dependent manner. Second, we have characterized the DNA methylome of visual disorders linked to internal and external environmental factors. Main conclusions allow certifying that crucial pathways related to Wnt-MAPK signaling pathways or neuroinflammation are epigenetically controlled in the fibrotic disorders involved in retinal detachment, but results also reinforced the contribution of neurovascularization (ETS1, HES5, PRDM16) in diabetic retinopathy. Finally, we had studied the methylome in the most frequent intraocular tumors in adults and children (uveal melanoma and retinoblastoma, respectively). We observed that hypermethylation of tumor suppressor genes is a frequent event in ocular tumors, but also unmethylation is associated with tumorogenesis. Interestingly, unmethylation of the proto-oncogen RAB31 was a predictor of metastasis risk in uveal melanoma. Loss of methylation of the oncogenic mir-17-92 cluster was detected in primary tissues but also in blood from patients.The research leading to these results was supported by European Research Council Advanced Grant EPINORC, RecerCaixa Foundation, Federación Española de Enfermedades Raras (FEDER), Federación Española de Enfermedades Neuromusculares (ASEM), Fundación Isabel Gemio, COST CM1406, Instituto de Salud Carlos III (PI/00816) and Health and Sciences Departments of the Catalan Government (Generalitat de Catalunya). M.E. is an Institució Catalana de Recerca i Estudis Avançats (ICREA) Research Professor. We thank the staff of the Biobank Facility at the Bellvitge Biomedical Research Institute (IDIBELL), Spanish National Cancer Research Center (CNIO), Institute of Rare Diseases Research (BioNER-ISCIII), Vall d’Hebron Research Institute (VHIR) and Banc de Sang i Teixits (BST) of the Catalan Ministry of Health. We also thank Dr. Mercedes Hurtado (Department of Ophthalmology, University and Polytechnic Hospital La Fe) and Dr. Dolores Pinazo (Department of Ophthalmology, Dr. Peset University Hospital) for obtaining samples from glaucomatous patients. We thank the patients and their families.S

Nuevas estrategias docentes para la adquisición de competencias en Proyectos de Grado

Memoria ID12-0114. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013

DNA methylomes reveal biological networks involved in human eye development, functions and associated disorders

This work provides a comprehensive CpG methylation landscape of the different layers of the human eye that unveils the gene networks associated with their biological functions and how these are disrupted in common visual disorders. Herein, we firstly determined the role of CpG methylation in the regulation of ocular tissue-specification and described hypermethylation of retinal transcription factors (i.e., PAX6, RAX, SIX6) in a tissue-dependent manner. Second, we have characterized the DNA methylome of visual disorders linked to internal and external environmental factors. Main conclusions allow certifying that crucial pathways related to Wnt-MAPK signaling pathways or neuroinflammation are epigenetically controlled in the fibrotic disorders involved in retinal detachment, but results also reinforced the contribution of neurovascularization (ETS1, HES5, PRDM16) in diabetic retinopathy. Finally, we had studied the methylome in the most frequent intraocular tumors in adults and children (uveal melanoma and retinoblastoma, respectively). We observed that hypermethylation of tumor suppressor genes is a frequent event in ocular tumors, but also unmethylation is associated with tumorogenesis. Interestingly, unmethylation of the proto-oncogen RAB31 was a predictor of metastasis risk in uveal melanoma. Loss of methylation of the oncogenic mir-17-92 cluster was detected in primary tissues but also in blood from patients

Caracterización bioquímica del nervio óptico en el ratón que sobreexpresa el gen p53. Análisis de estrés oxidativo

[EN]: [Purpose]: The tumour inhibitor p53 gene has the ability of triggering proliferation arrest and cellular death by apoptosis subsequent to several factors, among them oxidative stress. The p53 protein is a major regulator of gene expression. Using genetically manipulated mice carrying an extra copy of gene p53 (transgenic mice super p53) versus control mice, we have investigated the generation of reactive oxygen species and antioxidant activity in the optic nerve of mice in relation to p53 availability. [Methods]: We studied two groups of 12-month-old mice of the strain C57BL/6: 1) super p53 group (Sp53) and 2) wild-type control group (CG). Mice were anesthetized in ether atmosphere and the eyeball and retrobulbar optic nerves were excised, washed, soaked in PBS, and stored in liquid nitrogen at –85ºC until processing. Three-four optic nerves from the same group were placed in an eppendorf tube, homogenized and enzymatic-colorimetric methods used to determine oxidative and antioxidant activities and the nitric oxide synthesis. [Results]: A significant increase in free radical formation (via lipid peroxidation; p<0.001), antioxidant activity (p<0.001) and nitric oxide synthesis (p<0.001) was found in the optic nerves from transgenic super p53 mice compared to respective controls. [Conclusion]: The presence of an extra copy of the p53 gene correlated with redox status in the mouse optic nerve. This transgenic mouse could be useful as an experimental model to study cell resistance to neurodegenerative processes in relation to oxidative stress and to apoptosis induction, such as glaucomatous optic neuropathy or age-related macular degeneration.[ES]: [Objetivos]: El gen supresor tumoral p53 detiene la proliferación y la muerte celular por apoptosis subsecuente a la acción de diversos factores, entre ellos el estrés oxidativo. La proteína p53 es fundamentalmente un regulador de la expresión génica. Utilizando ratones genéticamente manipulados para presentar una copia extra del gen p53 (transgénicos super p53) frente a ratones controles, hemos investigado el estado oxidativo y antioxidante en los nervios ópticos, en relación a p53. [Método]: Se han utilizado ratones de la cepa C57BL/6 de 12 meses de edad en dos grupos: 1) grupo super p53 (Sp53) y 2) grupo de controles wild-type (GC). Los ratones fueron anestesiados en atmósfera de éter, extrayendo los globos oculares y nervios ópticos que se lavaron en PBS, manteniendo las muestras en nitrógeno líquido y en congelador de –85ºC hasta su procesamiento. Se homogeneizaron 3-4 nervios ópticos por cada eppendorf, clasificando por grupos y determinando mediante métodos enzimático-colorimétricos la actividad peroxidativa y actividad antioxidante total y la concentración de oxido nítrico. [Resultados]: Existe aumento significativo en la formación de radicales libres via peroxidación lipídica (p<0,001), de la actividad antioxidante (p<0,001) y síntesis de óxido nítrico (p<0,05) en los nervios ópticos de los ratones transgénicos super p53, frente a los ratones controles. [Conclusiones]: La presencia de una copia extra del gen p53 está ligada a modificaciones de la actividad redox en el nervio óptico del ratón, sugiriendo que p53 otorga una mayor resistencia a la agresión oxidativa. Valoramos la utilización de este modelo de ratón transgénico en procesos neurodegenerativos relacionados con el estrés oxidativo y la inducción de la apoptosis, como la neuropatía óptica glaucomatosa o la degeneración macular asociada a la edad.7 páginas, 4 figuras.Peer reviewe