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Radiation treatment inhibits monocyte entry into the optic nerve head and prevents neuronal damage in a mouse model of glaucoma
Gareth R. Howell, … , Richard T. Libby, Simon W.M. John
Gareth R. Howell, … , Richard T. Libby, Simon W.M. John
Published March 19, 2012
Citation Information: J Clin Invest. 2012;122(4):1246-1261. https://doi.org/10.1172/JCI61135.
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Research Article Neuroscience

Radiation treatment inhibits monocyte entry into the optic nerve head and prevents neuronal damage in a mouse model of glaucoma

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Abstract

Glaucoma is a common ocular disorder that is a leading cause of blindness worldwide. It is characterized by the dysfunction and loss of retinal ganglion cells (RGCs). Although many studies have implicated various molecules in glaucoma, no mechanism has been shown to be responsible for the earliest detectable damage to RGCs and their axons in the optic nerve. Here, we show that the leukocyte transendothelial migration pathway is activated in the optic nerve head at the earliest stages of disease in an inherited mouse model of glaucoma. This resulted in proinflammatory monocytes entering the optic nerve prior to detectable neuronal damage. A 1-time x-ray treatment prevented monocyte entry and subsequent glaucomatous damage. A single x-ray treatment of an individual eye in young mice provided that eye with long-term protection from glaucoma but had no effect on the contralateral eye. Localized radiation treatment prevented detectable neuronal damage and dysfunction in treated eyes, despite the continued presence of other glaucomatous stresses and signaling pathways. Injection of endothelin-2, a damaging mediator produced by the monocytes, into irradiated eyes, combined with the other glaucomatous stresses, restored neural damage with a topography characteristic of glaucoma. Together, these data support a model of glaucomatous damage involving monocyte entry into the optic nerve.

Authors

Gareth R. Howell, Ileana Soto, Xianjun Zhu, Margaret Ryan, Danilo G. Macalinao, Gregory L. Sousa, Lura B. Caddle, Katharine H. MacNicoll, Jessica M. Barbay, Vittorio Porciatti, Michael G. Anderson, Richard S. Smith, Abbot F. Clark, Richard T. Libby, Simon W.M. John

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Figure 2

Local radiation robustly protects from glaucoma in DBA/2J mice (assessed at 12 months of age).

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Local radiation robustly protects from glaucoma in DBA/2J mice (assessed...
(A) Lead shielding allowed either head-only irradiation (shown) or body-only irradiation (all of body without head). (B) Irradiation of the head robustly prevented glaucoma compared with untreated eyes (P = 1.8 × 10–32, treated 87/102 eyes, 85% NOE; untreated 37/140 eyes, 26% NOE). Body-only irradiation was not protective (7/34 eyes, 21% NOE). For comparison, a summary of the 0 and 10 Gy whole body data from Figure 1 is included. (C–E) X-ray irradiation of just the eye protects from glaucoma. (C) X-ray doses of 7.2 and 14.4 Gy protected the vast majority of eyes from glaucoma (7.2 Gy, 58/60 eyes, 96% NOE; 14.4 Gy, 40/40 eyes, 100% NOE). 3.6 Gy and 5.4 Gy more than doubled the number of NOE eyes compared to no treatment (3.6 Gy, 32/50 eyes, 64% NOE; 5.4 Gy, 33/54 eyes, 61%). Doses of 0.6 and 2.4 Gy were not protective (0.6 Gy, 2/17 eyes, 11% NOE; 2.4 Gy, 9/32 eyes, 28%). (D–F) Optic nerve and ganglion cell layer (GCL) phenotypes for 12-month-old DBA/2J and radiation-treated (7.2 Gy) DBA/2J mice. Eyes with the most common phenotype for each experimental group were assessed. Optic nerve cross-sections were stained with PPD and flat-mounted retinas were stained with cresyl violet. Scale bar: 50 μm. Protection was evident by (E) axon and (F) ganglion cell layer counts. (G) A 1-time x-ray dose of 7.2 Gy to a single eye protects from glaucoma, while the untreated fellow eye remained susceptible to glaucoma (n > 40 for each treatment class, P = 2 × 10–7).

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