Bioengineered glaucomatous 3D human trabecular meshwork as an in vitro disease model.

Intraocular pressure (IOP) is mostly regulated by aqueous humor outflow through the human trabecular meshwork (HTM) and represents the only modifiable risk factor of glaucoma. The lack of IOP-modulating therapeutics that targets HTM underscores the need of engineering HTM for understanding the outflow physiology and glaucoma pathology in vitro. Using a 3D HTM model that allows for regulation of outflow in response to a pharmacologic steroid, a fibrotic state has been induced resembling that of glaucomatous HTM. This disease model exhibits HTM marker expression, ECM overproduction, impaired HTM cell phagocytic activity and outflow resistance, which represent characteristics found in steroid-induced glaucoma. In particular, steroid-induced ECM alterations in the glaucomatous model can be modified by a ROCK inhibitor. Altogether, this work presents a novel in vitro disease model that allows for physiological and pathological studies pertaining to regulating outflow, leading to improved understanding of steroid-induced glaucoma and accelerated discovery of new therapeutic targets. Biotechnol. Bioeng. 2016;113: 1357-1368. © 2015 Wiley Periodicals, Inc.

A Closer Look at Schlemm's Canal Cell Physiology: Implications for Biomimetics.

Among ocular pathologies, glaucoma is the second leading cause of progressive vision loss, expected to affect 80 million people worldwide by 2020. A primary cause of glaucoma appears to be damage to the conventional outflow tract. Conventional outflow tissues, a composite of the trabecular meshwork and the Schlemm's canal, regulate and maintain homeostatic responses to intraocular pressure. In glaucoma, filtration of aqueous humor into the Schlemm's canal is hindered, leading to an increase in intraocular pressure and subsequent damage to the optic nerve, with progressive vision loss. The Schlemm's canal encompasses a unique endothelium. Recent advances in culturing and manipulating Schlemm's canal cells have elucidated several aspects of their physiology, including ultrastructure, cell-specific marker expression, and biomechanical properties. This review highlights these advances and discusses implications for engineering a 3D, biomimetic, in vitro model of the Schlemm's canal endothelium to further advance glaucoma research, including drug testing and gene therapy screening.

A biomimetic Schlemm's canal inner wall: A model to study outflow physiology, glaucoma pathology and high-throughput drug screening.

Glaucoma is a disease that damages the optic nerve, frequently leading to blindness. Elevated intraocular pressure (IOP) is the only modifiable risk factor for glaucoma, which is expected to affect 80 million people by 2020, causing bilateral blindness in over 10 million individuals. Because pathological changes to Schlemm's canal (SC) may account for significant resistance to outflow, there is considerable interest in characterizing and evaluating the Schlemm's canal as a target for glaucoma therapeutics. In conventional, two-dimensional culture, human Schlemm's canal (HSC) cells lose spatial, mechanical and biochemical cues, resulting in altered gene expression and cell signaling than observed in vivo, compromising the clinical relevance of data obtained from such systems. Here, we report, for the first time, that 3D culture of HSC cells on microfabricated scaffolds with defined physical and biochemical cues, rescued expression of key HSC markers, VE-cadherin and PECAM1, and mediated pore formation, crucial for the Schlemm's canal regulation of IOP. We demonstrated that following treatment with the glaucopathogenic agent, TGF-ß2, HSC cells undergo an endothelial-mesenchymal transition, which together with the increase in extracellular matrix (ECM) proteins might account for the decrease in outflow facility observed in patients with high TGF-ß2 levels in their aqueous humor. We also demonstrated that unlike 2D cultures, 3D cultures of HSC cells are amenable to gene transfer. Thus, our data imply that 3D culture of HSC cells may be used as a platform to advance our understanding of HSC physiology and pathology and as a model for high-throughput drug and gene screening.

Walking through trabecular meshwork biology: Toward engineering design of outflow physiology.

According to the World Health Organization, glaucoma remains the second leading cause of blindness in the world. Glaucoma belongs to a group of optic neuropathies that is characterized by chronic degeneration of the optic nerve along with its supporting glia and vasculature. Despite significant advances in the field, there is no available cure for glaucoma. The trabecular meshwork has been implicated as the primary site for regulation of intraocular pressure, the only known modifiable factor in glaucoma development. In this review, we describe the current models for glaucoma studies, primary culture, anterior eye segments, and animal studies and their limitations. These models, especially anterior eye segments and animal tissues, often require careful interpretation given the inter-species variation and are cumbersome and expensive. The lack of an available in vitro 3D model to study trabecular meshwork cells and detailed mechanisms of their regulation of intraocular pressure has limited progress in the field of glaucoma research. In this paper, we review the current status of knowledge of the trabecular meshwork and how the current advances in tissue engineering techniques might be applied in an effort to engineer a synthetic trabecular meshwork as a 3D in vitro model to further advance glaucoma research. In addition, we describe strategies for selection and design of biomaterials for scaffold fabrication as well as extracellular matrix components to mimic and support the trabecular architecture. We also discuss possible uses for a bioengineered trabecular meshwork for both developing a fundamental understanding of trabecular meshwork biology as well as high-throughput screening of glaucoma drugs.

Reprogramming of the microRNA transcriptome mediates resistance to rapamycin.

The mammalian target of rapamycin (mTOR) is a central regulator of cell proliferation that is often deregulated in cancer. Inhibitors of mTOR, including rapamycin and its analogues, are being evaluated as antitumor agents. For their promise to be fulfilled, it is of paramount importance to identify the mechanisms of resistance and develop novel therapies to overcome it. Given the emerging role of microRNAs (miRNAs) in tumorigenesis, we hypothesized that miRNAs could play important roles in the response of tumors to mTOR inhibitors. Long-term rapamycin treatment showed extensive reprogramming of miRNA expression, characterized by up-regulation of miR-17-92 and related clusters and down-regulation of tumor suppressor miRNAs. Inhibition of members of the miR-17-92 clusters or delivery of tumor suppressor miRNAs restored sensitivity to rapamycin. This study identifies miRNAs as new downstream components of the mTOR-signaling pathway, which may determine the response of tumors to mTOR inhibitors. It also identifies potential markers to assess the efficacy of treatment and provides novel therapeutic targets to treat rapamycin-resistant tumors.

Rapamycin resistance is linked to defective regulation of Skp2.

The mammalian target of rapamycin (mTOR) plays a role in controlling malignant cellular growth. mTOR inhibitors, including rapamycin (sirolimus), are currently being evaluated in cancer trials. However, a significant number of tumors are rapamycin resistant. In this study, we report that the ability of rapamycin to downregulate Skp2, a subunit of the ubiquitin protein ligase complex, identifies tumors that are sensitive to rapamycin. RNA interference (RNAi)-mediated silencing of Skp2 in human tumor cells increased their sensitivity to rapamycin in vitro and inhibited the growth of tumor xenografts in vivo. Our findings suggest that Skp2 levels are a key determinant of antitumor responses to mTOR inhibitors, highlighting a potentially important pharmacogenomic marker to predict sensitivity to rapamycin as well as Skp2 silencing strategies for therapeutic purposes.