Does the oxidation of nitric oxide by oxyMyoglobin share an intermediate with the metMyoglobin-catalyzed isomerization of peroxynitrite?

The reaction of nitric oxide with oxy-myoglobin (oxyMb) to form ferric myoglobin (metMb) and nitrate, and the metMb-catalyzed isomerization of peroxynitrite to nitrate, have long been assumed to proceed via the same iron-bound peroxynitrite intermediate (metMb(OONO)). More recent research showed that the metMb-catalyzed isomerization of peroxynitrite to nitrate produces detectable amounts of nitrogen dioxide and ferryl myoglobin (ferrylMb). This suggests a mechanism in which the peroxynitrite binds to the metMb, ferrylMb is transiently generated by dissociation of NO2, and nitrate is formed when the NO2 nitrogen attacks the ferrylMb oxo ligand. The presence of free NO2 and ferrylMb products reveals that small amounts of NO2 escape from myoglobin's interior before recombination can occur. Free NO2 and ferrylMb should also be generated in the reaction of oxyMb with NO, if the common intermediate metMb(OONO) is formed. However, this report presents a series of time-resolved UV/vis spectroscopy experiments in which no ferrylMb was detected when oxyMb and NO reacted. The sensitivity of the methodology is such that as little as 10% of the ferrylMb predicted from the experiments with metMb and peroxynitrite should have been detectable. These results lead to the conclusion that the oxyMb + NO and metMb + ONOO(-) reactions do not proceed via a common intermediate as previously thought. The conclusion has significant implications for researchers that propose a possible role of oxyMb in intracellular NO regulation, because it means that toxic NO2 and ferrylMb are not generated during NO oxidation by this species.

Use of intraocular human recombinant tissue plasminogen activator as an adjunct treatment of posterior synechiae in patients with uveitis.

PURPOSE: To evaluate the effect of intracameral injection of small doses of human recombinant tissue plasminogen activator (hr-tPA) as an adjunct to lysing extensive recent-onset posterior synechiae associated with uveitis in the setting of impending pupillary seclusion. METHODS: This is an interventional retrospective case series involving three patients. All patients received an intracameral injection of hr-tPA while on maximum antiinflammatory therapy. Two patients had unilateral acute anterior uveitis with extensive (270°-360°) recent-onset posterior synechiae, while 1 patient had chronic recurrent anterior uveitis complicated by recent and preexisting posterior synechiae. RESULTS: Two patients with acute uveitis had rapid and complete synechiolysis (360°) after an intracameral injection of hr-tPA within 24 hours. One patient with acute reactivation of recurrent uveitis had subtotal (270°) synechiolysis because of incomplete lysis of chronic synechiae. With resolution of inflammation, all patients regained their preuveitis visual acuity. No cataract or glaucoma was reported at 12-month follow-up. CONCLUSION: We evaluated the role of intracameral hr-tPA injections as an adjunct to maximum antiinflammatory therapy. We conclude that a low-dose (3 µg) low-volume (0.05 mL) intracameral injection of hr-tPA in patients with extensive recent-onset posterior synechiae associated with uveitis leads to rapid lysis of synechiae, reducing the risk of pupillary seclusion and associated glaucoma.

Non-invasive gene transfer by iontophoresis for therapy of an inherited retinal degeneration.

Despite extensive research on many of the genes responsible for inherited retinal degenerations leading to blindness, no effective treatment is currently available for patients affected with these diseases. Among the therapeutic approaches tested on animal models of human retinal degeneration, gene therapy using different types of viral vectors as delivery agents has yielded promising results. We report here our results on a non-invasive, non-viral delivery approach using transscleral iontophoresis for transfer of plasmid DNA into mouse retina. Proof of principle experiments were carried out using plasmid containing GFP cDNA to demonstrate expression of the transferred gene in the retina after single applications of iontophoresis. Various parameters for multiple applications of iontophoresis were optimized to sustain GFP gene expression in mouse photoreceptors. Subsequently, repeated iontophoresis of plasmid containing normal cGMP-phosphodiesterase beta-subunit (beta-PDE) cDNA was performed in the rd1 mouse, an animal model of autosomal recessive retinitis pigmentosa caused by a mutant beta-PDE gene. In normal mice, transscleral iontophoresis of the GFP plasmid provided a significant increase in fluorescence of the retina in the treated versus non-treated eyes. In rd1 mice, repeated iontophoresis of beta-PDE cDNA plasmid partially rescued photoreceptors morphologically, as observed by microscopy, and functionally, as recorded on ERG measurements, without adverse effects. Therefore, transscleral iontophoresis of plasmid DNA containing therapeutic genes may be an efficient, safe and non-invasive method for the treatment of retinal degenerations.

Sp4 is expressed in retinal neurons, activates transcription of photoreceptor-specific genes, and synergizes with Crx.

To investigate the molecular mechanisms of photoreceptor-specific gene transcription, we examined the role of the neuronal-enriched Sp4 nuclear protein in transcription from the rod-specific beta-PDE and rod opsin gene promoters and compared it to the ubiquitous members of the Sp family, Sp1 and Sp3. Sp4 activates both the rod opsin and beta-PDE promoters, whereas Sp1 activates only the rod opsin promoter and Sp3 activates neither promoter. Interestingly, Sp1 and Sp3 competitively repress Sp4-mediated activation of the beta-PDE promoter. In addition, Sp4, Sp1, and Sp3 each show functional synergy with the photoreceptor-enriched Crx transcriptional regulator on the rod opsin promoter but not the beta-PDE promoter, although Sp4-mediated activation was the most significant. Sp4, Sp1, and Sp3 bind Crx in co-immunoprecipitation experiments, and their zinc finger domains as well as the Crx homedomain are necessary and sufficient for these interactions. Chromatin immunoprecipitation showed that the rod opsin and beta-PDE promoters are targets of both Sp4 and Crx, which further supports Sp4-Crx interactions in vivo in the context of retinal chromatin environment. In situ hybridization and immunohistochemistry demonstrated that Sp4 is abundantly expressed in various neurons of all retinal layers, and thus co-localizes or overlaps with multiple retina-restricted and -enriched genes, its putative targets. Our results indicate that photoreceptor-specific gene transcription is controlled by the combinatorial action of Sp4 and Crx. The other Sp family members may be involved in photoreceptor-specific transcription directly or through their competition with Sp4. These data suggest the potential importance of Sp4 in retinal neurobiology and pathology.

Buccal fat pad hemorrhage after retrobulbar injection.

PURPOSE: To enable ophthalmologists to recognize and manage buccal fat pad hemorrhage occurring after retrobulbar injection. DESIGN: Interventional case report. METHODS: A 52-year-old woman with proliferative diabetic retinopathy underwent left retrobulbar injection before panretinal photocoagulation (PRP). RESULTS: Immediately after PRP, the patient complained of left cheek swelling. Ocular examination was unremarkable. Computed tomographic imaging studies confirmed the clinical diagnosis of hemorrhage within the buccal fat pad. No hemorrhage was found within the retrobulbar space. The hemorrhage resolved spontaneously without sequelae. CONCLUSION: This case widens the known spectrum of hemorrhagic complications after retrobulbar injection.

The rod cGMP-phosphodiesterase beta-subunit promoter is a specific target for Sp4 and is not activated by other Sp proteins or CRX.

The beta-subunit of cGMP-phosphodiesterase (beta-PDE) is a key protein in phototransduction expressed exclusively in rod photoreceptors. It is necessary for visual function and for structural integrity of the retina. beta-PDE promoter deletions showed that the -45/-23 region containing a consensus Crx-response element (CRE) was necessary for low level transcriptional activity. Overexpressed Crx modestly transactivated this promoter in 293 human embryonic kidney cells; however, mutation of CRE had no significant effect on transcription either in transfected Y79 retinoblastoma cells or Xenopus embryonic heads. Thus, Crx is unlikely to be a critical beta-PDE transcriptional regulator in vivo. Interestingly, although the beta/GC element (-59/-49) binds multiple Sp transcription factors in vitro, only Sp4, but not Sp1 or Sp3, significantly enhanced beta-PDE promoter activity. Thus, the Sp4-mediated differential activation of the beta-PDE transcription defines the first specific Sp4 target gene reported to date and implies the importance of Sp4 for retinal function. Further extensive mutagenesis of the beta-PDE upstream sequences showed no additional regulatory elements. Although this promoter lacks a canonical TATA box or Inr element, it has the (T/A)-rich beta/TA sequence located within the -45/-23 region. We found that it binds purified TBP and TFIIB in gel mobility shift assays with cooperative enhancement of binding affinity.