title: Expression of pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF) in sickle cell retina and choroid.
abstract: Pigment epithelium-derived factor (PEDF) has been shown to be an inhibitor of angiogenesis as well as a multipotent neurotrophic factor in the mammalian eye. Changes in PEDF levels have been correlated with development of retinal neovascularization in oxygen-induced retinopathy. The purpose of this study was to determine the localization and relative level of PEDF in human retinas and choroids using immunohistochemistry and evaluate the changes in PEDF and vascular endothelial growth factor (VEGF) localization and their relation to the progression of proliferative sickle cell retinopathy. Cryopreserved tissues from eyes of normal subjects and subjects with non-proliferative or proliferative sickle cell retinopathy were used with streptavidin peroxidase immunohistochemistry. A rabbit polyclonal antibody was made against recombinant human PEDF. Binding of the antibody was blocked by preincubation of the antibody with excess human recombinant PEDF. Relative levels of immunoreactivity were scored with a seven-point grading system and by microdensitometric analysis.The most prominent sites of PEDF localization in the normal eye were the vitreous condensed at the internal limiting membrane and RPE-Bruch's membrane-choriocapillaris complex. PEDF was also prominent in choroidal stroma. There was limited immunoreactivity in some cells of the neural retinas, in blood vessels and in the interphotoreceptor matrix (IPM). There was no difference in ratio (1.47 vs. 1.44) of PEDF/VEGF or the relative levels of either growth factor in the retinal vasculatures of the control subjects and perfused area of non-proliferative sickle cell retinas. The ratio was increased in the non-perfused area of the non-proliferative sickle cell retinas (2.24). In eyes with proliferative sickle cell retinopathy, elevated PEDF and VEGF immunostaining was present in viable vessels of sea fan neovascular formations as well as feeder vessels of sea fans. The PEDF/VEGF ratio in sea fans was 1.0. Immunoreactivity for PEDF was prominent in retinal vessels in non-perfused regions and in atrophic sea fans, while VEGF immunoreactivity was weak or absent in these structures. In conclusion, PEDF and VEGF were both significantly elevated in viable sea fan formations in sickle cell disease (p<0.05) but only PEDF was present in non-viable sea fans. The highest levels of PEDF in all eyes were associated with extracellular matrices (vitreous, choroidal stroma, IPM, and walls of blood vessels). PEDF might play an important role in inhibiting angiogenesis and inducing the regression of sea fans. Progression of angiogenesis may be dependent on the ratio of PEDF/VEGF.
authors.affiliation: The Wilmer Ophthalmological Institute, Department of Ophthalmology, School of Medicine, The Johns Hopkins University, Baltimore, MD 21287-9115, USA.
authors.forename: Sahng Yeon
authors.initials: SY
authors.lastname: Kim
authors.forename: Carmen
authors.initials: C
authors.lastname: Mocanu
authors.forename: D Scott
authors.initials: DS
authors.lastname: Mcleod
authors.forename: Imran A
authors.initials: IA
authors.lastname: Bhutto
authors.forename: Carol
authors.initials: C
authors.lastname: Merges
authors.forename: Mark
authors.initials: M
authors.lastname: Eid
authors.forename: Patrick
authors.initials: P
authors.lastname: Tong
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Lutty
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000378:metabolism*; D002829:Choroid / Q000378:metabolism*; D020256:Choroidal Neovascularization / Q000150:complications / Q000378:metabolism; D003720:Densitometry / Q000379:methods; D016228:Endothelial Growth Factors / Q000032:analysis*; D005136:Eye Proteins; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis*; D008222:Lymphokines / Q000032:analysis*; D008297:Male; D009414:Nerve Growth Factors; D011506:Proteins / Q000032:analysis*; D012160:Retina / Q000378:metabolism*; D012164:Retinal Diseases / Q000150:complications / Q000378:metabolism*; D012171:Retinal Vessels / Q000378:metabolism; D015843:Serpins / Q000032:analysis*; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D000099174:Pigment Epithelium-Derived Factor
chemical_list: D016228:Endothelial Growth Factors; D005136:Eye Proteins; D036341:Intercellular Signaling Peptides and Proteins; D008222:Lymphokines; D009414:Nerve Growth Factors; D011506:Proteins; D015843:Serpins; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D000099174:Pigment Epithelium-Derived Factor