title: Increased Endoplasmic Reticulum Stress in Human Glaucomatous Trabecular Meshwork Cells and Tissues.
abstract: OBJECTIVE
  Primary open-angle glaucoma (POAG) is the most common form of glaucoma and is accompanied by elevated intraocular pressure (IOP) resulting from increased aqueous humor outflow resistance through the trabecular meshwork (TM). The pathological mechanisms underlying increased outflow resistance have not been fully delineated. We recently demonstrated that chronic endoplasmic reticulum (ER) stress in the TM is associated with ocular hypertension in mouse models of glaucoma. The purpose of this study was to determine whether ER stress is also increased in human glaucomatous TM cells and tissues.
  
  
  METHODS
  Endoplasmic reticulum stress markers including GRP78, GRP94, and C/EBP homologous protein (CHOP) were examined by immunohistochemistry in the TM of age-matched normal (n = 18) and open-angle glaucoma donors (n = 18). GRP78, GRP94, activating transcription factor (ATF)-4, endoplasmic oxidoreductin-1alpha (ERO-1α), phosphorylated eukaryotic translation initiation factor 2α (EIF-2α), and CHOP were examined by Western blot analysis in TM tissue lysates from age-matched normal (n = 4) and POAG donors (n = 5). In addition, ER stress markers were examined in primary TM cells isolated from normal (n = 4 NTM) and glaucoma (n = 4 GTM) human donors.
  
  
  RESULTS
  Immunohistochemical analysis demonstrated a significant increase in GRP78 and GRP94 in the glaucomatous TM (n = 18) compared to normal TM (P < 0.0001, n = 18). Interestingly, there was minimum CHOP immunostaining observed in normal TM tissues. However, there was a 3-fold increase in CHOP levels in the glaucomatous TM (P < 0.0001; n = 18), indicating the presence of chronic ER stress in the glaucomatous TM. Western blot analysis of TM tissue lysates also demonstrated increased ER stress markers in the glaucomatous TM tissues including GRP78, GRP94, ATF-4, ERO-1α, and CHOP. Densitometric analysis of Western blots showed a significant increase in ATF-4, ERO-1α, and CHOP expression in the glaucomatous TM (n = 5) compared to age-matched normal TM (n = 4). In addition, primary TM cells obtained from glaucoma donors demonstrated increased ER stress markers including increased GRP78, GRP94, ATF-4, ERO-1α, and CHOP compared to normal TM cells. However, glaucomatous TM cells did not show splicing of XBP-1, a marker of unfolded protein response pathway.
  
  
  CONCLUSIONS
  These studies indicate the presence of chronic ER stress in human glaucomatous TM tissues and cells and further suggest that ER stress pathway may provide a novel target for developing disease-modifying glaucoma treatments.
authors.affiliation: Department of Cell Biology & Immunology and the North Texas Eye Research Institute University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas, United States.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Peters
authors.affiliation: Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, United States.
authors.forename: Sanjoy
authors.initials: S
authors.lastname: Bhattacharya
authors.affiliation: Department of Cell Biology & Immunology and the North Texas Eye Research Institute University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas, United States.
authors.forename: Abbot F
authors.initials: AF
authors.lastname: Clark
authors.affiliation: Department of Cell Biology & Immunology and the North Texas Eye Research Institute University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas, United States.
authors.forename: Gulab S
authors.initials: GS
authors.lastname: Zode
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002478:Cells, Cultured; D000091342:Endoplasmic Reticulum Chaperone BiP; D059865:Endoplasmic Reticulum Stress; D005902:Glaucoma, Open-Angle / Q000378:metabolism*; D006801:Humans; D014129:Trabecular Meshwork / Q000378:metabolism* / Q000473:pathology