Monocytes have been shown to normally circulate through the trabecular meshwork (TM) and to be recruited in increased numbers to the TM following the application of laser irradiation. In addition, monocytes have been shown to enhance aqueous outflow in an animal model in vivo and also to increase the permeability of cultured Schlemm's canal endothelial (SCE) cells in vitro. The organizing hypothesis of this project is that in the human eye monocytes interact with SCE cells in a paracrine manner, thus forming a cellular module that regulates the outflow of aqueous humor.
The specific aims are to test particular predictions of this hypothesis about the roles of monocytes by:  Determining the types of monocytes that modulate the permeability and intercellular junction status of Schlemm's canal (SC) lining endothelial cells in situ. Human peripheral blood monocytes will be separated into three types and then these groups of monocytes, and media conditioned by these cell preparations, will be compared in their ability to influence the time-course behavior of SC permeability, as well as in terms of their ability to influence the junction assembly/disassembly process in the outflow tissues from perfused eyes.  Testing the prediction that individual cytokines secreted by monocytes bind onto SC endothelial cells that can induce pronounced changes in outflow facility.  Identifying intracellular signaling pathways regulating SCE-permeability via the junction-disassembly process. The secretion by monocytes of several cytokines will be assessed using ELISA. The results will provide a model to envision the role of intracellular signaling pathways, and important mediators including cytokines and intercellular junctions. The model specifically considers the role of monocytes and monocyte secreted cytokines. These cytokines are proposed to bind onto the cells lining SC and to modulate candidate intracellular signaling pathways including RhoA GTPase and the myosin-light chain kinase. These signaling molecules in turn induce a sequence of intracellular events that include alternating the state of cortical cytoskeletal elements, inducing the disassembly of intercellular junctions and increasing the egress of aqueous from the eye. The identification of key cytokines, which function by increasing the permeability properties of cellular barriers, will open up a new therapeutic approach to treat glaucoma by promoting the outflow of aqueous through the trabecular or conventional aqueous outflow pathway. Therefore, subsequent studies would translate our theoretical model into clinically relevant approaches for glaucoma treatments, and including cytokine-based or cell-based treatment modalities.
The proposed project is targeted at the blinding eye disease glaucoma by testing novel hypotheses about the mechanisms by which monocytes regulate intraocular pressure. The knowledge generated by these studies will lead to a better understanding of the regulation of intraocular pressure. Moreover, this new information will also lay the foundation for future focused clinical studies aimed at developing new and better means of treatment for glaucoma, a disease that afflicts over three million people in the United States.
|Hollander, David A; Pennesi, Mark E; Alvarado, Jorge A (2017) Management of plateau iris syndrome with cataract extraction and endoscopic cyclophotocoagulation. Exp Eye Res 158:190-194|
|Alvarado, Jorge A; Chau, Phuonglan; Wu, Jianfeng et al. (2015) Profiling of Cytokines Secreted by Conventional Aqueous Outflow Pathway Endothelial Cells Activated In Vitro and Ex Vivo With Laser Irradiation. Invest Ophthalmol Vis Sci 56:7100-8|