Pharmacological blockade of the P2X7 receptor reverses retinal damage in a rat model of type 1 diabetes

Acta Diabetol. 2019 Sep;56(9):1031-1036. doi: 10.1007/s00592-019-01343-4. Epub 2019 Apr 13.

Abstract

Aims: Retinopathy is a leading cause of vision impairment in diabetes. Its pathogenesis involves inflammation, pathological angiogenesis, neuronal and glial dysfunction. The purinergic P2X7 receptor (P2X7R) has a leading role in inflammation and angiogenesis. Potent and selective P2X7R blockers have been synthesized and tested in Phase I/II clinical studies. We hypothesize that P2X7R blockade will ameliorate diabetes-related pathological retinal changes.

Methods: Streptozotocin (STZ)-treated rats were intraperitoneally inoculated with either of two small molecule P2X7R receptor inhibitors, A740003 and AZ10606120, and after blood glucose levels increased to above 400 mg/dL, retinae were analyzed for P2X7R expression, vascular permeability, VEGF, and IL-6 expression.

Results: STZ administration caused a near fourfold increase in blood glucose, a large increase in retinal microvasculature permeability, as well as in retinal P2X7R, VEGF, and IL-6 expression. P2X7R blockade fully reversed retinal vascular permeability increase, VEGF accumulation, and IL-6 expression, with no effect on blood glucose.

Conclusion: P2X7R blockade might be promising strategy for the treatment of microvascular changes observed in the early phases of diabetic retinopathy.

Keywords: Diabetic retinopathy; Extracellular ATP; Inflammation; P2X7; Retinal vasopermeability.

MeSH terms

  • Animals
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Experimental / complications
  • Diabetes Mellitus, Experimental / drug therapy
  • Diabetes Mellitus, Experimental / metabolism
  • Diabetes Mellitus, Experimental / pathology
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetic Retinopathy / drug therapy
  • Diabetic Retinopathy / metabolism
  • Diabetic Retinopathy / prevention & control*
  • Inflammation / complications
  • Inflammation / drug therapy
  • Inflammation / metabolism
  • Male
  • Neuroglia / drug effects
  • Neuroglia / metabolism
  • Neuroglia / pathology
  • Purinergic P2X Receptor Antagonists / pharmacology*
  • Rats
  • Rats, Wistar
  • Receptors, Purinergic P2X7 / metabolism
  • Retina / drug effects*
  • Retina / metabolism
  • Retina / pathology
  • Streptozocin
  • Treatment Outcome

Substances

  • Blood Glucose
  • Purinergic P2X Receptor Antagonists
  • Receptors, Purinergic P2X7
  • Streptozocin