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PROX1 loss in adult mouse Schlemm’s canal causes permanent ocular hypertension
Sofia Lara Ochoa, Hoi-Lam Li, Hyeohn Kim, Zihang Yan, Natalia C. Mendonca, Pan Liu, Hyunjoo J. Lee, Michael P. Vincent, Sultan Almunif, Hao F. Zhang, Haiyan Gong, Evan A. Scott, Mark Johnson, Benjamin R. Thomson
Sofia Lara Ochoa, Hoi-Lam Li, Hyeohn Kim, Zihang Yan, Natalia C. Mendonca, Pan Liu, Hyunjoo J. Lee, Michael P. Vincent, Sultan Almunif, Hao F. Zhang, Haiyan Gong, Evan A. Scott, Mark Johnson, Benjamin R. Thomson
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Research Article Ophthalmology Vascular biology

PROX1 loss in adult mouse Schlemm’s canal causes permanent ocular hypertension

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Abstract

Glaucoma is associated with ocular hypertension, and lowering intraocular pressure is the primary objective of current therapies. Recent studies have established a key role for Schlemm’s canal endothelium in this pressure increase and have shown that it has a unique, lymphatic-like hybrid phenotype characterized by expression of the lymphatic transcription factor PROX1. However, the functional importance of this hybrid phenotype in the adult canal remains unclear, as long-term studies have been limited by systemic requirements for lymphatic gene expression and a lack of Schlemm’s canal–specific animal models. Here, we designed and validated a strategy using 4OH-tamoxifen-loaded nanocarriers to generate targeted, Schlemm’s canal specific Prox1 knockout mice that specifically lacked lymphatic characteristics in the canal endothelium. Within 4 weeks, intraocular pressure was significantly elevated, and ocular hypertension was maintained for at least 24 weeks. Unlike lymphatic vessels, which degenerate following Prox1 deletion, Schlemm’s canal persisted but reverted to a less functional vein-like phenotype with no change in size or morphology. Together, these findings demonstrate the utility of nanocarrier-mediated tamoxifen delivery and establish the importance of the Schlemm’s canal lymphatic-like phenotype in intraocular pressure regulation, providing targets for future glaucoma therapies and a mouse model of adult-onset ocular hypertension.

Authors

Sofia Lara Ochoa, Hoi-Lam Li, Hyeohn Kim, Zihang Yan, Natalia C. Mendonca, Pan Liu, Hyunjoo J. Lee, Michael P. Vincent, Sultan Almunif, Hao F. Zhang, Haiyan Gong, Evan A. Scott, Mark Johnson, Benjamin R. Thomson

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Figure 1

Human and mouse Schlemm’s canal endothelial cells share a lymphatic-like hybrid phenotype mediated by PROX1.

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Human and mouse Schlemm’s canal endothelial cells share a lymphatic-like...
(A and B) Whole-mount immunostaining of mouse (A) and cryosections of human (B) Schlemm’s canals revealed robust expression of the lymphatic markers PROX1 and FLT4. Scale bars: 50 μm (A), 25 μm (B, left), 100 μm (B, right). (C) PROX1 and CCL21 expression was reduced in primary human Schlemm’s canal endothelial cells treated with PROX1 siRNA, while levels of the universally expressed endothelial gene TEK were unchanged when measured by real-time reverse transcriptase PCR (siControl, n = 6; siPROX1, n = 6). (D, quantified in E) Western blot revealed reduced expression of FLT4 protein in siPROX1-treated human Schlemm’s canal cells (n = 3 per group). (F) Reduced expression of lymphatic genes and increased expression of blood endothelial genes were detected in siPROX1-treated Schlemm’s canal cells by RNA sequencing, accompanied by increased expression of TGFB-signaling genes and reduction in cell proliferation markers (n = 3 per group). (G, quantified in H) Confocal microscopy of Schlemm’s canal flat mounts revealed reduced PROX1 and FLT4 expression in Prox1fl/fl Cdh5-CreERT2 mice 4 weeks after tamoxifen induction at 8 weeks of age (Prox1ΔEC). While Prox1 deletion was generally robust, some mosaicism was observed, and a small number of PROX1-positive nuclei were observed in Prox1ΔEC Schlemm’s canal (white arrowheads; Prox1ΔEC, n = 3; Control, n = 4). Dashed lines in G outline Schlemm’s canal. BG, background; AFU, arbitrary fluorescence units. Scale bar: 100 μm. (I and J) No significant change in IOP (Prox1ΔEC, n = 9; Control, n = 7) (I) or Schlemm’s canal (SC) width (Prox1ΔEC, n = 3; Control, n = 4) (J) was measured 4 weeks after whole-body tamoxifen induction. *P < 0.05, **P < 0.01 as determined by 2-tailed, unpaired Student’s t test. Error bars in C, E, H, and I indicate ± SEM, while each point denotes an independent biological replicate.

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