Complement activation contributes to subretinal fibrosis through the induction of epithelial-to-mesenchymal transition (EMT) in retinal pigment epithelial cells
Llorián-Salvador, María (Hospital Universitari Vall d'Hebron)
Byrne, Eimear M. (The Barcelona Institute of Science and Technology)
Szczepan, Manon (Queen's University Belfast, Northern Ireland, UK)
Little, Karis (Queen's University Belfast, Northern Ireland, UK)
Chen, Mei (Queen's University Belfast, Northern Ireland, UK)
Xu, Heping (Queen's University Belfast, Northern Ireland, UK)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2022
Resum:	We previously reported higher plasma levels of complement fragments C3a and C5a in neovascular Age-related Macular Degeneration (nAMD) patients with macular fibrosis. This study aimed to understand whether complement activation contributes to the development of macular fibrosis and the underlying mechanisms involved. Complement activation was blocked using a C5 neutralizing antibody (BB5. 1) in C57BL/6J mice after induction of subretinal fibrosis using the two-stage laser protocol. Fibrotic lesions were examined 10 days after the 2nd laser through fundus examination and immunohistochemistry. The expression of C5aR in fibrotic lesions and retinal pigment epithelial (RPE) cultures were examined by confocal microscopy. Primary murine RPE cells were treated with C3a or C5a (10-100 ng/mL) or TGF-β2 (10 ng/mL). Epithelial-to-mesenchymal transition (EMT) was assessed through various readouts. The expression of E-cadherin, vimentin, fibronectin, α-SMA, Slug, ERK/AKT and pSMAD2/3 were determined by Western blot and immunocytochemistry. Collagen contraction and wound-healing assays were used as functional readouts of EMT. The production of IL-6, TGF-β1, TGF-β2 and VEGF by RPE cells were determined by ELISA. PMX53 was used to block C5aR in RPE cultures and in vivo in mice with subretinal fibrosis. Extensive C5b-9 deposition was detected at the site of subretinal fibrosis. BB5. 1 treatment completely abrogated complement activation and significantly reduced subretinal fibrosis. C5aR was detected in RPE and infiltrating MHC-II + cells in subretinal fibrosis. In vitro, RPE cells constitutively express C5/C5a and C5aR, and their expression was increased by TGF-β2 treatment. C5a but not C3a increased fibronectin, α-SMA, vimentin and Slug expression, and decreased E-cadherin expression in RPE cells. C5a treatment also increased the contractility and migration of RPE cells and enhanced the production of VEGF and TGF-β1/2. C5a treatment induced pSmad2/3 and pERK1/2 expression in RPE cells and this was blocked by PMX53. PMX53 treatment significantly reduced sodium fluorescein leakage in the subretinal fibrosis model, while collagen-I + lesions only mildly reduced. Complement activation is critically involved in the development of subretinal fibrosis, partially through C5a-C5aR-mediated EMT in RPE cells. Targeting complement activation rather than C5a may be a novel approach for the management of macular fibrosis.
Nota:	Altres ajuts: Fight for Sight (5057/5058; 5105/5106)
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Age-related macular degeneration ; Macular fibrosis ; Inflammation ; Complement system ; Retinal pigment epithelial cell ; C5a ; C3a ; Subretinal fibrosis ; Epithelial-to-mesenchymal transition
Publicat a:	Journal of neuroinflammation, Vol. 19, Num. 1 (july 2022) , ISSN 1742-2094

DOI: 10.1186/s12974-022-02546-3
PMID: 35831910

17 p, 4.0 MB

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