Attenuation of choroidal neovascularization by β(2)-adrenoreceptor antagonism

JAMA Ophthalmol. 2013 Mar;131(3):376-82. doi: 10.1001/jamaophthalmol.2013.1476.

Abstract

Objectives: To determine whether β-adrenergic blockade inhibits choroidal neovascularization (CNV) in a mouse model of laser-induced CNV and to investigate the mechanism by which β-adrenoreceptor antagonism blunts CNV.

Design: Mice were subjected to laser burns, inducing CNV, and were treated with daily intraperitoneal injections of propranolol hydrochloride. Neovascularization was measured on choroidal-scleral flat mounts using intercellular adhesion molecule 2 immunofluorescence staining. The effect of β-adrenoreceptor signaling on expression of vascular endothelial growth factor (VEGF) was investigated using primary mouse choroidal endothelial cells (ChECs) and retinal pigment epithelial (RPE) cells. These cells were incubated with β-adrenoreceptor agonists and/or antagonists and assayed for Vegf messenger RNA and protein levels.

Setting: University of Wisconsin School of Medicine and Public Health.

Participants: Wild-type 6-week-old female C57BL/6j mice.

Main outcome measures: Inhibition of CNV after propranolol treatment and Vegf messenger RNA and protein expression after treatment with β-adrenoreceptor agonists and antagonists.

Results: Propranolol-treated mice demonstrated a 50% reduction in laser-induced CNV. Treatment with norepinephrine bitartrate stimulated Vegf messenger RNA expression and protein secretion in ChECs and RPE cells. This effect was blocked by β2-adrenoreceptor antagonism and mimicked by β2-adrenoreceptor agonists.

Conclusions: Attenuation of CNV is achieved by β-adrenergic blockade. The β2-adrenoreceptors regulate VEGF expression in ChECs and RPE cells.

Clinical relevance: Antagonists of β-adrenoreceptors are safe and well tolerated in patients with glaucoma and cardiovascular disease. Thus, blockade of β-adrenoreceptors may provide a new avenue to inhibit VEGF expression in CNV.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-1 Receptor Agonists / pharmacology
  • Adrenergic beta-2 Receptor Agonists / pharmacology
  • Adrenergic beta-2 Receptor Antagonists / pharmacology*
  • Animals
  • Cells, Cultured
  • Choroid / blood supply
  • Choroidal Neovascularization / genetics
  • Choroidal Neovascularization / metabolism
  • Choroidal Neovascularization / prevention & control*
  • Disease Models, Animal*
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / metabolism
  • Female
  • Mice
  • Mice, Inbred C57BL
  • Propranolol / pharmacology*
  • RNA, Messenger / metabolism
  • Receptors, Adrenergic, beta-2 / physiology
  • Retinal Pigment Epithelium / drug effects
  • Retinal Pigment Epithelium / metabolism
  • Reverse Transcriptase Polymerase Chain Reaction
  • Vascular Endothelial Growth Factor A / genetics
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Adrenergic beta-1 Receptor Agonists
  • Adrenergic beta-2 Receptor Agonists
  • Adrenergic beta-2 Receptor Antagonists
  • RNA, Messenger
  • Receptors, Adrenergic, beta-2
  • Vascular Endothelial Growth Factor A
  • vascular endothelial growth factor A, mouse
  • Propranolol