Truncated netrin-1 contributes to pathological vascular permeability in diabetic retinopathy

J Clin Invest. 2016 Aug 1;126(8):3006-22. doi: 10.1172/JCI84767. Epub 2016 Jul 11.

Abstract

Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of blindness in the working-age population. Impaired blood-retinal barrier function leads to macular edema that is closely associated with the deterioration of central vision. We previously demonstrated that the neuronal guidance cue netrin-1 activates a program of reparative angiogenesis in microglia within the ischemic retina. Here, we provide evidence in both vitreous humor of diabetic patients and in retina of a murine model of diabetes that netrin-1 is metabolized into a bioactive fragment corresponding to domains VI and V of the full-length molecule. In contrast to the protective effects of full-length netrin-1 on retinal microvasculature, the VI-V fragment promoted vascular permeability through the uncoordinated 5B (UNC5B) receptor. The collagenase matrix metalloprotease 9 (MMP-9), which is increased in patients with diabetic macular edema, was capable of cleaving netrin-1 into the VI-V fragment. Thus, MMP-9 may release netrin-1 fragments from the extracellular matrix and facilitate diffusion. Nonspecific inhibition of collagenases or selective inhibition of MMP-9 decreased pathological vascular permeability in a murine model of diabetic retinal edema. This study reveals that netrin-1 degradation products are capable of modulating vascular permeability, suggesting that these fragments are of potential therapeutic interest for the treatment of DR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Animals
  • Blood-Retinal Barrier
  • Capillary Permeability*
  • Case-Control Studies
  • Diabetes Mellitus, Experimental
  • Diabetic Retinopathy / genetics
  • Diabetic Retinopathy / metabolism*
  • Disease Models, Animal
  • Humans
  • Macular Edema / metabolism
  • Matrix Metalloproteinase 9 / metabolism*
  • Mice
  • Mice, Inbred C57BL
  • Microglia / metabolism
  • Middle Aged
  • Nerve Growth Factors / genetics
  • Nerve Growth Factors / metabolism*
  • Netrin-1
  • Protein Domains
  • Retina / metabolism
  • Streptozocin
  • Tumor Suppressor Proteins / genetics
  • Tumor Suppressor Proteins / metabolism*

Substances

  • NTN1 protein, human
  • Nerve Growth Factors
  • Ntn1 protein, mouse
  • Tumor Suppressor Proteins
  • Netrin-1
  • Streptozocin
  • MMP9 protein, human
  • Matrix Metalloproteinase 9