Pathogenic Effects of Mineralocorticoid Pathway Activation in Retinal Pigment Epithelium

• Main Authors: Jérémie Canonica, Min Zhao, Tatiana Favez, Emmanuelle Gelizé, Laurent Jonet, Laura Kowalczuk, Justine Guegan, Damien Le Menuet, Say Viengchareun, Marc Lombès, Eric Pussard, Yvan Arsenijevic, Francine Behar-Cohen
• Format: Article
• Language: English
• Published: MDPI AG 2021-09-01
• Series: International Journal of Molecular Sciences
• Subjects: retina; eye; corticoids; retinal pigment epithelium; mineralocorticoid; transcriptional regulation
• Online Access: https://www.mdpi.com/1422-0067/22/17/9618

Glucocorticoids are amongst the most used drugs to treat retinal diseases of various origins. Yet, the transcriptional regulations induced by glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) activation in retinal pigment epithelium cells (RPE) that form the outer blood–retina barrier are unknown. Levels of endogenous corticoids, ligands for MR and GR, were measured in human ocular media. Human RPE cells derived from induced pluripotent stem cells (iRPE) were used to analyze the pan-transcriptional regulations induced by aldosterone—an MR-specific agonist, or cortisol or cortisol + RU486—a GR antagonist. The retinal phenotype of transgenic mice that overexpress the human MR (P1.hMR) was analyzed. In the human eye, the main ligand for GR and MR is cortisol. The iRPE cells express functional GR and MR. The subset of genes regulated by aldosterone and by cortisol + RU-486, and not by cortisol alone, mimics an imbalance toward MR activation. They are involved in extracellular matrix remodeling (<i>CNN1</i>, <i>MGP</i>, <i>AMTN)</i>, epithelial–mesenchymal transition, RPE cell proliferation and migration (<i>ITGB3</i>, <i>PLAUR</i> and <i>FOSL1</i>) and immune balance (<i>TNFSF18</i> and <i>PTX3</i>). The P1.hMR mice showed choroidal vasodilation, focal alteration of the RPE/choroid interface and migration of RPE cells together with RPE barrier function alteration, similar to human retinal diseases within the pachychoroid spectrum. RPE is a corticosteroid-sensitive epithelium. MR pathway activation in the RPE regulates genes involved in barrier function, extracellular matrix, neural regulation and epithelial differentiation, which could contribute to retinal pathology.