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Editors Selection IGR 9-2

Basic Research: TM and apoptosis

Comment by Douglas Rhee on:

22066 Apoptosis in the trabecular meshwork of glaucomatous patients, Baleriola J; Garcia-Feijoo J; Martinez-de-la-Casa JM et al., Molecular Vision, 2008; 14: 1513-1516

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Poor aqueous drainage through the trabecular meshwork (TM) is the cause of the elevated IOP in POAG. One of the many observations about the TM from eyes with POAG is that there is a decreased number of TM endothelial cells compared to age matched controls. Accelerated senescence is one of the proposed mechanisms to account for this explanation. Baleriola et al. (1322), investigated one possible mechanism of the increased TM cell loss ‐ programmed cell death, i.e., apoptosis. The investigators compared the amount of apoptosis, as measured by TUNEL staining, seen in trabeculectomy samples from eyes with POAG versus from eyes with chronic angle-closure glaucoma (CACG). The authors found greater TUNEL staining in the TM from POAG eyes. This study elucidates one of the possible mechanisms in which TM cells die and is an important observation. If induced apoptosis is a causative event, then it is possible that an intervention aimed at interrupting the apoptotic pathway could decrease the rate of TM cell death and possibly intervene in the process that causes an elevated IOP even if the inciting event is unknown.

Trabecular meshwork cells utilize apoptosis

There are uncontrolled confounding factors that limit this study's generalizability. There is no indication that the POAG eyes in this sample had reduced cellularity compared to age-matched controls. The comparison group is CACG and not non-glaucomatous tissue. Thus, it is possible that the mechanism(s) responsible for CACG confers a protective effect resulting in decreased apoptosis (e.g., the peripheral anterior synechia shielding the TM from potentially deleterious effects of chronic topical medication use). There is no description of anti-metabolite usage, if any; differences between the two groups could affect their results. Despite these limitations, the authors have demonstrated an important observation that TM cells utilize apoptosis.

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