BACKGROUND AND PURPOSEHypoxia-mediated neovascularization plays an important role in age-related macular degeneration (AMD). There are few animal models or effective treatments for AMD. Here, we investigated the effects of the flavonoid silibinin on hypoxia-induced angiogenesis in a rat AMD model. EXPERIMENTAL APPROACHRetinal pigmented epithelial (RPE) cells were subjected to hypoxia in vitro and the effects of silibinin on activation of key hypoxia-induced pathways were examined by elucidating the hypoxia-inducible factor-1 alpha (HIF-1a) protein level by Western blot. A rat model of AMD was developed by intravitreal injection of VEGF in Brown Norway rats, with or without concomitant exposure of animals to hypoxia. Animals were treated with oral silibinin starting at day 7 post-VEGF injection and AMD changes were followed by fluorescein angiography on days 14 and 28 post-injection. KEY RESULTSSilibinin pretreatment of RPE cells increased proline hydroxylase-2 expression, inhibited HIF-1a subunit accumulation, and inhibited VEGF secretion. Silibinin-induced HIF-1a and VEGF down-regulation required suppression of hypoxia-induced phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin (mTOR) pathway. In the rat model of AMD, silibinin administration prevented VEGF-and VEGF plus hypoxia-induced retinal oedema and neovascularization. CONCLUSION AND IMPLICATIONSThe effects of silibinin, both in vitro and in vivo, support its potential as a therapeutic for the prevention of neovascular AMD. AbbreviationsAMD, age-related macular degeneration; ARNT, aryl hydrocarbon receptor nuclear translocator; HIF-1a, hypoxia-inducible factor-1a; HRE, hypoxia-response element; mTOR, mammalian target of rapamycin; p70S6K, ribosomal protein S6 kinase; PHD, proline hydroxylase; RPE cell, retinal pigment epithelial cell; VHL, von Hippel-Lindau protein

New blood vessel formation is necessary for the repair of ischemia-damaged tissues. Endothelial cells produce exogenous and endogenous angiogenic factors in the mediation of angiogenesis and neovasculogenesis during neovascularization. Exposure to environmental pollutants may alter proangiogenic capacity or desensitize the responses of endothelial cells to stimulation by basic fibroblast growth factor and vascular endothelial growth factor. Human umbilical vein endothelial cells (HUVECs) were pretreated with benzo[a]pyrene (B[a]P), the major carcinogenic constituent found in tobacco smoke, for 24 h. Neovasculogenesis, migration, and proliferation were evaluated in solvent-treated and B[a]P-treated HUVECs. Endothelial capillary-like tube formation, cell migration, mitogen-activated protein kinase (MAPK) phosphorylation, and integrin expression were reduced in B[a]P-treated HUVECs with angiogenic factor stimulation, in comparison to solvent-treated HUVECs, although cell proliferation and Akt activation remained unaffected. Inhibition of B[a]P-mediated MAPK and neovasculogenesis was significantly rescued by pretreatment with α-naphthoflavone, an aryl hydrocarbon receptor (AhR) antagonist. The B[a]P-mediated inhibition of neovasculogenesis was also rescued in AhR-silenced HUVECs, suggesting the requirement for AhR in B[a]P-associated effects. B[a]P also inhibited angiogenesis in a chorioallantoic membrane assay. We conclude that B[a]P is a potent inhibitor of angiogenesis, and its effects are mediated via AhR-dependent phenotypic changes in B[a]P-treated HUVECs. These findings contribute to an understanding of the involvement of AhR agonists in vasculotoxicity.

p53, can regulate cell apoptosis in both transcription-dependent and -independent manners. The transcription-independent pathway was demonstrated by the translocation of p53 to mitochondria. Our study showed that p53 mitochondrial translocation was found in mitomycin C (MMC)-treated HepG2. The p53 C-terminal domain is clustered with potential nuclear leading sequences and showed strong electrostatic ion-ion interactions with cardiolipin, phosphatidylglycerol and phosphatidic acid in vitro. Disruption of cardiolipin biosynthesis by phosphatidylglycero-phosphate synthase (PGS) or CDP-diacylglycerol synthase 2 (CDS-2) short hairpin RNA (shRNA) transfection eliminated the MMC-induced translocation of mitochondrial p53. The elimination of mitochondrial p53 translocation also reduced Bcl-xL and Bcl-2 mitochondrial distribution. In HEK 293T models with saturated p53 expression, the mitochondrial partition of p53, Bcl-xL, and Bcl-2 obviously decreased in their PGS shRNA- or CDS-2 shRNA-expressing stable clones. In p53-null H1299 models, both the mitochondrial partitions of Bcl-xL and Bcl-2 were strongly reduced in relation to the HEK 293T models. The Bcl-xL mitochondrial partition was elevated in H1299 models expressing pCEP4-p53wt suggesting the direct carrier role of p53 in transporting Bcl-xL to the mitochondria. We also found that the cytosolic pool of Bcl-xL and Bcl-2 remained unaffected in the low-dose MMC treatment but decreased in the high-dose MMC treatment. The cytosolic pool of Bcl-2 and Bcl-xL directly regulated their amounts in p53-dependent mitochondrial distribution. In the low-dose MMC treatment, the increased mitochondrial p53, Bcl-xL, and Bcl-2 could attenuate apoptosis. However, in the high-dose MMC treatment, only the p53 translocated to the mitochondria and resulted in apoptosis progression. On the basis of this study, we thought mitochondrial p53 might regulate apoptosis in a biphasic manner.