The mechanism of oxidative damage to the lens through intraocular photochemical generation of superoxide and its derivatization to other oxidants such as singlet oxygen, hydroxyl radical and hydrogen peroxide has been studied. Rat lenses when organ cultured aerobically in TC 199 containing additional amounts of riboflavin were damaged as demonstrated by an inhibition of the uptake of Rb 86 against a concentration gradient. The pump was not affected by light if the culture was conducted in the basal TC 199. However, light was observed to induce significant peroxidative degradation of the tissue lipids even in the basal medium, the degradation being indicated by the formation of malonaldehyde. Both the inhibition of the pump as well as the peroxidative degradation of the tissue lipids, were attenuated considerably by scavengers of superoxide and hydrogen peroxide. In addition, the lipid degradation was prevented by vitamins C and E. The results suggest that the photodynamic injury to the lens cation pump as well as to membrane lipids is incumbent upon an initial generation of superoxide and its derivatization to other oxidants. Thus, the ocular lens is susceptible to oxidative insult and physiological damage through photocatalytic generation of various oxygen radicals. Large concentrations of ascorbic acid in the aqueous humor seems to be able to provide significant protection against such an insult. Thus, this may be one of the functions of high concentration of ascorbic acid in the aqueous humor. The implication of oxidative stress has also been examined in the genesis of cataracts in vivo. Treatment with vitamin E of the Emory mouse led to a decrease in the rate of cataract progression suggesting that at least in some instances an oxidative stress could participate in the formation of cataracts. Oxygen radicals may inflict damage at multifarious biochemical sites. Human lens lipids were also shown to have an absorption maxima at 239 nm indicating their susceptibility to oxidative degradation. In addition the lipid extract has fluorescence similar to that of lipofuscins. The levels of MDA were higher in the brunescent cataracts as compared to that in the nonbrunescent cataracts. The implications of oxidative stress towards the genesis of cataracts in humans is being explored further.
An orally active inhibitor of aldose reductase, 1,3-dioxo-1H-benz[de]-isoquinoline-2(3H)acetic acid (AY-22,284), prevented cataractous changes in cultured lenses exposed to high concentrations of galactose. When given orally, AY-22,284 markedly decreased the accumulation of polyols in the lenses and sciatic nerves of galactosemic rats and rats with streptozotocin-induced diabetes. In addition, treatment of galactosemic rats with AY-22,284 effectively suppressed the formation of cataracts.
The cation pump activity of the ocular lens was damaged by exposure to light in the presence of riboflavin phosphate. The intensit of ight was similar to that used for reading purposes. The observed light-induced damage was due to superoxide or its derivatives, the superoxide being produced photochemically. Such damage was attenuated by vitamin C in amounts comparable to that in the aqueous humor. Thus, a new role for the high ascorbate level present in the anterior chamber fluid and the lens has been suggested. Ascorbate in other tissues also might have this novel physiological function of protecting against damage due to superoxide and its derivatives produced during normal cellular oxidation. The concentration of ascorbic acid (vitamin C) in the aqueous humor of man, monkey, and many other animals is one of the highest among the various body fluids (1). The prevalence of this high level of ascorbate has been attributed to the ability of the ciliary epithelium to transport this compound actively from the plasma to the posterior chamber through the blood aqueous barrier (2). For reasons undefined at the present time, the concentration of ascorbate is also high in tissues surrounding the aqueous humor-namely, the cornea and the lens. The concentration in the latter tissue in many instances is second only to that in adrenals (1). Although the importance of ascorbic acid in hydroxylation reactions is known in many tissues, the relevance of a high ascorbate level in the aqueous humor and the lens is not precisely known, although it has been suggested that photochemical oxidation of ascorbic acid in the anterior chamber serves to provide hydrogen peroxide to the lens. The peroxide, in turn, may regulate the tissue hexose monophosphate shunt through the following series of interlinked reactions
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