PURPOSE. CD147/basigin is a chaperone for lactate:H þ cotransporters (monocarboxylate transporters) MCT1 and MCT4. We tested the hypothesis that MCT1 and -4 in corneal endothelium contribute to lactate efflux from stroma to anterior chamber and that silencing CD147 expression would cause corneal edema.METHODS. CD147 was silenced via small interfering ribonucleic acid (siRNA) transfection of rabbit corneas ex vivo and anterior chamber lenti-small hairpin RNA (shRNA) pseudovirus in vivo. CD147 and MCT expression was examined by Western blot, RT-PCR, and immunofluorescence. Functional effects were examined by measuring lactate-induced cell acidification, corneal lactate efflux, [lactate], central cornea thickness (CCT), and Azopt (a carbonic anhydrase inhibitor) sensitivity.RESULTS. In ex vivo corneas, 100 nM CD147 siRNA reduced CD147, MCT1, and MCT4 expression by 85%, 79%, and 73%, respectively, while MCT2 expression was unaffected. CD147 siRNA decreased lactate efflux from 3.9 6 0.81 to 1.5 6 0.37 nmol/min, increased corneal [lactate] from 19.28 6 7.15 to 56.73 6 8.97 nmol/mg, acidified endothelial cells (pH i ¼ 6.83 6 0.07 vs. 7.19 6 0.09 in control), and slowed basolateral lactate-induced acidification from 0.0034 6 0.0005 to 0.0012 6 0.0005 pH/s, whereas apical acidification was unchanged. In vivo, CD147 shRNA increased CCT by 28.1 6 0.9 lm at 28 days; Azopt increased CCT to 24.4 6 3.12 vs. 12.0 6 0.48 lm in control, and corneal [lactate] was 47.63 6 6.29 nmol/mg in shCD147 corneas and 17.82 6 4.93 nmol/mg in paired controls.CONCLUSIONS. CD147 is required for the expression of MCT1 and MCT4 in the corneal endothelium. Silencing CD147 slows lactate efflux, resulting in stromal lactate accumulation and corneal edema, consistent with lactate efflux as a significant component of the corneal endothelial pump.Keywords: CD147, lactate transport, MCT1, MCT4, corneal endothelial pump T he cornea's energy needs are supplied predominantly from glucose.1 Glucose enters the cornea from the aqueous humor across the corneal endothelium and diffuses through the stroma to the corneal epithelium. Corneal epithelial cells are very glycolytic, converting 85% of glucose to lactate.
2-4Therefore, for every 100 glucose molecules entering the cornea, 170 lactate molecules are produced. The accumulation of lactate within the cornea can create an osmotic load that will increase stromal hydration and corneal thickness. 5 To maintain corneal hydration and transparency, the large quantity of lactate must be simultaneously exported out. Since the surface corneal epithelial cells are impermeable to lactate, lactate efflux must take place across the endothelium. Efflux is driven by the 2-fold [lactate] gradient from cornea to anterior chamber. 5,6 Facilitated transport of lactate has been extensively studied in rabbit corneal endothelium.7,8 Lactate along with a H þ is cotransported through the plasma membrane of many cell types via stereospecific, pH-dependent monocarboxylate transporters (MCT1-4).9-18 Recently, we have identified MCT1, -2,...