Aim-To investigate whether the ocular hypotensive eVect of alpha melanocyte stimulating hormone (MSH) is related to eicosanoids or cyclic AMP (cAMP).Methods-Intraocular pressure (IOP) readings were taken at a similar time on the day before and after a single dose of topical MSH. Changes in the levels of prostaglandin E 2 (PGE 2 ) and prostacyclin in incubated iris ciliary body (ICB) explants were measured by specific radioimmunoassay (RIA). Incubated ICB explants were exposed to MSH or adrenaline (epinephrine) for a week. In addition, cAMP levels in the medium were determined following short term incubation using RIA. Results-A significant dose related reduction in IOP was noted with topical MSH (mean (SD) maximal eVect 4.5 (0.1) mm Hg (21%); p<0.001 v appropriate baseline) which persisted up to 6 hours (p=0.05). MSH treated ICB explants showed a 1.5-fold increase in PGE 2 and prostacyclin levels (p<0.001 for each parameter) while cAMP levels were increased twofold (p<0.001). Conclusions-A single application of MSH caused a sustained dose related ocular hypotensive eVect with no side eVects. An increase in eicosanoid and cAMP levels following ICB exposure to MSH indicated their involvement in MSH induced ocular hypotension. MSH and its analogues might have clinical relevance as antiglaucoma drugs with fewer side eVects because of their antiallergic and antiinflammatory properties. (Br J Ophthalmol 2000;84:1411-1414 Alpha melanocyte stimulating hormone (MSH) is a basic tridecapeptide which originates from pro-opiomelanocortin (POMC) found in the pituitary, 1 brain, 2 skin, 3 and at other sites. 4 POMC is the precursor for a family of biologically active peptides called melanocortins which include alpha, beta and gamma MSH, lipotropins, endorphins, and adrenocorticotrophic hormone (ACTH). MSH, named after its eVect on the pigmentation of amphibian skin, is involved in modulation of neuroprotection, anti-inflammatory activity, 5-7 and obesity regulation. 8 Its eVect is receptor specific and is not duplicated by ACTH, ACTH fragments, or glucocorticosteroids.
10In the eye MSH has been identified as a constitutive component of the normal aqueous humour of humans, rabbits, and mice.11 12 Its involvement in the regulation of intraocular pressure (IOP) was first noted in the 1960s and 1970s when high doses of the hormone were found to have a biphasic eVect on IOP.
13-15Melanocortins act by the activation of G protein coupled receptors and production of cyclic AMP (cAMP). 16 Cyclic AMP modulates IOP reduction by adrenergic agonists 17 18 and prostaglandin derivatives such as latanoprost.19 20 Enhancement of eicosanoid production by MSH treated ocular pigmented epithelium 21 is another possible role for melanocortins in the regulation on IOP. The activity of melanocortins in most organs is dose related so we have examined its role in IOP regulation using physiological doses, 22 23 unlike previous studies. 13-15 24-26 In this study we have investigated whether MSH causes a sustained reduction in IOP following a ...