Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, China
Tear film hyperosmolarity plays a core role in the development of dry eye disease (DED) by mediating the disruption of ocular surface homeostasis and triggering inflammation in ocular surface epithelium. In this study, the mechanisms involving the hyperosmolar microenvironment, glycolysis mediating metabolic reprogramming, and pyroptosis were explored clinically, in vitro, and in vivo. Data from DED clinical samples indicated that the expression of glycolysis and pyroptosis-related genes, including PKM2 and GSDMD, was significantly upregulated and that the secretion of IL-1β significantly increased. In vitro, the indirect coculture of macrophages derived from THP-1 and human corneal epithelial cells (HCECs) was used to discuss the interaction among cells. The hyperosmolar environment was found to greatly induce HCECs’ metabolic reprogramming, which may be the primary cause of the subsequent inflammation in macrophages upon the activation of the related gene and protein expression. 2-Deoxy-d-glucose (2-DG) could inhibit the glycolysis of HCECs and subsequently suppress the pyroptosis of macrophages. In vivo, 2-DG showed potential efficacy in relieving DED activity and could significantly reduce the overexpression of genes and proteins related to glycolysis and pyroptosis. In summary, our findings suggested that hyperosmolar-induced glycolytic reprogramming played an active role in promoting DED inflammation by mediating pyroptosis.
F Stapleton, M Alves, VY Bunya, I Jalbert, K Lekhanont, F Malet, KS Na, D Schaumberg, M Uchino, J Vehof, E Viso, S Vitale, L Jones. TFOS DEWS II epidemiology report. Ocul Surf 2017; 15(3): 334–365 https://doi.org/10.1016/j.jtos.2017.05.003
pmid: 28736337
2
KF Farrand, M Fridman, IÖ Stillman, DA Schaumberg. Prevalence of diagnosed dry eye disease in the United States among adults aged 18 years and older. Am J Ophthalmol 2017; 182: 90–98 https://doi.org/10.1016/j.ajo.2017.06.033
pmid: 28705660
3
P Song, W Xia, M Wang, X Chang, J Wang, S Jin, J Wang, W Wei, I Rudan. Variations of dry eye disease prevalence by age, sex and geographic characteristics in China: a systematic review and meta-analysis. J Glob Health 2018; 8(2): 020503 https://doi.org/10.7189/jogh.08.020503
pmid: 30206477
4
L Jones, LE Downie, D Korb, JM Benitez-Del-Castillo, R Dana, SX Deng, PN Dong, G Geerling, RY Hida, Y Liu, KY Seo, J Tauber, TH Wakamatsu, J Xu, JS Wolffsohn, JP Craig. TFOS DEWS II management and therapy report. Ocul Surf 2017; 15(3): 575–628 https://doi.org/10.1016/j.jtos.2017.05.006
pmid: 28736343
5
SC Pflugfelder, CS de Paiva. The pathophysiology of dry eye disease: what we know and future directions for research. Ophthalmology 2017; 124(11): S4–S13 https://doi.org/10.1016/j.ophtha.2017.07.010
pmid: 29055361
6
Y Dai, J Zhang, J Xiang, Y Li, D Wu, J Xu. Calcitriol inhibits ROS-NLRP3-IL-1β signaling axis via activation of Nrf2-antioxidant signaling in hyperosmotic stress stimulated human corneal epithelial cells. Redox Biol 2019; 21: 101093 https://doi.org/10.1016/j.redox.2018.101093
pmid: 30611121
7
YF Meng, Q Pu, SY Dai, Q Ma, X Li, W Zhu. Nicotinamide mononucleotide alleviates hyperosmolarity-induced IL-17a secretion and macrophage activation in corneal epithelial cells/macrophage co-culture system. J Inflamm Res 2021; 14: 479–493 https://doi.org/10.2147/JIR.S292764
pmid: 33658825
Y Jiang, C Yang, Y Zheng, Y Liu, Y Chen. A set of global metabolomic biomarker candidates to predict the risk of dry eye disease. Front Cell Dev Biol 2020; 8: 344 https://doi.org/10.3389/fcell.2020.00344
pmid: 32582687
P Rao, S Suvas. Development of inflammatory hypoxia and prevalence of glycolytic metabolism in progressing herpes stromal keratitis lesions. J Immunol 2019; 202(2): 514–526 https://doi.org/10.4049/jimmunol.1800422
pmid: 30530484
12
V Chayakul, M Reim. The enzymatic activities in the alkali-burnt rabbit cornea. Graefes Arch Clin Exp Ophthalmol 1982; 218(3): 145–148 https://doi.org/10.1007/BF02215652
pmid: 7095440
13
IC You, TG Coursey, F Bian, FL Barbosa, CS de Paiva, SC Pflugfelder. Macrophage phenotype in the ocular surface of experimental murine dry eye disease. Arch Immunol Ther Exp (Warsz) 2015; 63(4): 299–304 https://doi.org/10.1007/s00005-015-0335-0
pmid: 25772203
14
D Zhou, YT Chen, F Chen, M Gallup, T Vijmasi, AF Bahrami, LB Noble, N van Rooijen, NA McNamara. Critical involvement of macrophage infiltration in the development of Sjögren’s syndrome-associated dry eye. Am J Pathol 2012; 181(3): 753–760 https://doi.org/10.1016/j.ajpath.2012.05.014
pmid: 22770665
15
L Yu, C Yu, H Dong, Y Mu, R Zhang, Q Zhang, W Liang, W Li, X Wang, L Zhang. Recent developments about the pathogenesis of dry eye disease: based on immune inflammatory mechanisms. Front Pharmacol 2021; 12: 732887 https://doi.org/10.3389/fphar.2021.732887
pmid: 34421626
16
MS Milner, KA Beckman, JI Luchs, QB Allen, RM Awdeh, J Berdahl, TS Boland, C Buznego, JP Gira, DF Goldberg, D Goldman, RK Goyal, MA Jackson, J Katz, T Kim, PA Majmudar, RP Malhotra, MB McDonald, RK Rajpal, T Raviv, S Rowen, N Shamie, JD Solomon, K Stonecipher, S Tauber, W Trattler, KA Walter, GO 4th Waring, RJ Weinstock, WF Wiley, E Yeu. Dysfunctional tear syndrome: dry eye disease and associated tear film disorders—new strategies for diagnosis and treatment. Curr Opin Ophthalmol 2017; 27(Suppl 1): 3–47 https://doi.org/10.1097/01.icu.0000512373.81749.b7
pmid: 28099212
17
S Wang, YH Yuan, NH Chen, HB Wang. The mechanisms of NLRP3 inflammasome/pyroptosis activation and their role in Parkinson’s disease. Int Immunopharmacol 2019; 67: 458–464 https://doi.org/10.1016/j.intimp.2018.12.019
pmid: 30594776
18
A Wree, A Eguchi, MD McGeough, CA Pena, CD Johnson, A Canbay, HM Hoffman, AE Feldstein. NLRP3 inflammasome activation results in hepatocyte pyroptosis, liver inflammation, and fibrosis in mice. Hepatology 2014; 59(3): 898–910 https://doi.org/10.1002/hep.26592
pmid: 23813842
19
G Lorenz, MN Darisipudi, HJ Anders. Canonical and non-canonical effects of the NLRP3 inflammasome in kidney inflammation and fibrosis. Nephrol Dial Transplant 2014; 29(1): 41–48 https://doi.org/10.1093/ndt/gft332
pmid: 24026244
Q Ji, L Wang, J Liu, Y Wu, H Lv, Y Wen, L Shi, B Qu, N Szentmáry. Aspergillus fumigatus-stimulated human corneal epithelial cells induce pyroptosis of THP-1 macrophages by secreting TSLP. Inflammation 2021; 44(2): 682–692 https://doi.org/10.1007/s10753-020-01367-x
pmid: 33118609
22
JS Wolffsohn, R Arita, R Chalmers, A Djalilian, M Dogru, K Dumbleton, PK Gupta, P Karpecki, S Lazreg, H Pult, BD Sullivan, A Tomlinson, L Tong, E Villani, KC Yoon, L Jones, JP Craig. TFOS DEWS II diagnostic methodology report. Ocul Surf 2017; 15(3): 539–574 https://doi.org/10.1016/j.jtos.2017.05.001
pmid: 28736342
23
J Gao, G Morgan, D Tieu, TA Schwalb, JY Luo, LA Wheeler, ME Stern. ICAM-1 expression predisposes ocular tissues to immune-based inflammation in dry eye patients and Sjögrens syndrome-like MRL/lpr mice. Exp Eye Res 2004; 78(4): 823–835 https://doi.org/10.1016/j.exer.2003.10.024
pmid: 15037117
24
X Ma, J Zou, L He, Y Zhang. Dry eye management in a Sjögren’s syndrome mouse model by inhibition of p38-MAPK pathway. Diagn Pathol 2014; 9: 5 https://doi.org/10.1186/1746-1596-9-5
pmid: 2444398
25
Z Liu, D Chen, X Chen, F Bian, W Qin, N Gao, Y Xiao, J Li, SC Pflugfelder, DQ Li. Trehalose induces autophagy against inflammation by activating TFEB signaling pathway in human corneal epithelial cells exposed to hyperosmotic stress. Invest Ophthalmol Vis Sci 2020; 61(10): 26 https://doi.org/10.1167/iovs.61.10.26
pmid: 32785678
26
Q Zheng, Y Ren, PS Reinach, Y She, B Xiao, S Hua, J Qu, W Chen. Reactive oxygen species activated NLRP3 inflammasomes prime environment-induced murine dry eye. Exp Eye Res 2014; 125: 1–8 https://doi.org/10.1016/j.exer.2014.05.001
pmid: 24836981
M Christofi, Sommer S Le, C Mölzer, IP Klaska, L Kuffova, JV Forrester. Low-dose 2-deoxy glucose stabilises tolerogenic dendritic cells and generates potent in vivo immunosuppressive effects. Cell Mol Life Sci 2021; 78(6): 2857–2876 https://doi.org/10.1007/s00018-020-03672-y
pmid: 33074350
29
X Zhang, VJ M, Y Qu, X He, S Ou, J Bu, C Jia, J Wang, H Wu, Z Liu, W Li. Dry eye management: targeting the ocular surface microenvironment. Int J Mol Sci 2017; 18(7): 1398 https://doi.org/10.3390/ijms18071398
pmid: 28661456
X Chen, J Rao, Z Zheng, Y Yu, S Lou, L Liu, Q He, L Wu, X Sun. Integrated tear proteome and metabolome reveal panels of inflammatory-related molecules via key regulatory pathways in dry eye syndrome. J Proteome Res 2019; 18(5): 2321–2330 https://doi.org/10.1021/acs.jproteome.9b00149
pmid: 30966751
33
V Pucino, M Certo, V Bulusu, D Cucchi, K Goldmann, E Pontarini, R Haas, J Smith, SE Headland, K Blighe, M Ruscica, F Humby, MJ Lewis, JJ Kamphorst, M Bombardieri, C Pitzalis, C Mauro. Lactate buildup at the site of chronic inflammation promotes disease by inducing CD4+ T cell metabolic rewiring. Cell Metab 2019; 30(6): 1055–1074.e8 https://doi.org/10.1016/j.cmet.2019.10.004
pmid: 31708446
34
S Hui, JM Ghergurovich, RJ Morscher, C Jang, X Teng, W Lu, LA Esparza, T Reya, Zhan Le, Guo J Yanxiang, E White, JD Rabinowitz. Glucose feeds the TCA cycle via circulating lactate. Nature 2017; 551(7678): 115–118 https://doi.org/10.1038/nature24057
pmid: 29045397
35
JY Zhang, B Zhou, RY Sun, YL Ai, K Cheng, FN Li, BR Wang, FJ Liu, ZH Jiang, WJ Wang, D Zhou, HZ Chen, Q Wu. The metabolite α-KG induces GSDMC-dependent pyroptosis through death receptor 6-activated caspase-8. Cell Res 2021; 31(9): 980–997 https://doi.org/10.1038/s41422-021-00506-9
pmid: 34012073
36
JP Craig, KK Nichols, EK Akpek, B Caffery, HS Dua, CK Joo, Z Liu, JD Nelson, JJ Nichols, K Tsubota, F Stapleton. TFOS DEWS II definition and classification report. Ocul Surf 2017; 15(3): 276–283 https://doi.org/10.1016/j.jtos.2017.05.008
pmid: 28736335
37
JJ López-Cano, MA González-Cela-Casamayor, V Andrés-Guerrero, R Herrero-Vanrell, JM Benítez-Del-Castillo, IT Molina-Martínez. Combined hyperosmolarity and inflammatory conditions in stressed human corneal epithelial cells and macrophages to evaluate osmoprotective agents as potential DED treatments. Exp Eye Res 2021; 211: 108723 https://doi.org/10.1016/j.exer.2021.108723
pmid: 34384756
38
H Chen, X Gan, Y Li, J Gu, Y Liu, Y Deng, X Wang, Y Hong, Y Hu, L Su, W Chi. NLRP12- and NLRC4-mediated corneal epithelial pyroptosis is driven by GSDMD cleavage accompanied by IL-33 processing in dry eye. Ocul Surf 2020; 18(4): 783–794 https://doi.org/10.1016/j.jtos.2020.07.001
pmid: 32735949