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388

M.M. Ward et al.

44.3.2 ATP and Glial Transmission

The long held belief that glial cells in the central nervous system were solely responsible for neuronal support has recently changed. It is now thought that these cells may also play a role in the regulation of neuronal transmission (Fields and Stevens 2000). In the retina, there is evidence that the bi-directional communication between neurons and glial cells is in part controlled by purinergic transmission (Newman and Zahs 1998; Newman 2003, 2004, 2005).

Intercellular calcium waves have been observed to propagate between astrocytes in culture and in intact retinal tissue and are therefore thought to be involved in glial cell communication. Although originally believed to be mediated by gap junctional coupling between cells, physically isolated astrocytes in culture also display Ca2+ waves (Hassinger et al. 1996), suggesting that signal propagation relies on the release of an extracellular signaling molecule. In the retina, studies by Newman and Zahs (1997) and Newman (2001) have suggested that ATP acting as an extracellular messenger facilitates communication between retinal astrocytes and Müller cells. More recently, this work has extended to suggest that glial cells may also modulate neuronal transmission in the inner retina, however this is likely to be due to the action of adenosine on P1 receptors following ATP release from Müller cells and its subsequent hydrolysis in the extracellular milieu (Newman and Zahs 1998; Newman 2003, 2004; Newman and Volterra 2004).

Propagation of calcium waves by ATP is supported by anatomical evidence for purinergic receptors on Müller cells, although this remains contentious. Early studies suggested that P2XRs were present on Müller cells in human (Pannicke et al. 2000) and rat retina (Neal et al. 1998; Jabs et al. 2000), however, it is now apparent that P2YRs mediate Müller cell responses to ATP (Li et al. 2001). Li et al. (2001) suggested that intercellular calcium signalling in Müller cells was likely to arise via P2Y1R stimulation based on purinergic agonist sensitivity profiles of isolated cells. In agreement with the functional profiling, immunocytochemical studies from our laboratory found that P2Y1 receptors are strongly expressed on Müller cell processes in the inner retina (Ward and Fletcher 2009).

44.4 The Role of Purinergic Receptors in Retinal Disease

The ubiquitous presence of ATP in all cells means that under pathological conditions such as ischemia, large amounts of ATP can be liberated from dead or dying cells (Franke et al. 2006). There is a growing body of evidence which suggests that extracellular ATP may be an important factor in retinal pathologies (Franke and Illes 2006). Whilst the excitotoxic properties of P2X7Rs have been considered in the retina (Innocenti et al. 2004; Zhang et al. 2005; Puthussery and Fletcher 2009), P2Y receptors appear more likely to be involved in gliotic events during disease (Uckermann et al. 2003; Iandiev et al. 2006).

The high permeability of P2X7Rs to Ca2+ ions and the potential for pore formation make them a potential contributor to neurodegenerative processes. Intravitreal

44 The Role of Purinergic Receptors in Retinal Function and Disease

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injection of ATP into adult rat eyes leads to selective apoptosis of photoreceptors (Puthussery and Fletcher 2009), and there is an increase in P2X7R mRNA in the retina of the BALBCrds mouse during the peak period of photoreceptor degeneration (Franke et al. 2005). Stimulation of P2X7Rs on neonatal ganglion cells in culture causes an influx of extracellular calcium leading to cell death (Zhang et al. 2005) and increases in ocular pressure also lead to ganglion cell damage, likely to be mediated by P2X7R activation (Resta et al. 2007; Reigada et al. 2008). Therefore, altered extracellular ATP signalling may be involved in ganglion cell death during glaucoma.

Reactive gliosis is a common feature of many retinal diseases including diabetic retinopathy (Mizutani et al. 1998), retinal detachment (Francke et al. 2005) and retinal degeneration (Eisenfeld et al. 1984). However, the underlying cause of glial cell change during disease is not well understood. Some recent studies have suggested that activation of P2Y receptors on Müller cells may regulate some of these changes. Following induced retinal detachment in rabbit retinae, it was shown that Müller cells in vivo were more responsive to ATP (Uckermann et al. 2003). Similarly, in a porcine model of retinal detachment, increases in Müller cell Ca2+ responses following application of ATP was found, as was a concomitant increase in the expression of P2Y1 and 2 receptors in Müller cells (Iandiev et al. 2006). This is supported by studies on cultured guinea pig Müller cells, which were shown to respond to application of ATP with an increase in DNA synthesis, which suggests cellular proliferation (Moll et al. 2002; Milenkovic et al. 2003). In light of the important role of that purinergic receptors play in glial-glial and glial-neuronal signalling in the retina, it is possible that altered purinergic transmission contributes to glial cell dysfunction during disease.

44.5 Concluding Remarks

Our understanding of the role of extracellular ATP in modulation of retinal signalling is rapidly expanding. Furthermore, exciting findings suggest that changes in purinergic signalling may contribute to retinal pathologies, in particular glial cell function and photoreceptor death, and therefore may provide novel therapeutic interventions in the future.

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Part IV

Macular Degeneration