Xiao Fan, Wu Feipeng, Zhong Peipei, Hu Tian, Luo Rong
Ophthalmology Department, The First Affiliated Hospital of Nanchang Medical College, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China.
Diabet Med. 2025 Mar 11:e70014. doi: 10.1111/dme.70014.
Diabetic retinopathy (DR) is a prevalent microvascular complication of diabetes and a leading cause of vision loss among diabetic individuals. Retinal pigment epithelium (RPE) cells play a crucial role in the pathophysiology of DR by releasing cytokines and exosomal cargo, such as long non-coding RNAs (lncRNAs), that modulate local immune responses, maintain retinal immune homeostasis and influence macrophage polarisation. Recent studies suggest that lncRNA cancer susceptibility candidate 2 (CASC2) may be involved in the regulation of DR progression. However, the regulatory mechanisms linking CASC2 with RPE cells and its role in macrophage polarisation remain insufficiently understood.
Various types of cells, including human retinal pigment epithelial cells (ARPE-19), THP-1 monocytes and additional retinal cell lines, were cultured under normal glucose and high glucose conditions. ARPE-19 cells were exposed to oxidative stress, inflammatory stimulation, or hypoxic conditions. Plasma and aqueous humour samples were collected from DR patients and diabetic controls. Exosomes were extracted from AREP-19 cells and characterised. Various gene and protein expression analyses were performed using techniques including quantitative reverse transcription polymerase chain reaction, Western blot, immunofluorescence, flow cytometry, enzyme-linked immunosorbent assay, and histological staining. Cell proliferation and migration were assessed using Cell Counting Kit-8 assays and Transwell migration assays, respectively. The interactions among CASC2, suppressor of cytokine signalling 6 (SOCS6), and U2 small nuclear RNA auxiliary factor 2 (U2AF2) were explored using RNA immunoprecipitation and dual-luciferase reporter assays. An in vivo diabetic rat model was established.
lncRNA CASC2 expression levels were significantly lower in plasma and aqueous humour from DR patients compared to those from diabetic patients without retinopathy. Overexpression of CASC2 significantly attenuated DR and inflammatory damage both in vitro and in vivo. We demonstrated that exosomal CASC2 from ARPE-19 cells mediated macrophage polarisation by inhibiting M1 polarisation and promoting M2 polarisation. Our findings suggest that CASC2 regulates this polarisation through the stabilisation of SOCS6 mRNA via U2AF2.
CASC2 derived from RPE cells was transported to macrophages, inducing M2 polarisation by stabilising SOCS6 mRNA through the recruitment of U2AF2. This research may provide a foundation for developing novel therapeutic strategies for DR.
糖尿病视网膜病变(DR)是糖尿病常见的微血管并发症,也是糖尿病患者视力丧失的主要原因。视网膜色素上皮(RPE)细胞在DR的病理生理过程中起关键作用,通过释放细胞因子和外泌体成分,如长链非编码RNA(lncRNAs),来调节局部免疫反应、维持视网膜免疫稳态并影响巨噬细胞极化。最近的研究表明,lncRNA癌症易感性候选基因2(CASC2)可能参与DR进展的调控。然而,将CASC2与RPE细胞联系起来的调控机制及其在巨噬细胞极化中的作用仍未得到充分了解。
在正常葡萄糖和高葡萄糖条件下培养包括人视网膜色素上皮细胞(ARPE-19)、THP-1单核细胞及其他视网膜细胞系在内的多种细胞类型。将ARPE-19细胞暴露于氧化应激、炎症刺激或缺氧条件下。从DR患者和糖尿病对照组收集血浆和房水样本。从ARPE-19细胞中提取外泌体并进行表征。使用定量逆转录聚合酶链反应、蛋白质免疫印迹、免疫荧光、流式细胞术、酶联免疫吸附测定和组织学染色等技术进行各种基因和蛋白质表达分析。分别使用细胞计数试剂盒-8法和Transwell迁移试验评估细胞增殖和迁移。通过RNA免疫沉淀和双荧光素酶报告基因试验探索CASC2、细胞因子信号转导抑制因子6(SOCS6)和U2小核RNA辅助因子2(U2AF2)之间的相互作用。建立体内糖尿病大鼠模型。
与无视网膜病变的糖尿病患者相比,DR患者血浆和房水中lncRNA CASC2的表达水平显著降低。CASC2的过表达在体外和体内均显著减轻了DR和炎症损伤。我们证明,ARPE-19细胞来源的外泌体CASC2通过抑制M1极化和促进M2极化介导巨噬细胞极化。我们的研究结果表明,CASC2通过U2AF2稳定SOCS6 mRNA来调节这种极化。
RPE细胞来源的CASC2被转运至巨噬细胞,通过招募U2AF稳定SOCS6 mRNA诱导M2极化。本研究可能为开发DR的新型治疗策略提供基础。