GDNF gene therapy attenuates retinal ischemic injuries in rats

Purpose: To examine the protective effects of glial cell line-derived neurotrophic factor (GDNF) on retinal ischemia-reperfusion injury by using gene delivery. Methods: Gene delivery to retinal cells was achieved through intravitreal injections of recombinant adeno-associated virus expressing GDNF (rAAV-GDNF) in the right eyes and AAV expressing Escherichia coli LacZ (rAAV-LacZ) in the left eyes of Sprague-Dawley rats. Ischemic injury was introduced three weeks after gene delivery. The synthesis and accumulation of GDNF within the retina were determined using immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) three weeks after gene delivery. The neuroprotective effects of GDNF were evaluated by determining the preservation of the inner retina thickness and the cell counts in the retinal ganglion cell (RGC) layer one week after reperfusion. In addition, eletroretinograms (ERGs) were performed to determine the functionality of the retinas. Finally, the levels of RGC apoptosis were measured using the TdT-dUTP terminal nick-end labeling (TUNEL) method 6 h after reperfusion. Results: Gene expression of GDNF was demonstrated through immunohistochemistry and ELISA. Thinning of the inner retina and decreased numbers of cells in RGC layer were noted after ischemia in all of the eyes. However, the thickness of the inner retina and the numbers of cells in RGC layer were better preserved in rAAV-GDNF treated eyes than in rAAV-LacZ treated eyes seven days after reperfusion (p=0.028 and p<0.001, respectively). Also, seven days after reperfusion, the rAAV-GDNF treated eyes had retained larger b-wave amplitudes than rAAV-LacZ treated eyes (p=0.003). Finally, rAAV-GDNF treated eyes had statistically fewer apoptotic cells in the RGC layer than the control eyes (p=0.011). Conclusions: In these experiments, GDNF moderately protected rat retina from ischemia-reperfusion injury, possibly by preventing apoptosis in retinal cells.