<p>The visual system in humans provides the ability to interpret our surroundings from many distances. This complex system serves as a powerful sense which can drastically impact the quality of life when threatened or eliminated. While the mechanisms involved in visual interpretation are largely understood, many of the mechanisms of ocular diseases remain elusive. The most common ocular disorders are refractive errors, where failure of normal growth processes results in eye components with shape and sizes that are not matched to provide uncorrected sharp visual acuity without correction. Myopia, or nearsightedness, is a refractive error with prevalence rates of epidemic proportions in some urban Asian settings, and rising in other developed countries. Pathological, or high myopia, has an increased risk for potentially blinding ocular morbidities which can be irreversible and further negatively impact quality of life. Myopia, like other common ocular disorders, results from a combination of environmental and genetic factors. Over 20 candidate genomic regions have been identified as involved in myopic development progression. </p><p>One such locus, <italic>MYP3</italic>, on chromosome 12q21-23 spans nearly 44 Mb with more than 200 protein-encoding genes mapped within. Sizable candidate disease genomic regions typically require refinement to identify genes or variants within them which may contribute to disease development. Without an understanding of the underlying mechanistic framework of a disease, as is the case with myopia, biological inferences are difficult to make in prioritizing candidates, which can make finding true disease causing variants seem like finding a needle in a haystack. A better understanding of human ocular growth, as it relates to refractive error, may lead to more knowledgeable approaches to identifying the cause(s) of myopic development and associated ocular diseases. </p><p>To identify genes involved in ocular growth and development, whole genome expression patterns were assessed in human ocular tissues of fetal versus adult eyes, and adult posterior versus peripheral tissues. No database exists of fetal ocular tissue gene expression. In addition to providing insights into expression patterns during ocular development, these tissues were also compared as a surrogate to study rapid eye growth states such as in myopia. Only ocular tissue types with clinical phenotypes associated with myopic development were considered. Human retina/retinal pigment epithelium (RPE), choroid, sclera, cornea* and optic nerve* tissues were isolated from fetal (N=9; *N= 6) and adult (N=6) normal donor eyes. The Illumina® whole genome expression microarray platform was used to assess differential expression of genes. Fetal tissues were compared to their adult counterparts while adult posterior tissues were compared to their peripheral counterparts, and the differences in each were assessed using Ingenuity Pathway Analysis (IPA) for enriched functional groups and canonical pathways. Statistical significance for all tissue comparisons was determined using the Benjamin and Hochberg False Discovery Rate (FDR, 5%). Differentially expressed genes were compared to previously identified candidates for myopic development.</p><p>Additionally, qualitative and quantitative association studies in a large family (N=82) based high myopia cohort by genotyping 768 single nucleotide polymorphisms (SNPs) in the peak linkage area was performed to fine map the <italic>MYP3</italic> linkage peak. Qualitative testing for high myopia (&#8804; -5 diopter (D) affected, > -5 D unaffected) and quantitative testing on the average (avg) dioptric sphere (SPH) was performed. Five candidate SNPs were genotyped in a replicate high myopia cohort for independent validation. Additionally, the most significant SNPs were screened in a previously genotyped twin cohort as a second independent validation cohort.</p><p>Ocular growth expression data were used to help prioritize the resulting association candidates as supporting evidence and was not used on its own to identify or exclude candidates. Candidate genes (within 100 kilobases (kb) of highly associated SNPs) identified through either qualitative or quantitative association testing were screened in the most disease relevant tissues (retina/ retinal pigment epithelium (RPE), choroid and sclera) for differential expression during ocular growth and by physical regions of the tissues within the eye. Genes that were identified by microarray studies as being differentially expressed in one or more tissue were validated using quantitative real time PCR (RT-qPCR). </p><p>Significant gene expression changes with fold changes > 1.5 were found in adult versus fetal retina/RPE (N=1185), choroid (N=6446), sclera (N=1349), and cornea (N=3872), but not the optic nerve nor any of the central versus peripheral tissues. In all adult versus fetal tissues, differentially expressed genes belonging to cancer, development, and cell death/growth functional groups, as well as signaling canonical pathways were enriched. Seventeen genes previously associated with increased susceptibility for non-syndromic high myopia were in the most significant functional assignments for at least one adult versus fetal ocular tissue. In adult central versus peripheral tissues, there was considerably more variation by tissue in enriched functions and canonical pathways of differentially expressed genes. The only functional category shared by all three tissue types was development. </p><p><italic>MYP3</italic> association testing yielded several genetic markers as nominally significant in association with high myopia in qualitative testing including <italic>rs3803036</italic> (p=9.1X10-4), a missense mutation in <italic>PTPRR</italic>; and <italic>rs4764971</italic> (p = 6.1X10-4), an intronic SNP in <italic>UHRF1BP1L</italic>. After correction for multiple testing, quantitative tests found statistically significant SNPs<italic> rs4764971</italic> (p = 3.1x10-6), also found by qualitative testing; <italic>rs7134216</italic> (p = 5.4X10-7), in the 3<super>1</super> UTR of <italic>DEPDC4</italic>; and <italic>rs17306116<iitalic> (p < 9X10-4), intronic within <italic>PPFIA2<italic>. The intronic SNP in <italic>UHRF1BP1L</italic>, <italic>rs4764971</italic>, was validated for association with the quantitative trait of sphere (SPH) using an independently collected non-syndromic, high myopia cohort. SNPs within <italic>PTPRR</italic> (for quantitative association) and <italic>PPFIA2</italic> (for qualitative and quantitative association) both approached significance in the independent high myopia cohort.</p><p>As with screening genes previously implicated in myopic development, qualitative and quantitative association candidates were screened in the independent whole genome expression array analyses, comparing normal rapidly growing fetal to normal grown adult ocular tissues. <italic>PTPRR</italic> and <italic>PPFIA2<italic>, candidates from qualitative and quantitative association respectively, were both validated by RT-qPCR with differential expression in at least one disease relevant ocular tissue. <italic>PTPRR</italic> and <italic>PPFIA2<italic> belong to the same gene family- that of protein tyrosine phosphatase (PTP) genes. This family of genes relays extracellular signals that regulate cell growth, division, maturation and function, and its differential expression is consistent with our myopia surrogate model. </p><p>Many genes implicated in either syndromic or non-syndromic myopia were present in the most significantly enriched adult versus fetal functional and/or canonical pathways together. The adult versus fetal choroid and cornea tissue types had the most overlap with known non-syndromic myopic-associated genes in the most significantly enriched functional groups. Further exploration of the connections amongst these known genes may elucidate possible mechanistic roles for disease progression and/or reveal related novel candidate genes. Differentially expressed genes in central versus peripheral tissues yielded minimal overlap with genes implicated in myopia; however, in addition to broadening our understanding of the spatial variances in these tissues they may contain clues to the development and/or progression of other ocular diseases such as retinopathy of prematurity development.</p><p>The overlap with previously identified myopia-associated genes supports the model of eye growth for studying myopic development in human tissues. This expression data can be used both in prioritizing candidate genes other proposed genomic myopia loci, and also in detailed pathway analyses to identify potential biological mechanisms for candidates within these loci. Our most strongly associated candidate gene both in the discovery and replicate cohort was <italic>UHRF1BP1L</italic>, which was not differentially expressed in our data; however, interacting genes regulate the expression of at least one differentially expressed gene, indicating a possibly pathway connection. It is possible that differential expression may have been missed by the microarray data, or it may not be differentially expressed and affects myopic development through alternative or indirect means. While the expression data is a useful tool in prioritizing and inferring mechanistic roles for candidates, it cannot be used to exclude candidates. Deeper study of the pathways of candidate genes for myopic development may reveal connections to genes involved in ocular growth. Despite these potential limitations, two of the three novel candidates, <italic>PTPRR</italic> and <italic>PPFIA2</italic>, were supported by genomic convergence with the expression data, in addition to our discovery genetic association data. The other novel candidate, <italic>UHRF1BP1L</italic>, was validated in an independent Caucasian high-grade myopia cohort. Further validation and refinement of these three novel <italic>MYP3<italic> candidate genes is necessary to make further claims about their possible involvement in myopic progression.</p> / Dissertation

Current treatment for posterior segment ocular diseases requires intravitreal injections administered every 4-6 weeks. The potential for siRNA to be used to treat these diseases is extremely attractive due to the specificity of these molecules and their potential for making long term changes to the expression patterns of the cells. Due to physiological recognition, however siRNA undergoes rapid degradation upon application. The development of cationic nanogels using polymeric “smart” biomaterials with degradable components to transport siRNA is described. pH – sensitive N, N dimethylaminoethyl methacrylate (DMAEMA) was crosslinked with thermo-sensitive diethylene glycol methacrylate (DEGMA), by free radical emulsion-precipitation polymerization. Size, charge and morphology were analyzed to assess potential as a nanovehicle. Through modification of the particle composition, cationic nanogels, determined by zeta potential, with sizes of approximately 160 nm confirmed with dynamic light scattering (DLS), were synthesized. A composition of 55:45 (DEGMA:DMAEMA); a size and charge ideal for cellular uptake. These particles had minimal impact on cell proliferation and exhibited spherical morphology when imaged by TEM at physiological pH. The structure was maintained between pH 3.5-9. Sensitivity to pH was shown by DLS through swelling at physiological pH, which may be useful can be taken advantage of in future studies for loading and release. Degradation with a reducing agent was shown using gel permeation chromatography, DLS and turbidity analysis. The results suggest this formula will undergo degradation in the cell. Reducing environments mimicking intracellular conditions that promoted degradation of the crosslinker showed enhanced release of dexamethasone phosphate as a model drug. Ongoing work is focused on examining gene silencing using these formulations. / Thesis / Master of Applied Science (MASc)

Il est connu qu’on retrouve chez les femmes en post-ménopause un risque plus important de développer des maladies oculaires comparativement aux hommes du même groupe d’âge. Il semble que les changements hormonaux, et en particulier la baisse importante des niveaux d’estradiol, secondaires à la sénescence folliculaire constituent un facteur étiologique à long terme. Cela étant, il est légitime de se demander si les variations des niveaux d’hormones sexuelles endogènes peuvent également occasionner des effets à court terme sur les tissus de l’œil. Cette interrogation constitue d’ailleurs le motif principal de l’élaboration de la présente étude. Sachant qu’il se produit chez les femmes non ménopausées des variations continuelles des niveaux d’hormones sexuelles stéroïdiennes au cours de leur cycle menstruel, des femmes en âge de procréer ont été recrutées comme sujets d’étude. Dans un deuxième temps, afin de trouver le paramètre d’intérêt, on a effectué une revue de la documentation scientifique qui révèle un fait bien établi : les estrogènes favorisent la vasodilatation des vaisseaux sanguins par l’intermédiaire du monoxyde d’azote, et permettent, par le fait même, l’accroissement du débit sanguin tissulaire. Or, comment mesurer des variations de débit sanguin dans des tissus oculaires? Comme il est expliqué dans la discussion du présent mémoire, les variations d’oxygénation dans un organe dont le métabolisme est relativement stable sont le reflet de variations de débit sanguin. Grâce à une technique de mesure basée sur la spectroréflectométrie, il est possible de mesurer le taux d’oxyhémoglobine (HbO2) des lits capillaires du disque optique. En observant les variations du taux d’oxyhémoglobine au cours du cycle menstruel chez les sujets, on peut ainsi mesurer l’effet des variations hormonales cycliques sur l’irrigation des tissus oculaires. En somme, l’objectif de cette recherche est de mieux comprendre, en suivant le cycle menstruel des femmes, l’effet des hormones sexuelles endogènes sur l’oxygénation des lits capillaires du disque optique. Étant à la base du métabolisme de l’œil, l’apport en oxygène et en divers substrat véhiculés par la circulation sanguine est important au maintien de la santé oculaire. L’éclaircissement du lien entre les hormones et l’oxygénation de la rétine constituerait un avancement important, puisqu’il permettrait de comprendre pourquoi certaines atteintes oculaires, comme la cécité, touchent davantage les femmes. Les résultats de cette étude ont démontré que le taux d’oxyhémoglobine mesuré dans les lits capillaires du disque optique de l’œil ne subit pratiquement pas de variations significatives durant le cycle menstruel lorsqu’on considère les incertitudes des valeurs mesurées. Également, on observe une variabilité similaire des taux d’oxyhémoglobine mesurés chez les femmes en âge de procréation et chez les hommes du même groupe d’âge. Cela suggère que les changements hormonaux cycliques, qui ne se produisent que chez les femmes, n’occasionnent probablement pas de variation significative mesurable du taux d’oxyhémoglobine. Bref, malgré les effets possibles des estrogènes sur le diamètre artériolaire, il semble que les mécanismes locaux de régulation du débit sanguin tissulaire maintiennent un état d’équilibre propre au tissu irrigué et adapté aux besoins métaboliques locaux. / Postmenopausal women, when compared to men from the same age group, are more prone to develop ocular disease. It is thought that long term hormonal changes caused by ovarian senescence, and especially the drop in estradiol, are the etiological mechanism by which this phenomenon occurs. Whether variations in the levels of endogenous sexual hormones can produce short term effects in the tissues of the eye is less understood and, therefore, constitutes the main reason for carrying out the present study. Given that non menopausal women have repeated short term changes in the levels of sex steroid hormones during their menstrual cycle, we have recruited such women as study subjects. We also reviewed the scientific literature to establish what would be the parameter of interest and found a well characterised phenomenon: estrogens promote vasodilation by increasing nitrogen oxide production and thus promote a rise in blood flow. As to measuring variations in blood flow within the eye, it was explained in the discussion of the present memoir that changes in the oxygenation of an organ with a constant metabolism are induced by changes in the blood flow irrigating that organ. Using a method based on spectroreflectometry, it is possible to measure oxyhaemoglobin levels (HbO2) in the capillaries of the optic disc. By studying the variation of the HbO2 levels during the menstrual cycle, we can appreciate the effect of the cyclic hormonal changes on the ocular blood flow. The supply in oxygen and nutrients brought to an organ by its blood flow is essential for its metabolism. Therefore, the discovery of a correlation between sex hormone levels and the oxygenation of the retina would prove to be an important step towards understanding the higher frequency of certain ocular diseases in postmenopausal women, as compared to men of the same age group. The results of our study show that HbO2 levels in the capillary beds of the optic disc do not undergo statistically significant variations during the menstrual cycle. The same results were found, during a similar observational period, for male subjects used in the study as controls. These results suggest that cyclic variations in the levels of sex hormones, which occur only in nonmenaopausal women, do not induce significant changes in the oxygenation of the optic disc. In short, despite the possible effect of estrogens on the arteriolar diameter, it seems that local regulatory mechanisms of the blood flow maintain a tissue in a state of equilibrium that is adapted to its specific metabolic demand.

Il est connu qu’on retrouve chez les femmes en post-ménopause un risque plus important de développer des maladies oculaires comparativement aux hommes du même groupe d’âge. Il semble que les changements hormonaux, et en particulier la baisse importante des niveaux d’estradiol, secondaires à la sénescence folliculaire constituent un facteur étiologique à long terme. Cela étant, il est légitime de se demander si les variations des niveaux d’hormones sexuelles endogènes peuvent également occasionner des effets à court terme sur les tissus de l’œil. Cette interrogation constitue d’ailleurs le motif principal de l’élaboration de la présente étude. Sachant qu’il se produit chez les femmes non ménopausées des variations continuelles des niveaux d’hormones sexuelles stéroïdiennes au cours de leur cycle menstruel, des femmes en âge de procréer ont été recrutées comme sujets d’étude. Dans un deuxième temps, afin de trouver le paramètre d’intérêt, on a effectué une revue de la documentation scientifique qui révèle un fait bien établi : les estrogènes favorisent la vasodilatation des vaisseaux sanguins par l’intermédiaire du monoxyde d’azote, et permettent, par le fait même, l’accroissement du débit sanguin tissulaire. Or, comment mesurer des variations de débit sanguin dans des tissus oculaires? Comme il est expliqué dans la discussion du présent mémoire, les variations d’oxygénation dans un organe dont le métabolisme est relativement stable sont le reflet de variations de débit sanguin. Grâce à une technique de mesure basée sur la spectroréflectométrie, il est possible de mesurer le taux d’oxyhémoglobine (HbO2) des lits capillaires du disque optique. En observant les variations du taux d’oxyhémoglobine au cours du cycle menstruel chez les sujets, on peut ainsi mesurer l’effet des variations hormonales cycliques sur l’irrigation des tissus oculaires. En somme, l’objectif de cette recherche est de mieux comprendre, en suivant le cycle menstruel des femmes, l’effet des hormones sexuelles endogènes sur l’oxygénation des lits capillaires du disque optique. Étant à la base du métabolisme de l’œil, l’apport en oxygène et en divers substrat véhiculés par la circulation sanguine est important au maintien de la santé oculaire. L’éclaircissement du lien entre les hormones et l’oxygénation de la rétine constituerait un avancement important, puisqu’il permettrait de comprendre pourquoi certaines atteintes oculaires, comme la cécité, touchent davantage les femmes. Les résultats de cette étude ont démontré que le taux d’oxyhémoglobine mesuré dans les lits capillaires du disque optique de l’œil ne subit pratiquement pas de variations significatives durant le cycle menstruel lorsqu’on considère les incertitudes des valeurs mesurées. Également, on observe une variabilité similaire des taux d’oxyhémoglobine mesurés chez les femmes en âge de procréation et chez les hommes du même groupe d’âge. Cela suggère que les changements hormonaux cycliques, qui ne se produisent que chez les femmes, n’occasionnent probablement pas de variation significative mesurable du taux d’oxyhémoglobine. Bref, malgré les effets possibles des estrogènes sur le diamètre artériolaire, il semble que les mécanismes locaux de régulation du débit sanguin tissulaire maintiennent un état d’équilibre propre au tissu irrigué et adapté aux besoins métaboliques locaux. / Postmenopausal women, when compared to men from the same age group, are more prone to develop ocular disease. It is thought that long term hormonal changes caused by ovarian senescence, and especially the drop in estradiol, are the etiological mechanism by which this phenomenon occurs. Whether variations in the levels of endogenous sexual hormones can produce short term effects in the tissues of the eye is less understood and, therefore, constitutes the main reason for carrying out the present study. Given that non menopausal women have repeated short term changes in the levels of sex steroid hormones during their menstrual cycle, we have recruited such women as study subjects. We also reviewed the scientific literature to establish what would be the parameter of interest and found a well characterised phenomenon: estrogens promote vasodilation by increasing nitrogen oxide production and thus promote a rise in blood flow. As to measuring variations in blood flow within the eye, it was explained in the discussion of the present memoir that changes in the oxygenation of an organ with a constant metabolism are induced by changes in the blood flow irrigating that organ. Using a method based on spectroreflectometry, it is possible to measure oxyhaemoglobin levels (HbO2) in the capillaries of the optic disc. By studying the variation of the HbO2 levels during the menstrual cycle, we can appreciate the effect of the cyclic hormonal changes on the ocular blood flow. The supply in oxygen and nutrients brought to an organ by its blood flow is essential for its metabolism. Therefore, the discovery of a correlation between sex hormone levels and the oxygenation of the retina would prove to be an important step towards understanding the higher frequency of certain ocular diseases in postmenopausal women, as compared to men of the same age group. The results of our study show that HbO2 levels in the capillary beds of the optic disc do not undergo statistically significant variations during the menstrual cycle. The same results were found, during a similar observational period, for male subjects used in the study as controls. These results suggest that cyclic variations in the levels of sex hormones, which occur only in nonmenaopausal women, do not induce significant changes in the oxygenation of the optic disc. In short, despite the possible effect of estrogens on the arteriolar diameter, it seems that local regulatory mechanisms of the blood flow maintain a tissue in a state of equilibrium that is adapted to its specific metabolic demand.