Vitamin E protects against retinopathy of prematurity through action on spindle cells

Abstract

In the premature infant, exposure of the incompletely vascularized retina to increased oxygen tension can result in the development of a blinding disease, retinopathy of prematurity (ROP). Despite the judicious curtailment of oxygen, the incidence of ROP is on the increase due to the technological advances that have improved the survival of the very young preterm infant1. Six clinical trials2–7 have documented the efficacy of vitamin E supplementation in suppressing the development of severe ROP8–10, but the mechanism of this protection has remained unknown. This report proposes that spindle cells, mesenchymal precursors of the inner retinal capillaries, are the primary inducers of the neovascularization associated with ROP. Exposure of spindle cells to elevated oxygen tension increases their gap junction area. This early morphologic event immediately halts the normal vasoformative process and eventually triggers the neovascularization that is observed clinically 8–12 weeks later. Vitamin E supplementation above the deficient plasma levels of these infants11 suppresses gap junction formation and clinically reduces the severity without altering the total incidence of ROP.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1

    Patz, A. Ophthalmology 90, 425–427 (1983).

    CAS  Article  Google Scholar 

  2. 2

    Johnson, L., Schaffer, D. & Boggs, T. R. Am. J. clin. Nutr. 27, 1158–1173 (1974).

    CAS  Article  Google Scholar 

  3. 3

    Finer, N. N., Schindler, R. F., Grant, G. D., Hill, G. B. & Peters, K. L. Lancet i, 1087–1091 (1982).

    Article  Google Scholar 

  4. 4

    Finer, N. N., Schindler, R. F., Peters, K. L. & Grant, G. D. Ophthalmology 90, 428–435 (1983).

    CAS  Article  Google Scholar 

  5. 5

    Hittner, H. M. et al. New Engl. J. Med. 305, 1365–1371 (1981).

    CAS  Article  Google Scholar 

  6. 6

    Hittner, H. M. et al. Pediatrics 71, 423–432 (1983).

    CAS  PubMed  Google Scholar 

  7. 7

    Hittner, H. M. et al. Pediatrics 73, 238–249 (1984).

    CAS  PubMed  Google Scholar 

  8. 8

    Kretzer, F. L. et al. in Developing and Regenerating Vertebrate Nervous Systems (eds Coates, P. W., Markwald, R. R. & Kenny, A. D.) 199–210 (Liss, New York, 1983).

    Google Scholar 

  9. 9

    Hittner, H. M. & Kretzer, F. L. Ciba Fdn Symp. 101, 165–185 (1983).

    CAS  Google Scholar 

  10. 10

    Hittner, H. M., Kretzer, F. L. & Rudolph, A. J. Hos. Pract. 19, 85–99 (1984).

    CAS  Article  Google Scholar 

  11. 11

    Farrell, P. M. J. Pediatr. 95, 869–872 (1979).

    CAS  Article  Google Scholar 

  12. 12

    Sobel, S., Gueriguian, J., Troendle, G. & Nevius, E. New Engl. J. Med. 306, 867 (1982).

    Google Scholar 

  13. 13

    Hittner, H. M. et al. New Engl. J. Med. 309, 669–670 (1983).

    Article  Google Scholar 

  14. 14

    Kretzer, F. L., Hittner, H. M., Johnson, A. T., Mehta, R. S. & Godio, L. B. Ann. N. Y. Acad. Sci. 393, 145–166 (1982).

    ADS  CAS  Article  Google Scholar 

  15. 15

    Kretzer, F. L., Hittner, H. M. & Mehta, R. S. Arch. Ophthalmol. 99, 2000–2006 (1981).

    CAS  Article  Google Scholar 

  16. 16

    Flower, R. W. & Blake, D. A. Pediat. Res. 15, 1293–1302 (1981).

    CAS  Article  Google Scholar 

  17. 17

    Ben Sira, I., Nissenkorn, I., Grunwald, E. & Yassur, Y. Br. J. Ophthalmol. 64, 758–762 (1980).

    CAS  Article  Google Scholar 

  18. 18

    Mousel, D. K. & Hoyt, C. S. Ophthalmology 11, 1121–1127 (1980).

    Article  Google Scholar 

  19. 19

    Nissenkorn, I., Kremer, I., Ben Sira, I., Cohen, S. & Garner, A. Br. J. Ophthalmol. 68, 36–41 (1984).

    CAS  Article  Google Scholar 

  20. 20

    Flynn, J. T. Trans. Am. Acad. Ophthalmol. Otolaryngol. 76, 1234–1246 (1972).

    Google Scholar 

  21. 21

    O'Grady, G. E., Flynn, J. T. & Herrera, J. A. South. med. J. 65, 655–658 (1972).

    CAS  Article  Google Scholar 

  22. 22

    Kingham, J. D. Arch. Ophthalmol. 96, 2049–2053 (1978).

    CAS  Article  Google Scholar 

  23. 23

    Ashton, N. Br. med. Bull. 26, 103–106 (1970).

    CAS  Article  Google Scholar 

  24. 24

    Patz, A. Curr. Eye Res. 3, 159–163 (1984).

    CAS  Article  Google Scholar 

  25. 25

    Patz, A. Br. J. Ophthalmol. 68, 42–46 (1984).

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kretzer, F., Mehta, R., Johnson, A. et al. Vitamin E protects against retinopathy of prematurity through action on spindle cells. Nature 309, 793–795 (1984). https://doi.org/10.1038/309793a0

Download citation

Further reading

Comments

By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.