In proliferative retinopathies, complications derived from neovascularization cause
blindness. During early disease, pericyte's apoptosis contributes to endothelial dysfunction and leakage.
Hypoxia then drives
VEGF (
vascular endothelial growth factor) secretion and pathological neoangiogenesis. Cardiac
ANP (
atrial natriuretic peptide) contributes to systemic microcirculatory homeostasis.
ANP is also formed in the retina, with unclear functions. Here, we characterized whether endogenously formed
ANP regulates
retinal (neo)angiogenesis. Approach and Results:
Retinal vascular development and
ischemia-driven neovascularization were studied in mice with global deletion of GC-A (
guanylyl cyclase-A), the cGMP (cyclic
guanosine monophosphate)-forming
ANP receptor. Mice with a floxed GC-A gene were interbred with Tie2-Cre, GFAP-Cre, or PDGF-Rβ-CreERT2 lines to dissect the endothelial, astrocyte versus pericyte-mediated actions of
ANP in vivo. In neonates with global GC-A deletion (KO), vascular development was mildly delayed. Moreover, such KO mice showed augmented vascular regression and exacerbated
ischemia-driven neovascularization in the model of
oxygen-induced retinopathy. Notably, absence of GC-A in endothelial cells did not impact
retinal vascular development or
pathological neovascularization. In vitro
ANP/GC-A/cGMP signaling, via activation of
cGMP-dependent protein kinase I, inhibited
hypoxia-driven astrocyte's
VEGF secretion and TGF-β (
transforming growth factor beta)-induced pericyte apoptosis. In neonates lacking
ANP/GC-A signaling in astrocytes, vascular development and
hyperoxia-driven vascular regression were unaltered;
ischemia-induced neovascularization was modestly increased. Remarkably, inactivation of GC-A in pericytes retarded physiological
retinal vascularization and markedly enhanced cell apoptosis, vascular regression, and subsequent neovascularization in
oxygen-induced retinopathy.
CONCLUSIONS: Protective pericyte effects of the
ANP/GC-A/cGMP pathway counterregulate the initiation and progression of experimental proliferative retinopathy. Our observations indicate augmentation of endogenous pericyte
ANP signaling as target for treatment of retinopathies associated with neovascularization.