sorbinil and Galactosemias

Tissues of the eye affected by diabetes are the lens, cornea, and retina. The lens becomes cataractous through osmotic swelling of its cortical fibers. Sorbitol, formed in the presence of aldose reductase, accumulates in the lens during hyperglycemia. Dulcitol similarly accumulates in the presence of galactosemia. Cataractogenesis in both cases can be prevented by inhibitors of aldose reductase. The efficacy of synthetic inhibitors differs in various tissues and species, but they react with aldose reductase at a common structural site. The most promising inhibitor is sorbinil . Diabetic retinopathy is similarly related to sorbitol accumulation and may be prevented or reversed by inhibition of aldose reductase. Healing of corneal wounds in diabetes is facilitated by enzyme inhibition. Retinal vasculopathy of diabetes is due to selective loss of the intramural pericytes that normally form structural elements in the retinal capillary walls. The vulnerability of these cells is due to their aldose reductase content. Whether inhibition of aldose reductase will prevent retinopathy is being tested in a randomized trial conducted by the National Eye Institute.

Topics: Aldehyde Reductase; Animals; Axonal Transport; Cataract; Corneal Diseases; Diabetic Neuropathies; Diabetic Retinopathy; Disease Models, Animal; Galactosemias; Humans; Imidazoles; Imidazolidines; Lens, Crystalline; Osmolar Concentration; Peripheral Nerves; Rats; Sorbitol; Structure-Activity Relationship; Sugar Alcohol Dehydrogenases

An increased prevalence of cataract is associated with diabetes. Biochemical studies of diabetic lenses have revealed a variety of metabolic abnormalities including changes in the levels of electrolytes, glutathione, nucleotides and sugars. Similar biochemical changes have also been observed in cataracts associated with galactosaemia, suggesting that these sugar cataracts have a common biochemical aetiology. The common biochemical factor found to initiate both types of sugar cataract is the formation of sugar alcohols (polyols) from either glucose or galactose by the enzyme aldose reductase (alditol: NADP+ 1-oxidoreductase, EC 1.1.1.21). Increased intracellular levels of these polar alcohols have a hyperosmotic effect which leads to lens fibre swelling, vacuole formation and subsequent opacification. The process of sugar cataract formation in animals can be prevented by inhibiting aldose reductase.

Topics: Aldehyde Reductase; Animals; Cataract; Diabetes Complications; Diabetes Mellitus; Diabetes Mellitus, Experimental; Galactose; Galactosemias; Glucose; Humans; Imidazoles; Imidazolidines; Intracellular Fluid; Lens, Crystalline; Mice; Osmosis; Rats; Sugar Alcohols

The acetic acid derivatives of [1,2,4]triazino[4,3-a]benzimidazole (TBI) were synthesized and tested in vitro and in vivo as selective aldose reductase (ALR2) inhibitors. Compound PS11 showed highest inhibitory activity (IC(50)) 0.32 microM and was found to be effective in preventing cataract development in severely galactosemic rats when administered as an eyedrop solution. All the compounds investigated were selective for ALR2, since none of them inhibited appreciably aldehyde reductase, sorbitol dehydrogenase, or glutathione reductase.

Topics: Acetic Acid; Aldehyde Reductase; Animals; Benzimidazoles; Cataract; Disease Models, Animal; Enzyme Inhibitors; Galactosemias; Inhibitory Concentration 50; Molecular Structure; Naphthalenes; Ophthalmic Solutions; Rats

Cyano(2-oxo-2,3-dihydroindol-3-yl)acetic acid derivatives were synthesized and tested as a novel class of aldose reductase (ALR2) inhibitors. Each compound was evaluated as a diastereomeric mixture, due to tautomeric equilibria in solution. The parent compound 39 exhibited a good inhibitory activity with an IC(50) value of 0.85 microM, similar to that of the well-known ARI sorbinil (IC(50) 0.50 microM). The concurrent introduction of a halogen and a lipophilic group in the 5- and in the 1-positions, respectively, of the indole nucleus of 39, gave compound 55, cyano[5-fluoro-1-(4-methylbenzyl)-2-oxo-2,3-dihydroindol-3-yl]acetic acid, which displayed the highest activity (IC(50) 0.075 microM, very close to that of tolrestat IC(50) 0.046 microM), with a good selectivity toward ALR2 compared with aldehyde reductase (ALR1) (16.4-fold), and no appreciable inhibitory properties against sorbitol dehydrogenase (SD), or glutathione reductase (GR). The isopropyl ester 59, a prodrug of 55, was found to be almost as effective as tolrestat in preventing cataract development in severely galactosemic rats when administered as an eye drop solution. Docking simulation of 55 into a three-dimensional model of human ALR2 made it possible to formulate the hypothesis that the 2-hydroxy tautomer was the active species binding into the catalytic site of the enzyme. This was fully consistent with the structure-activity relationships within this series of cyanooxoindolylacetic acid derivatives.

Topics: Acetates; Aldehyde Reductase; Animals; Cataract; Enzyme Inhibitors; Galactosemias; Humans; Indoles; Models, Molecular; Ophthalmic Solutions; Rats; Rats, Sprague-Dawley; Stereoisomerism; Structure-Activity Relationship

Acetic acid derivatives of [1,2,4]triazino[4,3-a]benzimidazole (TBI) were synthesized and tested in vitro and in vivo as a novel class of aldose reductase (ALR2) inhibitors. Compound 3, (10-benzyl[1,2,4]triazino[4,3-a]benzimidazol-3,4(10H)-dion-2-yl)acetic acid, displayed the highest inhibitory activity (IC(50) = 0.36 microM) and was found to be effective in preventing cataract development in severely galactosemic rats when administered as an eyedrop solution. All the compounds investigated were selective for ALR2, since none of them inhibited appreciably aldehyde reductase, sorbitol dehydrogenase, or glutathione reductase. The activity of 3 was lowered by inserting various substituents on the pendant phenyl ring, by shifting the acetic acid moiety from the 2 to the 3 position of the TBI nucleus, or by cleaving the TBI system to yield benzimidazolylidenehydrazines as open-chain analogues. A three-dimensional model of human ALR2 was built, taking into account the conformational changes induced by the binding of inhibitors such as zopolrestat, to simulate the docking of 3 into the enzyme active site. The theoretical binding mode of 3 was fully consistent with the structure-activity relationships in the TBI series and will guide the design of novel ALR2 inhibitors.

Topics: Acetates; Aldehyde Reductase; Animals; Benzimidazoles; Binding Sites; Cataract; Enzyme Inhibitors; Galactosemias; Humans; Models, Molecular; Ophthalmic Solutions; Protein Binding; Rats; Stereoisomerism; Structure-Activity Relationship; Triazines

The suitability of the galactose-fed rat as a model of diabetic retinopathy was examined in nondiabetic rats fed diets enriched with either 30% or 50% galactose for up to 2 years.. Retinal capillaries were examined by light and electron microscopy, and the prevalence or severity of diabetic-like lesions was quantitated.. Histologic evaluation of trypsin digests of retina revealed significantly greater than normal frequencies of pericyte ghosts and acellular capillaries at both 15 and 23 months receiving a 50% galactose diet. Similar lesions were observed in rats receiving a 30% galactose diet for 23 months. Capillary basement membrane thickening, dilated hypercellular capillaries (or intra-retinal microvascular abnormalities), and foci of vascular cells appeared in rats fed 50% galactose, but saccular microaneurysms characteristic of retinopathy in diabetic patients, diabetic dogs, and experimentally galactosemic dogs were not observed. Administration of the aldose reductase inhibitor, Sorbinil, to rats fed 50% galactose resulted in a significant inhibition of cataract and of galactitol accumulation in nerve and blood (by more that 90%) and retina (by 62%), but did not inhibit development of the retinal microvascular lesions.. Two years of galactosemia in rats seems to reproduce only a portion of the lesions characteristic of diabetic retinopathy in patients or dogs. Nevertheless, lesions characteristic of at least the early stages of retinopathy clearly do develop in this galactosemic rat model, and are not restrained by inhibition of retinal polyol accumulation by 62%.

Topics: Aldehyde Reductase; Animals; Basement Membrane; Capillaries; Cataract; Diabetic Retinopathy; Disease Models, Animal; Erythrocytes; Galactitol; Galactose; Galactosemias; Imidazoles; Imidazolidines; Male; Rats; Rats, Sprague-Dawley; Retina; Retinal Vessels; Sciatic Nerve

Recent work from our laboratory revealed a correlation between the degree of protein pigmentation in human cataractous lens and the advanced Maillard reaction as reflected by pentosidine formation. Although the data suggested a role for ascorbate in pentosidine formation in senile cataractous lenses, elevated pentosidine levels in diabetic cataracts suggested that glucosylation may be involved directly in pentosidine biosynthesis. To clarify this issue, we quantified pentosidine in lenses from rats with experimental galactosemia with and without aldose reductase inhibitor treatment. At 12 months, pentosidine-like fluorescence (335/385 nm) was three to six times higher (P < 0.0001) in water soluble and insoluble crystallins of galactosemic compared with nongalactosemic rats. Actual pentosidine levels increased shortly after onset of galactosemia. Contents in water-insoluble crystallins were 6.32 +/- 2.2 and 1.40 +/- 0.66 pmol/mg protein in galactosemic and control lenses, respectively (P < 0.001). Fluorescence and pentosidine were suppressed to almost control levels upon treatment with sorbinil. Incubation experiments showed that pentosidine could form slowly from galactose, but much more rapidly from ascorbate and its oxidation products. Its formation could be inhibited partly by both reduced and oxidized glutathione or epsilon-aminocaproic acid. The requirement of oxygen for pentosidine formation suggests that oxidative stress associated with glutathione depletion and ascorbate oxidation are plausible mechanisms for rapid pentosidine formation upon onset of galactosemia. In contrast, Maillard reaction by glycoxidation products may account for the sustained increase in pentosidine. Both these events may be linked to the newly recognized pseudohypoxic state of cells exposed to high sugar concentrations.

Topics: Aldehyde Reductase; Animals; Arginine; Ascorbic Acid; Diet; Female; Galactitol; Galactose; Galactosemias; Glutathione; Imidazoles; Imidazolidines; Lens, Crystalline; Lysine; Maillard Reaction; Rats; Rats, Sprague-Dawley; Time Factors

To evaluate the role of excessive polyol pathway activity in the pathogenesis of nerve disorders in diabetes mellitus, nerve conduction velocity was measured in motor nerves of diabetic dogs given an aldose reductase inhibitor (Sorbinil) or placebo, and also in non-diabetic dogs made experimentally galactosaemic. The nerve conduction velocity slowly declined in the diabetic placebo group, becoming significantly less than normal by the fifth year of the study, and the decline was prevented by administration of the aldose reductase inhibitor. Non-diabetic dogs made galactosaemic by consuming a 30% galactose diet developed erythrocyte and nerve polyol concentrations many times greater than that of diabetic or normal animals, but the nerve conduction velocity remained normal throughout 5 years of study. These results in dogs suggest that aldose reductase inhibitors may prevent defective nerve conduction in long-term diabetes, and raise the possibility that excessive accumulation of polyol itself is not sufficient to produce the nerve defect in the absence of excessive polyol utilization.

Topics: Aldehyde Reductase; Animals; Blood Glucose; Diabetes Mellitus, Experimental; Diabetic Neuropathies; Dogs; Erythrocytes; Galactosemias; Glycated Hemoglobin; Glycosuria; Imidazoles; Imidazolidines; Neural Conduction; Time Factors; Ulnar Nerve

Topics: Aldehyde Reductase; Animals; Cataract; Diabetic Retinopathy; Dogs; Galactosemias; Imidazoles; Imidazolidines; Research Design

To investigate a possible role of excessive polyol production in the pathogenesis of diabetic retinopathy, 16 ALX-induced diabetic dogs and 20 experimentally galactosemic dogs were randomly assigned to 5 yr of treatment with either sorbinil, an aldose reductase inhibitor, or a placebo. The severity of hyperglycemia in sorbinil-treated and placebo groups was monitored throughout the 5-yr study by assay of glycosuria and nonenzymatically glycated plasma protein and HbA1 needed in an effort to avoid confounding possible group differences in hyperglycemia severity with possible drug effects. Inhibition of polyol production by sorbinil was monitored in erythrocytes throughout the study and also in retina and other tissue obtained at autopsy. Trypsin digests of retinal vessels were compared after 60 mo of diabetes and after 42 and 60 mo of galactosemia. In diabetic dogs, development of retinopathy was not significantly influenced by a sorbinil dose (20 mg.kg-1 x day-1) sufficient to prevent elevation of sorbitol levels in retina and other tissue. Likewise, in dogs made experimentally galactosemic for 42-60 mo, administration of sorbinil (60-80 mg.kg-1 x day-1) had no significant effect on the development of retinopathy notwithstanding prevention of 93-96% of the polyol elevation in retina and other tissue. Retinal capillary basement membrane was significantly thicker than normal in diabetic and in galactosemic dogs and was not significantly influenced by administration of sorbinil in either dog model. Thus, no evidence was found that the development of retinopathy is critically dependent on excessive polyol production or accumulation.

Topics: Aldehyde Reductase; Animals; Diabetes Mellitus, Experimental; Diabetic Retinopathy; Dogs; Galactosemias; Imidazoles; Imidazolidines; Random Allocation; Sugar Alcohols

Galactitol and myo-inositol concentrations were measured in retinas, erythrocytes, and skeletal muscle of experimentally galactosemic dogs receiving a placebo or the aldose reductase inhibitor, sorbinil, for 5 yr. The concentration of galactitol was increased more than 30-fold in the retina and other tissues by galactosemia, and the increase was inhibited 90-96% in all tissues by sorbinil. The concentration of free myo-inositol was greater than normal in retinas of galactosemic dogs, and its concentration was not altered by the aldose-reductase inhibitor. The myo-inositol concentration likewise was greater than normal in the retinas of dogs that were diabetic for 2-4 months. The marked inhibition of polyol production and accumulation in the retina of sorbinil-treated galactosemic dogs was not associated with a comparable inhibition of retinopathy.

Topics: Aldehyde Reductase; Alloxan; Animals; Chromatography, Gas; Diabetes Mellitus, Experimental; Disease Models, Animal; Dogs; Erythrocytes; Galactitol; Galactosemias; Imidazoles; Imidazolidines; Inositol; Muscles; Retina

Chronic experimental hyperglycemia mediated by galactose has been shown to induce browning and cross-linking of rat tail tendon collagen that could be duplicated in vitro by nonenzymatic galactosylation. To investigate the nature of these changes, Sprague-Dawley rats were placed on a 33% galactose diet without and with sorbinil for 6 and 12 mo. Collagen-linked fluorescence and pentosidine cross-links increased with age and galactosemia in tail tendons (P less than 0.001) and skin but were essentially unresponsive to aldose reductase inhibition (ARI). In contrast, tendon breaking time in urea, a likely parameter of cross-linking, was markedly improved (P less than 0.001) by ARI. Fluorescence that was inhibited by sorbinil treatment was increased in pepsin and proteinase K digest of aortic tissue from galactosemic rats (P less than 0.001), but impaired enzymatic digestibility was not observed. Systolic blood pressure as potential consequence of aortic stiffening was not increased in galactosemia. These data suggest that fluorescence in skin and tendon might be in part due to advanced glycosylation and pentosidine formation because these were not decreased by ARI. However, they also suggest that nonfluorescent cross-links may also be forming because, in contrast to fluorescence, tail tendon breaking time was partly corrected by ARI. Thus, it appears that extracellular matrix changes in chronic galactosemia are complex, being partly attributable to advanced glycosylation and partly to polyol-pathway activation.

Topics: Aldehyde Reductase; Animals; Arginine; Body Weight; Collagen; Extracellular Matrix; Galactosemias; Glycated Hemoglobin; Imidazoles; Imidazolidines; Lysine; Male; Rats; Rats, Inbred Strains; Reference Values; Spectrometry, Fluorescence; Tendons

Biochemical alterations in the composition of retinal capillary basement membrane components were investigated in galactosemic rats, an animal model that develops basement membrane lesions comparable to those of diabetic retinopathy. Normotensive Wistar-Kyoto rats fed a 30% galactose diet for 9 months developed significant thickening of retinal capillary basement membranes by comparison with animals fed a control test diet (P less than 0.001), or animals on a diet containing 30% galactose and 250 mg kg-1 of the aldose reductase inhibitor sorbinil (P less than 0.001). A quantitative electron microscopic immunogold technique applied on ultrathin sections of the retinas of these animals showed that the labeling densities of collagen type IV and laminin per unit cross-sectional area (which is presumably proportional to the concentrations of these molecules) were significantly increased in the retinal capillary basement membranes of galactose-fed rats, compared with animals on the control test diet. Increases in these two components of basement membranes were prevented by addition of sorbinil to the diet. However, there was no significant change in the labeling density of heparan sulfate proteoglycan (HSPG) core protein in the basement membranes of galactose-fed rats in comparison to animals on either the control diet or galactose-sorbinil diet. Two types of striated fibrillar materials were frequently found in areas of focal thickening of basement membranes of galactose fed rats only. Thinner fibrils reacted strongly with collagen type III antibody, whereas thicker fibrils reacted weakly with collagen type I antibody. Our results indicate that there is an increase in labeling densities of collagen type IV and laminin in thickened basement membranes of retinal capillaries of galactosemic rats along with the expression of interstitial collagens like collagen type III and an abnormal collagen that weakly cross-reacts with antibody to collagen type I, and these effects of galactosemia on the basement membranes are preventable by an aldose reductase inhibitor.

Topics: Aldehyde Reductase; Animals; Basement Membrane; Capillaries; Collagen; Diabetic Retinopathy; Galactose; Galactosemias; Imidazoles; Imidazolidines; Laminin; Rats; Rats, Inbred WKY; Retinal Vessels; Sugar Alcohol Dehydrogenases

These studies were undertaken to assess the effects of increased galactose (v increased glucose) metabolism via the polyol pathway on vascular filtration function in the kidneys, eyes, nerves, and aorta. Quantitative radiolabeled tracer techniques were used to assess glomerular filtration rate (GFR) and regional tissue vascular clearance of plasma 131I-bovine serum albumin (BSA) in five groups of male Sprague-Dawley rats: nondiabetic controls, streptozotocin-diabetic rats, nondiabetic rats fed a 50% galactose diet, diabetic rats treated with sorbinil (an aldose reductase inhibitor), and galactose-fed rats treated with sorbinil. Sorbinil was added to the diet to provide a daily dose of approximately .2 mmol/kg body weight. After 2 months of diabetes or galactose ingestion, albumin clearance was increased twofold to fourfold in the eye (anterior uvea, choroid, and retina), sciatic nerve, aorta, and kidney; GFR was increased approximately twofold and urinary excretion of endogenous albumin and IgG were increased approximately 10-fold. Sorbinil treatment markedly reduced or completely prevented all of these changes in galactose-fed, as well as in diabetic rats. These observations support the hypothesis that increased metabolism of glucose via the sorbitol pathway is of central importance in mediating virtually all of the early changes in vascular filtration function associated with diabetes in the kidney, as well as in the eyes, nerves, and aorta. On the other hand, renal hypertrophy in diabetic rats and polyuria, hyperphagia, and impaired weight gain in galactose-fed and in diabetic rats were unaffected by sorbinil and therefore are unlikely to be mediated by increased polyol metabolism.

Topics: Animals; Aorta; Blood Vessels; Cobalt Radioisotopes; Diabetes Mellitus, Experimental; Edetic Acid; Eye; Galactose; Galactosemias; Glomerular Filtration Rate; Hemodynamics; Imidazoles; Imidazolidines; Immunoglobulin G; Iodine Radioisotopes; Kidney; Male; Metabolic Clearance Rate; Polymers; Rats; Rats, Inbred Strains; Sciatic Nerve; Serum Albumin, Bovine

Breakdown of the blood-retinal barrier (BRB) is an early event in diabetic and galactosemic rats, but the location and nature of the specific defect(s) are controversial. Using an electron microscopic immunocytochemical technique, the retinas of normal, diabetic, and galactosemic rats were immunostained for endogenous albumin. Normal rats showed little evidence of BRB breakdown at either the inner barrier (retinal vasculature) or the outer barrier (retinal pigment epithelium) (RPE). In diabetic and galactosemic rats, as was true in human diabetics, BRB breakdown occurred predominantly at the inner BRB, but in some cases at the outer barrier as well. Treatment with the aldose reductase inhibitor sorbinil largely prevented BRB failure in galactosemic rats. In the inner retina of diabetic and galactosemic rats, albumin was frequently demonstrated on the abluminal side of the retinal capillary endothelium (RCE) in intercellular spaces, basal laminae, pericytes, ganglion cells, astrocytes, and the perinuclear cytoplasm of cells in the inner nuclear layer. Albumin did not appear to cross RCE cell junctions; however, it was occasionally seen in RCE cytoplasm of galactosemic rats. In the outer retina, albumin was frequently detected in the subretinal space, in the intercellular space between photoreceptors, and in the perinuclear cytoplasm of photoreceptor cells, but was only infrequently found in the RPE cells constituting the barrier. Albumin derived from the choroidal vasculature did not appear to cross the tight junctions of the RPE. These findings suggest that specific sites of BRB compromise are infrequent but that once albumin has crossed the RCE or RPE it freely permeates the retinal tissue by filling intercellular spaces and permeating the membranes of cells not implicated in BRB formation. The diffuse cytoplasmic staining of some RCE and RPE cells suggests that the predominant means of BRB breakdown in diabetes and galactosemia involves increased focal permeability of the surface membranes of the RCE and RPE cells rather than defective tight junctions or vesicular transport.

Topics: Albumins; Aldehyde Reductase; Animals; Biological Transport; Blood-Retinal Barrier; Cell Membrane Permeability; Diabetes Mellitus, Experimental; Galactosemias; Imidazoles; Imidazolidines; Immunohistochemistry; Microscopy, Electron; Osmosis; Pigment Epithelium of Eye; Rats

Crystallin-bound non-tryptophan fluorescence and protein cross-linking were studied in chronic galactosemia. Fluorescence (excitation/emission--370/440 nm) was significantly higher in galactosemic rats compared to controls (P less than 0.001). Accumulation of fluorescence was significantly reduced both in water soluble (P less than 0.001) and insoluble (P less than 0.005) lens fractions in galactosemic rats receiving the aldose reductase inhibitor sorbinil. High performance liquid chromatography of water soluble lens crystallins showed an increase in the content of high molecular weight proteins and the fluorescence associated with it. Sorbinil partly prevented the formation of such fluorescent high molecular weight proteins. Under reducing conditions, sodium dodecyl sulfate polyacrylamide gel electrophoresis of water soluble proteins revealed a distinct high molecular weight protein of 60 kDa in galactosemia. Sorbinil treatment completely abolished the formation of this protein. Western blotting using rabbit antiserum to bovine alpha-, beta- and gamma-crystallins revealed the presence of gamma, but not alpha- and beta-crystallins in the 60-kDa protein. Formation of this protein may result from trimerization of gamma-crystallins or from an association of gamma-crystallin with a non-crystallin cytosolic protein or mixed protein cross-linking of gamma-crystallins with membrane protein(s). The present study shows that polyol pathway in cataractogenesis also extends to protein cross-linking and formation of fluorescent compounds, the nature of which remains to be elucidated.

Topics: Aldehyde Reductase; Animals; Blotting, Western; Crystallins; Fluorescence; Galactosemias; Imidazoles; Imidazolidines; Molecular Weight; Rats; Rats, Inbred Strains

Wide-field specular microscopy was used to examine the central corneal endothelium of age- and sex-matched beagle dogs fed for up to 32 months either normal control diets containing 30% nonnutrient filler (13 dogs) or diets containing 30% galactose with (13 dogs) or without (12 dogs) concomitant treatment with the aldose reductase inhibitor, sorbinil. Computerized morphometric analysis of the endothelial cells indicated that a significant decrease in cell density and increase in mean cell area occurred in untreated galactose-fed dogs after 32 months of feeding compared with the normal controls. However, no significant difference could be observed in similar galactose-fed dogs treated with sorbinil. No significant difference in the coefficient of variation of the area, or percent hexagonality of the endothelial cells, or the corneal thickness could be observed in any group. These findings demonstrated that endothelial abnormalities were present in the cornea of the galactose-fed dogs which were similar to those reported for diabetic dogs, rats, and patients and that these changes can be prevented by the concomitant administration of an aldose reductase inhibitor. These findings suggest a role for aldose reductase in the abnormalities noted in the corneal endothelium in diabetes and galactosemia.

Topics: Aldehyde Reductase; Animals; Cell Count; Dogs; Endothelium, Corneal; Galactose; Galactosemias; Image Processing, Computer-Assisted; Imidazoles; Imidazolidines; Male; Random Allocation

Rats were maintained on a 50% galactose diet with and without the aldose reductase inhibitor, Sorbinil, or on a normal diet of rat chow, and the retinas and retinal pigment epithelium were examined ultrastructurally at time points ranging from 4 weeks to 20 months. Several ultrastructural changes were observed in the retinal pigment epithelium and retinal capillaries of galactosemic rats that were not seen in rats on a normal diet. Only some of these changes are similar to those that have been previously noted in diabetic (glucosemic) rats. As in diabetics, galactosemic rats demonstrated thickening of the basal laminae of the retinal pigment epithelium and retinal capillaries. They also manifested vacuolization and degenerative foci in the retinal pigment epithelium that were similar, but not identical, to changes seen in diabetic rats. Each of these changes was significantly inhibited by Sorbinil. Unlike diabetics, galactosemic rats did not have dilated basal infoldings, but did have outer retinal folds and a significant increase in large-lipofuscin-like aggregates in the retinal pigment epithelium, both of which were partly prevented by Sorbinil. These data suggest that multiple mechanisms may be involved in retinal and retinal pigment epithelium changes in diabetic and galactosemic rats, and that enhanced polyol metabolism is likely to be involved in some of the changes in both.

Topics: Aldehyde Reductase; Animals; Galactosemias; Imidazoles; Imidazolidines; Pigment Epithelium of Eye; Rats; Rats, Inbred Strains; Retina; Sugar Alcohol Dehydrogenases

Permeability-surface-area products (PA) for sucrose at the blood-retinal barrier (BRB) were determined with quantitative in vivo techniques and compared in control rats, rats fed a 50% galactosemic diet, and rats fed a diet containing both galactose and the aldose reductase inhibitor sorbinil. The mean PA +/- SE for controls was 0.656 x 10(-5) +/- 0.13 ml.g-1.s-1 and increased by approximately 500% in galactose-fed animals to 3.13 x 10(-5) +/- 0.32 ml.g-1.s-1. Animals fed both galactose and sorbinil showed no significant difference from control animals (P greater than .05), with a PA of 0.91 x 10(-5) +/- 0.22 ml.g-1.s-1. No breach in the BRB to horseradish peroxidase was detected in any of the groups. These results demonstrate an increased permeability at the BRB to small molecules in galactosemic rats that is prevented by an aldose reductase inhibitor. This suggests that the retinal capillary basement membrane thickening seen in galactosemic rats is associated with an increased permeability of the BRB and that aldose reductase is implicated in its pathogenesis.

Topics: Aldehyde Reductase; Animals; Blood Pressure; Female; Galactosemias; Imidazoles; Imidazolidines; Permeability; Rats; Rats, Inbred Strains; Reference Values; Regional Blood Flow; Retina; Sugar Alcohol Dehydrogenases

Rats fed a high-galactose diet develop marked thickening of their retinal capillary basement membranes. The effect is prevented if the animals also receive the aldose reductase inhibitor sorbinil. The effect does not appear to be due to aldose reductase itself, since immunoreactive aldose reductase has not been found in the retinal microvasculature of the rat but rather to a related enzyme with similar substrate specificity. The detailed biochemical mechanism for basement membrane thickening is obscure, involving an alteration of the extracellular matrix, where aldose reductase and similar enzymes have not been described; osmotic damage to the microvascular cells, such as has been described following aldose reductase-induced sugar alcohol accumulation in lens epithelial cells, is not apparent in diabetic or galactosemic animals. It is possible that concentrations of intracellular sugar alcohols that do not substantially change the osmolarity of the cell cytosol alter intracellular enzyme activities. This, in turn, could affect the biosynthesis of extracellular matrix macromolecules, as suggested, for example, by the hypothesis of Rohrbach et al, based on studies of a basement membrane-producing tumor implanted in diabetic mice, which proposes that the hyperglycemia of diabetes mellitus causes a reduced synthesis of the heparan sulfate BM-1 proteoglycan with a subsequent overproduction of type IV collagen. This and other hypotheses of basement membrane thickening can be tested in diabetic or galactosemic rats, some of which receive aldose reductase inhibitors, or in retinal microvascular pericytes and endothelial cells grown in culture.

Topics: Aldehyde Reductase; Animals; Basement Membrane; Collagen; Diabetes Mellitus; Dogs; Female; Galactose; Galactosemias; Humans; Imidazoles; Imidazolidines; Mice; Microscopy, Electron; Rats; Rats, Inbred WKY; Retinal Vessels; Sugar Alcohol Dehydrogenases

The resistance of the action potential to ischemic inactivation observed in diabetic patients has been reproduced in vivo in rat rendered diabetic with streptozotocin and, acutely, in normal rats given p.o. a load of glucose. The resistance phenomenon was not detected in galactosemic rats. The preservation of the action potential was reversed by the administration of insulin, but not by treatment with an aldose reductase (AR) inhibitor. The ischemic resistance is attributed to the metabolic availability of excess glucose to the nerve. AR does not appear to be involved in the phenomenon.

Topics: Action Potentials; Aldehyde Reductase; Animals; Blood Glucose; Body Temperature; Diabetes Mellitus, Experimental; Diabetic Neuropathies; Galactosemias; Glucose; Imidazoles; Imidazolidines; Insulin; Ischemia; Neural Conduction; Rats; Rats, Inbred Strains

The interrelationship between sorbitol excess and myoinositol deficiency in the peripheral nerve was examined in acutely diabetic rats. Nerve myoinositol concentration was also studied in galactosemic rats. Polyol pathway blockade with Sorbinil (Pfizer, Connecticut) prevented nerve myoinositol reduction in both groups of animals. This conclusion was independent of alteration in the fluid content of the peripheral nerve. It is likely that myoinositol loss from nerves is causally related to the sorbitol and galactitol accumulation.

Topics: Aldehyde Reductase; Animals; Diabetes Mellitus, Experimental; Erythrocytes; Female; Galactosemias; Imidazoles; Imidazolidines; Inositol; Peripheral Nerves; Rats; Rats, Inbred Strains; Sciatic Nerve; Sorbitol; Sugar Alcohol Dehydrogenases

Rats fed a 50% galactose diet were treated topically in one eye with 1% Sorbinil . The eye treated with Sorbinil remained clear during the following 4-week period. Unexpectedly, the lens of the untreated eye also maintained transparency. Histologically both lenses remained normal. Moreover, the reduced dulcitol levels in the lenses of both eyes were identical. These findings suggest that the effect of topically administered Sorbinil in galactosemic rats was mainly systemic rather than local. Confirmation of this came from the observations that the extent of inhibition of polyol synthesis in these rats was found to be similar in the sciatic nerve, blood, and lens. A reversal of the galactose cataracts also was affected by Sorbinil eye drop treatment.

Topics: Animals; Cataract; Galactosemias; Imidazoles; Imidazolidines; Rats; Rats, Inbred Strains

A twofold thickening of capillary basement membranes of rat retinas resulting from dietary galactose was prevented by sorbinil, an inhibitor of aldose reductase. Since the basement membrane thickening was ultrastructurally similar to that typical of diabetic retinopathy, it may indicate changes in vessel permeability and susceptibility to hemorrhage. Galactosemic rats should be useful models for studying basement membrane-related complications of diabetes and for examining the potential biochemical regulation of basement membrane synthesis by aldose reductase inhibitors.

Topics: Animals; Basement Membrane; Capillaries; Diabetic Retinopathy; Disease Models, Animal; Galactosemias; Imidazoles; Imidazolidines; Male; Rats; Rats, Inbred Strains; Retinal Vessels

Abnormalities in corneal epithelial healing in diabetic patients have been described recently. Defects in corneal re-epithelialization in diabetic rats have been reported, and it was found that treatment with aldose reductase (AR) inhibitors effectively prevented these defects. Experiments using galactosemic rats to study further the role of AR in these defects, since AR is known to be the common factor involved in sugar cataractogeneses, are reported herein. Similar defects in corneal re-epithelialization in galactosemic rats as in diabetic rats were found. The delay in re-epithelialization was documented by computer planimetry. Light microscopy showed marked corneal stroma edema and wider intercellular spaces in the epithelium after complete re-epithelialization, while scanning electron microscopy revealed fewer filopodia projecting from the leading margin during the active migration stage. These defects were prevented by treating galactosemic rats with the aldose reductase inhibitor, Pfizer's Sorbinil. These suggest that AR plays a role in the defects in corneal re-epithelialization observed in diabetes.

Topics: Animals; Cornea; Epithelium; Galactosemias; Imidazoles; Imidazolidines; Rats; Rats, Inbred Strains; Wound Healing

Sorbinil, a potent aldose reductase inhibitor, can effectively block the progression of a galactose cataract even though the cataractous process is well underway. The prevention of dulcitol accumulation by Sorbinil is just as effective in reversing the cataract as the removal of galactose from the diet. The progression and reversal of the cataract were followed by ophthalmoscopy and histology. The results also further support the concept that in galactosemia the cataract is not caused by the toxic effects of galactose per se but by the consequence of the aldose reductase reaction.

Topics: Animals; Cataract; Galactosemias; Imidazoles; Imidazolidines; Rats; Rats, Inbred Strains

Topics: Animals; Cataract; Disease Models, Animal; Galactose; Galactosemias; Glycoproteins; Imidazoles; Imidazolidines; Lens, Crystalline; Proteins; Rats

In some tissues containing aldose reductase, increased flux through the polyol pathway has been implicated as being causative in diabetic complications (e.g., cataracts, peripheral neuropathy). We have found CP-45,634 (d-6-fluoro-spiro[chroman-4,4'-imidazolidine]-2',5'-dione) to be a highly potent, structurally novel, uncompetitive inhibitor of calf lens aldose reductase (IC50 approximately 5 X 10(-7)M). In a system in which sorbitol accumulation in isolated rat sciatic nerves was monitored in the presence of high (50 mM) glucose concentrations, CP-45,634 produced inhibition of polyol accumulation at levels as low as 1 X 10(-6)M. To determine if in vitro activity would translate to in vivo models, sorbitol accumulation in rat sciatic nerves was measured 27 hr after induction of diabetes with streptozotocin. Orally administered CP-45,634 was effective at dose levels as low as 0.25 mg/kg, t.i.d., and at 0.75 mg/kg produced an 85% inhibition of sorbitol accumulation. Two weeks after induction of diabetes by streptozotocin, sorbitol levels in rat lens and the sciatic nerve rose to 21,203 nmole/gm and 1,161 nmole/gm, respectively. Subsequent oral administration of CP-45,634 (2.5 mg/kg, b.i.d.) for 1 wk reduced these levels by 92% in nerves and 90% in lenses. In galactosemic rats, CP-45,634 inhibited the rise in lens galactitol and effectively delayed cataract formation at oral doses as low as 5 mg/kg/day. These high levels of in vivo activity suggest that CP-45,634 has potential for assessing the role of the polyol pathway in diabetic complications.

Topics: Aldehyde Reductase; Animals; Benzopyrans; Cataract; Chromans; Diabetes Mellitus, Experimental; Galactitol; Galactose; Galactosemias; Imidazoles; Imidazolidines; Kinetics; Lens, Crystalline; Male; Polymers; Rats; Sciatic Nerve; Sorbitol; Sugar Alcohol Dehydrogenases