Citation: He S, Barron E, Ishikawa K, et al. Inhibition of DNA methylation and methyl-CpG-binding protein 2 suppresses RPE transdifferentiation: relevance to proliferative vitreoretinopathy. Invest Ophthalmol Vis Sci. 2015;56:5579-5589. DOI:10.1167/ iovs.14-16258 PURPOSE. The purpose of this study was to evaluate expression of methyl-CpG-binding protein 2 (MeCP2) in epiretinal membranes from patients with proliferative vitreoretinopathy (PVR) and to investigate effects of inhibition of MeCP2 and DNA methylation on transforming growth factor (TGF)-b-induced retinal pigment epithelial (RPE) cell transdifferentiation.
METHODS.Expression of MeCP2 and its colocalization with cytokeratin and a-smooth muscle actin (a-SMA) in surgically excised PVR membranes was studied using immunohistochemistry. The effects of 5-AZA-2 0 -deoxycytidine (5-AZA-dC) on human RPE cell migration and viability were evaluated using a modified Boyden chamber assay and the colorimetric 3-(4,5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay. Expression of RASAL1 mRNA and its promoter region methylation were evaluated by real-time PCR and methylationspecific PCR. Effects of 5-AZA-dC on expression of a-SMA, fibronectin (FN), and TGF-b receptor 2 (TGF-b R2) and Smad2/3 phosphorylation were analyzed by Western blotting. Effect of short interfering RNA (siRNA) knock-down of MeCP2 on expression of a-SMA and FN induced by TGFb was determined.RESULTS. MeCP2 was abundantly expressed in cells within PVR membranes where it was double labeled with cells positive for cytokeratin and a-SMA. 5-AZA-dC inhibited expression of MeCP2 and suppressed RASAL1 gene methylation while increasing expression of the RASAL1 gene. Treatment with 5-AZA-dC significantly suppressed the expression of a-SMA, FN, TGF-b R2 and phosphorylation of Smad2/3 and inhibited RPE cell migration. TGF-b induced expression of a-SMA, and FN was suppressed by knock-down of MeCP2.CONCLUSIONS. MeCP2 and DNA methylation regulate RPE transdifferentiation and may be involved in the pathogenesis of PVR.