Co-delivery of ripasudil and dexamethasone in trabecular meshwork cells for potential prevention of GC-induced ocular hypertension

The purpose of this in vitro study is to investigate whether the co-delivery of Ripasudil (Rip) can suppress the expression of genes related to glaucoma pathogenesis induced by prolonged dexamethasone (Dex) use, which can lead to ocular hypertension and potentially glaucoma formation. The effects of Rip (10 μM) on Dex (100 nM)-treated human trabecular meshwork (TM) cells were tested through co-delivery and sequential treatments using RNA-seq. Genome-wide analysis was performed using gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis with Enrichr and DAVID gene analysis tools. Gene enrichment and pathway analysis revealed that Rip, when co-delivered or sequentially delivered with Dex, influenced genes involved in glaucoma-related pathways such as focal adhesion, extracellular matrix (ECM) organization, and regulation of the actin cytoskeleton. Rip treatment downregulated genes like ACTA2, COL11A1, ECM2, MBP, and ANGPTL7, which are associated with increased outflow resistance and elevated intraocular pressure (IOP). Additionally, Rip upregulated ITGA11, a gene that promotes actin cytoskeleton reorganization and TM cell relaxation by inhibiting the Rho-ROCK pathway. Overall, co-delivery or sequential delivery of Rip can reverse or prevent Dex-induced ocular hypertension and glaucoma formation by modulating the expression of glaucoma-related genes at the transcriptional level.