Epigenetics and eye diseases III – glaucoma

Nothing major happens for a long time. Nothing hurts, you can see perfectly normally, and yet for a long time now destructive processes have been going on intensively in your eyes, which in time can rob you of your sight. This is the main problem of an eye disease called glaucoma, popularly known as glaucoma.

The human eye is an extremely complex organ, with a huge number of genes involved in its development and function. In order for everything to work as it should, some genes need to be switched on at the right time (i.e. to make proteins) and others need to be switched off. It is this switching on and off that controls the processes we call epigenetic. These are biochemical reactions that can change the activity of individual genes in our DNA.

The fact that a gene is turned off or on is neither good nor bad in principle. It is necessary for individual genes to be active or inactive at exactly the right time. If this is not the case, it can become the basis for a whole range of diseases.

Our eyes are very sensitive to all epigenetic influences because of the number of genes involved in their functioning. Negative ones are also a major contributor to most eye problems, whether they are common refractive errors (i.e. myopia and hyperopia) or serious diseases that can lead to blindness. Glaucoma, or glaucoma, is one of the latter. Its essence is the accumulation of intraocular fluid, which leads to an increase in pressure inside the eye, which in turn damages the optic nerve.

A major problem with glaucoma is the fact mentioned in the introduction – that the affected person does not experience any symptoms for a long time. It is only in the later stages that he or she begins to perceive visual disturbances, such as visual field blurring, distorted peripheral vision or reduced visual acuity, but by then the optic nerve is irreversibly damaged and the treatment options are very complicated.

Why and how does glaucoma occur?

There can be a number of causes of the disease. Often it is a side effect of certain diseases (typically diabetes, high blood pressure or thyroid disease) or the use of certain medications (e.g. corticosteroids). However, genetic predispositions also play a role. In particular, factors that we refer to as epigenetic have a major influence.

Epigenetics is implicated in disease in several ways. First, changes in the production of histone deacetylase enzymes have been detected in patients – those with serial numbers 2 and 3 are usually increased, while HDCA 4 is decreased. These changes are probably related to damage to retinal and optic nerve cells.

The accumulation of chamber water in the eye leads to inadequate oxygenation of some tissues, which also causes changes in epigenetic processes, especially in terms of excessive methylation.

An important role is also played by microRNAs, very short-chain ribonucleic acids that can completely stop the process by which genes make proteins (i.e. turn off the gene). In fact, cells damaged by increased intraocular pressure release certain types of microRNAs (in particular those numbered 21, 450, 107 and 149), which then contribute to damage to the optic nerve. Other types of microRNAs are produced in lower quantities in patients, particularly those involved in protecting the ocular tissues from fibrosis.

Oxidative stress (i.e. free radical damage) and inflammatory processes also contribute to retinal and optic nerve damage.

An interesting finding is that valproic acid and its salts, which are used in the treatment of epilepsy and bipolar disorder, are very effective in regulating the formation of histone deacetylases that cause glaucoma.

What can help?

There are many factors that influence the activity of genes in our DNA. Positive ones include regular exercise, sufficient rest or a healthy diet containing all the necessary nutrients, while negative ones include an unhealthy diet (especially in the sense of excess carbohydrates, saturated fats and chemical toxins), stress, smoking, excessive drinking or a polluted environment. These factors also have a major impact on the health of our eyes and are therefore important in the prevention of all eye disorders and diseases, including glaucoma.

Dietary supplements that contain high concentrations of substances with positive epigenetic effects can be of great help. Specifically for glaucoma, the following are very useful:

Coleus forskohlii – this is an interesting herb growing in the lower elevations of the Himalayas. It contains a unique substance called forskolin, which can very effectively increase the body’s production of cyclic adenosine monophosphate (cAMP). CAMP is an essential substance that functions in the so-called cell signalling – it is involved in the transmission of information within cells and thus fundamentally affects the ability of cells to communicate with their surroundings and with each other. What makes it special for glaucoma sufferers is that it helps to effectively reduce intraocular pressure, even in cases where the individual is not responding to conventional treatment. In one study, for example, taking an extract of the plant reduced intraocular pressure by an average of 10%. In addition to oral use, eye drops with forskolin (1% solution) can be applied and reduce intraocular pressure for up to five hours.

Astaxanthin, an orange dye from the carotenoid family found in salmon, shrimp and lobster, has an overall positive effect on eye health and has been shown to be effective in the prevention and treatment of glaucoma. It effectively protects the cells of the retina and optic nerve from damage due to excessive production of free radicals (it is a powerful antioxidant), lack of oxygen and other influences.

Vitamins – the positive effect on overall eye health has been shown especially for vitamins C, D3 and E. Among minerals, zinc and selenium are important. In particular, with glaucoma, it is important to ensure a sufficient supply of vitamin B3.