Activated neutrophils contribute to retinal endothelial cell (EC) death and capillary degeneration associated with early diabetic retinopathy (DR), a major vision-threatening complication of diabetes. However, the factors and mechanisms driving neutrophil activation and cytotoxicity in diabetes remain insufficiently understood. Here, we show that lysyl oxidase (LOX), a matrix cross-linking and stiffening enzyme that increases retinal EC susceptibility to activated neutrophils, simultaneously activates neutrophils in its soluble form. Specifically, treatment of diabetic mice with LOX inhibitor β-aminopropionitrile (BAPN) prevented the diabetes-induced increase in neutrophil activation (extracellular release of neutrophil elastase and superoxide) and cytotoxicity toward cocultured mouse retinal ECs. Mouse neutrophils and differentiated (neutrophil-like) human HL-60 cells treated with recombinant LOX alone exhibited significant activation and cytotoxicity. Mechanistically, this LOX-induced neutrophil activation was associated with biphasic F-actin remodeling, with the initial and rapid (∼10 min) F-actin depolymerization followed by a significant increase in F-actin polymerization and polarization. Preventing the initial F-actin depolymerization blocked LOX-induced neutrophil activation and cytotoxicity toward cocultured retinal ECs. Finally, this biphasic F-actin remodeling was found to be essential for LOX-induced membrane aggregation of azurophilic granule marker CD63 and NADPH organizer p47phox, which are associated with extracellular release of neutrophil elastase and superoxide, respectively. By revealing a previously unrecognized causal link between LOX and actin-dependent neutrophil activation in diabetes, these findings provide fresh mechanistic insights into the proinflammatory role of LOX in early DR that goes beyond its canonical matrix-stiffening effects.
- Activated neutrophils kill retinal endothelial cells (ECs) in early diabetic retinopathy, but how neutrophils become activated in diabetes is not well understood.
- We found that lysyl oxidase (LOX), whose matrix-localized form activates retinal ECs, can also directly activate neutrophils in its soluble form.
- LOX-induced release of neutrophil elastase and superoxide is mediated by actin remodeling and membrane aggregation of azurophilic granules.
- The dual ability of LOX to activate neutrophils (in its soluble form) and retinal ECs (in its matrix-localized form) implicates it as a key proinflammatory target for early diabetic retinopathy.

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