Synergistic protective effects of escin and low‑dose glucocorticoids against vascular endothelial growth factor‑induced blood‑retinal barrier breakdown in retinal pigment epithelial and umbilical vein endothelial cells.

Previous studies have shown that escin possesses glucocorticoid (GC)‑like anti‑edematous and anti‑inflammatory effects. The present study was designed to investigate whether escin exhibits synergistic protective effects against blood‑retinal barrier (BRB) breakdown when combined with GC in an in vitro monolayer BRB model, based on retinal pigment epithelial (RPE) cells and human umbilical vein endothelial cells (HUVECs). The results showed that low concentrations of escin and triamcinolone acetonide (TA) administered separately did not affect BRB trans‑endothelial (epithelium) resistance (TEER). However, when administered together, escin and TA significantly inhibited reduced BRB TEER following treatment with vascular endothelial growth factor (VEGF). Furthermore, low‑concentrations of escin and TA administered together significantly increased the expression levels of occludin and ZO‑1. This demonstrates that escin and GC have synergistic protective effects against BRB breakdown, and the molecular mechanisms may be related to the upregulation of occludin and ZO‑1 expression. The combination of escin with GC indicates a potential beneficial strategy for the treatment of breakdown of the BRB.