Abstract

Background Choroidal neovascularization (CNV) is a leading cause of central vision impairment with limited treatment options. Ethyl ferulate is a natural compound with antioxidant and anti-angiogenic properties; however, its application for treating CNV and the underlying mechanisms remain largely unexplored. Purpose The aim of this study was to evaluate the therapeutic effects of ethyl ferulate on CNV and elucidate the underlying molecular mechanisms involved. Methods A laser-induced CNV mouse model received intravitreal injection of ethyl ferulate. Ocular evaluations included fundus fluorescein angiography, optical coherence tomography, and H&E staining. Mechanistic studies in retinal pigment epithelial (RPE) cells employed western blotting, co-immunoprecipitation, surface plasmon resonance, molecular docking, RT-qPCR, and chromatin immunoprecipitation, while anti-angiogenic activity in human umbilical vein endothelial cells utilized proliferation, migration, and tube formation assays. Results Intravitreal injection of ethyl ferulate significantly suppressed neovascularization in mice with laser-induced CNV in vivo , and conditioned medium from ethyl ferulate-treated ARPE-19 cells inhibited the proliferation, migration, and tube formation of endothelial cells in vitro . Mechanistically, the proteasome 26S subunit non-ATPase 14 (PSMD14) bound to and stabilized Keap1. Ethyl ferulate, however, reduced the expression of the deubiquitinase PSMD14, promoting Keap1 ubiquitination and degradation, which activated the Nrf2 antioxidant pathway. Furthermore, enrichment of the transcription factor MAZ was detected in the promoter region of PSMD14, which enhanced PSMD14 transcription. Ethyl ferulate treatment downregulated MAZ expression, thereby reducing PSMD14 transcription. Conclusion Inhibition of the deubiquitinase PSMD14 to activate the Keap1/Nrf2 pathway may represent a mechanism by which ethyl ferulate suppresses CNV, supporting its promising prospects as a potentia