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The Role of NMDA, GLUR4, NF-κB, and Nrf2 in Glaucoma Pathophysiology: Evidence from Wistar Rat Model

1Ophthalmology Department, Faculty of Medicine, Universitas Diponegoro, Indonesia

2Ophthalmology Department, Faculty of Medicine, Padjadjaran University, Indonesia

3Ophthalmology Department, Faculty of Medicine, Diponegoro University, Indonesia

4 Clinical Pathology Department, Faculty of Medicine, Diponegoro University, Indonesia

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Received: 22 Dec 2025; Revised: 18 Mar 2026; Accepted: 1 Apr 2026; Available online: 29 Apr 2026; Published: 30 Apr 2026.
Open Access Copyright (c) 2026 Journal of Biomedicine and Translational Research
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Glaucoma is a neurodegenerative disorder involving retinal ganglion cell loss. Elevated intraocular pressure activates the N-methyl-D-aspartate (NMDA) and Glutamate Receptor 4 (GluR4), inducing oxidative stress via the nuclear factor-kappa B (NF-κB) pathway and triggering antioxidant responses through the nuclear factor erythroid 2-related factor 2 (NRF2) pathway, which contributes to disease progression and informs therapeutic insights.

Objective: To explore NMDA, GluR4, NF-κB, and NRF2 roles in glaucoma pathophysiology and identify therapeutic targets using Wistar rat models.

Methods: This experimental research was conducted using a post-test-only control group design. 

Fourteen male Wistar rats were divided into two groups (n = 7). The glaucoma group underwent episcleral veincauterization (EVC) to induce a high intraocular pressure (IOP), whereas the control group remained untreated. Four weeks after EVC, evaluations included the expression of NMDA, GluR4, NF-κB, and NRF2 receptors. Statistical significance was defined as a p-value < 0.05. Statistical analysis was performed using a parametric independent t-test and a Mann-Whitney U test.

Results: The mean NMDA expression was significantly higher in the glaucoma group (14.50 ± 4.23) compared to the control group (7.74 ± 3.24, p=0.006). Similarly, the mean GluR4 expression was elevated in the glaucoma group (10.77 ±2.40) compared to the control group (3.03 ± 4.05, p = 0.012). The mean NF-κB expression was 14.96 ± 4.87 in the glaucoma group, significantly higher than 6.72 ± 1.84 in the control group (p = 0.003). Conversely, the mean NRF2  expression was significantly lower in the glaucoma group (3.98 ± 1.10) than in the control group (7.18 ± 1.61, p < 0.001).

Conclusion: The study highlights significant changes in all four variables, where NMDA, GluR4, NF-κB expressions were higher, and NRF2 expression was lower

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Keywords: Glaucoma, NMDA Receptor, Glutamate Receptor, Nuclear Factor-Kappa B, Nuclear Factor Erythroid 2-Related Factor 2

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Section: Original Research Articles
Language : EN
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