Innovative gene delivery systems for retinal disease therapy

The human retina, a complex and highly specialized structure, includes multiple cell types that work synergistically to generate and transmit visual signals. However, genetic predisposition or age-related degeneration can lead to retinal damage that severely impairs vision or causes blindness. Treatment options for retinal diseases are limited, and there is an urgent need for innovative therapeutic strategies. Cell and gene therapies are promising because of the efficacy of delivery systems that transport therapeutic genes to targeted retinal cells. Gene delivery systems hold great promise for treating retinal diseases by enabling the targeted delivery of therapeutic genes to affected cells or by converting endogenous cells into functional ones to facilitate nerve regeneration, potentially restoring vision. This review focuses on two principal categories of gene delivery vectors used in the treatment of retinal diseases: viral and non-viral systems. Viral vectors, including lentiviruses and adeno-associated viruses, exploit the innate ability of viruses to infiltrate cells, which is followed by the introduction of therapeutic genetic material into target cells for gene correction. Lentiviruses can accommodate exogenous genes up to 8 kb in length, but their mechanism of integration into the host genome presents insertion mutation risks. Conversely, adeno-associated viruses are safer, as they exist as episomes in the nucleus, yet their limited packaging capacity constrains their application to a narrower spectrum of diseases, which necessitates the exploration of alternative delivery methods. In parallel, progress has also occurred in the development of novel non-viral delivery systems, particularly those based on liposomal technology. Manipulation of the ratios of hydrophilic and hydrophobic molecules within liposomes and the development of new lipid formulations have led to the creation of advanced non-viral vectors. These innovative systems include solid lipid nanoparticles, polymer nanoparticles, dendrimers, polymeric micelles, and polymeric nanoparticles. Compared with their viral counterparts, non-viral delivery systems offer markedly enhanced loading capacities that enable the direct delivery of nucleic acids, mRNA, or protein molecules into cells. This bypasses the need for DNA transcription and processing, which significantly enhances therapeutic efficiency. Nevertheless, the immunogenic potential and accumulation toxicity associated with non-viral particulate systems necessitates continued optimization to reduce adverse effects in vivo . This review explores the various delivery systems for retinal therapies and retinal nerve regeneration, and details the characteristics, advantages, limitations, and clinical applications of each vector type. By systematically outlining these factors, our goal is to guide the selection of the optimal delivery tool for a specific retinal disease, which will enhance treatment efficacy and improve patient outcomes while paving the way for more effective and targeted therapeutic interventions.

Mesenchymal stem cell-derived small extracellular vesicles enhance the therapeutic effect of retinal progenitor cells in retinal degenerative disease rats

JOURNAL/nrgr/04.03/01300535-202602000-00050/figure1/v/2025-05-05T160104Z/r/image-tiff Our previous study demonstrated that combined transplantation of bone marrow mesenchymal stem cells and retinal progenitor cells in rats has therapeutic effects on retinal degeneration that are superior to transplantation of retinal progenitor cells alone. Bone marrow mesenchymal stem cells regulate and interact with various cells in the retinal microenvironment by secreting neurotrophic factors and extracellular vesicles. Small extracellular vesicles derived from bone marrow mesenchymal stem cells, which offer low immunogenicity, minimal tumorigenic risk, and ease of transportation, have been utilized in the treatment of various neurological diseases. These vesicles exhibit various activities, including anti-inflammatory actions, promotion of tissue repair, and immune regulation. Therefore, novel strategies using human retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles may represent an innovation in stem cell therapy for retinal degeneration. In this study, we developed such an approach utilizing retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles to treat retinal degeneration in Royal College of Surgeons rats, a genetic model of retinal degeneration. Our findings revealed that the combination of bone marrow mesenchymal stem cell-derived small extracellular vesicles and retinal progenitor cells significantly improved visual function in these rats. The addition of bone marrow mesenchymal stem cell-derived small extracellular vesicles as adjuvants to stem cell transplantation with retinal progenitor cells enhanced the survival, migration, and differentiation of the exogenous retinal progenitor cells. Concurrently, these small extracellular vesicles inhibited the activation of regional microglia, promoted the migration of transplanted retinal progenitor cells to the inner nuclear layer of the retina, and facilitated their differentiation into photoreceptors and bipolar cells. These findings suggest that bone marrow mesenchymal stem cell-derived small extracellular vesicles potentiate the therapeutic efficacy of retinal progenitor cells in retinal degeneration by promoting their survival and differentiation.

Epilepsy therapy beyond neurons: Unveiling astrocytes as cellular targets

Epilepsy is a leading cause of disability and mortality worldwide. However, despite the availability of more than 20 antiseizure medications, more than one-third of patients continue to experience seizures. Given the urgent need to explore new treatment strategies for epilepsy, recent research has highlighted the potential of targeting gliosis, metabolic disturbances, and neural circuit abnormalities as therapeutic strategies. Astrocytes, the largest group of nonneuronal cells in the central nervous system, play several crucial roles in maintaining ionic and energy metabolic homeostasis in neurons, regulating neurotransmitter levels, and modulating synaptic plasticity. This article briefly reviews the critical role of astrocytes in maintaining balance within the central nervous system. Building on previous research, we discuss how astrocyte dysfunction contributes to the onset and progression of epilepsy through four key aspects: the imbalance between excitatory and inhibitory neuronal signaling, dysregulation of metabolic homeostasis in the neuronal microenvironment, neuroinflammation, and the formation of abnormal neural circuits. We summarize relevant basic research conducted over the past 5 years that has focused on modulating astrocytes as a therapeutic approach for epilepsy. We categorize the therapeutic targets proposed by these studies into four areas: restoration of the excitation-inhibition balance, reestablishment of metabolic homeostasis, modulation of immune and inflammatory responses, and reconstruction of abnormal neural circuits. These targets correspond to the pathophysiological mechanisms by which astrocytes contribute to epilepsy. Additionally, we need to consider the potential challenges and limitations of translating these identified therapeutic targets into clinical treatments. These limitations arise from interspecies differences between humans and animal models, as well as the complex comorbidities associated with epilepsy in humans. We also highlight valuable future research directions worth exploring in the treatment of epilepsy and the regulation of astrocytes, such as gene therapy and imaging strategies. The findings presented in this review may help open new therapeutic avenues for patients with drug-resistant epilepsy and for those suffering from other central nervous system disorders associated with astrocytic dysfunction.

Positive impact of indicaxanthin from Opuntia ficus-indica fruit on high-fat diet-induced neuronal damage and gut microbiota dysbiosis

JOURNAL/nrgr/04.03/01300535-202601000-00036/figure1/v/2025-06-09T151831Z/r/image-tiff Indicaxanthin is a betalain that is abundant in Opuntia ficus-indica orange fruit and has antioxidative and anti-inflammatory effects. Nevertheless, very little is known about the neuroprotective potential of indicaxanthin. This study investigated the impact of indicaxanthin on neuronal damage and gut microbiota dysbiosis induced by a high-fat diet in mice. The mice were divided into three groups according to different diets: the negative control group was fed a standard diet; the high-fat diet group was fed a high-fat diet; and the high-fat diet + indicaxanthin group was fed a high-fat diet and received indicaxanthin orally (0.86 mg/kg per day) for 4 weeks. Brain apoptosis, redox status, inflammation, and the gut microbiota composition were compared among the different animal groups. The results demonstrated that indicaxanthin treatment reduced neuronal apoptosis by downregulating the expression of proapoptotic genes and increasing the expression of antiapoptotic genes. Indicaxanthin also markedly decreased the expression of neuroinflammatory proteins and genes and inhibited high-fat diet-induced neuronal oxidative stress by reducing reactive oxygen and nitrogen species, malondialdehyde, and nitric oxide levels. In addition, indicaxanthin treatment improved the microflora composition by increasing the abundance of healthy bacterial genera, known as producers of short-chain fatty acids ( Lachnospiraceae , Alloprovetella , and Lactobacillus ), and by reducing bacteria related to unhealthy profiles ( Blautia , Faecalibaculum , Romboutsia and Bilophila ). In conclusion, indicaxanthin has a positive effect on high-fat diet-induced neuronal damage and on the gut microbiota composition in obese mice.

Contribution of ferroptosis and SLC7A11 to light-induced photoreceptor degeneration

JOURNAL/nrgr/04.03/01300535-202601000-00043/figure1/v/2025-06-09T151831Z/r/image-tiff Progressive photoreceptor cell death is one of the main pathological features of age-related macular degeneration and eventually leads to vision loss. Ferroptosis has been demonstrated to be associated with retinal degenerative diseases. However, the molecular mechanisms underlying ferroptosis and photoreceptor cell death in age-related macular degeneration remain largely unexplored. Bioinformatics and biochemical analyses in this study revealed xC - , solute carrier family 7 member 11-regulated ferroptosis as the predominant pathological process of photoreceptor cell degeneration in a light-induced dry age-related macular degeneration mouse model. This process involves the nuclear factor-erythroid factor 2-related factor 2-solute carrier family 7 member 11-glutathione peroxidase 4 signaling pathway, through which cystine depletion, iron ion accumulation, and enhanced lipid peroxidation ultimately lead to photoreceptor cell death and subsequent visual function impairment. We demonstrated that solute carrier family 7 member 11 overexpression blocked this process by inhibiting oxidative stress in vitro and in vivo . Conversely, solute carrier family 7 member 11 knockdown or the solute carrier family 7 member 11 inhibitor sulfasalazine and ferroptosis-inducing agent erastin aggravated H 2 O 2 -induced ferroptosis of 661W cells. These findings indicate solute carrier family 7 member 11 may be a potential therapeutic target for patients with retinal degenerative diseases including age-related macular degeneration.

Single-cell RNA sequencing reveals the heterogeneity and interactions of immune cells and Müller glia during zebrafish retina regeneration

JOURNAL/nrgr/04.03/01300535-202512000-00031/figure1/v/2025-01-31T122243Z/r/image-tiff Inflammation plays a crucial role in the regeneration of fish and avian retinas. However, how inflammation regulates Müller glia (MG) reprogramming remains unclear. Here, we used single-cell RNA sequencing to investigate the cell heterogeneity and interactions of MG and immune cells in the regenerating zebrafish retina. We first showed that two types of quiescent MG (resting MG1 and MG2) reside in the uninjured retina. Following retinal injury, resting MG1 transitioned into an activated state expressing known reprogramming genes, while resting MG2 gave rise to rod progenitors. We further showed that retinal microglia can be categorized into three subtypes (microglia-1, microglia-2, and proliferative) and pseudotime analysis demonstrated dynamic changes in microglial status following retinal injury. Analysis of cell-cell interactions indicated extensive crosstalk between immune cells and MG, with many interactions shared among different immune cell types. Finally, we showed that inflammation activated Jak1-Stat3 signaling in MG, promoting their transition from a resting to an activated state. Our study reveals the cell heterogeneity and crosstalk of immune cells and MG in zebrafish retinal repair, and may provide valuable insights into future mammalian retina regeneration.

External stimuli-responsive drug delivery to the posterior segment of the eye

Posterior segment eye diseases represent the leading causes of vision impairment and blindness globally. Current therapies still have notable drawbacks, including the need for frequent invasive injections and the associated risks of severe ocular complications. Recently, the utility of external stimuli, such as light, ultrasound, magnetic field, and electric field, has been noted as a promising strategy to enhance drug delivery to the posterior segment of the eye. In this review, we briefly summarize the main physiological barriers against ocular drug delivery, focusing primarily on the recent advancements that utilize external stimuli to improve treatment outcomes for posterior segment eye diseases. The advantages of these external stimuli-responsive drug delivery strategies are discussed, with illustrative examples highlighting improved tissue penetration, enhanced control over drug release, and targeted drug delivery to ocular lesions through minimally invasive routes. Finally, we discuss the challenges and future perspectives in the translational research of external stimuli-responsive drug delivery platforms, aiming to bridge existing gaps toward clinical use.

Potential of ultrasound stimulation and sonogenetics in vision restoration: a narrative review

Vision restoration presents a considerable challenge in the realm of regenerative medicine, while recent progress in ultrasound stimulation has displayed potential as a non-invasive therapeutic approach. This narrative review offers a comprehensive overview of current research on ultrasound-stimulated neuromodulation, emphasizing its potential as a treatment modality for various nerve injuries. By examining of the efficacy of different types of ultrasound stimulation in modulating peripheral and optic nerves, we can delve into their underlying molecular mechanisms. Furthermore, the review underscores the potential of sonogenetics in vision restoration, which involves leveraging pharmacological and genetic manipulations to inhibit or enhance the expression of related mechanosensitive channels, thereby modulating the strength of the ultrasound response. We also address how methods such as viral transcription can be utilized to render specific neurons or organs highly responsive to ultrasound, leading to significantly improved therapeutic outcomes.

International Society of Sports Nutrition Position Stand: Long-Chain Omega-3 Polyunsaturated Fatty Acids

Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of the literature surrounding the effects of long-chain omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation on exercise performance, recovery, and brain health. This position stand is intended to provide a scientific foundation for athletes, dietitians, trainers, and other practitioners regarding the effects of supplemental ω-3 PUFA in healthy and athletic populations. The following conclusions represent the official position of the ISSN: Athletes may be at a higher risk for ω-3 PUFA insufficiency.Diets rich in ω-3 PUFA, including supplements, are effective strategies for increasing ω-3 PUFA levels.ω-3 PUFA supplementation, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been shown to enhance endurance capacity and cardiovascular function during aerobic-type exercise.ω-3 PUFA supplementation may not confer a muscle hypertrophic benefit in young adults.ω-3 PUFA supplementation in combination with resistance training may improve strength in a dose- and duration-dependent manner.ω-3 PUFA supplementation may decrease subjective measures of muscle soreness following intense exercise.ω-3 PUFA supplementation can positively affect various immune cell responses in athletic populations.Prophylactic ω-3 PUFA supplementation may offer neuroprotective benefits in athletes exposed to repeated head impacts.ω-3 PUFA supplementation is associated with improved sleep quality.ω-3 PUFA are classified as prebiotics; however, studies on the gut microbiome and gut health in athletes are currently lacking.

Ophthalmic formulation of methotrexate: a strategy of using the self-assembled LacAC4A nanoparticles for non-invasive drug delivery to the ocular posterior segment

Drug delivery to ocular posterior segment remains difficult due to the challenges imposed by dynamic and static ocular barriers, lesion point targeting, and off-target effect. In this study, a novel approach is demonstrated for non-invasive drug delivery to the ocular posterior segments using lactose-modified azocalix[4] arene (LacAC4A) as a supramolecular ocular drug delivery platform. LacAC4A contains azo groups and is covalently modified by lactose groups, which confers active targeting to the retina, and induces a hypoxic response. The immunomodulator methotrexate (MTX), which is commonly used in ophthalmology to treat immune system diseases such as uveitis, was also selected as a guest to prepare MTX@LacAC4A. The prepared LacAC4A and MTX@LacAC4A systems were characterized, then the internalization mechanisms and hypoxia response abilities were determined through flow cytometry and fluorescence imaging, respectively. Besides, the delivery route and efficiency were verified, and the safety profile of MTX@LacAC4A was evaluated in multiple dimensions. Importantly, it was found that the prepared MTX@LacAC4A exhibits good biocompatibility, can effectively reach the posterior segment, and demonstrates potential ophthalmic applications. These findings lay the grounds for the future development of non-invasive ocular posterior segment disease treatments based on the advanced use of LacAC4A as a drug delivery platform.

Bidirectional causality of physical exercise in retinal neuroprotection

Physical exercise is recognized as an effective intervention to improve mood, physical performance, and general well-being. It achieves these benefits through cellular and molecular mechanisms that promote the release of neuroprotective factors. Interestingly, reduced levels of physical exercise have been implicated in several central nervous system diseases, including ocular disorders. Emerging evidence has suggested that physical exercise levels are significantly lower in individuals with ocular diseases such as glaucoma, age-related macular degeneration, retinitis pigmentosa, and diabetic retinopathy. Physical exercise may have a neuroprotective effect on the retina. Therefore, the association between reduced physical exercise and ocular diseases may involve a bidirectional causal relationship whereby visual impairment leads to reduced physical exercise and decreased exercise exacerbates the development of ocular disease. In this review, we summarize the evidence linking physical exercise to eye disease and identify potential mediators of physical exercise-induced retinal neuroprotection. Finally, we discuss future directions for preclinical and clinical research in exercise and eye health.

Ketorolac, melatonin and latanoprost tri-loaded PLGA microspheres for neuroprotection in glaucoma

Glaucoma is a multifactorial neurodegenerative disease that affects the retina and optic nerve. The aim of this work was to reach different therapeutics targets by co-encapsulating three neuroprotective substances with hypotensive (latanoprost), antioxidant (melatonin) and anti-inflammatory (ketorolac) activity in biodegradable poly (lactic-co-glycolic acid) (PLGA) microspheres (MSs) capable of releasing the drugs for months after intravitreal injection, avoiding the need for repeated administrations. Multi-loaded PLGA MSs were prepared using the oil-in-water emulsion solvent extraction-evaporation technique and physicochemically characterized. PLGA 85:15 was the polymer ratio selected for the selected formulation. Tri-loaded MSs including vitamin E as additive showed good tolerance in retinal pigment epithelium cells after 24 h exposure (>90% cell viability). The final formulation (KMLVE) resulted in 33.58 ± 5.44 µm particle size and drug content (µg/mg MSs) of 39.70 ± 5.89, 67.28 ± 4.17 and 7.51 ± 0.58 for melatonin, ketorolac and latanoprost respectively. KMLVE were able to release in a sustained manner the three drugs over 70 days. KMLVE were injected at 2 and 12 weeks in Long-Evans rats (n = 20) after the induction of chronic glaucoma. Ophthalmological tests were performed and compared to not treated glaucomatous (n = 45) and healthy (n = 17) animals. Treated glaucomatous rats reached the lowest intraocular pressure, enhanced functionality of bipolar and retinal ganglion cells and showed greater neuroretinal thickness by optical coherence tomography (p < 0.05) compared to not treated glaucomatous rats at 24 weeks follow-up. According to the results, the tri-loaded microspheres can be considered as promising controlled-release system for the treatment of glaucoma.

Five years comparation of efficacy and safety after ICL-V4c implantation for high and super high myopia correction

OBJECTIVES

The objective of the investigation is to examine the long term efficacy, safety, and predictability of ICL-V4c implantation for high and super-high myopic patients in order to provide reliable guidance for the selection of refractive surgical procedures.

METHODS

We reviewed 125 eyes from 64 patients who implanted ICL-V4c at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. These eyes were divided into two groups based on their preoperative spherical equivalent (SE) degree: high myopia (≥ -10D) and super-high myopia groups (< -10D). We followed up with the patients over 5 years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length (AL), refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault.

RESULTS

The efficacy indices of ICL-V4c implantation in high and super-high myopia groups were 0.91 ± 0.23 and 0.80 ± 0.25, respectively at 5 years after operation. Compared to high myopia group, the efficacy index of super-high myopia was obviously decreased (p = 0.020) and the △AL of super-high myopia was significantly increased (p = 0.001). The mean safety indices were 1.10 ± 0.15 and 1.10 ± 0.21 respectively in high and super-high myopia groups (p = 0.850). At the 5-year mark, 11.67% vs 20.00% (High vs Super-high) of eyes were within ±0.50 D (Spherical Equivalent), and 75.00% vs 70.77% (High vs Super-high) of eyes were within ±2.00 D. No significant difference of ECD was found in the high (2823.45 ± 274.75 cells/mm2) and super-high myopia (2856.71 ± 323.53cells/mm2) at the visit of 5 years. Compared to baseline, we observed a significant increase in IOP at the 1-week follow-up, which decreased significantly at the one-month visit. Furthermore, there was a significant difference of vault between the high and super-high groups at 1-month (p = 0.042) and 5-year (p = 0.002) after surgery.

CONCLUSIONS

ICL-V4c implantation is effective, safe, and stable for correcting high and super-high myopia. However, ophthalmologists need to be aware of the potential for greater myopia regression in super-high myopic patients, as well as the increase in axial length and associated fundus complications.

Harnessing nanofibers for targeted delivery of phytoconstituents in age-related macular degeneration

Age-related macular degeneration is a degenerative eye condition that affects the macula and results in central vision loss. Phytoconstituents show great promise in the treatment of AMD. AMD therapy can benefit from the advantages of phytoconstituents loaded nanofibers. There are opportunities to improve the effectiveness of phytoconstituents in the treatment of age-related macular degeneration (AMD) through the use of nanofiber-based delivery methods. These novel platforms encapsulate and distribute plant-derived bioactives by making use of the special qualities of nanofibers. These qualities include their high surface area-to-volume ratio, variable porosity, and biocompatibility. Exploring the use of nanofiber-based delivery methods to provide phytoconstituents in AMD treatment is a great choice for enhancing patient adherence, safety, and efficacy in managing this condition. This article explores the potential of nanofiber-based delivery methods to revolutionize AMD treatment, providing an innovative and effective approach to treat this condition.

From injury to recovery: investigating wound healing in a 3D tissue-engineered cornea equivalent

The semi-automatic generation of a multilayer cornea model was to study the process of wound healing and the influence of substances modulating wound healing. We generated in vitro corneal human tissues including epithelium and a semi automatedly produced stroma equivalent based on a hydrogel matrix. The maturation was evaluated using impedance spectroscopy, histology and immunofluorescence over 21 days. Inflicting corneal wounds by clinical excimer laser, injury was observed under treated with gentamicin and non-treated for 14 days by histology and optical coherence tomography (OCT). The semi-automated system produced a standardized corneal stroma equivalent that allowed reproducible growth of a multilayered epithelium. The histology and marker expression were comparable to human cornea. Histology confirmed epithelial wound closure 10 days after laser wounding. The wound ratio at day 3, 7, 10 was continuously increasing, day 14 indicating no significant difference to unwounded models. Gentamicin, a standard antibiotic eye drop, displayed reduced closure. In conclusion, the 3D cornea tissue model is recapitulating the human cornea and can be used as a valuable in vitro model for studying wound healing. A robust method to use the hydrogel as biocompatible material is needed. Non-destructive impedance spectroscopy and OCT allow online monitoring of the wound closure.

Exome sequencing identifies a homozygous splice site variant in RP1 as the underlying cause of autosomal recessive retinitis pigmentosa in a Pakistani family

BACKGROUND

Mutations in RP1 gene are the third leading cause of inherited retinal dystrophies (IRDs) in Pakistani families.

PATIENTS

A two-generation consanguineous Pakistani family underwent both clinical and genetic analyses. Clinical examinations included visual acuity test, visual field, fundoscopy, and ocular coherence tomography (OCT). Whole exome sequencing (WES) was performed on the proband's DNA, and Sanger sequencing was performed to validate the WES findings. Splicing prediction tools such as Human Splicing Finder (HSF), NNSplice predictor, SpliceAI, MaxENTScan, and SpliceRover were used.

RESULTS

A nuclear family of seven children, comprising five affected individuals (four males and one female) and two healthy siblings, was recruited from northwestern Pakistan. The proband was a 49-years old male who was presented with complaints of decreased visual acuity and night blindness since early childhood. Upon clinical evaluation, the proband appeared to have severely reduced visual acuity of hand movement (HM), bilateral visual field constriction, a waxy pale disc with vascular attenuation, pigmentary bone spicules at the periphery associated with chorioretinal degeneration, diffuse macular atrophy, and horizontal nystagmus in both of his eyes. Exome sequencing (ES) in the proband identified a homozygous splice site variant (NM_006269.2: c.615 + 1G > A) in RP1 gene. In-silico analysis, genotype-phenotype co-segregation study, and literature survey strongly supported the causality of the detected variant.

CONCLUSIONS

We report a previously known pathogenic splice site variant of RP1 as the underlying cause of early-onset autosomal recessive retinitis pigmentosa (arRP) in a Pakistani family. We contemplate that the detected allele might constitute a mutational hotspot in RP1.

Role of the C-terminal domain in modifying pH-dependent regulation of Cav1.4 Ca2+ channels

In the retina, Ca2+ influx through Cav1.4 Ca2+ channels triggers neurotransmitter release from rod and cone photoreceptors. Changes in extracellular pH modify channel opening, enabling a feedback regulation of photoreceptor output that contributes to the encoding of color and contrast. However, the mechanisms underlying pH-dependent modulation of Cav1.4 are poorly understood. Here, we investigated the role of the C-terminal domain (CTD) of Cav1.4 in pH-dependent modulation of Ba2+ currents (IBa) in HEK293T cells transfected with the full length CaV1.4 (FL) or variants lacking portions of the CTD due to alternative splicing (Δe47) or a disease-causing mutation (K1591X). While extracellular alkalinization caused an increase in IBa for each variant, the magnitude of this increase was significantly diminished (~40-50%) for both CTD variants; K1591X was unique in showing no pH-dependent increase in maximal conductance. Moreover, the auxiliary α2δ-4 subunit augmented the pH sensitivity of IBa, as compared to α2δ-1 or no α2δ, for FL and K1591X but not Δe47. We conclude that the CTD and α2δ-4 are critical determinants of pH-dependent modulation of Cav1.4 and may influence the processing of visual information in normal and diseased states of the retina.

Emerging liposomal therapies for diabetic retinopathy: a review of novel targeting approaches and advances in retinal health outcomes

Diabetic retinopathy (DR), which affects over millions of individuals globally, is the leading cause of permanent visual loss. Current therapies, including as intravitreal anti-vascular endothelial growth factor (VEGF) medications and laser photocoagulation, are limited by frequent dosing and side effects. Liposomes, with their ability to encapsulate hydrophilic and hydrophobic medications, offer tailored delivery, prolonged release, and low systemic toxicity. This study looks at advances in liposomal formulations that address DR's multifactorial etiology, including as anti-angiogenic, anti-inflammatory, and antioxidant processes. We assess new preparation methods (e.g. supercritical CO2, microfluidics) and clinical considerations, including stability and cost-effectiveness. To address the heterogeneity of DR, future endeavors will prioritize combinatorial medications and customized therapy.

Exploring the potential for gene therapy in Cav1.4-related retinal channelopathies

The visual process begins with photon detection in photoreceptor outer segments within the retina, which processes light signals before transmission to the thalamus and visual cortex. Cav1.4 L-type calcium channels play a crucial role in this process, and dysfunction of these channels due to pathogenic variants in corresponding genes leads to specific manifestations in visual impairments. This review explores the journey from basic research on Cav1.4 L-type calcium channel complexes in retinal physiology and pathophysiology to their potential as gene therapy targets. Moreover, we provide a concise overview of key findings from studies using different animal models to investigate retinal diseases. It will critically examine the constraints these models present when attempting to elucidate retinal channelopathies. Additionally, the paper will explore potential strategies for addressing Cav1.4 channel dysfunction and discuss the current challenges facing gene therapy approaches in this area of research.

The role of peripheral blood microRNAs in the pathogenesis and treatment response of age-related macular degeneration

Age-related macular degeneration is a leading cause of vision loss in aging populations, driven by complex interactions between genetic, environmental, and molecular factors. MicroRNAs have emerged as crucial regulators of cellular processes such as oxidative stress, inflammation, and angiogenesis, all of which contribute to AMD pathogenesis. This narrative review aims to summarize the involvement of peripheral blood microRNAs in the pathogenesis of AMD, focusing on key pathways such as oxidative stress, inflammation, and angiogenesis. Additionally, it explores their potential as biomarkers for predicting treatment response, particularly to anti-VEGF therapies. The potential of miRNAs as noninvasive biomarkers for early diagnosis and personalized treatment strategies is also explored, highlighting future directions for research.

Safety and biocompatibility of a novel biodegradable aflibercept-drug delivery system in rhesus macaques

A clinical need exists for more effective intravitreal (IVT) drug delivery systems (DDS). This study tested the hypothesis that a novel biodegradable, injectable microsphere-hydrogel drug delivery system loaded with aflibercept (aflibercept-DDS) would exhibit long-term safety and biocompatibility in a non-human primate (NHP) model. We generated aflibercept-loaded poly (lactic-co-glycolic acid) microparticles with a modified double emulsion technique then embedded them into a biodegradable, thermo-responsive poly (ethylene glycol)-co-(L-lactic-acid) diacrylate/N-isopropylacrylamide hydrogel. Aflibercept-DDS (50 µL, 15 µg) was injected into the right eye of 23 healthy rhesus macaques. A complete ophthalmic examination, intraocular pressure (IOP), corneal pachymetry, specular microscopy, A-scan biometry, streak retinoscopy, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and electroretinography (ERG) were performed monthly. Globes from 7 NHPs were histologically examined. Aflibercept-DDS was visualized in the vitreous up to 9 months post-IVT injection, slightly impeding fundoscopy in 4 of 23 eyes; no other consistent abnormalities were appreciated during ophthalmic examination. The IOP and total retinal thickness remained normal in all animals over all timepoints. Central corneal thickness, endothelial cell density, axial globe length, and refractive error did not significantly differ from baseline. Scotopic mixed rod-cone implicit times and amplitudes along with photopic cone response implicit times and amplitudes did not significantly differ from control values. No retinal or choroidal vascular abnormalities were detected with FA and normal retinal architecture was preserved using SD-OCT. Intravitreal injection of a biodegradable aflibercept-DDS was safe and well tolerated in NHPs up to 24 months.

Machine learning-assisted design of immunomodulatory lipid nanoparticles for delivery of mRNA to repolarize hyperactivated microglia

Regulating inflammatory microglia presents a promising strategy for treating neurodegenerative and autoimmune disorders, yet effective therapeutic agents delivery to these cells remains a challenge. This study investigates modified lipid nanoparticles (LNP) for mRNA delivery to hyperactivated microglia, particularly those with pro-inflammatory characteristics, utilizing supervised machine learning (ML) classifiers. We developed and screened a library of 216 LNP formulations with varying lipid compositions, N/P ratios, and hyaluronic acid (HA) modifications. The transfection efficiency of eGFP mRNA was assessed in the BV-2 murine microglia cell line under different immunological states, including resting and activated conditions (LPS-activated and IL4/IL13-activated). ML-guided morphometric analysis tracked the phenotypes of various microglia subtypes before and after transfection. Four supervised ML classifiers were investigated to predict transfection efficiency and phenotypic changes based on LNP design parameters. The Multi-Layer Perceptron (MLP) neural network emerged as the best-performing model, achieving weighted F1-scores ≥0.8. While it accurately predicted responses from LPS-activated and resting cells, it struggled with IL4/IL13-activated cells. The MLP model was validated by predicting the performance of four unseen LNP formulations delivering eGFP mRNA to LPS-activated BV2 cells. HA-LNP2 emerged as optimal formulation for delivering target IL10 mRNA, effectively suppressing inflammatory phenotypes, evidenced by shifts in cell morphology, increased IL10 expression, and reduced TNF-α levels. We also evaluated HA-LNP2 on LPS-activated human iPSC-derived microglia, confirming its efficacy in modulating inflammatory responses. This study highlights the potential of tailored LNP design and ML techniques to enhance mRNA therapy for neuroinflammatory disorders by leveraging carrier's immunogenic properties to modulate microglial responses.

Development of a conjunctival contact-type drug delivery device for latanoprost using hyaluronic acid

Effective topical drug delivery is crucial for glaucoma treatment, necessitating more convenient methods to enhance patient compliance. This study evaluates the efficacy and safety of using freeze-dried hyaluronic acid (HA) as a carrier for a novel conjunctival-contact drug delivery system. We developed HA tablets loaded with latanoprost (HA-latanoprost) and verified the concentration using high-performance liquid chromatography. Twenty mice (C57BL6) were divided into four groups (n = 5 per group): normal saline (group 1), control HA tablet (group 2), Xalatan™ (group 3), and HA-latanoprost tablet (group 4). Treatments were administered to the right eyes, with the left eyes serving as no-treatment controls. Intraocular pressure (IOP) and irritation (measured by scratching motions) were monitored for 10 days. On day 10, we quantified gene expression of inflammatory cytokines and IOP-affecting proteins using polymerase chain reaction, and performed histological and immunohistochemical analyses. Results showed that IOP was significantly lower in groups 3 and 4 compared to the other groups, with group 4 exhibiting the greatest reduction by day 10. Group 4 also experienced less irritation. Additionally, group 4 had lower expression of inflammatory cytokine genes and higher expression of IOP-lowering protein genes compared to group 3. No significant side effects were observed in any group. Overall, HA-latanoprost effectively lowered IOP and reduced ocular irritation more than latanoprost eyedrops in mice. However, these results are based on animal testing, so further development is needed for clinical use.

Magnesium-assisted hydrogen improves isoproterenol-induced heart failure

Heart failure (HF) is a leading cause of mortality among patients with cardiovascular disease and is often associated with myocardial apoptosis and endoplasmic reticulum stress (ERS). While hydrogen has demonstrated potential in reducing oxidative stress and ERS, recent evidence suggests that magnesium may aid in hydrogen release within the body, further enhancing these protective effects. This study aimed to investigate the cardioprotective effects of magnesium in reducing apoptosis and ERS through hydrogen release in a rat model of isoproterenol (ISO)-induced HF. Magnesium was administered orally to ISO-induced HF rats, which improved cardiac function, reduced myocardial fibrosis and cardiac hypertrophy, and lowered the plasma levels of creatine kinase-MB, cardiac troponin-I, and N-terminal B-type natriuretic peptide precursor in ISO-induced HF rats. It also inhibited cardiomyocyte apoptosis by upregulating B-cell lymphoma-2, downregulating Bcl-2-associated X protein, and suppressing ERS markers (glucose-related protein 78, activating transcription factor 4, and C/EBP-homologous protein). Magnesium also elevated hydrogen levels in blood, plasma, and cardiac tissue, as well as in artificial gastric juice and pure water, where hydrogen release lasted for at least four hours. Additionally, complementary in vitro experiments were conducted using H9C2 cardiomyocyte injury models, with hydrogen-rich culture medium as the intervention. Hydrogen-rich culture medium improved the survival and proliferation of ISO-treated H9C2 cells, reduced the cell surface area, inhibited apoptosis, and downregulated ERS pathway proteins. However, the protective effects of hydrogen were negated by tunicamycin (an inducer of ERS) in H9C2 cells. In conclusion, magnesium exerts significant cardioprotection by mitigating ERS and apoptosis through hydrogen release effects in ISO-induced HF.

Retinal and choroidal microvascular analysis by swept-source optical coherence tomography angiography in thyroid-associated ophthalmopathy (TAO) and hyperthyroidism without clinical signs of TAO

OBJECTIVE

To analyse retinal and choroidal microvascular alterations in patients with thyroid-associated ophthalmopathy (TAO) and hyperthyroidism without signs of TAO using swept-source optical coherence tomography angiography (SS-OCTA) and to investigate the potential reasons for ocular microvascular changes in patients with TAO.

METHODS

Thirty patients with active TAO (group A), thirty patients with hyperthyroidism without signs of TAO (group B), and thirty healthy subjects (group C) were recruited. The images of macula and optic nerve head were obtained by SS-OCTA. Vessel density (VD) of superficial capillary plexus (SCP), deep capillary plexus, radial peripapillary capillary and choriocapillaris (CC), choroidal vascularity index, foveal avascular zone area, macular thickness, macular ganglion cell complex thickness, choroidal thickness (CT), and retinal nerve fibre layer thickness were measured.

RESULTS

Group A had significantly higher VD of SCP than group C (all p < 0.05), and group B had significantly lower VD of SCP than group C (all p < 0.05). The VD of CC was significantly lower in group A than in groups B and C (p < 0.05). CT was significantly thicker in groups A and B than in group C (all p < 0.05). Multivariable regression analysis showed that the free triiodothyronine was significantly negatively correlated with the VD of SCP in the parafoveal regions in groups B and C (p < 0.05) and proptosis was significantly positively correlated with the VD of SCP in groups A and B (all p < 0.05).

CONCLUSION

We noted a difference in the VD of SCP and CC between patients with TAO and patients with hyperthyroidism without signs of TAO. These relative differences in ocular microvasculature indicated that local (orbital) and systemic (thyroid-related) factors may both play a role in disease presentation and progression, with orbital factors having a greater impact.

Mitochondrial transplantation: a promising strategy for the treatment of retinal degenerative diseases

The retina, a crucial neural tissue, is responsible for transforming light signals into visual information, a process that necessitates a significant amount of energy. Mitochondria, the primary powerhouses of the cell, play an integral role in retinal physiology by fulfilling the high-energy requirements of photoreceptors and secondary neurons through oxidative phosphorylation. In a healthy state, mitochondria ensure proper visual function by facilitating efficient conversion and transduction of visual signals. However, in retinal degenerative diseases, mitochondrial dysfunction significantly contributes to disease progression, involving a decline in membrane potential, the occurrence of DNA mutations, increased oxidative stress, and imbalances in quality-control mechanisms. These abnormalities lead to an inadequate energy supply, the exacerbation of oxidative damage, and the activation of cell death pathways, ultimately resulting in neuronal injury and dysfunction in the retina. Mitochondrial transplantation has emerged as a promising strategy for addressing these challenges. This procedure aims to restore metabolic activity and function in compromised cells through the introduction of healthy mitochondria, thereby enhancing the cellular energy production capacity and offering new strategies for the treatment of retinal degenerative diseases. Although mitochondrial transplantation presents operational and safety challenges that require further investigation, it has demonstrated potential for reviving the vitality of retinal neurons. This review offers a comprehensive examination of the principles and techniques underlying mitochondrial transplantation and its prospects for application in retinal degenerative diseases, while also delving into the associated technical and safety challenges, thereby providing references and insights for future research and treatment.

Endothelia-targeting eye drops deliver a STING inhibitor to effectively reduce retinal neovascularization in ischemic retinopathy

Retinal neovascularization is the main pathologic feature of ischemic retinopathy, which eventually leads to vision loss and even blindness. Current treatments like laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor A drugs are invasive, expensive, and incompetent. Therefore, it is urgent to explore optimized therapies, particularly eye drops, to improve treatment effects. Our recent study reported that abnormal up-regulation of stimulator of interferon genes (STING) is closely associated with retinal vascular diseases, and it is highly enriched in retinal endothelial cells with retinopathy. Thus, we evaluated whether endothelial STING affects retinal neovascularization. In addition, we constructed iRGD- and TAT-decorated nanoparticles (NPs) loaded with C-176 (I/T-C-NP), capable of penetrating the cornea and targeting retinal endothelial cells. The I/T-C-NP eye drops were applied to the eyes of oxygen-induced retinopathy mice, resulting in attenuated activation of the STING pathway. Consequently, retinal neovascularization and vascular tortuosity were effectively reduced, astrocyte activation was prohibited, and pericyte coverage was improved. These observations suggest that I/T-C-NP eye drops can be a potential solution for the treatment of retinal neovascularization.

Role of human γD-crystallin tryptophans in the ultraviolet radiation response

Cataracts are the leading cause of reversible blindness worldwide, primarily associated with the aggregation of proteins such as γ-crystallins, which are essential for maintaining lens transparency. Among these, human γD-crystallin (HγD) contains four conserved tryptophans, hypothesized to act as a protective mechanism against ultraviolet (UV) radiation. This study investigated the effects of low-dose UV-B radiation on HγD and its variants, in which each tryptophan was replaced by phenylalanine. The substitutions did not significantly affect the protein's secondary or tertiary structure but markedly reduced thermal stability, particularly in the W42F mutant. Aggregation kinetics were accelerated in all variants, with pronounced increases observed in the W130F and W156F mutants. Molecular dynamics simulations revealed that these substitutions disrupt hydrophobic interactions in both the N- and C-terminal domains, promoting instability and enhancing aggregation propensity. UV radiation induced chemical modifications, where Trp42 and Trp130 were the most affected, further driving aggregation. Changes in fluorescence spectra after UV exposure indicated the breakdown of the tryptophan indole ring and the formation of degradation products. These results confirm that tryptophans in HγD serve a crucial protective role against UV-induced damage by preserving structural stability and minimizing aggregation.

Advances in the application of smart materials in the treatment of ophthalmic diseases

Smart materials dynamically sense and respond to physiological signals like reactive oxygen species (ROS), pH, and light, surpassing traditional materials such as poly(lactic-co-glycolic acid), which have high drug loss rates and limited spatiotemporal control. These innovative materials offer new strategies for ophthalmic treatments, with core advantages including targeted delivery via ROS-sensitive nanocarriers, precise regulation through microvalves, and multifunctional integration, such as glucose-responsive contact lenses that create a "sensing-treatment" loop. However, challenges remain, like pathological microenvironment interference with material response specificity, and the need to address long-term biocompatibility and energy dependence issues. This article systematically examines three key treatment barriers: the blood-ocular barrier, immune rejection, and physiological fluctuations, while reviewing innovative smart material design strategies. Future research should focus on biomimetic interface engineering, for example, cornea mimicking nanostructures, AI-driven dynamic optimization like causal network-regulated drug release, and multidisciplinary approaches combining gene editing with smart materials. These efforts aim to shift from structural replacement to physiological function simulation, enabling precise treatment of ophthalmic diseases. Clinical translation must balance innovation with safety, prioritizing clinical value to ensure reliable, widespread application of smart materials in ophthalmology.

Telencephalic stab wound injury induces regenerative angiogenesis and neurogenesis in zebrafish: unveiling the role of vascular endothelial growth factor signaling and microglia

JOURNAL/nrgr/04.03/01300535-202510000-00025/figure1/v/2024-11-26T163120Z/r/image-tiff After brain damage, regenerative angiogenesis and neurogenesis have been shown to occur simultaneously in mammals, suggesting a close link between these processes. However, the mechanisms by which these processes interact are not well understood. In this work, we aimed to study the correlation between angiogenesis and neurogenesis after a telencephalic stab wound injury. To this end, we used zebrafish as a relevant model of neuroplasticity and brain repair mechanisms. First, using the Tg( fli1:EGFP × mpeg1.1:mCherry ) zebrafish line, which enables visualization of blood vessels and microglia respectively, we analyzed regenerative angiogenesis from 1 to 21 days post-lesion. In parallel, we monitored brain cell proliferation in neurogenic niches localized in the ventricular zone by using immunohistochemistry. We found that after brain damage, the blood vessel area and width as well as expression of the fli1 transgene and vascular endothelial growth factor ( vegfaa and vegfbb ) were increased. At the same time, neural stem cell proliferation was also increased, peaking between 3 and 5 days post-lesion in a manner similar to angiogenesis, along with the recruitment of microglia. Then, through pharmacological manipulation by injecting an anti-angiogenic drug (Tivozanib) or Vegf at the lesion site, we demonstrated that blocking or activating Vegf signaling modulated both angiogenic and neurogenic processes, as well as microglial recruitment. Finally, we showed that inhibition of microglia by clodronate-containing liposome injection or dexamethasone treatment impairs regenerative neurogenesis, as previously described, as well as injury-induced angiogenesis. In conclusion, we have described regenerative angiogenesis in zebrafish for the first time and have highlighted the role of inflammation in this process. In addition, we have shown that both angiogenesis and neurogenesis are involved in brain repair and that microglia and inflammation-dependent mechanisms activated by Vegf signaling are important contributors to these processes. This study paves the way for a better understanding of the effect of Vegf on microglia and for studies aimed at promoting angiogenesis to improve brain plasticity after brain injury.

Aminated fullerene for comprehensive dry eye therapy: Promoting epithelial-barrier reconstruction and nerve regeneration by suppressing oxidation and inflammation

Dry eye disease (DED) affects up to 50 % of the global population, leading to serious discomforts that affect patients' quality of life. In the multifactorial etiology of DED, oxidative stress is at the core, initiating a sequence of inflammatory responses and surface damage via a vicious cycle. However, current therapies merely have a narrow focus on inflammation. In this study, we developed a novel antioxidative eye drop, ethylenediamine (EDA)-modified C70 fullerene derivatives (abbreviated as FN-EDA), to break this vicious cycle. FN-EDA was successfully synthesized by modifying C70 fullerene with multiple ethylenediamine (EDA) groups, resulting in enhanced water solubility and a positive charge. This modification significantly improved ocular surface retention time, cellular uptake, and lysosomal escape in vitro. Therapeutically, FN-EDA significantly alleviated dry eye disease (DED) in a mouse model. It reduced corneal epithelial damage by 3.8-fold compared to 0.05 % cyclosporine A (CsA) and restored tear secretion to approximately 65 % of the normal level. Mechanistically, both in vivo and in vitro results demonstrate that FN-EDA is endowed with superior biological activity in effectively scavenging excessive oxidative stress, down-regulating proinflammatory cytokines expression, and promoting epithelial barrier reconstruction, even recovering corneal innervation. Thus, our findings open an avenue to make this multi-functional eye drop a promising candidate for DED.

Evaluation of macular and peripapillary structure and microvasculature with optical coherence tomography angiography in migraine in the Indian population

BACKGROUND

Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve. Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins, alongside anterior and posterior ischemic optic neuropathy. With the advent of optical coherence tomography angiography (OCTA), it is easy to identify these macular subclinical microvascular and structural changes.

AIM

To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura (MA), migraine without aura (MW), and healthy control (HC) participants using OCTA.

METHODS

In this observational cross-sectional study, we studied a total of 100 eyes: (1) 32 eyes of 16 patients with MA; (2) 36 eyes of 18 patients with MW, recruited based on the International Classification of Headache Disorders; and (3) 32 eyes of 16 age and sex-matched healthy participants. Foveal flux, foveal avascular zone (FAZ), peripapillary flux obtained from OCTA, and foveal and peripapillary ganglion cell layer (GCL) thickness calculated via optical coherence tomography were compared among the groups.

RESULTS

The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants (P = 0.002). However, there was no significant difference between the FAZ of the MA and MW groups. Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW (P = 0.0018) and HCs (P = 0.002). There was also significant thinning of the GCL in patients with MA and MW (P = 0.001) compared to HCs. However, there was no significant difference in temporal GCL thickness between the MA and MW groups.

CONCLUSION

Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs. OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances, aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.

Deep learning-assisted 10-μL single droplet-based viscometry for human aqueous humor

Probing the viscosity of human aqueous humor is crucial for optimizing micro-tube shunts in glaucoma treatment. However, conventional viscometers are not suitable for aqueous humor due to the limited sample volume-only tens of microliters-that can be safely extracted without causing permanent ocular damage. Here, we present an artificial intelligence-assisted microfluidic viscometry for measuring 10-μL aqueous humor collected at the point of care. Our approach involves injecting a single droplet of the sample into a microfluidic chip using hydrostatic pressure, minimizing interfacial effects with surfactants and hydrophobic coatings, and analyzing the sample flow using a deep learning-based detection scheme. For the first time, we have measured the viscosity of a 10-μL human aqueous humor and observed approximately 30 % variation between individuals. These individual differences in aqueous humor viscosity should be considered when designing microtube shunts for glaucoma treatment. Our method paves the way for the viscometry of small-volume biofluids, enabling new diagnostic and therapeutic applications in biomedical technology.

Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis: A Nationwide Korean Cohort Study

Objective

The intersection of aortic stenosis (AS) and retinal vascular occlusive disease (RVOD) underscores the need for comprehensive cardiovascular and ophthalmic evaluations in patients with either condition. We aimed to evaluate the risk of RVOD in the entire Korean population with AS.

Design

A population-based retrospective cohort study.

Participants

We included 4094 patients with AS (2088 males) and 4094 age-, sex-, and index year-matched controls. Clinical and follow-up data of all patients diagnosed with AS and healthy controls from 2004 to 2015 were extracted from the Korean National Health Insurance Claim database.

Methods

The risk of RVOD, including retinal vein occlusion and retinal artery occlusion, was compared between the AS and control groups. Competing analysis was used to obtain aHRs. The covariates used in the final analysis included age, sex, income, body mass index, fasting glucose, systolic blood pressure, cholesterol level, smoking, alcohol consumption, atrial fibrillation (AF), and myocardial infarction (MI).

Main Outcome Measures

Adjusted hazard ratio (aHR) of RVOD, incidence rate of RVOD.

Results

The incidence rate of RVOD per 100 000 was 495.3 in the AS group and 366.2 in the control group (P < 0.001). During a mean follow-up period of 8 years, the aHR of RVOD was 1.48 (95% confidence interval [CI]: 1.19-1.83) in the AS group compared with the control group. Even after adjusting for AF and MI, the incidence of RVOD remained consistently and significantly higher in patients with AS (aHR 1.29, 95% CI: 1.03-1.63). In the subgroup analysis based on age, the risk of RVOD was significantly higher in patients with AS across all age groups. However, this significance weakened after adjusting for MI in patients ≥80 years (aHR 7.47, 95% CI: 0.97-57.55) and for AF in patients ≥65 years (aHR 1.36, 95% CI: 0.92-2.03).

Conclusions

The results suggest a possible clinical association between AS and subsequent RVOD. Continuous screening for ≥5 years for RVOD would be recommended in patients with AS.

Financial Disclosures

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

CLK2-SOX3 combination promotes choroidal neovascularization by SGLT1 inducing endothelial cell metabolic reprogramming

Choroidal neovascularization (CNV) is one of the main causes of visual loss. Endothelial cell metabolic reprogramming is an important mechanism in regulating pathological neovascularization. However, how endothelial cell metabolic reprogramming is regulated in CNV is not yet clear. In this study, we constructed CNV mouse model by laser injury and in vitro cell model by hypoxia-induced mouse brain microvascular endothelial cells (BMECs). We identified glucose transporter Sodium-Dependent Glucose Transporter 1 (SGLT1) regulating endothelial cell metabolic reprogramming by siRNA transfection and metabolomics analysis. Mechanistically, we manifested the TCTTTGTCTG and ATTGCCTC sequences in the sglt1 promoter was targeted by SRY-box transcription factor 3 (SOX3). Furtherly, the function of SOX3 was induced by its Ser97 site combining with CDC-like kinase 2 (CLK2). Our results show that the CLK2-SOX3 combination targets sglt1, thereby inducing metabolic reprogramming of endothelial cells and promoting CNV.

Blue light induced ferroptosis in retinal damage via iron overload-associated oxidative stress

The issue of light pollution has garnered increased attention recently, largely due to the widespread use of electronic devices. Blue light (BL) holds the highest energy level among visible light and has been extensively researched for its potential to cause damage to the retina. Ferroptosis, a recently identified form of programmed cell death form, has been linked to retinal diseases. However, the connection between BL-induced retinal damage and ferroptosis remains elusive. This study aims to investigate the involvement of ferroptosis in retinal damage under BL exposure and its underlying mechanism. In this study, a mouse retinal damage model and cultured ARPE-19 cells exposed to BL were employed. Various techniques including Haematoxylin-eosin staining, fundus photography, immunostaining, and transmission electron microscopy were employed to examine retinal structure and morphology changes resulting from BL exposure. To identify ferroptosis levels in vitro, we employed DCFH-DA, C11-BODIPY 581/591, and FeRhoNox™-1 probes. Additionally, real-time PCR and western blotting techniques were used to uncover potential targets in BL-induced ferroptosis. Our study showed that BL exposure can result in iron overload, oxidative stress, evidenced by increased markers TFR1, ACSL4, HO-1 and decreased expression level of SOD2, CAT and ferroptosis-associated gene of GPX4. Interestingly, we found that Deferoxamine mesylate, a compound capable of chelating excess Fe2+ caused by BL, effectively mitigated lipid peroxidation, and alleviated retinal damage both in vivo and in vitro. The discoveries will advance our knowledge of BL-induced retinal damage.

Mitophagy in acute central nervous system injuries: regulatory mechanisms and therapeutic potentials

Acute central nervous system injuries, including ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, traumatic brain injury, and spinal cord injury, are a major global health challenge. Identifying optimal therapies and improving the long-term neurological functions of patients with acute central nervous system injuries are urgent priorities. Mitochondria are susceptible to damage after acute central nervous system injury, and this leads to the release of toxic levels of reactive oxygen species, which induce cell death. Mitophagy, a selective form of autophagy, is crucial in eliminating redundant or damaged mitochondria during these events. Recent evidence has highlighted the significant role of mitophagy in acute central nervous system injuries. In this review, we provide a comprehensive overview of the process, classification, and related mechanisms of mitophagy. We also highlight the recent developments in research into the role of mitophagy in various acute central nervous system injuries and drug therapies that regulate mitophagy. In the final section of this review, we emphasize the potential for treating these disorders by focusing on mitophagy and suggest future research paths in this area.

Effect of Myopic Defocus on the Retina and Choroid and Its Interaction with Defocus Regions, Diurnal Rhythm, and Accommodation

Purpose

To explore the effect of defocus region and amount, diurnal rhythm, and accommodation on myopic defocus-induced changes in the retina and choroid.

Design

Four test lenses were used: single-vision soft contact lens (SVCL), bifocal spectacle lens (BSL) with +3.50 diopters (D) addition in the inferior visual field, defocus incorporated multiple segments lens (DIMS), and dual-focus contact lens (DFCL) with +2.00 D addition.

Participants

Twenty-one adults aged between 18 and 30 years, myopia between -1.00 D and -6.00 D, were included.

Methods

Four lenses were used in random order at 4 separate days for each participant. Participants underwent OCT and OCT angiography examinations after distance-viewing (4 m) and near-viewing (20 cm) for 20 minutes with 4 test lenses at both 10 am and 5 pm.

Main Outcome Measures

Retinal and choroidal thicknesses (RT and ChT) and vessel density were assessed.

Results

The changes in RT, retinal and choroidal vessel density were not significantly different between lenses or times (all P > 0.05). Choroidal thickness changes differed between lenses after near-viewing in both the morning and evening and after distance-viewing in the morning (all P < 0.05). Compared with SVCL, BSL, DIMS, and DFCL achieved lower ChT reductions (all P < 0.05), and BSL showed least reduction. No lenses completely inhibited ChT thinning after near-viewing.

Conclusions

Myopic defocus inhibited choroid thinning more effectively in the morning, and provided sufficient defocus in the superior retina was more effective. The amount of lens defocus in this study (+3.50 D) was insufficient to inhibit choroidal thinning with 5 D accommodation completely.

Financial Disclosures

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

MDL800, a SIRT6 activator, mitigates neuroinflammation-induced retinal damage by modulating microglial M1/M2 polarization in experimental glaucoma

PURPOSE

Glaucoma is a group of irreversible neurodegenerative disorders of the optic nerve, characterized by distinct optic nerve damage and progressive visual field loss, with its pathological foundation involving the apoptosis of retinal ganglion cells (RGCs) and axonal degeneration. Neuroinflammation driven by the polarization of retinal microglia significantly contributes to RGCs apoptosis. This study investigates the neuroprotective effects of the SIRT6 activator MDL800 on microglial polarization in experimental glaucoma.

METHODS

We used a lipopolysaccharide (LPS)-induced BV2 microglial inflammation model and an ocular hypertension (OHT) rat model. The regulatory effects of MDL800 on BV2 cell M1/M2 polarization were evaluated. After inhibiting SIRT6, MDL800's impact on MAPK and AMPK-Nrf2-HO-1/NQO-1 pathways was studied. A co-culture system of BV2 cells and retinal precursor cells R28 was established to observe the effect of MDL800-regulated BV2 cell polarization on R28 cell survival. In the rat model, the effects of MDL800 on microglial polarization, retinal structure, and RGCs apoptosis in glaucoma were assessed.

RESULTS

MDL800 facilitated BV2 cell polarization from M1 to M2 under LPS stimulation, exerting anti-inflammatory effects. It activated SIRT6 to regulate BV2 cell polarization by inhibiting the MAPK pathway and activating the AMPK-Nrf2-HO-1/NQO-1 axis. In a co-culture system of BV2 cells and R28 cells, MDL800 regulated the release of LPS-induced inflammatory factors by mediating the polarization of BV2 cells, which in turn inhibited the mitochondrial apoptotic pathway in R28 cells and promoted their survival. In the OHT rat model, MDL800 significantly inhibited retinal microglia proliferation and activation, promoted their polarization from M1 to M2, and reduced RGCs apoptosis.

CONCLUSIONS

MDL800 shows promise for clinical development and treatment of glaucoma.

Restoration of hydroxyapatite particle thickness and crystalline orientation does not lead to recovery of tissue-scale mechanical properties in regenerating rat calvarial bone defects

Various cellular activities regulate bone healing, causing structural changes and evolving mechanical characteristics during the regeneration process. This pilot study aimed to correlate the time- and space-resolved mechanical behavior of regenerating and related biological processes. While the mechanical properties of bone are known to be based on a nanostructure organization, this study intends to highlight the evolution of the strain distribution induced by the reconstruction process, which is mainly driven by the mineral part (i.e., hydroxyapatite) of the bone architecture. Multiscale mechanical (tensile and nanoindentation tests) and biological (X-ray microtomography measurements and histological observations) characterization methods were applied to 3 mm rat cranial defects, one of the most reproducible animal models used to assess bone regeneration, filled with bone grafts, the gold standard for bone repair. The size and crystallographic orientation of the hydroxyapatite particles as well as their lattice (elastic) strain distribution under tensile loading were investigated through in situ synchrotron wide-angle and small-angle X-ray scattering measurements at various healing stages. Analyses were completed to quantify the elastic properties at the tissue-scale via nanoindentation measurements. The resulting mappings of lattice strain, mean particle thickness and crystallographic orientations revealed how tissue evolves during bone repair. At the early stages of the regeneration process, the microstructural changes consisted of a restored hydroxyapatite platelet shape and crystallographic orientation. At later stages, the hydroxyapatite crystallographic orientation reached that of native bone, and the mechanical function of the tissue in the defect zone was restored at the mineral particle scale. Nevertheless, even for the longest regeneration duration (20 weeks), mechanical properties at the tissue-scale remained ineffective, highlighting the importance of multiscale investigations to address this type of issue.

Whole genome sequencing-based prediction of antibiotic-resistance of ocular Staphylococcus aureus across six continents

Staphylococcus aureus is a leading cause of ocular infections, resulting in vision loss in severe cases. Understanding the antibiotic resistance profiles of ocular S. aureus can help customize treatments. However, there is a lack of global data on the resistance patterns of ocular isolates and comparative regional analyses. Hence, WGS data from 195 ocular S. aureus isolates across six continents were analysed to identify antibiotic resistance genes (ARGs) and predict antibiotic resistance phenotypes in this study. A total of 40 ARGs were detected, involving resistance mechanisms against aminoglycosides, beta-lactams, macrolide-lacosamide-streptogramin B (MLSB), glycopeptides, tetracyclines, other antibiotic classes, and efflux pump regulators. Notably, the prevalences of ARGs associated with efflux pump regulators and beta-lactams were particularly high (>80 %). Resistance to 45 antibiotics was predicted across the isolates, with 51 % identified as multidrug-resistant (MDR), while only 8 % were predicted to be fully susceptible to all predicted antibiotics. Regional data varied, with isolates from North America and Asia exhibiting the most extensive resistance patterns, showing predicted resistance to 45 and 41 antibiotics, respectively. In contrast, Oceanian isolates were predicted to be resistant to only 14 antibiotics. Beta-lactams showed the highest predicted resistance prevalence among all antibiotic classes. Notably, North American isolates showed markedly higher resistance to MLSB antibiotics. A high proportion of cloud genes highlights the need for monitoring regional resistance. This study provides antibiotic resistance profiles among ocular S. aureus using WGS prediction, emphasizing the importance of regional surveillance and antimicrobial stewardship to suggest effective treatment strategies. It is recommended that WGS of more strains be deposited to overcome limited data, and laboratory tests be performed to analyse the consistency between genetic predicted and phenotypic resistance.

Modulation of TLR4 mediated HMGB1/RAGE/NF-κB axis through linarin against fenvalerate provoked cardiotoxicity

Fenvalerate (FVN) is a potent insecticidal agent that exhibits a wide range of organ impairments including cardiac damage. Linarin (LIN) is a polyphenolic compound with a diverse range of pharmacological potentials. The present investigation was conducted to quantify the mitigative ability of LIN against FVN induced cardiotoxicity. Thirty-six male Sprague Dawley rats were divided into four groups i.e., the control, FVN (40 mg/kg), FVN (40 mg/kg) + LIN (50 mg/kg) and LIN (50 mg/kg) alone treated group. It was observed that FVN exposure exacerbated the gene expression of interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), receptor for advanced glycation end products (RAGE), interleukin-1β (IL-1β), high mobility group box 1 (HMGB1), cyclooxygenase-2 (COX-2), nuclear factor- kappa B (NF-κB), toll-like receptor 4 (TLR4), and tumor necrosis factor-α (TNF-α). Moreover, the levels of reactive oxygen species (ROS) & malondialdehyde (MDA) were surged-up while the enzymatic action of heme oxygenase-1 (HO-1), glutathione (GSH), glutathione Peroxidase (GPx), superoxide dismutase (SOD), glutathione reductase (GSR), and catalase (CAT) were decreased following the FVN intoxication. Besides, FVN administration upregulated the concentrations of troponin-I, troponin-T, c-reactive protein, creatine kinase-MB (CK-MB), creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) in cardiac tissues. FVN exposure increased the levels of Caspase-9, Bax and Caspase-3 while reducing the levels of Bcl-2. Cardiac tissues showed abnormal morphology after FVN intoxication. Nonetheless, LIN therapy remarkably alleviated cardiac damages instigated through FVN exposure due to its anti-inflammatory, anti-oxidative as well as anti-apoptotic potentials.

Potential role of βB1 crystallin in cataract formation:a systematic review

βB1 crystallin is a soluble structural protein of the lens, which plays an important role in maintaining lens transparency and cell homeostasis. βB1 crystallin has conservative dual structural domains, each of which contains two Greek key motifs. Gene mutation or post-translational modification can affect the structure and function of βB1 crystallin, leading to abnormal protein aggregation and the occurrence of cataracts. This article will review the protein structure, post-translational modification, and related gene mutations of βB1 crystallin. Understanding these molecular mechanisms of βB1crystallin mutations not only aids in clarifying the pathogenesis of cataracts but also provides potential targets for pharmacological interventions.

CRB1 mutations cause structural and molecular defects in patient-derived retinal pigment epithelium cells

Mutations in the CRB1 gene can cause retinitis pigmentosa (RP), Leber congenital amaurosis, and other retinopathies, with retinal pigment epithelium (RPE) being a primary affected cell type. However, the effects of CRB1 variants on RPE cells remain poorly defined. Here, for the first time, we report an in vitro model of patient-specific RPE cells carrying the CRB1 mutations (c.2249G > A and c.2809G > A) to study CRB1-associated RP disease. The patient-derived RPE cells exhibited irregular cell morphology, sparse apical microvilli, abnormal tight junctions, and reduced expression of RPE markers. We also observed that impaired barrier function and phagocytosis lead to increased apical-to-basal movement of fluorescent molecules in disease RPE cells. Notably, transcriptomic analysis revealed decreased expression of cell junction-related genes. In addition, aggregated RPE cells on polydimethylsiloxane (PDMS) microwells significantly enhanced RPE phenotype and cell survival, which was associated with anti-epithelial-mesenchymal transition, anti-aging, and anti-apoptosis. In this study, our results reveal that CRB1-mutated RPE cells generated using RP patient-derived iPSCs could recapitulate the genotype-phenotype features of the disease and provide insights into the pathogenesis of CRB1-associated RPE cells. In addition, our study developed a cell aggregation culture method based on PDMS microwell platforms for the production of highly active and mature iPSC-derived RPE cells.

Identifying a role for oxytosis/ferroptosis in Pde6b-associated retinitis pigmentosa

Inherited retinal diseases (IRDs) are a large heterogeneous group of diseases that lead to visual impairment and complete vision loss. Retinitis pigmentosa (RP) is an IRD with progressive degeneration of photoreceptors and has been associated with mutations in over 80 genes. In this study, we investigated the mechanism of retinal degeneration caused by an inherited mutation in the Pde6b gene in the rd10 mouse model of RP, with a focus on alternative programmed cell death pathways. RNA-seq analysis was used to identify changes in gene expression in rd10 mice, using C57BL/6J mice as non-degenerating genetic background controls. The functional role of differentially expressed genes was investigated using pharmacological treatments and visual acuity was assessed using optomotor kinetic tracking assay. We found increased expression of genes involved in inflammatory response, while expression of genes involved in photoreceptor function and homeostasis were decreased. We also demonstrated increased expression of genes that regulate oxytosis/ferroptosis, a type of regulated necrosis that can promote inflammatory responses. We found no significant changes in expression of genes controlling other types of regulated necrosis. Treating rd10 mice with oxytosis/ferroptosis inhibitors led to significant improvements in visual acuity. Therefore, these findings suggest that disruption of Pde6b activity results in photoreceptor death via oxytosis/ferroptosis, contributing to inflammatory responses in the retina. Our results identify for the first time a possible role of oxytosis/ferroptosis in a model of inherited retinal degeneration and provide a foundation for further studies exploring oxytosis/ferroptosis inhibitors as a potential therapeutic strategy for RP.

Lycium barbarum glycopeptide reduces inflammation and fibrosis in corneal injury by modulating the NF-κB/NLRP3/IL-1 β signaling pathway and microRNA-21a-5p/SMAD7

Lycium barbarum glycopeptide (LbGp), derived from the Chinese medicinal plant Lycium barbarum, has demonstrated anti-inflammatory properties; however, its precise role and mechanism in corneal repair following injury remain elusive. The present research investigated the mechanisms and effects of LbGp on corneal repair following alkali burn injury using in vivo mouse models of corneal alkali burn and in vitro human keratocyte fibrosis models. Corneal inflammation, opacity, and epithelial defects were assessed via a slit lamp microscope. Results showed that LbGp-treated mice exhibited reduced edema, accelerated re-epithelialization, and decreased corneal opacity compared to the phosphate-buffered saline (PBS)-treated controls. Proteomic analysis revealed altered proteins enriched in the extracellular matrix among the control, injury, and LbGp treatment groups. Moreover, LbGp significantly attenuated TGFβ-1-induced myofibroblasts transdifferentiation from keratocytes. Consistently, LbGp treatment inhibited the upregulation of fibrosis markers (αSMA, fibronectin, and collagen III) at both the protein and mRNA levels after corneal alkali burns. LbGp also effectively suppressed the activation of the NF-κB/NLRP3/IL-1β signaling pathway and neutrophil infiltration following corneal alkali burn injury. Additionally, miR-21 was upregulated in TGFβ-1-stimulated keratocytes and in the alkali-burned mouse cornea. LbGp decreased miR-21 expression, while increasing expression of its target, Smad7, thereby dampening the TGFβ/Smad2/3 signaling pathway. This research demonstrates that LbGp promotes corneal healing by inhibiting inflammation and fibrosis after alkali burns, suggesting its potential as a supplementary therapy for corneal injury repair.

The effects of different riboflavin concentrations and infiltration times on rabbit scleral crosslinking

To explore the photosensitizer content, diffusion depth and crosslinking effects in rabbit sclera with different riboflavin (Rf) infiltration times and concentrations. For the fluorescence study, rabbit eyes were infiltrated in Rf solutions of different concentrations for different durations on the sclera. The scleral Rf infiltration depth and fluorescence intensity were analyzed with an LSM710 confocal microscope, and the Rf content was detected by the absorbance of the sclera homogenate supernatant. Ultraviolet A was used to perform scleral crosslinking (SXL). The effect of SXL was evaluated using uniaxial tensile testing and enzymatic resistance testing, and the biological safety was evaluated using HE and TUNEL staining. Transmission electron microscopy (TEM) observation was used to clarify the change in collagen fiber diameter. Rf quickly infiltrated the full scleral thickness at 0.05 % concentration for 5 min. The scleral Rf content was not statistically different after infiltration with 0.5 % Rf for 5 min or 10 min. The scleral tissues of the 0.1 % Rf-30 min group and the 0.5 % Rf-5 min group were digested completely within 22.7 ± 1.9 h and 25.3 ± 5.5 h, respectively. At 10 % strain, the Young's modulus of the 0.5 % Rf-5 min group was significantly higher than the control group (P = 0.0004). No obvious structural damage was observed in the retina or sclera, and the diameter of collagen fibers in the outer and middle scleral layers increased significantly after SXL. Ultimately, Rf infiltration at a concentration of 0.5 % for 5 min helped to shorten operation time and improve SXL effects.

A novel FTO-targeting nanodrug induces disulfidptosis and ameliorates the suppressive tumor immune environment to treat uveal melanoma

Uveal melanoma (UM) is the most prevalent primary ocular malignancy in adults, with high lethality and limited effective treatment options. Despite identified driver mutations in GNAQ, GNA11, and BAP1, therapeutic advancements have been minimal. This study highlights the pivotal role of N6-methyladenosine (m6A) modifications in UM pathogenesis and progression, focusing on the demethylase FTO as a therapeutic target. Elevated FTO expression in UM tissues correlates with decreased m6A levels, increased aggressiveness, and poor prognosis. The FTO inhibitor meclofenamic acid (MA) restored m6A levels, upregulated SLC7A11, and induced disulfidptosis, a unique form of cell death triggered by GSH depletion and NADPH consumption. To address MA's limitations in bioavailability and tumor targeting, we developed an MA-loaded nucleic acid nanodrug (SNAMA). SNAMA demonstrated effective tumor growth inhibition in orthotopic and metastatic UM models through GSH-responsive release and m6A-mediated disulfidptosis activation. Incorporating a PD-L1 aptamer into SNAMA further improved tumor targeting and immune modulation, enhancing therapeutic efficacy. This study identifies FTO as a critical target for UM therapy and introduces SNAMA-apt as a promising nanodrug. The findings offer a foundation for m6A-targeted approaches in UM and other malignancies, addressing bioavailability, targeting, and immune evasion challenges.

Sequential delivery of anti-inflammatory and anti-scar drugs by Rg3 liposome-embedded thiolated chitosan hydrogel eye drops for corneal alkali burn

Corneal injury is a major cause of inflammation, scarring, and even vision loss. The main treatment for corneal injury is local administration of eye drops. However, due to the limitation of the protective barrier of the eyes, conventional eye drops have the disadvantages of low bioavailability, high side effects, and limited efficacy. In this study, the anti-inflammatory agent dipotassium glycyrrhizate (DG) and the antifibrotic agent ginsenoside Rg3 were incorporated into a thermosensitive hydrogel in order to develop a multifunctional hybrid hydrogel eye drops (RDTG) for the synergistic treatment of corneal alkali burn. The hydrogel network was formed by thiolated chitosan and β-glycerophosphate through both physical and chemical crosslinking. DG was distributed in free state in the hydrogel, while Rg3 was incorporated into the hydrogel in the form of liposomes. Furthermore, RDTG showed the characteristic of sequential drug-release. In vivo studies using a mouse model of corneal alkali burn have confirmed that RDTG could effectively reduce inflammation, promote corneal wound healing, and inhibit corneal scar. Therefore, the efficient delivery of RDTG eye drops provided a promising approach for the treatment of corneal alkali burn.

Decellularized human amniotic member hydrogel promotes limbal stem cells proliferation

Allogeneic cultured limbal epithelial stem cell transplantation has shown variable clinical success in treating limbal stem cell deficiency, low success cases are likely due to insufficient stem cell quantity or functional impairment. In this study, we engineered a decellularized amniotic membrane hydrogel (dAM-gel) using a freeze-thaw protocol designed to retain extracellular matrix integrity. Post-processing, collagen content decreased modestly from 313.50 ± 27.89 μg/mg to 284.8 ± 14.82 μg/mg (P = 0.08), while glycosaminoglycan levels shifted from 7.20 ± 1.66 μg/mg to 6.28 ± 0.55 μg/mg (P = 0.27). Crucially, the protocol achieved near-complete DNA removal (7.41 ± 0.78 μg/mg vs. 0.14 ± 0.06 μg/mg) (P < 0.0001), ensuring minimal immunogenicity. Although the dAM-gel demonstrates limited gelation capacity at lower concentrations, it achieves robust gelation at 14 mg/ml, completing the process within 28.26 ± 1.21 minutes. Furthermore, dAM-gel facilitates the migration and proliferation of limbal stem cells, particularly p63 + cells, which are known to correlate with the success of clinical treatments. A plausible explanation for this phenomenon is that dAM-gel contains a high concentration of agrin, which facilitates the proliferation of limbal stem cells while preserving their stemness via the Yap1-cyclin D1 signaling pathway. In conclusion, dAM-gel derived from amniotic membrane presents therapeutic promise for treating limbal stem cell deficiency by enhancing the proliferation of limbal stem cells while maintaining their stem cell phenotype.