1
|
Romano F, Ding X, Yuan M, Vingopoulos F, Garg I, Choi H, Alvarez R, Tracy JH, Finn M, Ravazi P, Stettler IVM, Laìns I, Vavvas DG, Husain D, Miller JW, Miller JB. Progressive Choriocapillaris Changes on Optical Coherence Tomography Angiography Correlate With Stage Progression in AMD. Invest Ophthalmol Vis Sci 2024; 65:21. [PMID: 38990069 PMCID: PMC11246100 DOI: 10.1167/iovs.65.8.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/26/2024] [Indexed: 07/12/2024] Open
Abstract
Purpose We investigated the association between inner choroid flow deficit percentage (IC-FD%) using swept-source optical coherence tomography angiography (SS-OCTA) and progression of AMD. Methods Retrospective, observational study including 64 eyes (42 participants) with early or intermediate AMD at baseline. Participants had two or more consecutive swept-source optical coherence tomography angiography covering a period of at least 18 months. Demographics, visual acuity, and AMD staging based on Beckman classification were reviewed. OCT was analyzed for hyperreflective foci, subretinal drusenoid deposits, hyporeflective drusen cores, and subfoveal choroidal thickness. IC-FD% was measured within the central 3- and 6-mm using a 16-µm slab, after compensation and binarization (Phansalkar method). Mixed-effects Cox regression models assessed the association between imaging biomarkers and AMD progression. Results During follow-up (37 ± 9 months), 4 eyes with early AMD (31%) progressed to intermediate AMD and 30 (59%) eyes with intermediate AMD developed late AMD (19 geographic atrophy; 11 wet AMD). Baseline hyporeflective drusen core was associated with geographic atrophy development (P < 0.01), whereas greater IC-FD% (3-mm) was associated with wet AMD (P = 0.03). Time-varying analysis showed that faster subfoveal choroidal thickness reduction and IC-FD% (6-mm) increase were associated with geographic atrophy onset (P < 0.05), whereas IC-FD% (3-mm) increase was associated with wet AMD (P = 0.03). Notably, greater IC-FD% increases in the 3 mm (area under the curve = 0.72) and 6 mm (area under the curve = 0.89) were better predictive of wet AMD and geographic atrophy development, respectively. Conclusions Our longitudinal IC-FD% assessment emphasizes the role of progressive choriocapillaris changes as a biomarker for AMD progression. Our findings support that widespread choriocapillaris alterations (6 mm) may precede progression to geographic atrophy, whereas more central choriocapillaris loss (3 mm) may provide an ischemic stimulus for wet AMD.
Collapse
Affiliation(s)
- Francesco Romano
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Xinyi Ding
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Melissa Yuan
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Filippos Vingopoulos
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
| | - Itika Garg
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Department of Ophthalmology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - Hanna Choi
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Rodrigo Alvarez
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Jack H. Tracy
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Matthew Finn
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Peyman Ravazi
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Isabella V. M. Stettler
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Inês Laìns
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Demetrios G. Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Deeba Husain
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Joan W. Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - John B. Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| |
Collapse
|
2
|
Romano F, Vingopoulos F, Yuan M, Ding X, Garcia M, Ploumi I, Rodriguez J, Garg I, Tracy JH, Bannerman A, Choi H, Stettler I, Bennett C, Overbey KM, Laìns I, Kim LA, Vavvas DG, Husain D, Miller JW, Miller JB. Decreased Macular Choriocapillaris Perfusion Correlates with Contrast Sensitivity Function in Dry Age-Related Macular Degeneration. Ophthalmol Retina 2024:S2468-6530(24)00274-4. [PMID: 38878897 DOI: 10.1016/j.oret.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE To investigate the relationships between contrast sensitivity (CS), choriocapillaris perfusion, and other structural OCT biomarkers in dry age-related macular degeneration (AMD). DESIGN Cross-sectional, observational study. PARTICIPANTS One hundred AMD eyes (22 early, 52 intermediate, and 26 late) from 74 patients and 45 control eyes from 37 age-similar subjects. METHODS All participants had visual acuity (VA) assessment, quantitative CS function (qCSF) testing, macular OCT, and 6 × 6-mm swept-source OCT angiography scans on the same day. OCT volumes were analyzed for subretinal drusenoid deposits and hyporeflective drusen cores, and to measure thickness of the outer nuclear layer. OCT angiography scans were utilized to calculate drusen volume and inner choroid flow deficit percentage (IC-FD%), and to measure the area of choroidal hypertransmission defects (HTDs). Inner choroid flow deficit percentage was measured from a 16-μm thick choriocapillaris slab after compensation and binarization with Phansalkar's method. Generalized linear mixed-effects models were used to evaluate the associations between functional and structural variables. MAIN OUTCOME MEASURES To explore the associations between qCSF-measured CS, IC-FD%, and various AMD imaging biomarkers. RESULTS Age-related macular degeneration exhibited significantly reduced qCSF metrics eyes across all stages compared with controls. Univariate analysis revealed significant associations between various imaging biomarkers, reduced qCSF metrics, and VA in both groups. Multivariate analysis confirmed that higher IC-FD% in the central 5 mm was significantly associated with decreases in all qCSF metrics in AMD eyes (β = -0.74 to -0.25, all P < 0.05), but not with VA (P > 0.05). Outer nuclear layer thickness in the central 3 mm correlated with both VA (β = 2.85, P < 0.001) and several qCSF metrics (β = 0.01-0.90, all P < 0.05), especially in AMD eyes. Further, larger HTD areas were associated with decreased VA (β = -0.89, P < 0.001) and reduced CS at low-intermediate frequencies across AMD stages (β = -0.30 to -0.29, P < 0.001). CONCLUSIONS The significant association between IC-FD% in the central 5 mm and qCSF-measured CS reinforces the hypothesis that decreased macular choriocapillaris perfusion contributes to visual function changes in AMD, which are more pronounced in CS than in VA. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Francesco Romano
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Filippos Vingopoulos
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| | - Melissa Yuan
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Xinyi Ding
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Mauricio Garcia
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Ioanna Ploumi
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Jocelyn Rodriguez
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Itika Garg
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Jack H Tracy
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Augustine Bannerman
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Hanna Choi
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Isabella Stettler
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Cade Bennett
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Katherine M Overbey
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Inês Laìns
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Leo A Kim
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Demetrios G Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Deeba Husain
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Joan W Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - John B Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts.
| |
Collapse
|
3
|
Sacconi R, Fazzari G, Capuano V, Menean M, Beretta F, El Matri K, Bandello F, Souied E, Querques G. Pachy-Reticular Pseudodrusen. Ophthalmol Retina 2024:S2468-6530(24)00269-0. [PMID: 38844200 DOI: 10.1016/j.oret.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE To characterize the features of a peculiar association between reticular pseudodrusen (RPD) and pachychoroid (pachy-RPD) and to compare them with eyes affected by RPD and normal/leptochoroid. DESIGN Observational, retrospective, case-control study. PARTICIPANTS Among a cohort of patients with intermediate age-related macular degeneration (AMD), we selected eyes with RPD and pachychoroid (i.e., choroidal thickness of >50 μm). A control group of RPD eyes but without pachychoroid (i.e., a choroidal thickness of <250 μm) was included. METHODS Number and stages of RPD were evaluated in each ETDRS subfield. Furthermore, choroidal perfusion was investigated using the choroidal vascularity index (CVI), and choriocapillaris perfusion density (PD) on structural OCT and OCT angiography. MAIN OUTCOME MEASURES Description of the multimodal imaging features of pachy-RPD and differences with RPD associated with normal/leptochoroid. RESULTS Among 111 RPD eyes, 37 were included in the pachy-RPD group and 74 in the control group. Patients with pachy-RPD were significantly younger than patients with RPD and normal/leptochoroid (mean age, 75 ± 16 and 82 ± 7 years, respectively; P = 0.002). Total RPD number was comparable between the 2 groups (P = 0.220). However, pachy-RPD eyes showed a significantly higher number of stage 1 RPD in comparison to the controls (P < 0.001), and a lower number of stage 3 (P < 0.001) and stage 4 RPD (P = 0.052). The CVI and choriocapillaris PD were greater in pachy-RPD than in the control group (P < 0.001 and P= 0.010, respectively). CONCLUSIONS Pachy-RPD are characterized by a different distribution of RPD stages (i.e., more early stages and fewer advanced stages) in comparison to RPD with normal/leptochoroid. Furthermore, pachy-RPD eyes showed greater perfusion indices of the choroid. These features suggest that the presence of pachychoroid could be a protective factor in the RPD evolution to the advanced AMD forms. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Riccardo Sacconi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giusi Fazzari
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Vittorio Capuano
- Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Matteo Menean
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federico Beretta
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Khaled El Matri
- Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France; Faculté de Médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eric Souied
- Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Giuseppe Querques
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| |
Collapse
|
4
|
Vessey KA, Jobling AI, Greferath U, Fletcher EL. Pharmaceutical therapies targeting autophagy for the treatment of age-related macular degeneration. Curr Opin Pharmacol 2024; 76:102463. [PMID: 38788268 DOI: 10.1016/j.coph.2024.102463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
Age-related macular degeneration (AMD) is a major cause of irreversible vision loss in the elderly. Although new therapies have recently emerged, there are currently no ways of preventing the development of the disease. Changes in intracellular recycling processes. Changes in intracellular recycling processes, called autophagy, lead to debris accumulation and cellular dysfunction in AMD models and AMD patients. Drugs that enhance autophagy hold promise as therapies for slowing AMD progression in preclinical models; however, more studies in humans are required. While a definitive cure for AMD will likely hinge on a personalized medicine approach, treatments that enhance autophagy hold promise for slowing vision loss.
Collapse
Affiliation(s)
- Kirstan A Vessey
- Department of Anatomy and Physiology, The University of Melbourne, VIC 3010, Australia; School of Science and Technology, The University of New England, NSW 2350, Australia
| | - Andrew I Jobling
- Department of Anatomy and Physiology, The University of Melbourne, VIC 3010, Australia
| | - Ursula Greferath
- Department of Anatomy and Physiology, The University of Melbourne, VIC 3010, Australia
| | - Erica L Fletcher
- Department of Anatomy and Physiology, The University of Melbourne, VIC 3010, Australia.
| |
Collapse
|
5
|
Dontsov A, Ostrovsky M. Retinal Pigment Epithelium Pigment Granules: Norms, Age Relations and Pathology. Int J Mol Sci 2024; 25:3609. [PMID: 38612421 PMCID: PMC11011557 DOI: 10.3390/ijms25073609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
The retinal pigment epithelium (RPE), which ensures the normal functioning of the neural retina, is a pigmented single-cell layer that separates the retina from the Bruch's membrane and the choroid. There are three main types of pigment granules in the RPE cells of the human eye: lipofuscin granules (LG) containing the fluorescent "age pigment" lipofuscin, melanoprotein granules (melanosomes, melanolysosomes) containing the screening pigment melanin and complex melanolipofuscin granules (MLG) containing both types of pigments simultaneously-melanin and lipofuscin. This review examines the functional role of pigment granules in the aging process and in the development of oxidative stress and associated pathologies in RPE cells. The focus is on the process of light-induced oxidative degradation of pigment granules caused by reactive oxygen species. The reasons leading to increased oxidative stress in RPE cells as a result of the oxidative degradation of pigment granules are considered. A mechanism is proposed to explain the phenomenon of age-related decline in melanin content in RPE cells. The essence of the mechanism is that when the lipofuscin part of the melanolipofuscin granule is exposed to light, reactive oxygen species are formed, which destroy the melanin part. As more melanolipofuscin granules are formed with age and the development of degenerative diseases, the melanin in pigmented epithelial cells ultimately disappears.
Collapse
Affiliation(s)
| | - Mikhail Ostrovsky
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow 119334, Russia;
| |
Collapse
|
6
|
Mordechaev E, Jo JJ, Mordechaev S, Govindaiah A, Fei Y, Tai K, Tong Y, Bhuiyan A, Weinberger J, Deobhakta A, Dhamoon M, Rosen RB, Lema GMC, Smith RT. Internal Carotid Artery Stenosis and Ipsilateral Subretinal Drusenoid Deposits. Invest Ophthalmol Vis Sci 2024; 65:37. [PMID: 38407857 PMCID: PMC10902875 DOI: 10.1167/iovs.65.2.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/05/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose Subretinal drusenoid deposits (SDDs) in age-related macular degeneration (AMD) are strongly associated with vasculopathies such as myocardial infarction and ischemic stroke. This study evaluates ischemic stroke subjects for SDDs to determine whether ocular hypoperfusion from internal carotid artery (ICA) stenosis is associated with ipsilateral SDDs. Methods A cross-sectional study at Mount Sinai Hospital recruited 39 subjects with ischemic stroke (aged 52-90; 18 women, 21 men); 28 completed all study procedures. Computed tomography (CT) of the head and neck evaluated 54/56 ICAs for stenosis criteria: none (n = 33), mild (n = 12), moderate (n = 3), severe (n = 3), and complete (n = 3). Spectral-domain optical coherence tomography (SD-OCT) scans were read to consensus by two masked graders for soft drusen, SDDs and choroidal thickness (CTh; choroidal thinning = CTh < 250 µm). Univariate testing was done with Fisher's exact test. Multivariate logistic regression models tested age, gender, and ICA stenosis as covariates. Results Moderate or more ICA stenosis (≥50%-69%) was significantly associated with ipsilateral choroidal thinning (P = 0.021) and ipsilateral SDDs (P = 0.005); the latter were present distal to six of nine stenosed ICAs versus five of 33 normal ICAs. Mild ICA stenosis (≥1%-49%) was not significantly associated with ipsilateral SDDs. Multivariate regression found that older age (P = 0.015) and moderate or more ICA stenosis (P = 0.011) remained significant independent risks for ipsilateral SDDs. Conclusions At least moderate ICA stenosis (≥50%-69%) is strongly associated with ipsilateral SDDs and choroidal thinning, supporting downstream ophthalmic artery and choroidal hypoperfusion from ICA stenosis as the mechanism for SDD formation. SDDs may thus serve as sensitive biomarkers for ischemic stroke and other vascular diseases.
Collapse
Affiliation(s)
- Emanuel Mordechaev
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Jason J. Jo
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Samuel Mordechaev
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | | | - Yang Fei
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Katy Tai
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Yuehong Tong
- Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | | | - Jesse Weinberger
- Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Avnish Deobhakta
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Mandip Dhamoon
- Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Richard B. Rosen
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Gareth M. C. Lema
- Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - R. Theodore Smith
- Icahn School of Medicine at Mount Sinai, New York, New York, United States
| |
Collapse
|
7
|
Chen X, Chen L, Lin Y, Li G. Causality of Diabetic Nephropathy and Age-Related Macular Degeneration: A Mendelian Randomization Study. Gene 2023; 889:147787. [PMID: 37689221 DOI: 10.1016/j.gene.2023.147787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/19/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE Age-related macular degeneration (AMD) currently stands as the leading cause of irreversible vision loss in the present era. The primary objective of this study was to investigate the causal relationships between diabetic nephropathy (DN), its associated risk factors, and AMD among participants of European descent. METHODS Genetic variants associated with DN and its risk factors, encompassing glycemic traits, lipidemic traits, systolic/diastolic blood pressure, obesity, and urate, were obtained from previously published genome-wide association studies. Summary-level statistics for AMD were acquired from the FinnGen database. Univariable and multivariable Mendelian randomization (MR) were employed to conduct this investigation. RESULTS Our MR analyses indicated that per 1-standard deviation (SD) increase of DN heightened the risk of overall AMD (p = 1.03 × 10-8, OR = 1.24). And these findings remained consistent when examining both dry AMD (p = 2.27 × 10-4, OR = 1.17) and wet AMD (p = 5.15 × 10-6, OR = 1.33). Additionally, there was a causal association between high-density lipoprotein-cholesterol (HDL-C) levels and an increased risk of AMD (p = 2.69 × 10-3, OR = 1.23), while triglycerides were found to mitigate the risk (p = 0.02, OR = 0.83). Notably, no significant associations were observed between other risk factors of DN and AMD. CONCLUSIONS These findings suggest that the impact of DN on the development of AMD may be more substantial than previously believed. Furthermore, elevated HDL-C levels appear to heighten the risk of AMD, whereas triglycerides may provide a protective effect.
Collapse
Affiliation(s)
- Xiaxue Chen
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Lanlan Chen
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, China
| | - Yi Lin
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guangyu Li
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
| |
Collapse
|
8
|
Nielsen MK, Subhi Y, Falk M, Singh A, Sørensen TL, Nissen MH, Faber C. Complement factor H Y402H polymorphism results in diminishing CD4 + T cells and increasing C-reactive protein in plasma. Sci Rep 2023; 13:19414. [PMID: 37940659 PMCID: PMC10632322 DOI: 10.1038/s41598-023-46827-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/06/2023] [Indexed: 11/10/2023] Open
Abstract
Age-related macular degeneration (AMD) is a common cause of visual loss among the elderly. Genetic variants in the gene encoding complement factor H (CFH) have been identified as an AMD susceptibility gene, however, the mechanistic link is debated. Here, we investigated the link between the CFH Y402H genotype and low-grade inflammation. We recruited 153 healthy individuals, 84 participants with dry stages of AMD, and 148 participants with neovascular AMD. All participants were subjected to detailed retinal examination, and interview regarding comorbidities and lifestyle. Blood samples were analyzed for level of C-Reactive Protein (CRP), white blood cell differential count, and stained with fluorescent antibodies to differentiate CD4+ and CD8+ T cells. CFH Y402H genotyping was performed using an allele-specific polymerase chain reaction genotyping assay. Splenocytes from young and aged wild type and Cfh null mutant C57BL/6J mice were examined for CD4+ and CD8+ T cells. Healthy individuals with the CFH Y402H at-risk polymorphism HH had higher levels of CRP and lower proportions of CD4+ T cells compared to persons with the YH or YY polymorphism (P = 0.037, Chi-square). Healthy individuals with the HH polymorphism displayed lower proportions of CD4+ T cells with ageing (P < 0.01, one-way ANOVA), whereas both young and aged Cfh null mutant mice displayed lower proportions of CD4+ T cells (P < 0.001 and P < 0.05; unpaired t test). Participants with dry AMD and the HH polymorphism had similarly lower proportions of CD4+ T cells (P = 0.024, one-way ANOVA), but no difference in CRP-levels. In the neovascular stage of AMD, there was no difference in proportion of CD4+ cells or CRP levels according to genotype. The risk-associated CFH genotype is associated with an age-related decrease in proportion of CD4+ T cells and increased levels of CRP in healthy individuals. This indicates that decreased complement regulation results in extensive changes in innate and adaptive immune compartments that precede development of AMD.
Collapse
Affiliation(s)
- Marie Krogh Nielsen
- Clinical Eye Research Division, Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
| | - Yousif Subhi
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mads Falk
- Clinical Eye Research Division, Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
| | - Amardeep Singh
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Torben Lykke Sørensen
- Clinical Eye Research Division, Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mogens Holst Nissen
- Department of Immunology and Microbiology, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Carsten Faber
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
9
|
Zhang R, Wang L, Li Y, Gui C, Pei Y, Zhou G. Roles and mechanisms of long non-coding RNAs in age-related macular degeneration. Heliyon 2023; 9:e22307. [PMID: 38027818 PMCID: PMC10679503 DOI: 10.1016/j.heliyon.2023.e22307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Worldwide, age-related macular degeneration (AMD) is a multifactorial progressive fundus disorder that can cause vision impairment and severe central blindness in older adults. Currently, there are no approved prevention or treatment strategies for non-exudative AMD. While targeting VEGF is the main therapeutic approach to delay the degeneration process in exudative AMD, a significant number of patients show insensitivity or ineffectiveness to anti-VEGF therapy. Despite years of research, the exact mechanism underlying drusen formation and macular atrophy in AMD remains unknown. In the pathogenesis of AMD, lncRNAs play crucial roles, as discussed in this paper. This review focuses on the function of dysregulated lncRNAs and the mechanisms by which specific molecules target these lncRNAs in AMD. The analysis reveals that lncRNAs primarily regulate the progression of AMD by mediating apoptosis, epithelial-mesenchymal transition (EMT), dedifferentiation, and oxidative stress in choroidal vascular endothelial cells, retinal pigment epithelium (RPE) cells, and photoreceptors. Consequently, the regulation of apoptosis, dedifferentiation, EMT, and other processes by lncRNAs has emerged as a crucial focus in AMD research.These findings contribute to our understanding of the role of lncRNAs in AMD and their potential as valuable biomarkers. Furthermore, they highlight the need for further basic and clinical studies to explore the value of lncRNAs as biomarkers and potential therapeutic targets for AMD.
Collapse
Affiliation(s)
- Rong Zhang
- Department of Ophthalmology, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030002, China
| | - Lin Wang
- Department of Ophthalmology, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030002, China
| | - Yang Li
- Department of Ophthalmology, Yuncheng Central Hospital, Yuncheng, Shanxi 044000, China
| | - Chenwei Gui
- Department of Ophthalmology, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030002, China
| | - Yajing Pei
- Department of Ophthalmology, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030002, China
| | - Guohong Zhou
- Department of Ophthalmology, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030002, China
| |
Collapse
|
10
|
Rosa JGS, Disner GR, Pinto FJ, Lima C, Lopes-Ferreira M. Revisiting Retinal Degeneration Hallmarks: Insights from Molecular Markers and Therapy Perspectives. Int J Mol Sci 2023; 24:13079. [PMID: 37685886 PMCID: PMC10488251 DOI: 10.3390/ijms241713079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 09/10/2023] Open
Abstract
Visual impairment and blindness are a growing public health problem as they reduce the life quality of millions of people. The management and treatment of these diseases represent scientific and therapeutic challenges because different cellular and molecular actors involved in the pathophysiology are still being identified. Visual system components, particularly retinal cells, are extremely sensitive to genetic or metabolic alterations, and immune responses activated by local insults contribute to biological events, culminating in vision loss and irreversible blindness. Several ocular diseases are linked to retinal cell loss, and some of them, such as retinitis pigmentosa, age-related macular degeneration, glaucoma, and diabetic retinopathy, are characterized by pathophysiological hallmarks that represent possibilities to study and develop novel treatments for retinal cell degeneration. Here, we present a compilation of revisited information on retinal degeneration, including pathophysiological and molecular features and biochemical hallmarks, and possible research directions for novel treatments to assist as a guide for innovative research. The knowledge expansion upon the mechanistic bases of the pathobiology of eye diseases, including information on complex interactions of genetic predisposition, chronic inflammation, and environmental and aging-related factors, will prompt the identification of new therapeutic strategies.
Collapse
Affiliation(s)
| | | | | | | | - Monica Lopes-Ferreira
- Immunoregulation Unit, Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, São Paulo 05503900, Brazil; (J.G.S.R.); (G.R.D.); (F.J.P.); (C.L.)
| |
Collapse
|
11
|
Grigsby D, Klingeborn M, Kelly U, Chew LA, Asokan A, Devlin G, Smith S, Keyes L, Timmers A, Scaria A, Bowes Rickman C. AAV Gene Augmentation of Truncated Complement Factor H Differentially Rescues Ocular Complement Dysregulation in a Mouse Model. Invest Ophthalmol Vis Sci 2023; 64:25. [PMID: 37471073 PMCID: PMC10365136 DOI: 10.1167/iovs.64.10.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/22/2023] [Indexed: 07/21/2023] Open
Abstract
Purpose Complement dysregulation in the eye has been implicated in the pathogenesis of age-related macular degeneration (AMD), and genetic variants of complement factor H (CFH) are strongly associated with AMD risk. We therefore aimed to untangle the role of CFH and its splice variant, factor H-like 1 (FHL-1), in ocular complement regulation derived from local versus circulating sources. We assessed the therapeutic efficacy of adeno-associated viruses (AAVs) expressing human FHL-1 and a truncated version of CFH (tCFH), which retains the functional N- and C-terminal ends of the CFH protein, in restoring the alternative complement pathway in Cfh-/- mouse eyes and plasma. Methods Using Cfh-/- mice as a model of complement dysregulation, AAV vectors expressing tCFH or FHL-1 were injected subretinally or via tail vein, and the efficacy of the constructs was evaluated. Results Following subretinal injections, tCFH expression rescued factor B (FB) retention in the eye, but FHL-1 expression did not. By contrast, both constructs restored FB detection in plasma following tail vein injections. Both tCFH and FHL-1 proteins accumulated in the posterior eyecup from the circulation following liver transduction; however, neither was able to significantly regulate local ocular complement. Conclusions Our findings demonstrate that the C-terminus of human CFH is necessary for complement regulation in the murine eye. Furthermore, exogenous CFH must be synthesized locally to maximize complement regulation in the retina. These findings establish a critical foundation for development of CFH augmentation-based gene therapies for the eye.
Collapse
Affiliation(s)
- Daniel Grigsby
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, United States
| | - Mikael Klingeborn
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, United States
- McLaughlin Research Institute, Great Falls, Montana, United States
| | - Una Kelly
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, United States
| | - Lindsey A. Chew
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, United States
- Department of Cell Biology, Duke University School of Medicine, Durham, North Carolina, United States
| | - Aravind Asokan
- Departments of Surgery, Molecular Genetics and Microbiology, and Biomedical Engineering, Duke University School of Medicine, Durham, North Carolina, United States
| | - Garth Devlin
- Departments of Surgery, Molecular Genetics and Microbiology, and Biomedical Engineering, Duke University School of Medicine, Durham, North Carolina, United States
| | - Sharon Smith
- Applied Genetic Technologies Corporation, Alachua, Florida, United States
| | - Lisa Keyes
- Pfizer, Morrisville, North Carolina, United States
| | - Adrian Timmers
- Editas Medicine, Cambridge, Massachusetts, United States
| | - Abraham Scaria
- Applied Genetic Technologies Corporation, Alachua, Florida, United States
| | - Catherine Bowes Rickman
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, United States
- Department of Cell Biology, Duke University School of Medicine, Durham, North Carolina, United States
| |
Collapse
|
12
|
Owsley C, Swain TA, McGwin G, Clark ME, Kar D, Curcio CA. Biologically Guided Optimization of Test Target Location for Rod-mediated Dark Adaptation in Age-related Macular Degeneration: Alabama Study on Early Age-related Macular Degeneration 2 Baseline. OPHTHALMOLOGY SCIENCE 2023; 3:100274. [PMID: 36875335 PMCID: PMC9978854 DOI: 10.1016/j.xops.2023.100274] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023]
Abstract
Purpose We evaluate the impact of test target location in assessing rod-mediated dark adaptation (RMDA) along the transition from normal aging to intermediate age-related macular degeneration (AMD). We consider whether RMDA slows because the test locations are near mechanisms leading to or resulting from high-risk extracellular deposits. Soft drusen cluster under the fovea and extend to the inner ring of the ETDRS grid where rods are sparse. Subretinal drusenoid deposits (SDDs) appear first in the outer superior subfield of the ETDRS grid where rod photoreceptors are maximal and spread toward the fovea without covering it. Design Cross-sectional. Participants Adults ≥ 60 years with normal older maculas, early AMD, or intermediate AMD as defined by the Age-Related Eye Disease Study (AREDS) 9-step and Beckman grading systems. Methods In 1 eye per participant, RMDA was assessed at 5° and at 12° in the superior retina. Subretinal drusenoid deposit presence was identified with multi-modal imaging. Main Outcome Measures Rod intercept time (RIT) as a measure of RMDA rate at 5° and 12°. Results In 438 eyes of 438 persons, RIT was significantly longer (i.e., RMDA is slower) at 5° than at 12° for each AMD severity group. Differences among groups were bigger at 5° than at 12°. At 5°, SDD presence was associated with longer RIT as compared to SDD absence at early and intermediate AMD but not in normal eyes. At 12°, SDD presence was associated with longer RIT in intermediate AMD only, and not in normal or early AMD eyes. Findings were similar in eyes stratified by AREDS 9-step and Beckman systems. Conclusions We probed RMDA in relation to current models of deposit-driven AMD progression organized around photoreceptor topography. In eyes with SDD, slowed RMDA occurs at 5° where these deposits typically do not appear until later in AMD. Even in eyes lacking detectable SDD, RMDA at 5° is slower than at 12°. The effect at 5° may be attributed to mechanisms associated with the accumulation of soft drusen and precursors under the macula lutea throughout adulthood. These data will facilitate the design of efficient clinical trials for interventions that aim to delay AMD progression.
Collapse
Affiliation(s)
- Cynthia Owsley
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Thomas A. Swain
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gerald McGwin
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mark E. Clark
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Deepayan Kar
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christine A. Curcio
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
13
|
Yoon CK, Kim YA, Park UC, Kwon SH, Lee Y, Yoo HJ, Seo JH, Yu HG. Vitreous Fatty Amides and Acyl Carnitines Are Altered in Intermediate Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2023; 64:28. [PMID: 36939720 PMCID: PMC10043506 DOI: 10.1167/iovs.64.3.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
Purpose Age-related macular degeneration (AMD) is the leading cause of visual impairment worldwide. In this study, we aimed to investigate the vitreous humor metabolite profiles of patients with intermediate AMD using untargeted metabolomics. Methods We performed metabolomics using high-resolution liquid chromatography mass spectrometry on the vitreous humor of 31 patients with intermediate AMD and 30 controls who underwent vitrectomy for epiretinal membrane with or without cataract surgery. Univariate analyses after false discovery rate correction were performed to discriminate the metabolites and identify the significant metabolites of intermediate AMD. For biologic interpretation, enrichment and pathway analysis were conducted using MetaboAnalyst 5.0. Results Of the 858 metabolites analyzed in the vitreous humor, 258 metabolites that distinguished patients with AMD from controls were identified (P values < 0.05). Ascorbic acid and uric acid levels increased in the AMD group (all P values < 0.05). The acyl carnitines, such as acetyl L-carnitine (1.37-fold), and fatty amides, such as anandamide (0.9-fold) and docosanamide (0.67-fold), were higher in patients with intermediate AMD. In contrast, nicotinamide (-0.55-fold), and succinic acid (-1.69-fold) were lower in patients with intermediate AMD. The metabolic pathway related oxidation of branched chain fatty acids and carnitine synthesis showed enrichment. Conclusions Multiple metabolites related to fatty amides and acyl carnitine were found to be increased in the vitreous humor of patients with intermediate AMD, whereas succinic acid and nicotinamide were reduced, suggesting that altered metabolites related to fatty amides and acyl carnitines and energy metabolism may be implicated in the etiology of AMD.
Collapse
Affiliation(s)
- Chang-Ki Yoon
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Ye An Kim
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Seung-Hyun Kwon
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Korea
| | - Young Lee
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Korea
| | - Hyun Ju Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Je Hyun Seo
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Korea
- https://orcid.org/0000-0003-3127-7160
| | - Hyeong Gon Yu
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Retina Center, Sky Eye Institute, Seoul, Korea
| |
Collapse
|
14
|
Dörschmann P, Kopplin G, Roider J, Klettner A. Interaction of High-Molecular Weight Fucoidan from Laminaria hyperborea with Natural Functions of the Retinal Pigment Epithelium. Int J Mol Sci 2023; 24:2232. [PMID: 36768552 PMCID: PMC9917243 DOI: 10.3390/ijms24032232] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Fucoidans are polysaccharides and constituents of cell walls of brown algae such as Laminaria hyperborea (LH). They exhibit promising effects regarding age-related macular degeneration (AMD). However, the safety of this compound needs to be assured. The focus of this study lies on influences of an LH fucoidan on the retinal pigment epithelium (RPE). The high-molecular weight LH fucoidan Fuc1 was applied to primary porcine RPE cells, and a tetrazolium (MTT) cell viability assay was conducted. Further tests included a scratch assay to measure wound healing, Western blotting to measure expression of retinal pigment epithelium-specific 65 kDa protein (RPE65), as well as immunofluorescence to measure uptake of opsonized fluorescence beads into RPE cells. Lipopolysaccharide was used to proinflammatorily activate the RPE, and interleukin 6 (IL-6) and interleukin 8 (IL-8) secretion was measured. RPE/choroid cultures were used to assess vascular endothelial growth factor (VEGF) secretion. Real-time polymerase chain reaction (real-time PCR) was performed to detect the gene expression of 91 different genes in a specific porcine RPE gene array. Fuc1 slightly reduced wound healing, but did not influence cell viability, phagocytosis or RPE65 expression. Fuc1 lowered IL-6, IL-8 and VEGF secretion. Furthermore, Fuc1 did not change tested RPE genes. In conclusion, Fuc1 does not impair RPE cellular functions and shows antiangiogenic and anti-inflammatory activities, which indicates its safety and strengthens its suitability concerning ocular diseases.
Collapse
Affiliation(s)
- Philipp Dörschmann
- Department of Ophthalmology, University Medical Center, University of Kiel, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
| | - Georg Kopplin
- Alginor ASA, Haraldsgata 162, 5525 Haugesund, Norway
| | - Johann Roider
- Department of Ophthalmology, University Medical Center, University of Kiel, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
| | - Alexa Klettner
- Department of Ophthalmology, University Medical Center, University of Kiel, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
| |
Collapse
|
15
|
Song S, Jin K, Wang S, Yang C, Zhou J, Chen Z, Ye J. Retinal fluid is associated with cytokines of aqueous humor in age-related macular degeneration using automatic 3-dimensional quantification. Front Cell Dev Biol 2023; 11:1157497. [PMID: 36968207 PMCID: PMC10030496 DOI: 10.3389/fcell.2023.1157497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/27/2023] [Indexed: 03/29/2023] Open
Abstract
Background: To explain the biological role of cytokines in the eye and the possible role of cytokines in the pathogenesis of neovascular age-related macular degeneration (nAMD) by comparing the correlation between cytokine of aqueous humor concentration and optical coherence tomography (OCT) retinal fluid. Methods: Spectral-domain OCT (SD-OCT) images and aqueous humor samples were collected from 20 nAMD patient's three clinical visits. Retinal fluid volume in OCT was automatically quantified using deep learning--Deeplabv3+. Eighteen cytokines were detected in aqueous humor using the Luminex technology. OCT fluid volume measurements were correlated with changes in aqueous humor cytokine levels using Pearson's correlation coefficient (PCC). Results: The patients with intraretinal fluid (IRF) showed significantly lower levels of cytokines, such as C-X-C motif chemokine ligand 2 (CXCL2) (p = 0.03) and CXCL11 (p = 0.009), compared with the patients without IRF. And the IRF volume was negatively correlated with CXCL2 (r = -0.407, p = 0.048) and CXCL11 (r = -0.410, p = 0.046) concentration in the patients with IRF. Meanwhile, the subretinal fluid (SRF) volume was positively correlated with vascular endothelial growth factor (VEGF) concentration (r = 0.299, p = 0.027) and negatively correlated with interleukin (IL)-36β concentration (r = -0.295, p = 0.029) in the patients with SRF. Conclusion: Decreased level of VEGF was associated with decreased OCT-based retinal fluid volume in nAMD patients, while increased levels of CXCL2, CXCL11, and IL-36β were associated with decreased OCT-based retinal fluid volume in nAMD patients, which may suggest a role for inflammatory cytokines in retinal morphological changes and pathogenesis of nAMD patients.
Collapse
Affiliation(s)
- Siyuan Song
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kai Jin
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuai Wang
- School of Mechanical, Electrical and Information Engineering, Shandong University, Weihai, China
- School of Cyberspace, Hangzhou Dianzi University, Hangzhou, China
| | - Ce Yang
- School of Mechanical, Electrical and Information Engineering, Shandong University, Weihai, China
| | - Jingxin Zhou
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhiqing Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Zhiqing Chen, ; Juan Ye,
| | - Juan Ye
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Zhiqing Chen, ; Juan Ye,
| |
Collapse
|
16
|
El-Darzi N, Mast N, Hammer SS, Dorweiler TF, Busik JV, Pikuleva IA. 2-Hydroxypropyl-β-cyclodextrin mitigates pathological changes in a mouse model of retinal cholesterol dyshomeostasis. J Lipid Res 2022; 64:100323. [PMID: 36586438 PMCID: PMC9883287 DOI: 10.1016/j.jlr.2022.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/22/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022] Open
Abstract
CYP46A1 is a CNS-specific enzyme, which eliminates cholesterol from the brain and retina by metabolism to 24-hydroxycholesterol, thus contributing to cholesterol homeostasis in both organs. 2-Hydroxypropyl-β-cyclodextrin (HPCD), a Food and Drug Administration-approved formulation vehicle, is currently being investigated off-label for treatment of various diseases, including retinal diseases. HPCD was shown to lower retinal cholesterol content in mice but had not yet been evaluated for its therapeutic benefits. Herein, we put Cyp46a1-/- mice on high fat cholesterol-enriched diet from 1 to 14 months of age (control group) and at 12 months of age, started to treat a group of these animals with HPCD until the age of 14 months. We found that as compared with mature and regular chow-fed Cyp46a1-/- mice, control group had about 6-fold increase in the retinal total cholesterol content, focal cholesterol and lipid deposition in the photoreceptor-Bruch's membrane region, and retinal macrophage activation. In addition, aged animals had cholesterol crystals at the photoreceptor-retinal pigment epithelium interface and changes in the Bruch's membrane ultrastructure. HPCD treatment mitigated all these manifestations of retinal cholesterol dyshomeostasis and altered the abundance of six groups of proteins (genetic information transfer, vesicular transport, and cytoskeletal organization, endocytosis and lysosomal processing, unfolded protein removal, lipid homeostasis, and Wnt signaling). Thus, aged Cyp46a1-/- mice on high fat cholesterol-enriched diet revealed pathological changes secondary to retinal cholesterol overload and supported further studies of HPCD as a potential therapeutic for age-related macular degeneration and diabetic retinopathy associated with retinal cholesterol dyshomeostasis.
Collapse
Affiliation(s)
- Nicole El-Darzi
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Natalia Mast
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Sandra S. Hammer
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Tim F. Dorweiler
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Julia V. Busik
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Irina A. Pikuleva
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, USA,For correspondence: Irina A. Pikuleva
| |
Collapse
|
17
|
Li J, Li C, Huang Y, Guan P, Huang D, Yu H, Yang X, Liu L. Mendelian randomization analyses in ocular disease: a powerful approach to causal inference with human genetic data. J Transl Med 2022; 20:621. [PMID: 36572895 PMCID: PMC9793675 DOI: 10.1186/s12967-022-03822-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 12/11/2022] [Indexed: 12/27/2022] Open
Abstract
Ophthalmic epidemiology is concerned with the prevalence, distribution and other factors relating to human eye disease. While observational studies cannot avoid confounding factors from interventions, human eye composition and structure are unique, thus, eye disease pathogenesis, which greatly impairs quality of life and visual health, remains to be fully explored. Notwithstanding, inheritance has had a vital role in ophthalmic disease. Mendelian randomization (MR) is an emerging method that uses genetic variations as instrumental variables (IVs) to avoid confounders and reverse causality issues; it reveals causal relationships between exposure and a range of eyes disorders. Thus far, many MR studies have identified potentially causal associations between lifestyles or biological exposures and eye diseases, thus providing opportunities for further mechanistic research, and interventional development. However, MR results/data must be interpreted based on comprehensive evidence, whereas MR applications in ophthalmic epidemiology have some limitations worth exploring. Here, we review key principles, assumptions and MR methods, summarise contemporary evidence from MR studies on eye disease and provide new ideas uncovering aetiology in ophthalmology.
Collapse
Affiliation(s)
- Jiaxin Li
- grid.412449.e0000 0000 9678 1884Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning China
| | - Cong Li
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Yu Huang
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China ,grid.413405.70000 0004 1808 0686Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Peng Guan
- grid.412449.e0000 0000 9678 1884Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning China
| | - Desheng Huang
- grid.412449.e0000 0000 9678 1884Department of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, Liaoning China
| | - Honghua Yu
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Xiaohong Yang
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Lei Liu
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| |
Collapse
|
18
|
Wong JHC, Ma JYW, Jobling AI, Brandli A, Greferath U, Fletcher EL, Vessey KA. Exploring the pathogenesis of age-related macular degeneration: A review of the interplay between retinal pigment epithelium dysfunction and the innate immune system. Front Neurosci 2022; 16:1009599. [PMID: 36408381 PMCID: PMC9670140 DOI: 10.3389/fnins.2022.1009599] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/12/2022] [Indexed: 07/30/2023] Open
Abstract
Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in the older population. Classical hallmarks of early and intermediate AMD are accumulation of drusen, a waste deposit formed under the retina, and pigmentary abnormalities in the retinal pigment epithelium (RPE). When the disease progresses into late AMD, vision is affected due to death of the RPE and the light-sensitive photoreceptors. The RPE is essential to the health of the retina as it forms the outer blood retinal barrier, which establishes ocular immune regulation, and provides support for the photoreceptors. Due to its unique anatomical position, the RPE can communicate with the retinal environment and the systemic immune environment. In AMD, RPE dysfunction and the accumulation of drusen drive the infiltration of retinal and systemic innate immune cells into the outer retina. While recruited endogenous or systemic mononuclear phagocytes (MPs) contribute to the removal of noxious debris, the accumulation of MPs can also result in chronic inflammation and contribute to AMD progression. In addition, direct communication and indirect molecular signaling between MPs and the RPE may promote RPE cell death, choroidal neovascularization and fibrotic scarring that occur in late AMD. In this review, we explore how the RPE and innate immune cells maintain retinal homeostasis, and detail how RPE dysfunction and aberrant immune cell recruitment contribute to AMD pathogenesis. Evidence from AMD patients will be discussed in conjunction with data from preclinical models, to shed light on future therapeutic targets for the treatment of AMD.
Collapse
|
19
|
Ledesma-Gil G, Otero-Marquez O, Alauddin S, Tong Y, Tai K, Lloyd H, Koci M, Scolaro M, Pillai C, Ye C, Govindaiah A, Bhuiyan A, Dhamoon MS, Deobhakta A, Lema G, Narula J, Rosen RB, Yannuzzi LA, Freund KB, Smith RT. Subretinal drusenoid deposits are strongly associated with coexistent high-risk vascular diseases. BMJ Open Ophthalmol 2022. [DOI: 10.1136/bmjophth-2022-001154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background/aimsDemonstrate that subretinal drusenoid deposits (SDDs) in age-related macular degeneration (AMD) are linked to coexistent high-risk vascular diseases (HRVDs).MethodsCross-sectional study. Two hundred AMD subjects (aged 51–100 years; 121 women, 79 men) were recruited. Spectral domain optical coherence tomography, autofluorescence and near-infrared reflectance imaging, and lipid profiles were obtained. Subjects were assigned by health history questionnaires into those with or without HRVDs, defined as: cardiac valve defect (eg, aortic stenosis), myocardial defect (eg, myocardial infarction) and stroke/transient ischaemic attack. Masked readers assigned subjects into two groups: SDD (with or without drusen) and drusen (only). Univariate testing was performed by χ2test. We built multivariate regression models to test relationships of coexistent HRVD to SDD status, lipid levels and other covariates.ResultsThe prevalence of HRVD was 41.2% (40/97) and 6.8% (7/103) in the SDD and non-SDD groups, respectively (correlation of SDD with HRVD, p=9×10−9, OR 9.62, 95% CI 4.04 to 22.91). Multivariate regressions: only SDDs and high-density lipoprotein (HDL) in the first two HDL quartiles remained significant for HRVD (p=9.8×10−5, 0.021, respectively). Multivariate regression model: SDDs and an HDL in Q1 or Q2 identified the presence of HRVD with the accuracy of 78.5%, 95% CI 72.2% to 84.0%.ConclusionsHigh-risk cardiovascular and neurovascular diseases were accurately identified in an AMD cohort from SDDs and HDL levels. The SDDs may be related to inadequate ocular perfusion resulting from the systemic vasculopathies. Further research with this paradigm is warranted and might reduce mortality and morbidity from vascular disease.
Collapse
|
20
|
Evaluation of the microperimetry in eyes with cuticular drusen. Sci Rep 2022; 12:17557. [PMID: 36266529 PMCID: PMC9584893 DOI: 10.1038/s41598-022-22513-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/17/2022] [Indexed: 01/13/2023] Open
Abstract
Retinal sensitivity may vary by subtypes of cuticular drusen. This retrospective study included 52 eyes of 32 patients with cuticular drusen. All the patients underwent assessment of best-corrected visual acuity (BCVA), spectral-domain optical coherence tomography (SD-OCT), color fundus photography, fluorescein angiography, fundus autofluorescence, and microperimetry. The area occupied by drusen was counted using microperimetry. The cuticular drusen subtype was classified into 3 groups based on the SD-OCT findings. Age, BCVA, pattern standard deviation, area occupied by drusen, pupil size, and the false-positive rate were not significantly different (p > 0.05) according to the cuticular drusen type. The mean retinal sensitivity (MRS) (p = 0.063) and mean deviation (MD) (p = 0.098) showed marginally significant differences among the groups. In the subgroup analyses, type 1 and type 3 cuticular drusen showed significant differences in the MD (- 1.8 ± 2.1 vs - 5.1 ± 5.3; p = 0.011) and MRS (25.1 ± 2.2 vs 21.3 ± 5.7; p = 0.016) without differences in age, BCVA, or the area occupied by drusen (p > 0.05). The results indicate that depending on the subtypes of cuticular drusen type, the deterioration of retinal sensitivity is more likely to occur than decreased vision.
Collapse
|
21
|
Eichenbaum DA, Ahmed A, Hiya F. Ranibizumab port delivery system: a clinical perspective. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-001104. [PMID: 36161829 PMCID: PMC9516155 DOI: 10.1136/bmjophth-2022-001104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Age-related macular degeneration (AMD) represents a leading cause of blindness worldwide. Neovascular AMD (nAMD) is a subtype of AMD most frequently treated with intravitreal anti-vascular endothelial growth factor (aVEGF) injections, which has allowed for patients to maintain vision that would have otherwise been lost. However, the need for frequent intravitreal injections for optimal results poses a risk for undertreatment in nAMD patients due to the high treatment burden associated with current aVEGF therapy. Many novel agents and pathways are being explored and targeted for less burdensome treatment options, one of which is the ranibizumab port delivery system (PDS). The PDS is a surgically implanted, refillable device that allows for the sustained release of ranibizumab, a widely used aVEGF agent, into the vitreous cavity. Positive results non-inferior to monthly ranibizumab injections in both phase II and phase III clinical trials allowed for FDA approval of the device with refill intervals of 6 months, which represents the longest approved treatment interval to date for nAMD therapy. This article reviews the need for a durable nAMD treatment option in real-world practice, the clinical trial and extension study data for the PDS, the risk of adverse events and safety profile of the PDS and the potential clinical role of the PDS in answering the real-world needs of nAMD treatment. In addition, other pipeline sustained-treatment modalities are discussed in the context of ongoing clinical trials.
Collapse
Affiliation(s)
- David A Eichenbaum
- Retina Vitreous Associates of Florida, Saint Petersburg, Florida, USA .,Morsani College of Medicine at the Univeristy of South Florida, Tampa, Florida, USA
| | - Abrahim Ahmed
- Morsani College of Medicine at the Univeristy of South Florida, Tampa, Florida, USA
| | - Farhan Hiya
- Bascom Palmer Eye Institute Mary and Edward Norton Library of Ophthalmology, Miami, Florida, USA
| |
Collapse
|
22
|
Lewis LLM, Dörschmann P, Seeba C, Thalenhorst T, Roider J, Iloki Assanga SB, Ruiz JCG, Del Castillo Castro T, Rosas-Burgos EC, Plascencia-Jatomea M, Ezquerra Brauer JM, Klettner A. Properties of Cephalopod Skin Ommochromes to Inhibit Free Radicals, and the Maillard Reaction and Retino-Protective Mechanisms in Cellular Models Concerning Oxidative Stress, Angiogenesis, and Inflammation. Antioxidants (Basel) 2022; 11:antiox11081574. [PMID: 36009293 PMCID: PMC9404994 DOI: 10.3390/antiox11081574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Ommochromes are pigments of invertebrates that exhibit oxidative stress protection. The aim of this study was to investigate ommochromes extracted from cephalopod’s skin for their ability to inhibit age-related-macular degeneration (AMD)-related factors such as H2O2-induced and iron-dependent oxidative stress (ferroptosis and erastin), accumulation of advanced glycation end-products (AGEs), as well as vascular endothelial growth factor (VEGF), and inflammatory cytokines (interleukin 6 and interleukin 8) secretion. As cell systems, we used primary porcine retinal pigment epithelium (RPE), human retinal pigment epithelium cell line ARPE-19 and uveal melanoma cell line OMM-1. In vitro, ommochromes produced an antiglycation effect by the inhibition of fructosylation reaction. The ommochromes showed protective effects against erastin- induced cell death in ARPE-19. In addition, in long-term stimulation (7 days) ommochromes decreased constitutively secreted VEGF, as well as interleukin 6 and interleukin 8 induced by Poly I:C in primary RPE. No relevant effects were detected in OMM-1 cells. The effects are dependent on the cell system, time of exposition, and concentration. This substance is of interest for further research concerning age-related macular degeneration.
Collapse
Affiliation(s)
- Luján Lidianys María Lewis
- Departamento de Investigación y Posgrado en Alimentos, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo 83000, Sonora, Mexico
| | - Philipp Dörschmann
- Department of Ophthalmology, University of Kiel, University Medical Center, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
| | - Charlotte Seeba
- Department of Ophthalmology, University of Kiel, University Medical Center, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
| | - Tabea Thalenhorst
- Department of Ophthalmology, University of Kiel, University Medical Center, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
| | - Johann Roider
- Department of Ophthalmology, University of Kiel, University Medical Center, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
| | - Simon Bernard Iloki Assanga
- Department of Biological Chemical Sciences, Sonora University, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo 83000, Sonora, Mexico
| | - Juan Carlos Gálvez Ruiz
- Department of Biological Chemical Sciences, Sonora University, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo 83000, Sonora, Mexico
| | - Teresa Del Castillo Castro
- Department of Research on Polymers and Materials, Sonora University, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo 83000, Sonora, Mexico
| | - Ema Carina Rosas-Burgos
- Departamento de Investigación y Posgrado en Alimentos, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo 83000, Sonora, Mexico
| | - Maribel Plascencia-Jatomea
- Departamento de Investigación y Posgrado en Alimentos, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo 83000, Sonora, Mexico
| | - Josafat Marina Ezquerra Brauer
- Departamento de Investigación y Posgrado en Alimentos, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo 83000, Sonora, Mexico
| | - Alexa Klettner
- Department of Ophthalmology, University of Kiel, University Medical Center, Arnold-Heller-Str. 3, Haus 25, 24105 Kiel, Germany
- Correspondence: ; Tel.: +49-431-500-24283
| |
Collapse
|
23
|
Mallik S, Grodstein F, Bennett DA, Vavvas DG, Lemos B. Novel Epigenetic Clock Biomarkers of Age-Related Macular Degeneration. Front Med (Lausanne) 2022; 9:856853. [PMID: 35783640 PMCID: PMC9244395 DOI: 10.3389/fmed.2022.856853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/19/2022] [Indexed: 01/05/2023] Open
Abstract
Age-Related Macular Degeneration (AMD) is a bilateral ocular condition resulting in irreversible vision impairment caused by the progressive loss of photoreceptors in the macula, a region at the center of the retina. The progressive loss of photoreceptor is a key feature of dry AMD but not always wet AMD, though both forms of AMD can lead to loss of vision. Regression-based biological age clocks are one of the most promising biomarkers of aging but have not yet been used in AMD. Here we conducted analyses to identify regression-based biological age clocks for the retina and explored their use in AMD using transcriptomic data consisting of a total of 453 retina samples including 105 Minnesota Grading System (MGS) level 1 samples, 175 MGS level 2, 112 MGS level 3 and 61 MGS level 4 samples, as well as 167 fibroblast samples. The clocks yielded good separation among AMD samples with increasing severity score viz., MGS1-4, regardless of whether clocks were trained in retina tissue, dermal fibroblasts, or in combined datasets. Clock application to cultured fibroblasts, embryonic stem cells, and induced Pluripotent Stem Cells (iPSCs) were consistent with age reprograming in iPSCs. Moreover, clock application to in vitro neuronal differentiation suggests broader applications. Interesting, many of the age clock genes identified include known targets mechanistically linked to AMD and aging, such as GDF11, C16ORF72, and FBN2. This study provides new observations for retina age clocks and suggests new applications for monitoring in vitro neuronal differentiation. These clocks could provide useful markers for AMD monitoring and possible intervention, as well as potential targets for in vitro screens.
Collapse
Affiliation(s)
- Saurav Mallik
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Fran Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Demetrios G. Vavvas
- Ines and Frederick Yeatts Retina Research Laboratory, Retina Service, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, United States
| | - Bernardo Lemos
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, United States
- Broad Institute of Harvard and MIT, Cambridge, MA, United States
| |
Collapse
|
24
|
Kashani AH. Stem cell-derived retinal pigment epithelium transplantation in age-related macular degeneration: recent advances and challenges. Curr Opin Ophthalmol 2022; 33:211-218. [PMID: 35200164 DOI: 10.1097/icu.0000000000000838] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Age-related macular degeneration (AMD) is one of the leading causes of irreversible vision loss in the world with more than 80% of the prevalence accounted for by the nonneovascular (NNAMD) or 'dry' form of the disease. NNAMD does not have any definitive treatment once vision loss has ensued and presents a major unmet medical need. This review will highlight stem cell-based therapies that are a promising form of treatment for advanced NNAMD. RECENT FINDINGS In the past decade, clinical trials utilizing both induced pluripotent stem cell-derived RPE and human embryonic stem cell-derived RPE have been aggressively pursued as potential treatments of RPE loss and prevention of overlying neurosensory atrophy. While promising preliminary results demonstrating safety and potential efficacy have been published, new challenges have also been identified. These include selecting the most appropriate cell-based therapy, identifying and managing potential immune response as well as characterizing anatomic and functional efficacy. In this review, we will discuss some of these challenges in light of the available data from several early phase clinical trials and discuss the strategies that are being considered to further advance the field. SUMMARY Cell-based therapies demonstrate promising potential to treat advanced stages of NNAMD. Several early phase clinical trials using both induced pluripotent stem cells (iPSC) and human embryonic stem cell derived (hESC) have demonstrated safety and preliminary signs of efficacy and highlighted remaining challenges which appear surmountable. These challenges include development of selection criteria for use of cell suspensions versus RPE sheets, especially in light of immunological properties of RPE that are intrinsic to the status of RPE differentiation in each of these cell formulations.
Collapse
Affiliation(s)
- Amir H Kashani
- Department of Ophthalmology and Biomedical Engineering, T Boone Pickens Professorship in Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
25
|
Singh C. Metabolism and Vascular Retinopathies: Current Perspectives and Future Directions. Diagnostics (Basel) 2022; 12:diagnostics12040903. [PMID: 35453951 PMCID: PMC9031785 DOI: 10.3390/diagnostics12040903] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 01/03/2023] Open
Abstract
The retina is one of the most metabolically active organs in the body. Although it is an extension of the brain, the metabolic needs of the retina and metabolic exchanges between the different cell types in the retina are not the same as that of the brain. Retinal photoreceptors convert most of the glucose into lactate via aerobic glycolysis which takes place in their cytosol, yet there are immense numbers of mitochondria in photoreceptors. The present article is a focused review of the metabolic dysregulation seen in retinopathies with underlying vascular abnormalities with aberrant mitochondrial metabolism and Hypoxia-inducible factor (HIF) dependent pathogenesis. Special emphasis has been paid to metabolic exchanges between different cell types in retinopathy of prematurity (ROP), age-related macular degeneration (AMD), and diabetic retinopathy (DR). Metabolic similarities between these proliferative retinopathies have been discussed.
Collapse
Affiliation(s)
- Charandeep Singh
- Liver Center, Division of Gastroenterology, Mass General Hospital, Boston, MA 02114, USA
| |
Collapse
|
26
|
Complete Resolution of Central Soft Drusen without Geographic Atrophy or Choroidal Neovascularization. J Clin Med 2022; 11:jcm11061637. [PMID: 35329963 PMCID: PMC8951140 DOI: 10.3390/jcm11061637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/03/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
The treatment and prevention of dry age-related macular degeneration (AMD) traditionally involve lifestyle modifications and antioxidant supplementation, including the AREDS2 formula. We present a case of a woman with dry AMD in her right eye with several large, confluent central drusen on her exam and optical coherence tomography B-scan. Over the course of a year, the drusen almost completely disappeared, but the retinal layers were preserved without the development of geographic atrophy or choroidal neovascularization. While the exact cause of this phenomenon is unclear, it was thought to be associated with this patient’s strict daily use of numerous dietary supplements. This case highlights the potential in exploring alternative medicine supplements in the treatment of AMD.
Collapse
|
27
|
Urinary Mass Spectrometry Profiles in Age-Related Macular Degeneration. J Clin Med 2022; 11:jcm11040940. [PMID: 35207212 PMCID: PMC8874679 DOI: 10.3390/jcm11040940] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 02/05/2023] Open
Abstract
We and others have shown that patients with different severity stages of age-related macular degeneration (AMD) have distinct plasma metabolomic profiles compared to controls. Urine is a biofluid that can be obtained non-invasively and, in other fields, urine metabolomics has been proposed as a feasible alternative to plasma biomarkers. However, no studies have applied urinary mass spectrometry (MS) metabolomics to AMD. This study aimed to assess urinary metabolomic profiles of patients with different stages of AMD and a control group. We included two prospectively designed, multicenter, cross-sectional study cohorts: Boston, US (n = 185) and Coimbra, Portugal (n = 299). We collected fasting urine samples, which were used for metabolomic profiling (Ultrahigh Performance Liquid chromatography—Mass Spectrometry). Multivariable logistic and ordinal logistic regression models were used for analysis, accounting for gender, age, body mass index and use of AREDS supplementation. Results from both cohorts were then meta-analyzed. No significant differences in urine metabolites were seen when comparing patients with AMD and controls. When disease severity was considered as an outcome, six urinary metabolites differed significantly (p < 0.01). In particular, two of the metabolites identified have been previously shown by our group to also differ in the plasma of patients of AMD compared to controls and across severity stages. While there are fewer urinary metabolites associated with AMD than plasma metabolites, this study identified some differences across stages of disease that support previous work performed with plasma, thus highlighting the potential of these metabolites as future biomarkers for AMD.
Collapse
|
28
|
Complement activation by RPE cells preexposed to TNFα and IFNγ. Exp Eye Res 2022; 218:108982. [DOI: 10.1016/j.exer.2022.108982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 01/27/2023]
|
29
|
Kashani AH, Lebkowski JS, Hinton DR, Zhu D, Faynus MA, Chen S, Rahhal FM, Avery RL, Salehi-Had H, Chan C, Palejwala N, Ingram A, Dang W, Lin CM, Mitra D, Martinez-Camarillo JC, Bailey J, Arnold C, Pennington BO, Rao N, Johnson LV, Clegg DO, Humayun MS. Survival of an HLA-mismatched, bioengineered RPE implant in dry age-related macular degeneration. Stem Cell Reports 2022; 17:448-458. [PMID: 35120620 PMCID: PMC9039755 DOI: 10.1016/j.stemcr.2022.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/29/2022] Open
Abstract
Cell-based therapies face challenges, including poor cell survival, immune rejection, and integration into pathologic tissue. We conducted an open-label phase 1/2a clinical trial to assess the safety and preliminary efficacy of a subretinal implant consisting of a polarized monolayer of allogeneic human embryonic stem cell-derived retinal pigmented epithelium (RPE) cells in subjects with geographic atrophy (GA) secondary to dry age-related macular degeneration. Postmortem histology from one subject with very advanced disease shows the presence of donor RPE cells 2 years after implantation by immunoreactivity for RPE65 and donor-specific human leukocyte antigen (HLA) class I molecules. Markers of RPE cell polarity and phagocytosis suggest donor RPE function. Further histologic examination demonstrated CD34+ structures beneath the implant and CD4+, CD68+, and FoxP3+ cells in the tissue. Despite significant donor-host HLA mismatch, no clinical signs of retinitis, vitreitis, vasculitis, choroiditis, or serologic immune response were detected in the deceased subject or any other subject in the study. Subretinally implanted, HLA-mismatched donor RPE cells survive, express functional markers, and do not elicit clinically detectable intraocular inflammation or serologic immune responses even without long-term immunosuppression. Clinical trial of allogeneic RPE cell transplant as AMD therapeutic Postmortem histology shows 2-year survival and function of donor RPE cells Transplanted RPE cells are mature, polarized, and phagocytic Serologic immune and clinical cellular inflammatory responses are not detected
Collapse
Affiliation(s)
- Amir H Kashani
- Wilmer Eye Institute, Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD 21087 USA
| | - Jane S Lebkowski
- Regenerative Patch Technologies, 150 Gabarda Way, Portola Valley, CA 94028, USA
| | - David R Hinton
- Department of Pathology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, 7503, Los Angeles, CA 90033, USA; USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo, Los Angeles, CA 90033, USA
| | - Danhong Zhu
- Department of Pathology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, 7503, Los Angeles, CA 90033, USA
| | - Mohamed A Faynus
- Regenerative Patch Technologies, 150 Gabarda Way, Portola Valley, CA 94028, USA; Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, Mail Code 5060, University of California, Santa Barbara, CA 93016, USA
| | - Sanford Chen
- Orange County Retina Medical Group, 1200 N. Tustin Avenue, Suite 140, Santa Ana, CA 92705, USA
| | - Firas M Rahhal
- Retina-Vitreous Associates Medical Group, 9001 Wilshire Boulevard, Suite 301, Beverly Hills, CA 90211, USA
| | - Robert L Avery
- California Retina Consultants, 525 E. Micheltorena Street, Santa Barbara, CA 93103, USA
| | - Hani Salehi-Had
- Retina Associates of Southern California, 7777 Edinger Avenue, Suite 234, Huntington Beach, CA 92647, USA
| | - Clement Chan
- Southern California Desert Retina Consultants, University Park, 36-949 Cook Street, Suite 101, Palm Desert, CA 92211, USA
| | - Neal Palejwala
- Retinal Consultants of Arizona, 15401 North 29th Avenue, Phoenix, AZ 85053, USA
| | - April Ingram
- Regenerative Patch Technologies, 150 Gabarda Way, Portola Valley, CA 94028, USA
| | - Wei Dang
- Center for Biomedicine and Genetics, Beckman Research Institute of City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Chih-Min Lin
- Center for Biomedicine and Genetics, Beckman Research Institute of City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Debbie Mitra
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo, Los Angeles, CA 90033, USA
| | | | - Jeff Bailey
- Regenerative Patch Technologies, 150 Gabarda Way, Portola Valley, CA 94028, USA; Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, Mail Code 5060, University of California, Santa Barbara, CA 93016, USA
| | - Cassidy Arnold
- Regenerative Patch Technologies, 150 Gabarda Way, Portola Valley, CA 94028, USA; Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, Mail Code 5060, University of California, Santa Barbara, CA 93016, USA
| | - Britney O Pennington
- Regenerative Patch Technologies, 150 Gabarda Way, Portola Valley, CA 94028, USA; Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, Mail Code 5060, University of California, Santa Barbara, CA 93016, USA
| | - Narsing Rao
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo, Los Angeles, CA 90033, USA
| | - Lincoln V Johnson
- Regenerative Patch Technologies, 150 Gabarda Way, Portola Valley, CA 94028, USA
| | - Dennis O Clegg
- Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, Mail Code 5060, University of California, Santa Barbara, CA 93016, USA
| | - Mark S Humayun
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo, Los Angeles, CA 90033, USA; Department of Biomedical Engineering, Denney Research Center (DRB) 140, University of Southern California, 1042 Downey Way, Los Angeles, CA 90089, USA.
| |
Collapse
|
30
|
Landowski M, Bhute VJ, Takimoto T, Grindel S, Shahi PK, Pattnaik BR, Ikeda S, Ikeda A. A mutation in transmembrane protein 135 impairs lipid metabolism in mouse eyecups. Sci Rep 2022; 12:756. [PMID: 35031662 PMCID: PMC8760256 DOI: 10.1038/s41598-021-04644-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022] Open
Abstract
Aging is a significant factor in the development of age-related diseases but how aging disrupts cellular homeostasis to cause age-related retinal disease is unknown. Here, we further our studies on transmembrane protein 135 (Tmem135), a gene involved in retinal aging, by examining the transcriptomic profiles of wild-type, heterozygous and homozygous Tmem135 mutant posterior eyecup samples through RNA sequencing (RNA-Seq). We found significant gene expression changes in both heterozygous and homozygous Tmem135 mutant mouse eyecups that correlate with visual function deficits. Further analysis revealed that expression of many genes involved in lipid metabolism are changed due to the Tmem135 mutation. Consistent with these changes, we found increased lipid accumulation in mutant Tmem135 eyecup samples. Since mutant Tmem135 mice have similar ocular pathologies as human age-related macular degeneration (AMD) eyes, we compared our homozygous Tmem135 mutant eyecup RNA-Seq dataset with transcriptomic datasets of human AMD donor eyes. We found similar changes in genes involved in lipid metabolism between the homozygous Tmem135 mutant eyecups and AMD donor eyes. Our study suggests that the Tmem135 mutation affects lipid metabolism as similarly observed in human AMD eyes, thus Tmem135 mutant mice can serve as a good model for the role of dysregulated lipid metabolism in AMD.
Collapse
Affiliation(s)
- Michael Landowski
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA
| | - Vijesh J Bhute
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Chemical Engineering, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - Tetsuya Takimoto
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA
| | - Samuel Grindel
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA
| | - Pawan K Shahi
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Bikash R Pattnaik
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Sakae Ikeda
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA
| | - Akihiro Ikeda
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, WI, USA.
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA.
| |
Collapse
|
31
|
Yusef YN, Erichev VP, Budzinskaya MV, Khalatyan AS, Ausheva AK. [Gerontological aspects of eye diseases]. Vestn Oftalmol 2022; 138:227-233. [PMID: 36287160 DOI: 10.17116/oftalma2022138052227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The global rate of aging is rapidly rising due to the increase in life expectancy, and the number of age-related diseases - including eye diseases - is increasing. The most common eye conditions affecting people over 50 years old are age-related macular degeneration, cataract, glaucoma and diabetic retinopathy. Timely and effective treatment of age-related eye diseases requires a deeper understanding of the cellular mechanisms of aging.
Collapse
Affiliation(s)
- Yu N Yusef
- Research Institute of Eye Diseases, Moscow, Russia
| | - V P Erichev
- Research Institute of Eye Diseases, Moscow, Russia
| | | | | | - A Kh Ausheva
- Pirogov Russian National Research Medical University, Moscow, Russia
| |
Collapse
|
32
|
Plastino F, Pesce NA, André H. MicroRNAs and the HIF/VEGF axis in ocular neovascular diseases. Acta Ophthalmol 2021; 99:e1255-e1262. [PMID: 33729690 DOI: 10.1111/aos.14845] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 12/28/2022]
Abstract
Ocular neovascular diseases, such as proliferative diabetic retinopathy, retinopathy of prematurity and neovascular age-related macular degeneration, are the leading causes of visual impairment worldwide. The hypoxia-inducible factors and vascular endothelial growth factors are key molecular promoters of ocular neovascularization. Moreover, the role of microRNAs as regulators of angiogenesis has been expanding, particularly hypoxia-associated microRNA; hypoxamiRs. This review provides a summary of hypoxamiRs that directly and specifically target HIF1A and VEGF mRNAs, thus critically involved in the regulation of ocular neovascular pathologies. The discussed microRNAs highlight putative diagnostic markers and therapeutic agents in choroidal and retinal angiogenic diseases, including proliferative diabetic retinopathy, retinopathy of prematurity and neovascular age-related macular degeneration.
Collapse
Affiliation(s)
- Flavia Plastino
- Department of Clinical Neurosciences Division of Eye and Vision St. Erik Eye Hospital Karolinska Institutet Stockholm Sweden
| | - Noemi Anna Pesce
- Department of Clinical Neurosciences Division of Eye and Vision St. Erik Eye Hospital Karolinska Institutet Stockholm Sweden
| | - Helder André
- Department of Clinical Neurosciences Division of Eye and Vision St. Erik Eye Hospital Karolinska Institutet Stockholm Sweden
| |
Collapse
|
33
|
Landowski M, Bowes Rickman C. Targeting Lipid Metabolism for the Treatment of Age-Related Macular Degeneration: Insights from Preclinical Mouse Models. J Ocul Pharmacol Ther 2021; 38:3-32. [PMID: 34788573 PMCID: PMC8817708 DOI: 10.1089/jop.2021.0067] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Age-related macular degeneration (AMD) is a major leading cause of irreversible visual impairment in the world with limited therapeutic interventions. Histological, biochemical, genetic, and epidemiological studies strongly implicate dysregulated lipid metabolism in the retinal pigmented epithelium (RPE) in AMD pathobiology. However, effective therapies targeting lipid metabolism still need to be identified and developed for this blinding disease. To test lipid metabolism-targeting therapies, preclinical AMD mouse models are needed to establish therapeutic efficacy and the role of lipid metabolism in the development of AMD-like pathology. In this review, we provide a comprehensive overview of current AMD mouse models available to researchers that could be used to provide preclinical evidence supporting therapies targeting lipid metabolism for AMD. Based on previous studies of AMD mouse models, we discuss strategies to modulate lipid metabolism as well as examples of studies evaluating lipid-targeting therapeutics to restore lipid processing in the RPE. The use of AMD mouse models may lead to worthy lipid-targeting candidate therapies for clinical trials to prevent the blindness caused by AMD.
Collapse
Affiliation(s)
- Michael Landowski
- Department of Medical Genetics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Catherine Bowes Rickman
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA.,Department of Cell Biology, Duke University Medical Center, Durham, North Carolina, USA
| |
Collapse
|
34
|
Characterizations of Hamster Retina as a Model for Studies of Retinal Cholesterol Homeostasis. BIOLOGY 2021; 10:biology10101003. [PMID: 34681102 PMCID: PMC8533155 DOI: 10.3390/biology10101003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022]
Abstract
Simple Summary This work represents a comprehensive evaluation of hamster retina by state-of-the-art methodologies and provides evidence that hamsters may represent a better model for studies of retinal cholesterol maintenance than mice. The latter is an important finding, as disturbances in retinal cholesterol homeostasis are linked to age-related macular degeneration and diabetic retinopathy, which are blinding diseases. Abstract Cholesterol homeostasis in the retina, a sensory organ in the back of the eye, has been studied in mice but not hamsters, despite the latter being more similar to humans than mice with respect to their whole-body cholesterol maintenance. The goal of this study was to begin to assess hamster retina and conduct initial interspecies comparisons. First, young (3-month old) and mature (6-month old) Syrian (golden) hamsters were compared with 3- and 6-month old mice for ocular biometrics and retinal appearance on optical coherence tomography and fluorescein angiography. Of the 30 evaluated hamsters, seven had retinal structural abnormalities and all had increased permeability of retinal blood vessels. However, hamsters did not carry the mutations causing retinal degenerations 1 and 8, had normal blood glucose levels, and only slightly elevated hemoglobin A1c content. Cholesterol and six other sterols were quantified in hamster retina and compared with sterol profiles in mouse and human retina. These comparisons suggested that cholesterol turnover is much higher in younger than mature hamster retina, and that mature hamster and human retinas share similarities in the ratios of cholesterol metabolites to cholesterol. This study supports further investigations of cholesterol maintenance in hamster retina.
Collapse
|
35
|
Qiang W, Wei R, Chen Y, Chen D. Clinical Pathological Features and Current Animal Models of Type 3 Macular Neovascularization. Front Neurosci 2021; 15:734860. [PMID: 34512255 PMCID: PMC8427186 DOI: 10.3389/fnins.2021.734860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/29/2021] [Indexed: 02/05/2023] Open
Abstract
Type 3 macular neovascularization (MNV3), or retinal angiomatous proliferation (RAP), is a distinct type of neovascular age-related macular degeneration (AMD), which is a leading cause of vision loss in older persons. During the past decade, systematic investigation into the clinical, multimodal imaging, and histopathological features and therapeutic outcomes has provided important new insight into this disease. These studies favor the retinal origin of MNV3 and suggest the involvement of retinal hypoxia, inflammation, von Hippel–Lindau (VHL)–hypoxia-inducible factor (HIF)–vascular endothelial growth factor (VEGF) pathway, and multiple cell types in the development and progression of MNV3. Several mouse models, including the recently built Rb/p107/Vhl triple knockout mouse model by our group, have induced many of the histological features of MNV3 and provided much insight into the underlying pathological mechanisms. These models have revealed the roles of retinal hypoxia, inflammation, lipid metabolism, VHL/HIF pathway, and retinoblastoma tumor suppressor (Rb)–E2F cell cycle pathway in the development of MNV3. This article will summarize the clinical, multimodal imaging, and pathological features of MNV3 and the diversity of animal models that exist for MNV3, as well as their strengths and limitations.
Collapse
Affiliation(s)
- Wei Qiang
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Ran Wei
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yongjiang Chen
- The School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Danian Chen
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
36
|
Racic T, Chang A, Fernando N, Brandli A, Natoli R, Penfold P, Provis JM, Rutar M. Anti-inflammatory and neuroprotective properties of the corticosteroid fludrocortisone in retinal degeneration. Exp Eye Res 2021; 212:108765. [PMID: 34509498 DOI: 10.1016/j.exer.2021.108765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/05/2021] [Accepted: 09/08/2021] [Indexed: 12/20/2022]
Abstract
The pathogenesis of outer retinal degenerations has been linked to the elevation of cytokines that orchestrate pro-inflammatory responses within the retinal milieu, and which are thought to play a role in diseases such as geographic atrophy (GA), an advanced form of AMD. Here we sought investigate the anti-inflammatory and mechanistic properties of fludrocortisone (FA), as well as triamcinolone acetonide (TA), on Müller cell-mediated cytokine expression in response to inflammatory challenge. In addition, we investigated the neuroprotective efficacy of FA and TA in a photo-oxidative damage (PD), a model of outer retinal degeneration. Expression of CCL2, IL-6, and IL-8 with respect to FA and TA were assessed in Müller cells in vitro, following simulation with IL-1β or TNF-α. The dependency of this effect on mineralocorticoid and glucocorticoid signaling was also interrogated for both TA and TA via co-incubation with steroid receptor antagonists. For the PD model, C57BL/6 mice were intravitreally injected with FA or TA, and changes in retinal pathology were assessed via electroretinogram (ERG) and optical coherence tomography (OCT). FA and TA were found to dramatically reduce the expression of CCL2, IL-6, and IL-8 in Müller glia in vitro after inflammatory challenge with IL-1β or TNF-α (P < 0.05). Though FA acts as both a mineralocorticoid and glucocorticoid receptor agonist, co-incubation with selective steroid antagonists revealed that the suppressive effect of FA on CCL2, IL-6, and IL-8 expression is mediated by glucocorticoid signaling (P < 0.05). In PD, intravitreal FA was found to ameliorate outer-retinal atrophy as measured by ERG and OCT (P < 0.05), while TA had no significant effect (P > 0.05). Our data indicate potent anti-inflammatory and mechanistic properties of corticosteroids, specifically FA, in suppressing inflammation and neurodegeneration degeneration associated with outer retinal atrophy. Taken together, our findings indicate that corticosteroids such as FA may have value as a potential therapeutic for outer retinal degenerations where such pro-inflammatory factors are implicated, including AMD.
Collapse
Affiliation(s)
- Tanja Racic
- John Curtin School of Medical Research, The Australian National University, ACT, Australia
| | - Andrew Chang
- Sydney Retina Clinic & Day Surgery, Sydney, NSW, Australia; Save Sight Institute, The University of Sydney, NSW, Australia
| | - Nilisha Fernando
- John Curtin School of Medical Research, The Australian National University, ACT, Australia
| | - Alice Brandli
- Department of Anatomy and Physiology, The University of Melbourne, VIC, Australia
| | - Riccardo Natoli
- John Curtin School of Medical Research, The Australian National University, ACT, Australia; ANU Medical School, The Australian National University, ACT, Australia
| | - Philip Penfold
- John Curtin School of Medical Research, The Australian National University, ACT, Australia
| | - Jan M Provis
- John Curtin School of Medical Research, The Australian National University, ACT, Australia; ANU Medical School, The Australian National University, ACT, Australia
| | - Matt Rutar
- Department of Anatomy and Physiology, The University of Melbourne, VIC, Australia; Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, ACT, Australia.
| |
Collapse
|
37
|
Amadoro G, Latina V, Balzamino BO, Squitti R, Varano M, Calissano P, Micera A. Nerve Growth Factor-Based Therapy in Alzheimer's Disease and Age-Related Macular Degeneration. Front Neurosci 2021; 15:735928. [PMID: 34566573 PMCID: PMC8459906 DOI: 10.3389/fnins.2021.735928] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/10/2021] [Indexed: 12/23/2022] Open
Abstract
Alzheimer's disease (AD) is an age-associated neurodegenerative disease which is the most common cause of dementia among the elderly. Imbalance in nerve growth factor (NGF) signaling, metabolism, and/or defect in NGF transport to the basal forebrain cholinergic neurons occurs in patients affected with AD. According to the cholinergic hypothesis, an early and progressive synaptic and neuronal loss in a vulnerable population of basal forebrain involved in memory and learning processes leads to degeneration of cortical and hippocampal projections followed by cognitive impairment with accumulation of misfolded/aggregated Aβ and tau protein. The neuroprotective and regenerative effects of NGF on cholinergic neurons have been largely demonstrated, both in animal models of AD and in living patients. However, the development of this neurotrophin as a disease-modifying therapy in humans is challenged by both delivery limitations (inability to cross the blood-brain barrier (BBB), poor pharmacokinetic profile) and unwanted side effects (pain and weight loss). Age-related macular degeneration (AMD) is a retinal disease which represents the major cause of blindness in developed countries and shares several clinical and pathological features with AD, including alterations in NGF transduction pathways. Interestingly, nerve fiber layer thinning, degeneration of retinal ganglion cells and changes of vascular parameters, aggregation of Aβ and tau protein, and apoptosis also occur in the retina of both AD and AMD. A protective effect of ocular administration of NGF on both photoreceptor and retinal ganglion cell degeneration has been recently described. Besides, the current knowledge about the detection of essential trace metals associated with AD and AMD and their changes depending on the severity of diseases, either systemic or locally detected, further pave the way for a promising diagnostic approach. This review is aimed at describing the employment of NGF as a common therapeutic approach to AMD and AD and the diagnostic power of detection of essential trace metals associated with both diseases. The multiple approaches employed to allow a sustained release/targeting of NGF to the brain and its neurosensorial ocular extensions will be also discussed, highlighting innovative technologies and future translational prospects.
Collapse
Affiliation(s)
- Giuseppina Amadoro
- Institute of Translational Pharmacology (IFT)-CNR, Rome, Italy
- European Brain Research Institute, Rome, Italy
| | | | | | - Rosanna Squitti
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Monica Varano
- Research Laboratories in Ophthalmology, IRCCS-Fondazione Bietti, Rome, Italy
| | | | - Alessandra Micera
- Research Laboratories in Ophthalmology, IRCCS-Fondazione Bietti, Rome, Italy
| |
Collapse
|
38
|
Cozzi M, Monteduro D, Parrulli S, Ristoldo F, Corvi F, Zicarelli F, Staurenghi G, Invernizzi A. Prechoroidal cleft thickness correlates with disease activity in neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2021; 260:781-789. [PMID: 34491426 PMCID: PMC8850287 DOI: 10.1007/s00417-021-05384-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/29/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to investigate the structural variations of the hyporeflective pocket of fluid (prechoroidal cleft) located between Bruch’s membrane and the hyperreflective material within the pigment epithelial detachment (PED) in patients with neovascular age-related macular degeneration (nAMD). Methods In this retrospective, observational case series study, patients diagnosed with nAMD and prechoroidal cleft associated with other activity signs of the macular neovascularization (MNV) were included. Structural optical coherence tomography (OCT) scans were evaluated to obtain anatomical measurements of prechoroidal cleft and PED at three different visits (T0, inactive MNV; T1, active MNV; T2, treated inactive MNV). The variations in size of the cleft and the PED were correlated with nAMD activity. Results Twenty-nine eyes from 27 patients were included. The subfoveal measurements showed a significant increase of prechoroidal cleft height and width from T0 to T1 (P < 0.05) and a subsequent decrease of the cleft height after treatment with anti-VEGF agents (P = 0.004). A similar significant trend was observed for the greatest prechoroidal cleft height and width, obtained assessing the whole OCT raster. In the multivariate analysis, the cleft height was significantly affected by both time (P = 0.001) and PED height (P < 0.0001). By contrast, the effect of fibrovascular tissue size within the PED was not significant. Visual acuity did not correlate with prechoroidal cleft size. Conclusion Prechoroidal cleft increased in association with MNV reactivation and decreased after treatment. Our results suggest that prechoroidal cleft could represent an accumulation of fluid actively exudating from the MNV and should be considered a sign of nAMD activity. ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05384-w.
Collapse
Affiliation(s)
- Mariano Cozzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy
| | - Davide Monteduro
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy
| | - Salvatore Parrulli
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy
| | - Federica Ristoldo
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy
| | - Federico Corvi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy
| | - Federico Zicarelli
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74 - 20157, Milan, Italy. .,Faculty of Health and Medicine, Save Sight Institute, University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
39
|
Kashani AH, Lebkowski JS, Rahhal FM, Avery RL, Salehi-Had H, Chen S, Chan C, Palejwala N, Ingram A, Dang W, Lin CM, Mitra D, Pennington BO, Hinman C, Faynus MA, Bailey JK, Mohan S, Rao N, Johnson LV, Clegg DO, Hinton DR, Humayun MS. One-Year Follow-Up in a Phase 1/2a Clinical Trial of an Allogeneic RPE Cell Bioengineered Implant for Advanced Dry Age-Related Macular Degeneration. Transl Vis Sci Technol 2021; 10:13. [PMID: 34613357 PMCID: PMC8496407 DOI: 10.1167/tvst.10.10.13] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose To report 1-year follow-up of a phase 1/2a clinical trial testing a composite subretinal implant having polarized human embryonic stem cell (hESC)-derived retinal pigment epithelium (RPE) cells on an ultrathin parylene substrate in subjects with advanced non-neovascular age-related macular degeneration (NNAMD) Methods The phase 1/2a clinical trial included 16 subjects in two cohorts. The main endpoint was safety assessed at 365 days using ophthalmic and systemic exams. Pseudophakic subjects with geographic atrophy (GA) and severe vision loss were eligible. Low-dose tacrolimus immunosuppression was utilized for 68 days in the peri-implantation period. The implant was delivered to the worst seeing eye with a custom subretinal insertion device in an outpatient setting. A data safety monitoring committee reviewed all results. Results The treated eyes of all subjects were legally blind with a baseline best-corrected visual acuity (BCVA) of ≤ 20/200. There were no unexpected serious adverse events. Four subjects in cohort 1 had serious ocular adverse events, including retinal hemorrhage, edema, focal retinal detachment, or RPE detachment, which was mitigated in cohort 2 using improved hemostasis during surgery. Although this study was not powered to assess efficacy, treated eyes from four subjects showed an increased BCVA of >5 letters (6–13 letters). A larger proportion of treated eyes experienced a >5-letter gain when compared with the untreated eye (27% vs. 7%; P = not significant) and a larger proportion of nonimplanted eyes demonstrated a >5-letter loss (47% vs. 33%; P = not significant). Conclusions Outpatient delivery of the implant can be performed routinely. At 1 year, the implant is safe and well tolerated in subjects with advanced dry AMD. Translational Relevance This work describes the first clinical trial, to our knowledge, of a novel implant for advanced dry AMD.
Collapse
Affiliation(s)
- Amir H Kashani
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Firas M Rahhal
- Retina-Vitreous Associates Medical Group, Beverly Hills, CA, USA
| | | | | | - Sanford Chen
- Orange County Retina Medical Group, Santa Ana, CA, USA
| | - Clement Chan
- Southern California Desert Retina Consultants, Palm Desert, CA, USA
| | - Neal Palejwala
- Retinal Consultants of Arizona, Retinal Research Institute LLC, Phoenix, AZ, USA
| | - April Ingram
- Regenerative Patch Technologies, Menlo Park, CA, USA
| | - Wei Dang
- Center for Biomedicine and Genetics, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Chih-Min Lin
- Center for Biomedicine and Genetics, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Debbie Mitra
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Britney O Pennington
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Cassidy Hinman
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Mohamed A Faynus
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Jeffrey K Bailey
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Sukriti Mohan
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Narsing Rao
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lincoln V Johnson
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Dennis O Clegg
- Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - David R Hinton
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mark S Humayun
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
40
|
Vilkeviciute A, Bastikaityte N, Mockute R, Cebatoriene D, Kriauciuniene L, Balciuniene J, Zemaitiene R, Liutkeviciene R. The Role of SNPs in IL1RL1 and IL1RAP Genes in Age-related Macular Degeneration Development and Treatment Efficacy. In Vivo 2021; 34:2443-2451. [PMID: 32871771 DOI: 10.21873/invivo.12059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Age-related macular degeneration (AMD) affects the central part of the retina and causes blindness. In developed countries, AMD occurs in people over 50 years old. Important factors for AMD pathogenesis are an immune response, inflammation, and genetic factors. This study aimed to determine the impact of IL1RL1 rs1041973 and IL1RAP rs4624606 single nucleotide polymorphisms (SNPs) on the occurrence of AMD and the outcome of treatment with aflibercept and bevacizumab. PATIENTS AND METHODS 563 patients with AMD and 281 healthy candidates were evaluated. Patients with exudative AMD were treated with intravitreal bevacizumab and aflibercept and, after 6 months based on the changes in best-corrected visual acuity and central macular thickness, were classified as 'responders' or 'poor-responders'. Genotyping of IL1RL1 rs1041973 and IL1RAP rs4624606 was accomplished using real-time PCR. Age was compared using the Mann-Whitney U-test. Categorical data (gender, genotype, and allele distributions) compared between groups using the χ2 test or the Fisher's exact test. Associations of gene polymorphisms were calculated using logistic regression analysis with adjustment for age in exudative and atrophic AMD analysis. An adjusted significance threshold for multiple comparisons α=0.025 was applied. RESULTS Statistically significant differences in the distribution of IL1RAP rs4624606 genotypes (TT, TA and AA) were found between males with atrophic AMD and controls: 50%, 42.9% and 7.1% vs. 69.7%, 30.3% and 0%, respectively, p=0.015. Moreover, we found that 'responders' had a significantly better best-corrected visual acuity than 'poor-responders' before treatment (p=0.032). The central macular thickness was significantly lower in exudative AMD patients with IL1RL1 rs1041973 AA genotype than in wild type and heterozygous (CC+CA) genotype carriers before treatment (p=0.017). CONCLUSION IL1RAP rs4624606 may be associated with atrophic AMD in males while IL1RL1 rs1041973 may play a protective role against macular thickening in exudative AMD patients.
Collapse
Affiliation(s)
- Alvita Vilkeviciute
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | | | - Ruta Mockute
- Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Dzastina Cebatoriene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Loresa Kriauciuniene
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania.,Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Jurate Balciuniene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Reda Zemaitiene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Rasa Liutkeviciene
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania.,Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| |
Collapse
|
41
|
HK2 Mediated Glycolytic Metabolism in Mouse Photoreceptors Is Not Required to Cause Late Stage Age-Related Macular Degeneration-Like Pathologies. Biomolecules 2021; 11:biom11060871. [PMID: 34208233 PMCID: PMC8230848 DOI: 10.3390/biom11060871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/01/2021] [Accepted: 06/09/2021] [Indexed: 12/12/2022] Open
Abstract
Age-related macular degeneration (AMD) is a multifactorial disease of unclear etiology. We previously proposed that metabolic adaptations in photoreceptors (PRs) play a role in disease progression. We mimicked these metabolic adaptations in mouse PRs through deletion of the tuberous sclerosis complex (TSC) protein TSC1. Here, we confirm our previous findings by deletion of the other complex protein, namely TSC2, in rod photoreceptors. Similar to deletion of Tsc1, mice with deletion of Tsc2 in rods develop AMD-like pathologies, including accumulation of apolipoproteins, migration of microglia, geographic atrophy, and neovascular pathologies. Subtle differences between the two mouse models, such as a significant increase in microglia activation with loss of Tsc2, were seen as well. To investigate the role of altered glucose metabolism in disease pathogenesis, we generated mice with simulation deletions of Tsc2 and hexokinase-2 (Hk2) in rods. Although retinal lactate levels returned to normal in mice with Tsc2-Hk2 deletion, AMD-like pathologies still developed. The data suggest that the metabolic adaptations in PRs that cause AMD-like pathologies are independent of HK2-mediated aerobic glycolysis.
Collapse
|
42
|
Garland DL, Pierce EA, Fernandez-Godino R. Complement C5 is not critical for the formation of sub-RPE deposits in Efemp1 mutant mice. Sci Rep 2021; 11:10416. [PMID: 34001980 PMCID: PMC8128922 DOI: 10.1038/s41598-021-89978-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 05/05/2021] [Indexed: 12/27/2022] Open
Abstract
The complement system plays a role in the formation of sub-retinal pigment epithelial (RPE) deposits in early stages of age-related macular degeneration (AMD). But the specific mechanisms that connect complement activation and deposit formation in AMD patients are unknown, which limits the development of efficient therapies to reduce or stop disease progression. We have previously demonstrated that C3 blockage prevents the formation of sub-RPE deposits in a mouse model of EFEMP1-associated macular degeneration. In this study, we have used double mutant Efemp1R345W/R345W:C5-/- mice to investigate the role of C5 in the formation of sub-RPE deposits in vivo and in vitro. The data revealed that the genetic ablation of C5 does not eliminate the formation of sub-RPE deposits. Contrarily, the absence of C5 in RPE cultures promotes complement dysregulation that results in increased activation of C3, which likely contributes to deposit formation even in the absence of EFEMP1-R345W mutant protein. The results also suggest that genetic ablation of C5 alters the extracellular matrix turnover through an effect on matrix metalloproteinases in RPE cell cultures. These results confirm that C3 rather than C5 could be an effective therapeutic target to treat early AMD.
Collapse
Affiliation(s)
- Donita L Garland
- Ocular Genomics Institute at Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Eric A Pierce
- Ocular Genomics Institute at Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | | |
Collapse
|
43
|
Fleckenstein M, Keenan TDL, Guymer RH, Chakravarthy U, Schmitz-Valckenberg S, Klaver CC, Wong WT, Chew EY. Age-related macular degeneration. Nat Rev Dis Primers 2021; 7:31. [PMID: 33958600 DOI: 10.1038/s41572-021-00265-2] [Citation(s) in RCA: 366] [Impact Index Per Article: 122.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
Age-related macular degeneration (AMD) is the leading cause of legal blindness in the industrialized world. AMD is characterized by accumulation of extracellular deposits, namely drusen, along with progressive degeneration of photoreceptors and adjacent tissues. AMD is a multifactorial disease encompassing a complex interplay between ageing, environmental risk factors and genetic susceptibility. Chronic inflammation, lipid deposition, oxidative stress and impaired extracellular matrix maintenance are strongly implicated in AMD pathogenesis. However, the exact interactions of pathophysiological events that culminate in drusen formation and the associated degeneration processes remain to be elucidated. Despite tremendous advances in clinical care and in unravelling pathophysiological mechanisms, the unmet medical need related to AMD remains substantial. Although there have been major breakthroughs in the treatment of exudative AMD, no efficacious treatment is yet available to prevent progressive irreversible photoreceptor degeneration, which leads to central vision loss. Compelling progress in high-resolution retinal imaging has enabled refined phenotyping of AMD in vivo. These insights, in combination with clinicopathological and genetic correlations, have underscored the heterogeneity of AMD. Hence, our current understanding promotes the view that AMD represents a disease spectrum comprising distinct phenotypes with different mechanisms of pathogenesis. Hence, tailoring therapeutics to specific phenotypes and stages may, in the future, be the key to preventing irreversible vision loss.
Collapse
Affiliation(s)
- Monika Fleckenstein
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
| | - Tiarnán D L Keenan
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, VIC, Australia
| | - Usha Chakravarthy
- Department of Ophthalmology, Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | - Steffen Schmitz-Valckenberg
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.,Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Caroline C Klaver
- Department of Ophthalmology, Erasmus MC, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands.,Department of Ophthalmology, Radboud Medical Center, Nijmegen, Netherlands.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Wai T Wong
- Section on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Emily Y Chew
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
44
|
Lee D, Chan CK, Abraham P, Sarraf D. Post-hoc analysis of single nucleotide polymorphism profile for eyes with vascularized pigment epithelial detachment due to ARMD. Eur J Ophthalmol 2021; 31:1281-1290. [PMID: 32578437 DOI: 10.1177/1120672120932829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This post-hoc case-control study compares single nucleotide polymorphism (SNP) profile of eyes with vascularized pigment epithelial detachment (vPED) due to age-related macular degeneration (ARMD) with: (1) Control-1 eyes (no ARMD and AREDS Severity Scale 0); and (2) Control-2 eyes (drusen or AREDS Severity Scale 2). SNP profile of High Responders (HR) was also compared with Low Responders (LR) to ranibizumab. METHODS Blood samples from 40 patients with vPED treated with ranibizumab were sent for SNP-specific genotype analysis for comparison of variant allele frequencies of 23 SNPs associated with ARMD (VAF) to VAF in 184 Control-1 eyes, and VAF in 85 Control-2 eyes. VAF of HR-50 (⩾50% decrease in PED height) and VAF of HR-75 (⩾75% decrease in PED height) were also compared with VAF of LR. RESULTS These SNPs were more frequent in vPED than Control-1 eyes: APOE rs4420638 (A/G), HTRA1 rs104904924 (G/T), VEGF rs943080 (T/C), CFH rs1061170 (T/C), CFH rs2274700 (C/T), CFH rs10737680 (A/C), CFH rs10801555 (G/A). These SNPs were more frequent in vPED than Control-2 eyes: APOE rs4420638 (A/G), CFI rs4698775 (G/T), COL15A1/TGFBR1 rs334353 (T/G). FRK rs3812111 (T/A) was more frequent in HR-50 and HR-75 eyes compared with LR. CONCLUSION Seven SNPs were more frequent in vPED eyes than non-ARMD eyes, and three SNPs were more frequent in vPED eyes than drusen eyes. Adjusting for multiplicity, only CFH rs2274700 (C/T) was significant for first comparison, and only COL15A1/TGFBR1 rs334353 (T/G) was significant for second comparison. APOE rs4420638 (A/G) was the single SNP more frequently linked to vPED eyes for both comparisons. FRK rs3812111 (T/A) was consistently associated with high responders.
Collapse
Affiliation(s)
- Daniel Lee
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Clement K Chan
- Southern California Desert Retina Consultants, Palm Desert, CA, USA
- Department of Ophthalmology, Loma Linda University, Loma Linda, CA, USA
| | - Prema Abraham
- Retina Section, Black Hills Regional Eye Institute, Rapid City, SD, USA
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
45
|
Guerra MH, Yumnamcha T, Ebrahim AS, Berger EA, Singh LP, Ibrahim AS. Real-Time Monitoring the Effect of Cytopathic Hypoxia on Retinal Pigment Epithelial Barrier Functionality Using Electric Cell-Substrate Impedance Sensing (ECIS) Biosensor Technology. Int J Mol Sci 2021; 22:ijms22094568. [PMID: 33925448 PMCID: PMC8123793 DOI: 10.3390/ijms22094568] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
Disruption of retinal pigment epithelial (RPE barrier integrity is a hallmark feature of various retinal blinding diseases, including diabetic macular edema and age-related macular degeneration, but the underlying causes and pathophysiology are not completely well-defined. One of the most conserved phenomena in biology is the progressive decline in mitochondrial function with aging leading to cytopathic hypoxia, where cells are unable to use oxygen for energy production. Therefore, this study aimed to thoroughly investigate the role of cytopathic hypoxia in compromising the barrier functionality of RPE cells. We used Electric Cell-Substrate Impedance Sensing (ECIS) system to monitor precisely in real time the barrier integrity of RPE cell line (ARPE-19) after treatment with various concentrations of cytopathic hypoxia-inducing agent, Cobalt(II) chloride (CoCl2). We further investigated how the resistance across ARPE-19 cells changes across three separate parameters: Rb (the electrical resistance between ARPE-19 cells), α (the resistance between the ARPE-19 and its substrate), and Cm (the capacitance of the ARPE-19 cell membrane). The viability of the ARPE-19 cells and mitochondrial bioenergetics were quantified with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and seahorse technology, respectively. ECIS measurement showed that CoCl2 reduced the total impedance of ARPE-19 cells in a dose dependent manner across all tested frequencies. Specifically, the ECIS program’s modelling demonstrated that CoCl2 affected Rb as it begins to drastically decrease earlier than α or Cm, although ARPE-19 cells’ viability was not compromised. Using seahorse technology, all three concentrations of CoCl2 significantly impaired basal, maximal, and ATP-linked respirations of ARPE-19 cells but did not affect proton leak and non-mitochondrial bioenergetic. Concordantly, the expression of a major paracellular tight junction protein (ZO-1) was reduced significantly with CoCl2-treatment in a dose-dependent manner. Our data demonstrate that the ARPE-19 cells have distinct dielectric properties in response to cytopathic hypoxia in which disruption of barrier integrity between ARPE-19 cells precedes any changes in cells’ viability, cell-substrate contacts, and cell membrane permeability. Such differences can be used in screening of selective agents that improve the assembly of RPE tight junction without compromising other RPE barrier parameters.
Collapse
Affiliation(s)
- Michael H. Guerra
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Thangal Yumnamcha
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Abdul-Shukkur Ebrahim
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Elizabeth A. Berger
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Lalit Pukhrambam Singh
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
| | - Ahmed S. Ibrahim
- Department of Ophthalmology, Visual, and Anatomical Sciences, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA; (M.H.G.); (T.Y.); (A.-S.E.); (E.A.B.); (L.P.S.)
- Department of Pharmacology, School of Medicine, Wayne State University, 540 East Canfield, Gordon Scott Hall (room 7133), Detroit, MI 48201, USA
- Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
- Correspondence: ; Tel.: +1-313-577-7854 (Office) or +1-313-577-7864 (Lab)
| |
Collapse
|
46
|
IL-9 and IL-10 Single-Nucleotide Variants and Serum Levels in Age-Related Macular Degeneration in the Caucasian Population. Mediators Inflamm 2021; 2021:6622934. [PMID: 33953642 PMCID: PMC8057879 DOI: 10.1155/2021/6622934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/01/2021] [Accepted: 04/05/2021] [Indexed: 01/21/2023] Open
Abstract
Considering the immunological impairment in age-related macular degeneration (AMD), we aimed to determine the associations of IL-9 rs1859430, rs2069870, rs11741137, rs2069885, and rs2069884 and IL-10 rs1800871, rs1800872, and rs1800896 polymorphisms and their haplotypes, as well as the serum levels of IL-9 and IL-10 with AMD. 1209 participants were enrolled in our study. SNPs were genotyped using TaqMan SNP genotyping assays by real-time PCR method. IL-9 and IL-10 serum levels were evaluated using ELISA kits. Our study results have shown that haplotypes A-G-C-G-G and G-A-T-A-T of IL-9 SNPs are associated with the decreased odds of early AMD occurrence (p = 0.035 and p = 0.015, respectively). A set of rare haplotypes was associated with the decreased odds of exudative AMD occurrence (p = 0.033). Also, IL-10 serum levels were lower in exudative AMD than in controls (p = 0.049), patients with early AMD (p = 0.017), and atrophic AMD (p = 0.008). Furthermore, exudative AMD patients with IL-10 rs1800896 CT and TT genotypes had lower IL-10 serum concentrations than those with wild-type (CC) genotype (p = 0.048). In conclusion, our study suggests that IL-10 serum levels can be associated with a minor allele at IL-10 rs1800896 and exudative AMD. The haplotypes of IL-9 SNPs were also associated with the decreased odds of early and exudative AMD.
Collapse
|
47
|
Genomic-Metabolomic Associations Support the Role of LIPC and Glycerophospholipids in Age-Related Macular Degeneration. OPHTHALMOLOGY SCIENCE 2021; 1. [PMID: 34382031 PMCID: PMC8353724 DOI: 10.1016/j.xops.2021.100017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose Large-scale genome-wide association studies (GWAS) have reported important single nucleotide polymorphisms (SNPs) with significant associations with age-related macular degeneration (AMD). However, their role in disease development remains elusive. This study aimed to assess SNP–metabolite associations (i.e., metabolite quantitative trait loci [met-QTL]) and to provide insights into the biological mechanisms of AMD risk SNPs. Design Cross-sectional multicenter study (Boston, Massachusetts, and Coimbra, Portugal). Participants Patients with AMD (n = 388) and control participants (n = 98) without any vitreoretinal disease (> 50 years). Methods Age-related macular degeneration grading was performed using color fundus photographs according to the Age-Related Eye Disease Study classification scheme. Fasting blood samples were collected and evaluated with mass spectrometry for metabolomic profiling and Illumina OmniExpress for SNPs profiling. Analyses of met-QTL of endogenous metabolites were conducted using linear regression models adjusted for age, gender, smoking, 10 metabolite principal components (PCs), and 10 SNP PCs. Additionally, we analyzed the cumulative effect of AMD risk SNPs on plasma metabolites by generating genetic risk scores and assessing their associations with metabolites using linear regression models, accounting for the same covariates. Modeling was performed first for each cohort, and then combined by meta-analysis. Multiple comparisons were accounted for using the false discovery rate (FDR). Main Outcome Measures Plasma metabolite levels associated with AMD risk SNPs. Results After quality control, data for 544 plasma metabolites were included. Meta-analysis of data from all individuals (AMD patients and control participants) identified 28 significant met-QTL (β = 0.016–0.083; FDR q-value < 1.14 × 10–2), which corresponded to 5 metabolites and 2 genes: ASPM and LIPC. Polymorphisms in the LIPC gene were associated with phosphatidylethanolamine metabolites, which are glycerophospholipids, and polymorphisms in the ASPM gene with branched-chain amino acids. Similar results were observed when considering only patients with AMD. Genetic risk score–metabolite associations further supported a global impact of AMD risk SNPs on the plasma metabolome. Conclusions This study demonstrated that genomic–metabolomic associations can provide insights into the biological relevance of AMD risk SNPs. In particular, our results support that the LIPC gene and the glycerophospholipid metabolic pathway may play an important role in AMD, thus offering new potential therapeutic targets for this disease.
Collapse
|
48
|
Echinomycin mitigates ocular angiogenesis by transcriptional inhibition of the hypoxia-inducible factor-1. Exp Eye Res 2021; 206:108518. [PMID: 33639134 DOI: 10.1016/j.exer.2021.108518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/29/2021] [Accepted: 02/15/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Echinomycin (EKN), an inhibitor of hypoxia-inducible factor (HIF)-1 DNA-binding activity, has been implied as a possible therapeutic agent in ischemic diseases. Here, we assess EKN in hypoxia-driven responses in vitro using human primary adult retinal pigment epithelium cells (aRPE) and retinal endothelial cells (hREC), and in vivo using the laser-induced mouse choroidal neovascularization (CNV) model. METHODS Effects of EKN on hypoxia-mediated pathways in aRPE were analyzed by Western blotting for HIF-1α protein, quantitative PCR of HIF-target genes, and proteome array for soluble angiogenic factors. In vitro inhibition of angiogenesis by EKN was determined in hREC. In vivo inhibition of angiogenesis by EKN was determined in the mouse laser-induced CNV, as a model of HIF-associated ocular neovascularization. CNV lesion area was determined by fundus fluorescein angiography. RESULTS aRPE treated with EKN showed hypoxia-dependent significantly decreased cell recovery in the wound healing assay. These results were supported by lower levels of HIF-mediated transcripts detected in hypoxic aRPE cells treated with EKN compared with non-treated controls, and confirmed by proteome profiler for angiogenic factors. hREC exposed to aRPE EKN-conditioned medium displayed reduced sprouting angiogenesis. Mice with laser-induced CNV treated with intravitreally injected EKN showed significantly decreased vascular lesion area when compared with a mouse equivalent of aflibercept, or vehicle-treated controls. CONCLUSIONS Our data proposes EKN as a potent inhibitor of HIF-mediated angiogenesis in retinal cells and in the mouse model of CNV, which could have future implications in the treatment of patients with neovascular age-related macular degeneration.
Collapse
|
49
|
Heier JS, Singh RP, Wykoff CC, Csaky KG, Lai TYY, Loewenstein A, Schlottmann PG, Paris LP, Westenskow PD, Quezada-Ruiz C. THE ANGIOPOIETIN/TIE PATHWAY IN RETINAL VASCULAR DISEASES: A Review. Retina 2021; 41:1-19. [PMID: 33136975 DOI: 10.1097/iae.0000000000003003] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To provide a concise overview for ophthalmologists and practicing retina specialists of available clinical evidence of manipulating the angiopoietin/tyrosine kinase with immunoglobulin-like and endothelial growth factor-like domains (Tie) pathway and its potential as a therapeutic target in retinal vascular diseases. METHODS A literature search for articles on the angiopoietin/Tie pathway and molecules targeting this pathway that have reached Phase 2 or 3 trials was undertaken on PubMed, Association for Research in Vision and Ophthalmology meeting abstracts (2014-2019), and ClinicalTrials.gov databases. Additional information on identified pipeline drugs was obtained from publicly available information on company websites. RESULTS The PubMed and Association for Research in Vision and Ophthalmology meeting abstract search yielded 462 results, of which 251 publications not relevant to the scope of the review were excluded. Of the 141 trials related to the angiopoietin/Tie pathway on ClinicalTrials.gov, seven trials focusing on diseases covered in this review were selected. Vision/anatomic outcomes from key clinical trials on molecules targeting the angiopoietin/Tie pathway in patients with retinal vascular diseases are discussed. CONCLUSION Initial clinical evidence suggests a potential benefit of targeting the angiopoietin/Tie pathway and vascular endothelial growth factor-A over anti-vascular endothelial growth factor-A monotherapy alone, in part due to of the synergistic nature of the pathways.
Collapse
Affiliation(s)
| | - Rishi P Singh
- Department of Ophthalmology, Center for Ophthalmic Bioinformatics, Cleveland Clinic, Cleveland, Ohio
| | - Charles C Wykoff
- Retina Consultants of Houston, Retina Consultants of America, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Karl G Csaky
- Retina Foundation of the Southwest, Dallas, Texas
| | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Anat Loewenstein
- Department of Ophthalmology, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Carlos Quezada-Ruiz
- Genentech, Inc., South San Francisco, California; and
- Retina y Vitreo, Clínica de Ojos Garza Viejo, San Pedro Garza Garcia, Mexico
| |
Collapse
|
50
|
Age-Related Macular Degeneration: Epidemiology and Clinical Aspects. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1256:1-31. [PMID: 33847996 DOI: 10.1007/978-3-030-66014-7_1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Age-related macular degeneration (AMD) is a degenerative disease of the human retina affecting individuals over the age of 55 years. This heterogeneous condition arises from a complex interplay between age, genetics, and environmental factors including smoking and diet. It is the leading cause of blindness in industrialized countries. Worldwide, the number of people with AMD is predicted to increase from 196 million in 2020 to 288 million by 2040. By this time, Asia is predicted to have the largest number of people with the disease. Distinct patterns of AMD prevalence and phenotype are seen between geographical areas that are not explained fully by disparities in population structures. AMD is classified into early, intermediate, and late stages. The early and intermediate stages, when visual symptoms are typically absent or mild, are characterized by macular deposits (drusen) and pigmentary abnormalities. Through risk prediction calculators, grading these features helps predict the risk of progression to late AMD. Late AMD is divided into neovascular and atrophic forms, though these can coexist. The defining lesions are macular neovascularization and geographic atrophy, respectively. At this stage, visual symptoms are often severe and irreversible, and can comprise profoundly decreased central vision in both eyes. For these reasons, the condition has major implications for individuals and society, as affected individuals may experience substantially decreased quality of life and independence. Recent advances in retinal imaging have led to the recognition of an expanded set of AMD phenotypes, including reticular pseudodrusen, nonexudative macular neovascularization, and subtypes of atrophy. These developments may lead to refinements in current classification systems.
Collapse
|