The ‘Displacing Foods of Modern Commerce’ Are the Primary and Proximate Cause of Age-Related Macular Degeneration: A Unifying Singular Hypothesis

Integrated network pharmacology and experimental validation to explore the potential pharmacological mechanism of Qihuang Granule and its main ingredients in regulating ferroptosis in AMD

BACKGROUND

Qihuang Granule (QHG) is a traditional prescription  that has exhibited potential in safeguarding against age-related maculopathy (AMD). Salvia miltiorrhiza (SM) and Fructus lycii (FL) are the main components of QHG. Ferroptosis, a newly discovered, iron-dependent, regulated cell death pathway, have been implicated in the pathogenesis of AMD. This study delves into the intricate mechanism by which SM/FL and QHG confer protection against AMD by modulating the ferroptosis pathway, employing a combination of network pharmacology and experimental validation.

METHODS

Bioactive compounds and potential targets of SM and FL were gathered from databases such as TCMSP, GeneCard, OMIM, and FerrDb, along with AMD-related genes and key genes responsible for ferroptosis regulation. Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and protein-protein interaction (PPI) network were performed to discover the potential mechanism. The construction of an interaction network involving AMD, ferroptosis, SM/FL potential target genes was facilitated by the STRING database and realized using Cytoscape software. Subsequent validation was accomplished through molecular docking and in vitro cell experiments.

RESULTS

Noteworthy active compounds including quercetin, tanshinone IIA, luteolin, cryptotanshinone, and hub targets such as HIF-1α, EGFR, IL6, and VEGFA were identified. KEGG enrichment unveiled the HIF-1 signalling pathway as profoundly enriched, and IL6 and VEGF were involved. The molecular docking revealed the significant active compounds with hub genes and quercetin showed good binding to HIF-1α, which is involved in inflammation and angiogenesis. Experimental results verified that both herbs and QHG could regulate key ferroptosis-related targets in the retinal pigment epithelium and inhibit the expression of HIF-1α, VEGFA, and IL-6, subsequently increase cell viability and decrease the ROS content induced by H2O2.

CONCLUSION

This study demonstrates the molecular mechanism through which SM/FL and QHG protect against AMD and emerges as a plausible mechanism underlying this protection.

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

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.

Liquid Chicken Oil Could Be a Healthy Dietary Oil

Liquid chicken oil is similar to the human lipid ratio, and is similar to the ideal fatty acids ratio suggested by Hayes, but its benefits remain unclear (Hwang, K.N.; Tung, H.P.; Shaw, H.M. J. Oleo. Sci. 69, 199-206 (2020)). Using soybean oil as a control, liquid chicken oil, coconut oil, lard oil, and olive oil, were tested on SD rats with the rodent diet 5001 plus 1% of high cholesterol addition and moderate 10 % of test oils. Positive results showed that a 10% liquid chicken oil diet reduced LDL and triglycerides, atherogenic index while increasing superoxide dismutase more than the soybean oil control (0.05 ≦ p < 0.10). Moreover, increment of hepatic endogenous glutathione peroxidase was found to be significantly different from the soybean oil control (p < 0.05). In this study, liquid chicken oil had more benefits than vegetable soybean dietary oil, with little evidence of hyperlipidemia. Comparison of the test oils with categories of fatty acids to the idea ratio SFA : MUFA : PUFA = 1 : 1.5 : 1, scored by its average weight implied a parallel trend of lipidemia and hepatic antioxidant activity to its score. It is difficult to use the test of rat to reflect human physiology, it remain 19% different of the fatty acids ratio from human ratio, however, this study reveal that the healthiness of a dietary oil seems relate well to its compatibility to the idea ratio or the host oil ratio, in this case, it is the human ratio.

The pathogenesis of age-related macular degeneration is not inflammatory mediated but is instead due to immunosenescence-related failure of tissue repair

A natural consequence of everyday tissue metabolism is cell injury or stress. This injury activates a canonical immune-mediated inflammatory response in order to achieve tissue repair so that homeostasis is maintained. With aging there is increased tissue injury and therefore increasing demands placed on an immune system, which itself is aging (immunosenescence). Thus, the increased reparative demands are reflected by an increased inflammatory load both locally and systemically. Eventually, if the reparative demands are excessive, the aging immune system is overwhelmed and disease ensues. In the macula this age-related failure in repair gives rise to age-related macular degeneration (AMD). The hypothesis proposed herein is therefore, that AMD is due to age-related failure of tissue repair and the chronic inflammation associated with this failure ('inflammaging') is both a surrogate and biomarker of this reparative failure and not in itself the primary cause of disease. Such a hypothesis can be applied to all the diseases of aging and by extension suggests that effective therapies should be aimed at facilitating repair through immunotherapy, possibly and perhaps controversially, through the promotion of inflammation rather than the current approach of its inhibition (anti-inflammatory strategies), the latter which can ultimately only hinder the repair process and thereby lead to the persistence of disease.