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Gouveia N, Chukwunalu O, Oliveira C, Alves CH, Silva R, Murta J, Marques JP. Exploring self-reported visual function and vision-related anxiety in patients with RPGR-associated retinal degeneration. Sci Rep 2024; 14:15189. [PMID: 38956231 PMCID: PMC11220147 DOI: 10.1038/s41598-024-66170-2] [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: 05/08/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024] Open
Abstract
Variants in the retinitis pigmentosa GTPase regulator (RPGR) gene are responsible for the majority of X-linked retinitis pigmentosa cases, which not only affects male patients but also some heterozygous females. Vision-related disability and anxiety of patients with RPGR-associated retinal degeneration have never been explored before. This study aimed to evaluate self-reported visual function and vision-related anxiety in a Portuguese cohort of male and female patients with RPGR-associated retinal degeneration using two validated patient-reported outcome measures. Cross-sectional data of thirty-two genetically-tested patients was examined, including scores of the Michigan retinal degeneration questionnaire (MRDQ) and Michigan vision-related anxiety questionnaire. Patients were classified according to retinal phenotypes in males (M), females with male phenotype (FM), and females with radial or focal pattern. Both M and FM revealed higher rod-function and cone-function anxiety scores (p < 0.017). Most MRDQ disability scores were higher in M and FM (p < 0.004). Overall, positive correlations (p < 0.004) were found between every MRDQ domain and both anxiety scores. In RPGR-associated retinal degeneration, males and females with male phenotype show similar levels of increased vision-related anxiety and disability. Every MRDQ visual function domain showed a strong correlation with anxiety scores.
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Affiliation(s)
- Nuno Gouveia
- Department of Ophthalmology, Hospitais da Universidade de Coimbra, ULS de Coimbra, Portugal
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Oluji Chukwunalu
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Carolina Oliveira
- Faculty of Psychology and Education Sciences, University of Coimbra (FPCEUC), Coimbra, Portugal
| | - C Henrique Alves
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Rufino Silva
- Department of Ophthalmology, Hospitais da Universidade de Coimbra, ULS de Coimbra, Portugal
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Joaquim Murta
- Department of Ophthalmology, Hospitais da Universidade de Coimbra, ULS de Coimbra, Portugal
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - João Pedro Marques
- Department of Ophthalmology, Hospitais da Universidade de Coimbra, ULS de Coimbra, Portugal.
- Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal.
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.
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Sladen PE, Naeem A, Adefila-Ideozu T, Vermeule T, Busson SL, Michaelides M, Naylor S, Forbes A, Lane A, Georgiadis A. AAV-RPGR Gene Therapy Rescues Opsin Mislocalisation in a Human Retinal Organoid Model of RPGR-Associated X-Linked Retinitis Pigmentosa. Int J Mol Sci 2024; 25:1839. [PMID: 38339118 PMCID: PMC10855600 DOI: 10.3390/ijms25031839] [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: 12/05/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Variants within the Retinitis Pigmentosa GTPase regulator (RPGR) gene are the predominant cause of X-Linked Retinitis Pigmentosa (XLRP), a common and severe form of inherited retinal disease. XLRP is characterised by the progressive degeneration and loss of photoreceptors, leading to visual loss and, ultimately, bilateral blindness. Unfortunately, there are no effective approved treatments for RPGR-associated XLRP. We sought to investigate the efficacy of RPGRORF15 gene supplementation using a clinically relevant construct in human RPGR-deficient retinal organoids (ROs). Isogenic RPGR knockout (KO)-induced pluripotent stem cells (IPSCs) were generated using established CRISPR/Cas9 gene editing methods targeting RPGR. RPGR-KO and isogenic wild-type IPSCs were differentiated into ROs and utilised to test the adeno associated virus (AAV) RPGR (AAV-RPGR) clinical vector construct. The transduction of RPGR-KO ROs using AAV-RPGR successfully restored RPGR mRNA and protein expression and localisation to the photoreceptor connecting cilium in rod and cone photoreceptors. Vector-derived RPGR demonstrated equivalent levels of glutamylation to WT ROs. In addition, treatment with AAV-RPGR restored rhodopsin localisation within RPGR-KO ROs, reducing mislocalisation to the photoreceptor outer nuclear layer. These data provide mechanistic insights into RPGRORF15 gene supplementation functional potency in human photoreceptor cells and support the previously reported Phase I/II trial positive results using this vector construct in patients with RPGR-associated XLRP, which is currently being tested in a Phase III clinical trial.
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Affiliation(s)
- Paul E. Sladen
- MeiraGTx UK II, 34-38 Provost Street, London N1 7NG, UK (A.L.)
| | - Arifa Naeem
- MeiraGTx UK II, 34-38 Provost Street, London N1 7NG, UK (A.L.)
| | | | - Tijmen Vermeule
- MeiraGTx UK II, 34-38 Provost Street, London N1 7NG, UK (A.L.)
| | | | - Michel Michaelides
- MeiraGTx UK II, 34-38 Provost Street, London N1 7NG, UK (A.L.)
- Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK
- University College London Institute of Ophthalmology, London EC1V 9LF, UK
| | - Stuart Naylor
- MeiraGTx UK II, 34-38 Provost Street, London N1 7NG, UK (A.L.)
| | | | - Amelia Lane
- MeiraGTx UK II, 34-38 Provost Street, London N1 7NG, UK (A.L.)
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