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Schloesser L, Klose SM, Mauschitz MM, Abdullah Z, Finger RP. The role of immune modulators in age-related macular degeneration. Surv Ophthalmol 2024; 69:851-869. [PMID: 39097172 DOI: 10.1016/j.survophthal.2024.07.009] [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: 03/25/2024] [Revised: 07/27/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
We provide an overview of the expanding literature on the role of cytokines and immune mediators in pathophysiology of age-related macular degeneration (AMD). Although many immunological mediators have been linked to AMD pathophysiology, the broader mechanistic picture remains unclear with substantial variations in the levels of evidence supporting these mediators. Therefore, we reviewed the literature considering the varying levels of supporting evidence. A Medical Subject Headings (MeSH) term-based literature research was conducted in September, 2023, consisting of the MeSH terms "cytokine" and "Age-related macular degeneration" connected by the operator "AND". After screening the publications by title, abstract, and full text, a total of 146 publications were included. The proinflammatory cytokines IL-1β (especially in basic research studies), IL-6, IL-8, IL-18, TNF-α, and MCP-1 are the most extensively characterised cytokines/chemokines, highlighting the role of local inflammasome activation and altered macrophage function in the AMD pathophysiology. Among the antiinflammatory mediators IL-4, IL-10, and TGF-β were found to be the most extensively characterised, with IL-4 driving and IL-10 and TGF-β suppressing disease progression. Despite the extensive literature on this topic, a profound understanding of AMD pathophysiology has not yet been achieved. Therefore, further studies are needed to identify potential therapeutic targets, followed by clinical studies.
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Affiliation(s)
- Lukas Schloesser
- Department of Ophthalmology, University of Bonn, Bonn, Germany; Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Sara M Klose
- Institute of Molecular Medicine and Experimental Immunology, University of Bonn, Bonn, Germany; Asia-Pacific Centre for Animal Health, Faculty of Science, University of Melbourne, Melbourne, Australia
| | | | - Zeinab Abdullah
- Institute of Molecular Medicine and Experimental Immunology, University of Bonn, Bonn, Germany
| | - Robert P Finger
- Department of Ophthalmology, University of Bonn, Bonn, Germany; Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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2
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Wang D, Chen Y, Li J, Wu E, Tang T, Singla RK, Shen B, Zhang M. Natural products for the treatment of age-related macular degeneration. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 130:155522. [PMID: 38820665 DOI: 10.1016/j.phymed.2024.155522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/08/2024] [Accepted: 03/07/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Age-related macular degeneration (AMD) is a chronic retinal disease that significantly influences the vision of the elderly. PURPOSE There is no effective treatment and prevention method. The pathogenic process behind AMD is complex, including oxidative stress, inflammation, and neovascularization. It has been demonstrated that several natural products can be used to manage AMD, but systematic summaries are lacking. STUDY DESIGN AND METHODS PubMed, Web of Science, and ClinicalTrials.gov were searched using the keywords "Biological Products" AND "Macular Degeneration" for studies published within the last decade until May 2023 to summarize the latest findings on the prevention and treatment of age-related macular degeneration through the herbal medicines and functional foods. RESULTS The eligible studies were screened, and the relevant information about the therapeutic action and mechanism of natural products used to treat AMD was extracted. Our findings demonstrate that natural substances, including retinol, phenols, and other natural products, prevent the development of new blood vessels and protect the retina from oxidative stress in cells and animal models. However, they have barely been examined in clinical studies. CONCLUSION Natural products could be highly prospective candidate drugs used to treat AMD, and further preclinical and clinical research is required to validate it to control the disease.
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Affiliation(s)
- Dongyue Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yi Chen
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jiakun Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Erman Wu
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Tong Tang
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Rajeev K Singla
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China; School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab-144411, India.
| | - Bairong Shen
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China.
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
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Mendez K, Lains I, Kelly RS, Gil J, Silva R, Miller J, Vavvas DG, Kim I, Miller J, Liang L, Lasky-Su JA, Husain D. Metabolomic-derived endotypes of age-related macular degeneration (AMD): a step towards identification of disease subgroups. Sci Rep 2024; 14:12145. [PMID: 38802406 PMCID: PMC11130126 DOI: 10.1038/s41598-024-59045-z] [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: 12/29/2023] [Accepted: 04/05/2024] [Indexed: 05/29/2024] Open
Abstract
Age-related macular degeneration (AMD) is a leading cause of blindness worldwide, with a complex pathophysiology and phenotypic diversity. Here, we apply Similarity Network Fusion (SNF) to cluster AMD patients into putative metabolomics-derived endotypes. Using a discovery cohort of 163 AMD patients from Boston, US, and a validation cohort of 214 patients from Coimbra, Portugal, we identified four distinct metabolomics-derived endotypes with varying retinal structural and functional characteristics, confirmed across both cohorts. Patients clustered into Endotype 1 exhibited a milder form of AMD and were characterized by low levels of amino acids in specific metabolic pathways. Meanwhile, patients clustered into both Endotype 3 and 4 were associated with more severe AMD and exhibited low levels of fatty acid metabolites and elevated levels of sphingomyelins and fatty acid metabolites, respectively. These preliminary findings indicate that metabolomics-derived endotyping may offer a refined strategy for categorizing AMD patients based on their specific pathophysiological underpinnings, rather than relying solely on traditional observational clinical indicators.
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Affiliation(s)
- Kevin Mendez
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Centre for Integrative Metabolomics & Computational Biology, School of Science, Edith Cowan University, Perth, WA, Australia
| | - Ines Lains
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - João Gil
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Ophthalmology, Coimbra Hospital and University Center, Coimbra, Portugal
- Association for Innovation and Biomedical Research in Light and Image (AIBILI), Coimbra, Portugal
| | - John Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Ivana Kim
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Joan Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
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4
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Anderson DM, Kotnala A, Migas LG, Patterson NH, Tideman L, Cao D, Adhikari B, Messinger JD, Ach T, Tortorella S, Van de Plas R, Curcio CA, Schey KL. Lysolipids are prominent in subretinal drusenoid deposits, a high-risk phenotype in age-related macular degeneration. FRONTIERS IN OPHTHALMOLOGY 2023; 3:1258734. [PMID: 38186747 PMCID: PMC10769005 DOI: 10.3389/fopht.2023.1258734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Introduction Age related macular degeneration (AMD) causes legal blindness worldwide, with few therapeutic targets in early disease and no treatments for 80% of cases. Extracellular deposits, including drusen and subretinal drusenoid deposits (SDD; also called reticular pseudodrusen), disrupt cone and rod photoreceptor functions and strongly confer risk for advanced disease. Due to the differential cholesterol composition of drusen and SDD, lipid transfer and cycling between photoreceptors and support cells are candidate dysregulated pathways leading to deposit formation. The current study explores this hypothesis through a comprehensive lipid compositional analysis of SDD. Methods Histology and transmission electron microscopy were used to characterize the morphology of SDD. Highly sensitive tools of imaging mass spectrometry (IMS) and nano liquid chromatography tandem mass spectrometry (nLC-MS/MS) in positive and negative ion modes were used to spatially map and identify SDD lipids, respectively. An interpretable supervised machine learning approach was utilized to compare the lipid composition of SDD to regions of uninvolved retina across 1873 IMS features and to automatically discern candidate markers for SDD. Immunohistochemistry (IHC) was used to localize secretory phospholipase A2 group 5 (PLA2G5). Results Among the 1873 detected features in IMS data, three lipid classes, including lysophosphatidylcholine (LysoPC), lysophosphatidylethanolamine (LysoPE) and lysophosphatidic acid (LysoPA) were observed nearly exclusively in SDD while presumed precursors, including phosphatidylcholine (PC), phosphatidylethanolamine (PE) and phosphatidic acid (PA) lipids were detected in SDD and adjacent photoreceptor outer segments. Molecular signals specific to SDD were found in central retina and elsewhere. IHC results indicated abundant PLA2G5 in photoreceptors and retinal pigment epithelium (RPE). Discussion The abundance of lysolipids in SDD implicates lipid remodeling or degradation in deposit formation, consistent with ultrastructural evidence of electron dense lipid-containing structures distinct from photoreceptor outer segment disks and immunolocalization of secretory PLA2G5 in photoreceptors and RPE. Further studies are required to understand the role of lipid signals observed in and around SDD.
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Affiliation(s)
| | - Ankita Kotnala
- Department of Biochemistry, Vanderbilt University, Nashville TN
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham AL
| | - Lukasz G. Migas
- Delft Center for Systems and Control (DCSC), Delft University of Technology, Delft, Netherlands
| | | | - Léonore Tideman
- Delft Center for Systems and Control (DCSC), Delft University of Technology, Delft, Netherlands
| | - Dongfeng Cao
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham AL
| | - Bibek Adhikari
- Vision Science Graduate Program, University of Alabama at Birmingham, Birmingham AL
| | - Jeffrey D. Messinger
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham AL
| | - Thomas Ach
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Sara Tortorella
- Molecular Horizon Srl, Via Montelino 30, 06084 Bettona, Perugia, Italy
| | - Raf Van de Plas
- Department of Biochemistry, Vanderbilt University, Nashville TN
- Delft Center for Systems and Control (DCSC), Delft University of Technology, Delft, Netherlands
| | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham AL
| | - Kevin L. Schey
- Department of Biochemistry, Vanderbilt University, Nashville TN
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5
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Latifi-Navid H, Barzegar Behrooz A, Jamehdor S, Davari M, Latifinavid M, Zolfaghari N, Piroozmand S, Taghizadeh S, Bourbour M, Shemshaki G, Latifi-Navid S, Arab SS, Soheili ZS, Ahmadieh H, Sheibani N. Construction of an Exudative Age-Related Macular Degeneration Diagnostic and Therapeutic Molecular Network Using Multi-Layer Network Analysis, a Fuzzy Logic Model, and Deep Learning Techniques: Are Retinal and Brain Neurodegenerative Disorders Related? Pharmaceuticals (Basel) 2023; 16:1555. [PMID: 38004422 PMCID: PMC10674956 DOI: 10.3390/ph16111555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible visual impairment in the elderly. The current management of nAMD is limited and involves regular intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF). However, the effectiveness of these treatments is limited by overlapping and compensatory pathways leading to unresponsiveness to anti-VEGF treatments in a significant portion of nAMD patients. Therefore, a system view of pathways involved in pathophysiology of nAMD will have significant clinical value. The aim of this study was to identify proteins, miRNAs, long non-coding RNAs (lncRNAs), various metabolites, and single-nucleotide polymorphisms (SNPs) with a significant role in the pathogenesis of nAMD. To accomplish this goal, we conducted a multi-layer network analysis, which identified 30 key genes, six miRNAs, and four lncRNAs. We also found three key metabolites that are common with AMD, Alzheimer's disease (AD) and schizophrenia. Moreover, we identified nine key SNPs and their related genes that are common among AMD, AD, schizophrenia, multiple sclerosis (MS), and Parkinson's disease (PD). Thus, our findings suggest that there exists a connection between nAMD and the aforementioned neurodegenerative disorders. In addition, our study also demonstrates the effectiveness of using artificial intelligence, specifically the LSTM network, a fuzzy logic model, and genetic algorithms, to identify important metabolites in complex metabolic pathways to open new avenues for the design and/or repurposing of drugs for nAMD treatment.
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Affiliation(s)
- Hamid Latifi-Navid
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran 1497716316, Iran; (H.L.-N.); (M.D.); (N.Z.); (S.P.); (S.T.); (Z.-S.S.)
- Departments of Ophthalmology and Visual Sciences and Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Amir Barzegar Behrooz
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3T 2N2, Canada;
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1416634793, Iran
| | - Saleh Jamehdor
- Department of Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan 6517838636, Iran;
| | - Maliheh Davari
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran 1497716316, Iran; (H.L.-N.); (M.D.); (N.Z.); (S.P.); (S.T.); (Z.-S.S.)
| | - Masoud Latifinavid
- Department of Mechatronic Engineering, University of Turkish Aeronautical Association, 06790 Ankara, Turkey;
| | - Narges Zolfaghari
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran 1497716316, Iran; (H.L.-N.); (M.D.); (N.Z.); (S.P.); (S.T.); (Z.-S.S.)
| | - Somayeh Piroozmand
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran 1497716316, Iran; (H.L.-N.); (M.D.); (N.Z.); (S.P.); (S.T.); (Z.-S.S.)
| | - Sepideh Taghizadeh
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran 1497716316, Iran; (H.L.-N.); (M.D.); (N.Z.); (S.P.); (S.T.); (Z.-S.S.)
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
| | - Mahsa Bourbour
- Department of Biotechnology, Alzahra University, Tehran 1993893973, Iran;
| | - Golnaz Shemshaki
- Department of Studies in Zoology, University of Mysore, Manasagangothri, Mysore 570005, India;
| | - Saeid Latifi-Navid
- Department of Biology, Faculty of Sciences, University of Mohaghegh Ardabili, Ardabil 5619911367, Iran;
| | - Seyed Shahriar Arab
- Biophysics Department, Faculty of Biological Sciences, Tarbiat Modares University, Tehran 1411713116, Iran;
| | - Zahra-Soheila Soheili
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran 1497716316, Iran; (H.L.-N.); (M.D.); (N.Z.); (S.P.); (S.T.); (Z.-S.S.)
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran 1666673111, Iran;
| | - Nader Sheibani
- Departments of Ophthalmology and Visual Sciences and Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
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6
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Xiao J, Zhang JY, Luo W, He PC, Skondra D. The Emerging Role of Gut Microbiota in Age-Related Macular Degeneration. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:1627-1637. [PMID: 37156326 DOI: 10.1016/j.ajpath.2023.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/14/2023] [Accepted: 04/11/2023] [Indexed: 05/10/2023]
Abstract
Age-related macular degeneration (AMD) is a progressive, degenerative retinal disease that is a leading cause of blindness globally. Although multiple risk factors have been identified regarding disease incidence and progression, including smoking, genetics, and diet, the understanding of AMD pathogenesis remains unclear. As such, primary prevention is lacking, and current treatments have limited efficacy. More recently, the gut microbiome has emerged as an influential player in various ocular pathologies. As mediators of metabolism and immune regulation, perturbations in gut microbiota may impart significant effects distally on the neuroretina and its adjacent tissues, termed the gut-retina axis. In this review, key studies over the past several decades are summarized, both in humans and in animal models, which shed insight on the relationships between the gut microbiome and retinal biology and their implications for AMD. The literature linking gut dysbiosis with AMD is examined, along with preclinical animal models and techniques apt for studying the role of gut microbiota in AMD pathogenesis, which include interactions with systemic inflammation, immune regulation, chorioretinal gene expression, and diet. As understanding of the gut-retina axis continues to advance, so too will the possibility for more accessible and effective prevention and therapy of this vision-threatening condition.
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Affiliation(s)
- Jason Xiao
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Jason Y Zhang
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Wendy Luo
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - P Cody He
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Dimitra Skondra
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois.
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7
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Zhao T, Li J, Wang Y, Guo X, Sun Y. Integrative metabolome and lipidome analyses of plasma in neovascular macular degeneration. Heliyon 2023; 9:e20329. [PMID: 37780745 PMCID: PMC10539639 DOI: 10.1016/j.heliyon.2023.e20329] [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: 05/31/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Age-related macular degeneration (AMD) causes irreversible vision-loss among the elderly in industrial countries. Neovascular AMD (nAMD), which refers to late-stage AMD, is characterized by severe vision-threatening choroidal neovascularization (CNV). Herein, we constructed a global metabolic network of nAMD, based on untargeted metabolomic and lipidomic analysis of plasma samples collected from sixty subjects (30 nAMD patients and 30 age-matched controls). Among the nAMD and control groups, 62 and 44 significantly different metabolites were detected in the positive and negative ion modes, respectively. Grouping analysis further showed that lipid and lipid-like molecule-based superclasses contained the highest number of significantly different metabolites. Lipidomic analysis revealed that 53 lipids among the nAMD and control groups differed significantly; these belonged to four major lipid categories (glycerophospholipids, sphingolipids, glycerolipids, and fatty acids). A discriminative biomarker panel comprising 16 metabolites and lipids, which was constructed using multivariate statistical machine learning methods, could effectively identify nAMD cases. Among these 16 compounds, eight were lipids that belonged to three lipid categories (glycerophospholipids, sphingolipids, and prenol lipids). The top three biomarkers with the highest importance scores were all lipids (a glycerophospholipid and two sphingolipids), highlighting the crucial role played by glycerophospholipid and sphingolipid pathways in nAMD. These differences between the metabolic and lipid profiles of nAMD patients and elderly individuals without AMD provide a readout of the overall metabolic status of nAMD. Further insights into the identified discriminative biomarkers may pave the way for future diagnostic and therapeutic interventions for nAMD.
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Affiliation(s)
- Tantai Zhao
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Jiani Li
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Yanbin Wang
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Xiaojian Guo
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Yun Sun
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
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8
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Thee EF, Acar İE, Colijn JM, Meester-Smoor MA, Verzijden T, Baart SJ, Jarboui MA, Fauser S, Hoyng CB, Ueffing M, den Hollander AI, Klaver CCW. Systemic Metabolomics in a Framework of Genetics and Lifestyle in Age-Related Macular Degeneration. Metabolites 2023; 13:701. [PMID: 37367859 DOI: 10.3390/metabo13060701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Insights into the pathogenesis of age-related macular degeneration (AMD), a leading cause of blindness, point towards a complex interplay of genetic and lifestyle factors triggering various systemic pathways. This study aimed to characterize metabolomic profiles for AMD and to evaluate their position in the trias with genetics and lifestyle. This study included 5923 individuals from five European studies. Blood metabolomics were assessed using a nuclear magnetic resonance platform of 146 metabolites. Associations were studied using regression analyses. A genetic risk score (GRS) was calculated using β-values of 49 AMD variants, a lifestyle risk score (LRS) using smoking and diet data, and a metabolite risk score (MRS) using metabolite values. We identified 61 metabolites associated with early-intermediate AMD, of which 94% were lipid-related, with higher levels of HDL-subparticles and apolipoprotein-A1, and lower levels of VLDL-subparticles, triglycerides, and fatty acids (false discovery rate (FDR) p-value < 1.4 × 10-2). Late AMD was associated with lower levels of the amino acids histidine, leucine, valine, tyrosine, and phenylalanine, and higher levels of the ketone bodies acetoacetate and 3-hydroxybutyrate (FDR p-value < 1.5 × 10-3). A favorable lifestyle characterized by a healthy diet was associated with higher levels of amino acids and lower levels of ketone bodies, while an unfavorable lifestyle, including smoking, showed opposite effects (FDR p-value < 2.7 × 10-2). The MRS mediated 5% of the effect of the GRS and 20% of that of the LRS on late AMD. Our findings show that metabolomic profiles differ between AMD stages and show that blood metabolites mostly reflect lifestyle. The severity-specific profiles spur further interest into the systemic effects related to disease conversion.
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Affiliation(s)
- Eric F Thee
- Department of Ophthalmology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - İlhan E Acar
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Johanna M Colijn
- Department of Ophthalmology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Magda A Meester-Smoor
- Department of Ophthalmology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Timo Verzijden
- Department of Epidemiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Sara J Baart
- Department of Epidemiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Mohamed A Jarboui
- Department of Ophthalmology, Institute for Ophthalmic Research, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
- Department of Ophthalmology, University Eye Clinic, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital Cologne, 50937 Cologne, Germany
- Hoffman-La Roche AG, 4070 Basel, Switzerland
| | - Carel B Hoyng
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Marius Ueffing
- Department of Ophthalmology, Institute for Ophthalmic Research, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
- Department of Ophthalmology, University Eye Clinic, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | | | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, University of Basel, 4070 Basel, Switzerland
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9
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Wen X, Ng TK, Liu Q, Wu Z, Zhang G, Zhang M. Azelaic acid and guanosine in tears improve discrimination of proliferative from non-proliferative diabetic retinopathy in type-2 diabetes patients: A tear metabolomics study. Heliyon 2023; 9:e16109. [PMID: 37305454 PMCID: PMC10256905 DOI: 10.1016/j.heliyon.2023.e16109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
Background Diabetic retinopathy (DR) is the microvascular ocular complication of diabetes mellitus (DM), which can lead to irreversible blindness and visual impairment if not properly treated. Tears can be collected non-invasively, and the compositions of tears could be the potential biomarkers for ocular diseases. Here we aimed to delineate the metabolomics signature in tears collected from Chinese type-2 DM patients with DR. Methods The metabolomics profiles of tear samples from 41 Chinese type-2 DM patients with DR and 21 non-diabetic subjects were determined by the untargeted liquid chromatography-mass spectrometry. The associated pathways of the differentially abundant metabolites were delineated, and the receiver operating characteristic curve analysis was conducted to identify the metabolites differentiating non-proliferative DR (NPDR) from proliferative DR (PDR). Results Total 14 differentially abundant metabolites were identified between total DR and non-diabetic subjects, and 17 differentially abundant metabolites were found between the NPDR and PDR subjects. Moreover, total 18 differentially abundant metabolites were identified between the NPDR and PDR subjects with stratification in DR duration and blood glucose level. d-Glutamine and d-glutamate metabolism was significantly highlighted in the PDR group as compared to the non-diabetic group. For the predictive performance, azelaic acid combined with guanosine achieved the area under receiver operating characteristic curve of 0.855 in the comparison between NPDR and PDR groups. Conclusion This study revealed the metabolomics changes in tear samples of DR patients. The metabolites in tears could be the potential biomarkers in the DR analysis.
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Affiliation(s)
- Xin Wen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Qingping Liu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Zhenggen Wu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Guihua Zhang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
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10
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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.
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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
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11
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Huynh KT, Walters S, Foley EK, Hunter JJ. Separate lifetime signatures of macaque S cones, M/L cones, and rods observed with adaptive optics fluorescence lifetime ophthalmoscopy. Sci Rep 2023; 13:2456. [PMID: 36774443 PMCID: PMC9922306 DOI: 10.1038/s41598-023-28877-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 01/25/2023] [Indexed: 02/13/2023] Open
Abstract
In the retina, several molecules involved in metabolism, the visual cycle, and other roles exhibit intrinsic fluorescence. The overall properties of retinal fluorescence depend on changes to the composition of these molecules and their environmental interactions due to transient functional shifts, especially in disease. This behooves the understanding of the origins and deviations of these properties within the multilayered retina at high lateral and axial resolution. Of particular interest is the fluorescence lifetime, a potential biomarker of function and disease independent of fluorescence intensity that can be measured in the retina with adaptive optics fluorescence lifetime ophthalmoscopy (AOFLIO). This work demonstrates the utility of the phasor method of analysis, an alternate approach to traditional multiexponential fitting, to evaluate photoreceptor two-photon excited AOFLIO data and separate them based on functional differences. Phasor analysis on fluorescence lifetime decay data allowed the repeatable segregation of S from M/L cones, likely from differences in functional or metabolic demands. Furthermore, it is possible to track the lifetime changes in S cones after photodamage. Phasor analysis increases the sensitivity of AOFLIO to functional differences between cells and has the potential to improve our understanding of pathways involved in normal and diseased conditions at the cellular scale throughout the retina.
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Affiliation(s)
- Khang T Huynh
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627, USA.
- Center for Visual Science, University of Rochester, Rochester, NY, 14642, USA.
| | - Sarah Walters
- Currently with IDEX Health & Science, West Henrietta, NY, 14586, USA
- The Institute of Optics, University of Rochester, Rochester, NY, 14627, USA
| | - Emma K Foley
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627, USA
| | - Jennifer J Hunter
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627, USA
- Center for Visual Science, University of Rochester, Rochester, NY, 14642, USA
- The Institute of Optics, University of Rochester, Rochester, NY, 14627, USA
- Flaum Eye Institute, University of Rochester, Rochester, NY, 14642, USA
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12
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Bonelli R, Woods SM, Lockwood S, Bishop PN, Khan KN, Bahlo M, Ansell BRE, Fruttiger M. Spatial distribution of metabolites in the retina and its relevance to studies of metabolic retinal disorders. Metabolomics 2023; 19:10. [PMID: 36745234 PMCID: PMC9902429 DOI: 10.1007/s11306-022-01969-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/21/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The primate retina has evolved regional specialisations for specific visual functions. The macula is specialised towards high acuity vision and is an area that contains an increased density of cone photoreceptors and signal processing neurons. Different regions in the retina display unique susceptibility to pathology, with many retinal diseases primarily affecting the macula. OBJECTIVES To better understand the properties of different retinal areas we studied the differential distribution of metabolites across the retina. METHODS We conducted an untargeted metabolomics analysis on full-thickness punches from three different regions (macula, temporal peri-macula and periphery) of healthy primate retina. RESULTS Nearly half of all metabolites identified showed differential abundance in at least one comparison between the three regions. Furthermore, mapping metabolomics results from macula-specific eye diseases onto our region-specific metabolite distributions revealed differential abundance defining systemic metabolic dysregulations that were region specific. CONCLUSIONS The unique metabolic phenotype of different retinal regions is likely due to the differential distribution of different cell types in these regions reflecting the specific metabolic requirements of each cell type. Our results may help to better understand the pathobiology of retinal diseases with region specificity.
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Affiliation(s)
- Roberto Bonelli
- Population Health & Immunity Division, The Walter & Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Sasha M Woods
- UCL Institute of Ophthalmology, University College London, 11-43 Bath St, London, EC1V 9EL, UK
| | - Sarah Lockwood
- UC Davis, CA National Primate Research Centre, Davis, CA, 95616, USA
| | - Paul N Bishop
- Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, M13 9PT, UK
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Kamron N Khan
- The Leeds Teaching Hospitals NHS Trust, St. James's Hospital, Leeds, LS9 7TF, UK
| | - Melanie Bahlo
- Population Health & Immunity Division, The Walter & Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Brendan R E Ansell
- Population Health & Immunity Division, The Walter & Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Marcus Fruttiger
- UCL Institute of Ophthalmology, University College London, 11-43 Bath St, London, EC1V 9EL, UK.
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13
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Photoreceptor Cell Replacement Using Pluripotent Stem Cells: Current Knowledge and Remaining Questions. Cold Spring Harb Perspect Med 2023; 13:cshperspect.a041309. [PMID: 36617642 PMCID: PMC9899646 DOI: 10.1101/cshperspect.a041309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Retinal degeneration is an increasing global burden without cure for the majority of patients. Once retinal cells have degenerated, vision is permanently lost. Different strategies have been developed in recent years to prevent retinal degeneration or to restore sight (e.g., gene therapy, cell therapy, and electronic implants). Herein, we present current treatment strategies with a focus on cell therapy for photoreceptor replacement using human pluripotent stem cells. We will describe the state of the art and discuss obstacles and limitations observed in preclinical animal models as well as future directions to improve graft integration and functionality.
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14
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Shi WQ, Wan T, Li B, Li T, Zhou XD. EFEMP1 is a potential biomarker of choroid thickness change in myopia. Front Neurosci 2023; 17:1144421. [PMID: 36891459 PMCID: PMC9987712 DOI: 10.3389/fnins.2023.1144421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
Purpose To explore the possible molecular mechanism by which epidermal growth factor-containing fibulin-like extracellular matrix protein 1 (EFEMP1) regulates choroid thickness (CT) in the development of myopia. Methods In total, 131 subjects were divided into the emmetropia (EM) group, non-high myopia (non-HM) group and high myopia (HM) group. Their age, refraction, intraocular pressure, and other ocular biometric parameters were collected. A 6 × 6 mm area centered on the optic disc was scanned by coherent optical tomography angiography (OCTA) to measure CT, and the tear concentrations of EFEMP1 were quantified using enzyme-linked immunosorbent assay (ELISA) analysis. Twenty-two guinea pigs were divided into the control group and the form-deprivation myopia (FDM) group. The right eye of the guinea pig in the FDM group was covered for 4 weeks, and the diopter and axial length of the right eye of the guinea pig were measured before and after the treatment. After the measurement, the guinea pig was euthanized, and the eyeball was removed. Quantitative reverse transcription polymerase chain reaction, western blotting assays and immunohistochemistry were used to assess the expression of EFEMP1 in the choroid. Results There were significant differences in CT among the three groups (p < 0.001). CT was positively correlated with age in HM (r = -0.3613, p = 0.0021), but no significant correlation with SE (p > 0.05) was observed. Furthermore, there were increased levels of EFEMP1 in the tears of myopic patients. After 4 weeks of covering the right eye of the FDM guinea pigs, there was a significant increase in axial length and a decrease in diopter (p < 0.05). The mRNA and protein expression of EFEMP1 was significantly increased in the choroid. Conclusion Choroidal thickness was significantly thinner in myopic patients, and the expression level of EFEMP1 in the choroid increased during the development of FDM. Therefore, EFEMP1 may be involved in the regulation of choroidal thickness in myopia patients.
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Affiliation(s)
- Wen-Qing Shi
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Ting Wan
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Bing Li
- Central Laboratory, Jinshan Hospital of Fudan University, Shanghai, China
| | - Tao Li
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Xiao-Dong Zhou
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
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15
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Essential Role of Multi-Omics Approaches in the Study of Retinal Vascular Diseases. Cells 2022; 12:cells12010103. [PMID: 36611897 PMCID: PMC9818611 DOI: 10.3390/cells12010103] [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: 12/04/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Retinal vascular disease is a highly prevalent vision-threatening ocular disease in the global population; however, its exact mechanism remains unclear. The expansion of omics technologies has revolutionized a new medical research methodology that combines multiple omics data derived from the same patients to generate multi-dimensional and multi-evidence-supported holistic inferences, providing unprecedented opportunities to elucidate the information flow of complex multi-factorial diseases. In this review, we summarize the applications of multi-omics technology to further elucidate the pathogenesis and complex molecular mechanisms underlying retinal vascular diseases. Moreover, we proposed multi-omics-based biomarker and therapeutic strategy discovery methodologies to optimize clinical and basic medicinal research approaches to retinal vascular diseases. Finally, the opportunities, current challenges, and future prospects of multi-omics analyses in retinal vascular disease studies are discussed in detail.
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16
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RIP140-Mediated NF-κB Inflammatory Pathway Promotes Metabolic Dysregulation in Retinal Pigment Epithelium Cells. Curr Issues Mol Biol 2022; 44:5788-5801. [DOI: 10.3390/cimb44110393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Metabolic dysregulation of the retinal pigment epithelium (RPE) has been implicated in age-related macular degeneration (AMD). However, the molecular regulation of RPE metabolism remains unclear. RIP140 is known to affect oxidative metabolism and mitochondrial biogenesis by negatively controlling mitochondrial pathways regulated by PPAR-γ co-activator-1 α(PGC-1α). This study aims to disclose the effect of RIP140 on the RPE metabolic program in vitro and in vivo. RIP140 protein levels were assayed by Western blotting. Gene expression was tested using quantitative real-time PCR (qRT-PCR), ATP production, and glycogen concentration assays, and the release of inflammatory factors was analyzed by commercial kits. Mice photoreceptor function was measured by electroretinography (ERG). In ARPE-19 cells, RIP140 overexpression changed the expression of the key metabolic genes and lipid processing genes, inhibited mitochondrial ATP production, and enhanced glycogenesis. Moreover, RIP140 overexpression promoted the translocation of NF-κB and increased the expression and production of IL-1β, IL-6, and TNF-α in ARPE-19 cells. Importantly, we also observed the overexpression of RIP140 through adenovirus delivery in rat retinal cells, which significantly decreased the amplitude of the a-wave and b-wave measured by ERG assay. Therapeutic strategies that modulate the activity of RIP140 could have clinical utility for the treatment of AMD in terms of preventing RPE degeneration.
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17
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Ding J, Su G, Wang H, Tian X, Xu J, Li N, Luo X, Yang P. Comparison of metabolic profiles in aqueous humor of Fuchs' syndrome and presumed viral-induced anterior uveitis patients. Clin Exp Ophthalmol 2022; 50:1065-1081. [PMID: 35849327 DOI: 10.1111/ceo.14138] [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: 12/30/2021] [Revised: 06/30/2022] [Accepted: 07/16/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate and compare the metabolic profiles in the aqueous humor of Han Chinese patients with Fuchs' syndrome and presumed viral-induced anterior uveitis (PVIAU). METHODS The metabolites in the aqueous humor of 20 Fuchs' syndrome patients, 20 PVIAU patients and 20 senile cataract control patients were detected by liquid chromatography with mass spectrometry. Differential metabolites were analyzed by Student's t-test, multivariate analysis, cluster analysis and correlation analysis. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis was applied to explore the potential disrupted metabolic pathways in Fuchs' syndrome and PVIAU. RESULTS Comparisons of metabolic profiles identified 29 differential metabolites between Fuchs' syndrome patients and controls, 36 differential metabolites between PVIAU patients and controls, and 30 differential metabolites between Fuchs' syndrome patients and PVIAU patients. DL-serine was markedly elevated in Fuchs' syndrome, and 1-palmitoyl-sn-glycero-3-phosphocholine in PVIAU. KEGG pathway analysis suggested that the differential metabolites in Fuchs' syndrome compared with control were mostly enriched in central carbon metabolism in cancer, adenosine triphosphate-binding cassette (ABC) transporters, and mineral absorption, while those in PVIAU compared with control were mostly enriched in protein digestion and absorption, biosynthesis of unsaturated fatty acids, and ABC transporters. The metabolic pathways differentially affected in Fuchs' syndrome compared to PVIAU included central carbon metabolism in cancer, protein digestion and absorption, and ascorbate and aldarate metabolism. CONCLUSIONS In Fuchs' syndrome and PVIAU patients, the aqueous humor exhibited specific metabolic profiles and enriched metabolic pathways, which provides a better understanding of the pathogenesis of Fuchs' syndrome and PVIAU in Han Chinese patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jiadong Ding
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, People's Republic of China; The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Huafei Wang
- Department of Biological Sample Bank, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Tian
- Department of Biological Sample Bank, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Xu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Na Li
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, People's Republic of China; The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Xiang Luo
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Peizeng Yang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, People's Republic of China; The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China.,The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
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18
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Biomarkers as Predictive Factors of Anti-VEGF Response. Biomedicines 2022; 10:biomedicines10051003. [PMID: 35625740 PMCID: PMC9139112 DOI: 10.3390/biomedicines10051003] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/13/2022] [Accepted: 04/22/2022] [Indexed: 02/04/2023] Open
Abstract
Age-related macular degeneration is the main cause of irreversible vision in developed countries, and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are the current gold standard treatment today. Although anti-VEGF treatment results in important improvements in the course of this disease, there is a considerable number of patients not responding to the standardized protocols. The knowledge of how a patient will respond or how frequently retreatment might be required would be vital in planning treatment schedules, saving both resource utilization and financial costs, but today, there is not an ideal biomarker to use as a predictive response to ranibizumab therapy. Whole blood and blood mononuclear cells are the samples most studied; however, few reports are available on other important biofluid samples for studying this disease, such as aqueous humor. Moreover, the great majority of studies carried out to date were focused on the search for SNPs in genes related to AMD risk factors, but miRNAs, proteomic and metabolomics studies have rarely been conducted in anti-VEGF-treated samples. Here, we propose that genomic, proteomic and/or metabolomic markers could be used not alone but in combination with other methods, such as specific clinic characteristics, to identify patients with a poor response to anti-VEGF treatment to establish patient-specific treatment plans.
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19
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Valencia E, García M, Fernández-Vega B, Pereiro R, Lobo L, González-Iglesias H. Targeted Analysis of Tears Revealed Specific Altered Metal Homeostasis in Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2022; 63:10. [PMID: 35426907 PMCID: PMC9034717 DOI: 10.1167/iovs.63.4.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose Specific altered metal homeostasis has been investigated in the tear film of age-related macular degeneration (AMD) patients considering that metal dyshomeostasis contributes to the production of free radicals, inflammation, and apoptosis and results in conformational changes of proteins. Methods A multitargeted approach based on spectrophotometry and mass spectrometry techniques has been implemented to the multiplexed quantitation of lactoferrin (LF), S100 calcium binding protein A6 (S100A6), metallothionein 1A (MT1A), complement factor H (CFH), clusterin (CLU), amyloid precursor protein (APP), Mg, P, Na, Fe, Cu, Zn, and Ca, in the tear film from 60 subjects, 31 patients diagnosed with the dry form of AMD, and 29 healthy individuals Results Significant up-regulations of MT1A (1.9-fold) and S100A6 (1.4-fold) and down-regulations of LF (0.7-fold), Fe (0.6-fold), Mg (0.7-fold), and Cu (0.7-fold) were observed in AMD patients, when compared to control subjects. Of all the studied variables, only APP showed negative correlation with age in the AMD group. Also, positive correlations were observed for the variables Mg and Na, Cu and Mg, and P and Mg in both the AMD and control groups, whereas positive correlations were exclusively determined in the AMD group for Cu and LF, Na and Ca, and Mg and Ca. The panel constituted of MT1A, Na, and Mg predicts AMD disease in 73% of cases. Conclusions The different levels of target metals and (metallo-)proteins in the tear film suggest altered metal homeostasis in AMD patients. These observed pathophysiological changes may be related with the anomalous protein aggregation in the macula.
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Affiliation(s)
- Eva Valencia
- Ophtalmological Research Foundation, University Institute Fernández-Vega, University of Oviedo, Oviedo, Spain.,Department of Physical and Analytical Chemistry, Faculty of Chemistry, University of Oviedo, Oviedo, Spain
| | - Montserrat García
- Ophtalmological Research Foundation, University Institute Fernández-Vega, University of Oviedo, Oviedo, Spain.,Ophthalmological Institute Fernández-Vega, Oviedo, Spain
| | - Beatriz Fernández-Vega
- Ophtalmological Research Foundation, University Institute Fernández-Vega, University of Oviedo, Oviedo, Spain.,Ophthalmological Institute Fernández-Vega, Oviedo, Spain
| | - Rosario Pereiro
- Ophtalmological Research Foundation, University Institute Fernández-Vega, University of Oviedo, Oviedo, Spain.,Department of Physical and Analytical Chemistry, Faculty of Chemistry, University of Oviedo, Oviedo, Spain
| | - Lara Lobo
- Department of Physical and Analytical Chemistry, Faculty of Chemistry, University of Oviedo, Oviedo, Spain
| | - Héctor González-Iglesias
- Ophtalmological Research Foundation, University Institute Fernández-Vega, University of Oviedo, Oviedo, Spain.,Ophthalmological Institute Fernández-Vega, Oviedo, Spain
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20
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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.
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21
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Mead B, Tomarev S. The role of miRNA in retinal ganglion cell health and disease. Neural Regen Res 2022; 17:516-522. [PMID: 34380881 PMCID: PMC8504366 DOI: 10.4103/1673-5374.320974] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/19/2021] [Accepted: 04/15/2021] [Indexed: 12/03/2022] Open
Abstract
miRNA are short non-coding RNA responsible for the knockdown of proteins through their targeting and silencing of complimentary mRNA sequences. The miRNA landscape of a cell thus affects the levels of its proteins and has significant consequences to its health. Deviations in this miRNA landscape have been implicated in a variety of neurodegenerative diseases and have also garnered interest as targets for treatment. Retinal ganglion cells are the sole projection neuron of the retina with their axons making up the optic nerve. They are a focus of study not only for their importance in vision and the myriad of blinding diseases characterized by their dysfunction and loss, but also as a model of other central nervous system diseases such as spinal cord injury and traumatic brain injury. This review summarizes current knowledge on the role of miRNA in retinal ganglion cell function, highlighting how perturbations can result in disease, and how modulating their abundance may provide a novel avenue of therapeutic research.
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Affiliation(s)
- Ben Mead
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - Stanislav Tomarev
- Section of Retinal Ganglion Cell Biology, Laboratory of Retinal Cell and Molecular Biology, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
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Clare AJ, Liu J, Copland DA, Theodoropoulou S, Dick AD. Unravelling the therapeutic potential of IL-33 for atrophic AMD. Eye (Lond) 2022; 36:266-272. [PMID: 34531552 PMCID: PMC8807696 DOI: 10.1038/s41433-021-01725-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/08/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023] Open
Abstract
Age-related macular degeneration (AMD), a degenerative disease affecting the retinal pigment epithelium (RPE) and photoreceptors in the macula, is the leading cause of central blindness in the elderly. AMD progresses to advanced stages of the disease, atrophic AMD (aAMD), or in 15% of cases "wet" or neovascular AMD (nAMD), associated with substantial vision loss. Whilst there has been advancement in therapies treating nAMD, to date, there are no licenced effective treatments for the 85% affected by aAMD, with disease managed by changes to diet, vitamin supplements, and regular monitoring. AMD has a complex pathogenesis, involving highly integrated and common age-related disease pathways, including dysregulated complement/inflammation, impaired autophagy, and oxidative stress. The intricacy of AMD pathogenesis makes therapeutic development challenging and identifying a target that combats the converging disease pathways is essential to provide a globally effective treatment. Interleukin-33 is a cytokine, classically known for the proinflammatory role it plays in allergic disease. Recent evidence across degenerative and inflammatory disease conditions reveals a diverse immune-modulatory role for IL-33, with promising therapeutic potential. Here, we will review IL-33 function in disease and discuss the future potential for this homeostatic cytokine in treating AMD.
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Affiliation(s)
- Alison J. Clare
- grid.5337.20000 0004 1936 7603Academic Unit of Ophthalmology, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Jian Liu
- grid.5337.20000 0004 1936 7603Academic Unit of Ophthalmology, Translational Health Sciences, University of Bristol, Bristol, UK
| | - David A. Copland
- grid.5337.20000 0004 1936 7603Academic Unit of Ophthalmology, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Sofia Theodoropoulou
- grid.5337.20000 0004 1936 7603Academic Unit of Ophthalmology, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Andrew D. Dick
- grid.5337.20000 0004 1936 7603Academic Unit of Ophthalmology, Translational Health Sciences, University of Bristol, Bristol, UK ,grid.5337.20000 0004 1936 7603School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK ,grid.439257.e0000 0000 8726 5837NIHR Biomedical Research Centre of Ophthalmology, Moorfields Eye Hospital, London, UK ,grid.83440.3b0000000121901201UCL Institute of Ophthalmology, London, UK
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Christelle M, Lise M, Ben M'Barek K. Challenges of cell therapies for retinal diseases. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 166:49-77. [DOI: 10.1016/bs.irn.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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24
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Seo C, Park S, Kim Y, Ji M, Lee HS, Hwang YH, Choi S, Min J, Oh SJ, Yee ST, Lee W, Paik MJ. Metabolomic analysis of amino acids and organic acids in aging mouse eyes using gas chromatography-tandem mass spectrometry. Biomed Chromatogr 2021; 36:e5298. [PMID: 34913179 DOI: 10.1002/bmc.5298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 11/12/2022]
Abstract
This is a metabolomics study for monitoring of altered amino acid (AA) and organic acid (OA) metabolism of in the eyes from aging mouse model of 8-weeks, 18-weeks, and 18-months. Simultaneous metabolic profiling analysis of OAs and AAs was performed as ethoxycarbonyl/methoxime/tert-butyldimethylsilyl derivatives by gas chromatography-tandem mass spectrometry. A total 42 metabolites of 24 AAs and 18 OAs were determined and their composition values were normalized to the corresponding mean values of 8-week-old mice as control group. Then their normalized values were plotted as star graphs, which were distorted and readily distinguishable for age-related each group. Among 42 metabolites, 18 AAs and 11 OAs were age dependent and significantly different (p < 0.05). Principal component analysis and partial least squares discriminant analysis showed unclear separation between 8- and 18-week-old mice but clear separation between these and 18-month-old mice. Especially, the variables importance in projection (VIP) scores of 4-hydroxyproline, cis-aconitic acid, glycine, isocitric acid, leucine, pipecolic acid and lysine from PLS-DA were higher than 1.3. A heatmap for the classification and visualization of 42 metabolites showed differences in metabolite changes with aging. Altered AA and OA profiles were monitored, which may explain for metabolic disturbance of AA and OA. These findings are related with mitochondrial dysfunctions related with energy metabolism and impaired antioxidant system in the aging eye. Therefore, the present metabolomics results of the association between physiological states and altered metabolism of AA and OA will be useful for understanding aging eye and related diseases.
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Affiliation(s)
- Chan Seo
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Sehoon Park
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Youngbae Kim
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Moongi Ji
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Hyeon-Seong Lee
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea.,Natural Product Informatics Research Center, Gangneung Institute of Natural Products, Korea Institute of Science and Technology, Gangwon-do, Republic of Korea
| | - Yun-Ho Hwang
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Subin Choi
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Jeuk Min
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Song-Jin Oh
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Sung-Tae Yee
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | - Wonjae Lee
- College of Pharmacy, Chosun University, Gwangju, Republic of Korea
| | - Man-Jeong Paik
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
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25
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Plasma Metabolomics of Intermediate and Neovascular Age-Related Macular Degeneration Patients. Cells 2021; 10:cells10113141. [PMID: 34831363 PMCID: PMC8624113 DOI: 10.3390/cells10113141] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 01/19/2023] Open
Abstract
To characterize metabolites and metabolic pathways altered in intermediate and neovascular age-related macular degeneration (IAMD and NVAMD), high resolution untargeted metabolomics was performed via liquid chromatography-mass spectrometry on plasma samples obtained from 91 IAMD patients, 100 NVAMD patients, and 195 controls. Plasma metabolite levels were compared between: AMD patients and controls, IAMD patients and controls, and NVAMD and IAMD patients. Partial least-squares discriminant analysis and linear regression were used to identify discriminatory metabolites. Pathway analysis was performed to determine metabolic pathways altered in AMD. Among the comparisons, we identified 435 unique discriminatory metabolic features. Using computational methods and tandem mass spectrometry, we identified 11 metabolic features whose molecular identities had been previously verified and confirmed the molecular identities of three additional discriminatory features. Included among the discriminatory metabolites were acylcarnitines, phospholipids, amino acids, and steroid metabolites. Pathway analysis revealed that lipid, amino acid, and vitamin metabolism pathways were altered in NVAMD, IAMD, or AMD in general, including the carnitine shuttle pathway which was significantly altered in all comparisons. Finally, few discriminatory features were identified between IAMD patients and controls, suggesting that plasma metabolic profiles of IAMD patients are more similar to controls than to NVAMD patients.
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Preventive Effects against Retinal Degeneration by Centella asiatica Extract (CA-HE50) and Asiaticoside through Apoptosis Suppression by the Nrf2/HO-1 Signaling Pathway. Antioxidants (Basel) 2021; 10:antiox10040613. [PMID: 33923585 PMCID: PMC8072678 DOI: 10.3390/antiox10040613] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/30/2021] [Accepted: 04/14/2021] [Indexed: 01/22/2023] Open
Abstract
Age-related macular degeneration (AMD) is caused by the chronic and gradual oxidative degeneration of the retina. Unfortunately, the general purpose of current treatments is to slow AMD progression, as the retina cannot be restored to its pre-AMD condition. We aimed to identify natural products that can be potential treatments that prevent AMD and can delay the development of late-AMD and selected Centella asiatica extract (CA-HE50), which shows excellent efficacy in cytoprotection. In animal experiments using N-methyl-N-nitrosourea (MNU), CA-HE50 dramatically increased the thickness of photoreceptors and the outer nuclear layer (ONL) and the number of nuclei in the ONL (p < 0.05). Using retinal epithelial ARPE-19 cells showed that CA-HE50 inhibited apoptosis through inhibition of the intrinsic apoptosis signaling pathway and cell cycle regulation (p < 0.05). The anti-apoptotic efficacy was confirmed to be due to activation of the Nrf2/HO-1 antioxidation pathway (p < 0.05). These results were also observed with asiaticoside, a functional substance of CA-HE50. In addition, the accumulation of oxidized-N-retinylidene-N-retinylethanolamine (A2E), which induces AMD, was inhibited by CA-HE50, resulting in increased ARPE-19 cell viability (p < 0.05). This study demonstrates that CA-HE50 is worth further research and human application tests, to develop it as a raw material for treatment or dietary supplement for the prevention of AMD.
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Mendez KM, Kim J, Laíns I, Nigalye A, Katz R, Pundik S, Kim IK, Liang L, Vavvas DG, Miller JB, Miller JW, Lasky-Su JA, Husain D. Association of Human Plasma Metabolomics with Delayed Dark Adaptation in Age-Related Macular Degeneration. Metabolites 2021; 11:metabo11030183. [PMID: 33801085 PMCID: PMC8003957 DOI: 10.3390/metabo11030183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 01/16/2023] Open
Abstract
The purpose of this study was to analyze the association between plasma metabolite levels and dark adaptation (DA) in age-related macular degeneration (AMD). This was a cross-sectional study including patients with AMD (early, intermediate, and late) and control subjects older than 50 years without any vitreoretinal disease. Fasting blood samples were collected and used for metabolomic profiling with ultra-performance liquid chromatography-mass spectrometry (LC-MS). Patients were also tested with the AdaptDx (MacuLogix, Middletown, PA, USA) DA extended protocol (20 min). Two measures of dark adaptation were calculated and used: rod-intercept time (RIT) and area under the dark adaptation curve (AUDAC). Associations between dark adaption and metabolite levels were tested using multilevel mixed-effects linear modelling, adjusting for age, gender, body mass index (BMI), smoking, race, AMD stage, and Age-Related Eye Disease Study (AREDS) formulation supplementation. We included a total of 71 subjects: 53 with AMD (13 early AMD, 31 intermediate AMD, and 9 late AMD) and 18 controls. Our results revealed that fatty acid-related lipids and amino acids related to glutamate and leucine, isoleucine and valine metabolism were associated with RIT (p < 0.01). Similar results were found when AUDAC was used as the outcome. Fatty acid-related lipids and amino acids are associated with DA, thus suggesting that oxidative stress and mitochondrial dysfunction likely play a role in AMD and visual impairment in this condition.
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Affiliation(s)
- Kevin M. Mendez
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02114, USA;
| | - Janice Kim
- Harvard Medical School, Boston, MA 02114, USA;
| | - Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
| | - Archana Nigalye
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
| | - Raviv Katz
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
| | - Shrinivas Pundik
- Department of Ophthalmology, Schepens Eye Research Institute of Massachusetts Eye & Ear, Harvard Medical School, Boston, MA 02114, USA;
| | - Ivana K. Kim
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
| | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02114, USA;
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02114, USA
| | - Demetrios G. Vavvas
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
| | - John B. Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
| | - Joan W. Miller
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
| | - Jessica A. Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02114, USA;
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; (K.M.M.); (I.L.); (A.N.); (R.K.); (I.K.K.); (D.G.V.); (J.B.M.); (J.W.M.)
- Correspondence: ; Tel.: +1-617-573-4371
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Ma HH, Liutkevičienė R. Age-Related Macular Degeneration: What Do We Know So Far? Acta Med Litu 2021; 28:36-47. [PMID: 34393627 PMCID: PMC8311835 DOI: 10.15388/amed.2021.28.1.7] [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: 12/15/2020] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 01/17/2023] Open
Abstract
Ageing is a natural process that everyone experiences and nobody is an exception. With ageing, our body experiences physiological changes. In this article, the focus is made on the physiological changes of our eyes related to ageing and age-related macular degeneration (AMD), which is the most common cause of incurable visual impairment in developed countries. With ageing populations increasing in many countries, more and more patients will have AMD in a foreseeable future. In Eastern Europe, blindness due to AMD, currently, is approximately 20% and there has been an increasing trend depicted in the future. Generally, AMD can be divided into early stages and two forms in an advanced (late) stage. Advanced AMD form includes neovascular AMD (wet) and geographic atrophy (late dry), both of these are associated with substantial, progressive visual impairment. The pathogenesis of AMD is complex and, by far, not completely understood. Multiple factors have been studied, for example: environmental factor, genetic factor (complement factor H), lifestyle. It has been proved that they are linked to higher the risk of developing of AMD, however, the actual pathogenesis is not yet formulated. AMD progression can also be a culprit to certain biochemical events and molecular changes linked to inflammation and pathological angiogenesis. In nowadays, we do have diagnostic methods for both early and late forms of AMD as well as ways to prevent progression of early AMD and wet AMD. However, until now, there is still no treatment for dry AMD. This article is a brief review of AMD and may hopefully lead to some future directions in early diagnostic methods and treating dry AMD.
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Affiliation(s)
- Ho Hin Ma
- Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Rasa Liutkevičienė
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
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Lee AY, Lee CS, Blazes MS, Owen JP, Bagdasarova Y, Wu Y, Spaide T, Yanagihara RT, Kihara Y, Clark ME, Kwon M, Owsley C, Curcio CA. Exploring a Structural Basis for Delayed Rod-Mediated Dark Adaptation in Age-Related Macular Degeneration Via Deep Learning. Transl Vis Sci Technol 2020; 9:62. [PMID: 33344065 PMCID: PMC7745629 DOI: 10.1167/tvst.9.2.62] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/30/2020] [Indexed: 01/09/2023] Open
Abstract
Purpose Delayed rod-mediated dark adaptation (RMDA) is a functional biomarker for incipient age-related macular degeneration (AMD). We used anatomically restricted spectral domain optical coherence tomography (SD-OCT) imaging data to localize de novo imaging features associated with and to test hypotheses about delayed RMDA. Methods Rod intercept time (RIT) was measured in participants with and without AMD at 5 degrees from the fovea, and macular SD-OCT images were obtained. A deep learning model was trained with anatomically restricted information using a single representative B-scan through the fovea of each eye. Mean-occlusion masking was utilized to isolate the relevant imaging features. Results The model identified hyporeflective outer retinal bands on macular SD-OCT associated with delayed RMDA. The validation mean standard error (MSE) registered to the foveal B-scan localized the lowest error to 0.5 mm temporal to the fovea center, within an overall low-error region across the rod-free zone and adjoining parafovea. Mean absolute error (MAE) on the test set was 4.71 minutes (8.8% of the dynamic range). Conclusions We report a novel framework for imaging biomarker discovery using deep learning and demonstrate its ability to identify and localize a previously undescribed biomarker in retinal imaging. The hyporeflective outer retinal bands in central macula on SD-OCT demonstrate a structural basis for dysfunctional rod vision that correlates to published histopathologic findings. Translational Relevance This agnostic approach to anatomic biomarker discovery strengthens the rationale for RMDA as an outcome measure in early AMD clinical trials, and also expands the utility of deep learning beyond automated diagnosis to fundamental discovery.
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Affiliation(s)
- Aaron Y Lee
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Cecilia S Lee
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Marian S Blazes
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Julia P Owen
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Yelena Bagdasarova
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Yue Wu
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Theodore Spaide
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ryan T Yanagihara
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Yuka Kihara
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Mark E Clark
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - MiYoung Kwon
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christine A Curcio
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Hou XW, Wang Y, Pan CW. Metabolomics in Age-Related Macular Degeneration: A Systematic Review. Invest Ophthalmol Vis Sci 2020; 61:13. [PMID: 33315052 PMCID: PMC7735950 DOI: 10.1167/iovs.61.14.13] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/25/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Age-related macular degeneration (AMD) is one of the leading causes of blindness among the elderly, and the exact pathogenesis of the AMD remains unclear. The purpose of this review is to summarize potential metabolic biomarkers and pathways of AMD that might facilitate risk predictions and clinical diagnoses of AMD. Methods We obtained relevant publications of metabolomics studies of human beings by systematically searching the MEDLINE (PubMed) database before June 2020. Studies were included if they performed mass spectrometry-based or nuclear magnetic resonance-based metabolomics approach for humans. In addition, AMD was assessed from fundus photographs based on standardized protocols. The metabolic pathway analysis was performed using MetaboAnalyst 3.0. Results Thirteen studies were included in this review. Repeatedly identified metabolites including phenylalanine, adenosine, hypoxanthine, tyrosine, creatine, citrate, carnitine, proline, and maltose have the possibility of being biomarkers of AMD. Validation of the biomarker panels was observed in one study. Dysregulation of metabolic pathways involves lipid metabolism, carbohydrate metabolism, nucleotide metabolism, amino acid metabolism, and translation, which might play important roles in the development and progression of AMD. Conclusions This review summarizes the potential metabolic biomarkers and pathways related to AMD, providing opportunities for the construction of diagnostic or predictive models for AMD and the discovery of new therapeutic targets.
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Affiliation(s)
- Xiao-Wen Hou
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ying Wang
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
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Stahl A. The Diagnosis and Treatment of Age-Related Macular Degeneration. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 117:513-520. [PMID: 33087239 DOI: 10.3238/arztebl.2020.0513] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 02/16/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Age-related macular degeneration (AMD) is thought to cause approximately 9% of all cases of blindness worldwide. In Germany, half of all cases of blindness and high-grade visual impairment are due to AMD. In this review, the main risk factors, clinical manifestations, and treatments of this disease are presented. METHODS This review is based on pertinent publications retrieved by a selective search in PubMed for original articles and reviews, as well as on current position statements by the relevant specialty societies. RESULTS AMD is subdivided into early, intermediate, and late stages. The early stage is often asymptomatic; patients in the other two stages often have distorted vision or central visual field defects. The main risk factors are age, genetic predisposition, and nicotine consumption. The number of persons with early AMD in Germany rose from 5.7 million in 2002 to ca. 7 million in 2017. Late AMD is subdivided into the dry late form of the disease, for which there is no treatment at present, and the exudative late form, which can be treated with the intravitreal injection of VEGF inhibitors. CONCLUSION More research is needed on the dry late form of AMD in particular, which is currently untreatable. The treatment of the exudative late form with VEGF inhibitors is labor-intensive and requires a close collaboration of the patient, the ophthalmologist, and the primary care physician.
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Affiliation(s)
- Andreas Stahl
- Department of Ophthalmology, University Medicine Greifswald
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32
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Lambert V, Hansen S, Schoumacher M, Lecomte J, Leenders J, Hubert P, Herfs M, Blacher S, Carnet O, Yip C, Blaise P, Duchateau E, Locht B, Thys M, Cavalier E, Gothot A, Govaerts B, Rakic JM, Noel A, de Tullio P. Pyruvate dehydrogenase kinase/lactate axis: a therapeutic target for neovascular age-related macular degeneration identified by metabolomics. J Mol Med (Berl) 2020; 98:1737-1751. [PMID: 33079232 DOI: 10.1007/s00109-020-01994-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/22/2020] [Accepted: 10/13/2020] [Indexed: 12/19/2022]
Abstract
Neovascular age-related macular degeneration (nAMD) is the leading cause of blindness in aging populations. Here, we applied metabolomics to human sera of patients with nAMD during an active (exudative) phase of the pathology and found higher lactate levels and a shift in the lipoprotein profile (increased VLDL-LDL/HDL ratio). Similar metabolomics changes were detected in the sera of mice subjected to laser-induced choroidal neovascularization (CNV). In this experimental model, we provide evidence for two sites of lactate production: first, a local one in the injured eye, and second a systemic site associated with the recruitment of bone marrow-derived inflammatory cells. Mechanistically, lactate promotes the angiogenic response and M2-like macrophage accumulation in the eyes. The therapeutic potential of our findings is demonstrated by the pharmacological control of lactate levels through pyruvate dehydrogenase kinase (PDK) inhibition by dichloroacetic acid (DCA). Mice treated with DCA exhibited normalized lactate levels and lipoprotein profiles, and inhibited CNV formation. Collectively, our findings implicate the key role of the PDK/lactate axis in AMD pathogenesis and reveal that the regulation of PDK activity has potential therapeutic value in this ocular disease. The results indicate that the lipoprotein profile is a traceable pattern that is worth considering for patient follow-up. KEY MESSAGES: Lactate and lipoprotein profile are associated with the active phase of AMD and CNV development. Lactate is a relevant and functional metabolite correlated with AMD progression. Modulating lactate through pyruvate dehydrogenase kinase led to a decrease of CNV progression. Pyruvate dehydrogenase kinase is a new therapeutic target for neovascular AMD.
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Affiliation(s)
- Vincent Lambert
- Department of Ophthalmology, University Hospital of Liège, Liège, Belgium.,Laboratory of Tumor and Development Biology, GIGA, Université de Liège, Liège, Belgium
| | - Sylvain Hansen
- Laboratory of Tumor and Development Biology, GIGA, Université de Liège, Liège, Belgium
| | - Matthieu Schoumacher
- Center for Interdisciplinary Research on Medicines, Metabolomics Group, Université de Liège, Liège, Belgium
| | - Julie Lecomte
- Laboratory of Tumor and Development Biology, GIGA, Université de Liège, Liège, Belgium
| | - Justine Leenders
- Center for Interdisciplinary Research on Medicines, Metabolomics Group, Université de Liège, Liège, Belgium
| | - Pascale Hubert
- Laboratory of Experimental Pathology, GIGA, Université de Liège, avenue Hippocrate, Liège, Belgium
| | - Michael Herfs
- Laboratory of Experimental Pathology, GIGA, Université de Liège, avenue Hippocrate, Liège, Belgium
| | - Silvia Blacher
- Laboratory of Tumor and Development Biology, GIGA, Université de Liège, Liège, Belgium
| | - Oriane Carnet
- Laboratory of Tumor and Development Biology, GIGA, Université de Liège, Liège, Belgium
| | - Cassandre Yip
- Laboratory of Tumor and Development Biology, GIGA, Université de Liège, Liège, Belgium
| | - Pierre Blaise
- Department of Ophthalmology, University Hospital of Liège, Liège, Belgium
| | - Edouard Duchateau
- Department of Ophthalmology, University Hospital of Liège, Liège, Belgium
| | - Bénédicte Locht
- Department of Ophthalmology, University Hospital of Liège, Liège, Belgium
| | - Michèle Thys
- Department of Ophthalmology, University Hospital of Liège, Liège, Belgium
| | - Etienne Cavalier
- Department of Medical Chemistry, University Hospital of Liège, Liège, Belgium
| | - André Gothot
- Department of Hematology and Immuno-Hematology, University Hospital of Liège, Liège, Belgium
| | - Bernadette Govaerts
- Institute of Statistics Biostatistics and Actuarial Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Jean-Marie Rakic
- Department of Ophthalmology, University Hospital of Liège, Liège, Belgium
| | - Agnès Noel
- Laboratory of Tumor and Development Biology, GIGA, Université de Liège, Liège, Belgium
| | - Pascal de Tullio
- Center for Interdisciplinary Research on Medicines, Metabolomics Group, Université de Liège, Liège, Belgium.
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Plasma metabolites in treatment-requiring retinopathy of prematurity: Potential biomarkers identified by metabolomics. Exp Eye Res 2020; 199:108198. [PMID: 32828955 DOI: 10.1016/j.exer.2020.108198] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/02/2020] [Accepted: 08/13/2020] [Indexed: 02/08/2023]
Abstract
Retinopathy of prematurity (ROP) is a potentially blinding condition caused by disruption of retinal vascularization and metabolism. This study aims to identify altered metabolites from plasma in patients with treatment-requiring ROP (TR-ROP) compared with controls. An untargeted metabolomics analysis was performed to reveal the metabolomic profiles of the plasma between TR-ROP patients (n = 38) and age-matched infants (n = 23). The Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were conducted to explore the potential signaling pathways of the changed metabolites. Under positive ion mode, a total of 29 metabolites were significantly altered in plasma between TR-ROP patients and controls, and 23 altered metabolites were identified under negative ion mode. KEGG analyses indicated that "protein digestion and absorption" and "aminoacyl-tRNA biosynthesis" were the most enriched pathways of the altered metabolites. These results demonstrated that metabolomic profiles changed in plasma of TR-ROP, and the altered metabolites could be served as potential biomarkers for the diagnosis and prognosis of TR-ROP patients. Besides, the metabolomic profiles might provide clues to discover novel therapeutic strategies in ROP treatment.
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Morizur L, Herardot E, Monville C, Ben M'Barek K. Human pluripotent stem cells: A toolbox to understand and treat retinal degeneration. Mol Cell Neurosci 2020; 107:103523. [PMID: 32634576 DOI: 10.1016/j.mcn.2020.103523] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/24/2020] [Accepted: 06/30/2020] [Indexed: 12/13/2022] Open
Abstract
Age-related Macular Degeneration (AMD) and Retinitis Pigmentosa (RP) are retinal degenerative disorders that dramatically damage the retina. As there is no therapeutic option for the majority of patients, vision is progressively and irremediably lost. Owing to their unlimited renewal and potency to give rise to any cell type of the human adult body, human pluripotent stem cells (hPSCs) have been extensively studied in recent years to develop more physiologically relevant in vitro cellular models. Such models open new perspectives to investigate the pathological molecular mechanisms of AMD and RP but also in drug screening. Moreover, proof-of-concept of hPSC-derived retinal cell therapy in animal models have led to first clinical trials. This review outlines the recent advances in the use of hPSCs in pathological modeling of retinal degeneration and their use in regenerative medicine. We also address the associated limitations and challenges that need to be overcome when using hPSCs.
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Affiliation(s)
- Lise Morizur
- INSERM U861, I-Stem, AFM, Institute for Stem Cell Therapy and Exploration of Monogenic Diseases, 91100 Corbeil-Essonnes, France; Université Paris-Saclay, Université d'Evry, U861, 91100 Corbeil-Essonnes, France; Centre d'Etude des Cellules Souches, 91100 Corbeil-Essonnes, France
| | - Elise Herardot
- INSERM U861, I-Stem, AFM, Institute for Stem Cell Therapy and Exploration of Monogenic Diseases, 91100 Corbeil-Essonnes, France; Université Paris-Saclay, Université d'Evry, U861, 91100 Corbeil-Essonnes, France
| | - Christelle Monville
- INSERM U861, I-Stem, AFM, Institute for Stem Cell Therapy and Exploration of Monogenic Diseases, 91100 Corbeil-Essonnes, France; Université Paris-Saclay, Université d'Evry, U861, 91100 Corbeil-Essonnes, France.
| | - Karim Ben M'Barek
- INSERM U861, I-Stem, AFM, Institute for Stem Cell Therapy and Exploration of Monogenic Diseases, 91100 Corbeil-Essonnes, France; Université Paris-Saclay, Université d'Evry, U861, 91100 Corbeil-Essonnes, France; Centre d'Etude des Cellules Souches, 91100 Corbeil-Essonnes, France.
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Lin X, Lou L, Miao Q, Wang Y, Jin K, Shan P, Xu Y. The pattern and gender disparity in global burden of age-related macular degeneration. Eur J Ophthalmol 2020; 31:1161-1170. [PMID: 32498618 DOI: 10.1177/1120672120927256] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the trend patterns and gender disparity in global burden of age-related macular degeneration (AMD) by year, age, and socioeconomic status using disability-adjusted life-years (DALYs) from Global Burden of Disease (GBD) study 2017. METHODS DALYs and impairment data caused by AMD were extracted from GBD Study 2017. World Bank income level (WBIL) and human development index (HDI) in 2017 were cited as indicators of socioeconomic status. The Gini coefficients and the concentration indexes were calculated to unveil trends in between-country inequality. The association between gender inequality and socioeconomic levels was analyzed by Pearson correlation. RESULTS Total age-standardized DALYs of AMD showed a slightly descending pattern in recent years. However, gender disparity has existed since 1990 for almost three decades, with female being more heavily impacted. This pattern became more obvious with aging and varied among different WHO and WBIL regions. Meanwhile, female subjects tended to have higher vision impairments. Gini coefficients of AMD burden increased from 0.423 to 0.448, while the ones of female-to-male ratio fluctuated around 0.11 between 1990 and 2017, with concentration indexes changing from 0.024 to -0.057 and 0.046 to 0.029 respectively. Female-minus-male difference (r = 0.1721, p = 0.0195) and female-to-male ratio (r = 0.2072, p = 0.0048) of age-standardized DALYs rates were positively related to HDI. CONCLUSIONS Though global AMD health care is progressing, gender imbalance in disease burden of AMD distribution barely improved. Gender sensitive health policy should be emphasized for the increasing elder population and relieving the higher AMD burden of females.
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Affiliation(s)
- Xiling Lin
- Department of Endocrinology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Lixia Lou
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Qi Miao
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Yijie Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Kai Jin
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Pengfei Shan
- Department of Endocrinology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Yufeng Xu
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
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Chao de la Barca JM, Rondet-Courbis B, Ferré M, Muller J, Buisset A, Leruez S, Plubeau G, Macé T, Moureauzeau L, Chupin S, Tessier L, Blanchet O, Lenaers G, Procaccio V, Mirebeau-Prunier D, Simard G, Gohier P, Miléa D, Reynier P. A Plasma Metabolomic Profiling of Exudative Age-Related Macular Degeneration Showing Carnosine and Mitochondrial Deficiencies. J Clin Med 2020; 9:jcm9030631. [PMID: 32120889 PMCID: PMC7141125 DOI: 10.3390/jcm9030631] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022] Open
Abstract
To determine the plasma metabolomic profile of exudative age-related macular degeneration (AMD), we performed a targeted metabolomics study on the plasma from patients (n = 40, mean age = 81.1) compared to an age- and sex-matched control group (n = 40, mean age = 81.8). All included patients had documented exudative AMD, causing significant visual loss (mean logMAR visual acuity = 0.63), compared to the control group. Patients and controls did not differ in terms of body mass index and co-morbidities. Among the 188 metabolites analyzed, 150 (79.8%) were accurately measured. The concentrations of 18 metabolites were significantly modified in the AMD group, but only six of them remained significantly different after Benjamini–Hochberg correction. Valine, lysine, carnitine, valerylcarnitine and proline were increased, while carnosine, a dipeptide disclosing anti-oxidant and anti-glycating properties, was, on average, reduced by 50% in AMD compared to controls. Moreover, carnosine was undetectable for 49% of AMD patients compared to 18% in the control group (p-value = 0.0035). Carnitine is involved in the transfer of fatty acids within the mitochondria; proline, lysine and valerylcarnitine are substrates for mitochondrial electrons transferring flavoproteins, and proline is one of the main metabolites supplying energy to the retina. Overall, our results reveal six new metabolites involved in the plasma metabolomic profile of exudative AMD, suggesting mitochondrial energetic impairments and carnosine deficiency.
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Affiliation(s)
- Juan M. Chao de la Barca
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (J.M.C.d.l.B.); (S.C.); (L.T.); (V.P.); (D.M.-P.); (G.S.)
- Unité Mixte de Recherche MITOVASC, équipe Mitolab, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Université d’Angers, 49933 Angers, France; (M.F.); (G.L.)
| | - Barnabé Rondet-Courbis
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Marc Ferré
- Unité Mixte de Recherche MITOVASC, équipe Mitolab, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Université d’Angers, 49933 Angers, France; (M.F.); (G.L.)
| | - Jeanne Muller
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Adrien Buisset
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Stéphanie Leruez
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Guillaume Plubeau
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Thibaut Macé
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Laurie Moureauzeau
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Stéphanie Chupin
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (J.M.C.d.l.B.); (S.C.); (L.T.); (V.P.); (D.M.-P.); (G.S.)
| | - Lydie Tessier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (J.M.C.d.l.B.); (S.C.); (L.T.); (V.P.); (D.M.-P.); (G.S.)
| | - Odile Blanchet
- Centre de Ressources Biologiques, BB-0033-00038, Centre Hospitalier Universitaire, 49933 Angers, France;
| | - Guy Lenaers
- Unité Mixte de Recherche MITOVASC, équipe Mitolab, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Université d’Angers, 49933 Angers, France; (M.F.); (G.L.)
| | - Vincent Procaccio
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (J.M.C.d.l.B.); (S.C.); (L.T.); (V.P.); (D.M.-P.); (G.S.)
- Unité Mixte de Recherche MITOVASC, équipe Mitolab, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Université d’Angers, 49933 Angers, France; (M.F.); (G.L.)
| | - Delphine Mirebeau-Prunier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (J.M.C.d.l.B.); (S.C.); (L.T.); (V.P.); (D.M.-P.); (G.S.)
- Unité Mixte de Recherche MITOVASC, équipe Mitolab, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Université d’Angers, 49933 Angers, France; (M.F.); (G.L.)
| | - Gilles Simard
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (J.M.C.d.l.B.); (S.C.); (L.T.); (V.P.); (D.M.-P.); (G.S.)
| | - Philippe Gohier
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
| | - Dan Miléa
- Département d’Ophtalmologie, Centre Hospitalier Universitaire, 49933 Angers, France; (B.R.-C.); (J.M.); (A.B.); (S.L.); (G.P.); (T.M.); (L.M.); (P.G.); (D.M.)
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore 168751, Singapore
| | - Pascal Reynier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (J.M.C.d.l.B.); (S.C.); (L.T.); (V.P.); (D.M.-P.); (G.S.)
- Unité Mixte de Recherche MITOVASC, équipe Mitolab, Centre National de la Recherche Scientifique 6015, Institut National de la Santé et de la Recherche Médicale U1083, Université d’Angers, 49933 Angers, France; (M.F.); (G.L.)
- Correspondence: ; Tel.: +33-241-353-314
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Heesterbeek TJ, Lorés-Motta L, Hoyng CB, Lechanteur YTE, den Hollander AI. Risk factors for progression of age-related macular degeneration. Ophthalmic Physiol Opt 2020; 40:140-170. [PMID: 32100327 PMCID: PMC7155063 DOI: 10.1111/opo.12675] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/18/2020] [Indexed: 12/18/2022]
Abstract
Purpose Age‐related macular degeneration (AMD) is a degenerative disease of the macula, often leading to progressive vision loss. The rate of disease progression can vary among individuals and has been associated with multiple risk factors. In this review, we provide an overview of the current literature investigating phenotypic, demographic, environmental, genetic, and molecular risk factors, and propose the most consistently identified risk factors for disease progression in AMD based on these studies. Finally, we describe the potential use of these risk factors for personalised healthcare. Recent findings While phenotypic risk factors such as drusen and pigment abnormalities become more important to predict disease progression during the course of the disease, demographic, environmental, genetic and molecular risk factors are more valuable at earlier disease stages. Demographic and environmental risk factors such as age and smoking are consistently reported to be related to disease progression, while other factors such as sex, body mass index (BMI) and education are less often associated. Of all known AMD variants, variants that are most consistently reported with disease progression are rs10922109 and rs570618 in CFH, rs116503776 in C2/CFB/SKIV2L, rs3750846 in ARMS2/HTRA1 and rs2230199 in C3. However, it seems likely that other AMD variants also contribute to disease progression but to a lesser extent. Rare variants have probably a large effect on disease progression in highly affected families. Furthermore, current prediction models do not include molecular risk factors, while these factors can be measured accurately in the blood. Possible promising molecular risk factors are High‐Density Lipoprotein Cholesterol (HDL‐C), Docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), zeaxanthin and lutein. Summary Phenotypic, demographic, environmental, genetic and molecular risk factors can be combined in prediction models to predict disease progression, but the selection of the proper risk factors for personalised risk prediction will differ among individuals and is dependent on their current disease stage. Future prediction models should include a wider set of genetic variants to determine the genetic risk more accurately, and rare variants should be taken into account in highly affected families. In addition, adding molecular factors in prediction models may lead to preventive strategies and personalised advice.
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Affiliation(s)
- Thomas J Heesterbeek
- Departments of, Department of, Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Laura Lorés-Motta
- Departments of, Department of, Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of, Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carel B Hoyng
- Departments of, Department of, Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yara T E Lechanteur
- Departments of, Department of, Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anneke I den Hollander
- Departments of, Department of, Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of, Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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O’Neil E, Serrano L, Scoles D, Cunningham KE, Han G, Chiang J, Bennett J, Aleman TS. Detailed retinal phenotype of Boucher-Neuhäuser syndrome associated with mutations in PNPLA6 mimicking choroideremia. Ophthalmic Genet 2019; 40:267-275. [DOI: 10.1080/13816810.2019.1605392] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Erin O’Neil
- Scheie Eye Institute and the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leona Serrano
- Scheie Eye Institute and the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- The Center for Advanced Retinal and Ocular Therapeutics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Drew Scoles
- Scheie Eye Institute and the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Grace Han
- Scheie Eye Institute and the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John Chiang
- Molecular Vision Laboratory, Hillsboro, OR, USA
| | - Jean Bennett
- Scheie Eye Institute and the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- The Center for Advanced Retinal and Ocular Therapeutics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tomas S. Aleman
- Scheie Eye Institute and the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- The Center for Advanced Retinal and Ocular Therapeutics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Laíns I, Duarte D, Barros AS, Martins AS, Carneiro TJ, Gil JQ, Miller JB, Marques M, Mesquita TS, Barreto P, Kim IK, da Luz Cachulo M, Vavvas DG, Carreira IM, Murta JN, Silva R, Miller JW, Husain D, Gil AM. Urine Nuclear Magnetic Resonance (NMR) Metabolomics in Age-Related Macular Degeneration. J Proteome Res 2019; 18:1278-1288. [PMID: 30672297 PMCID: PMC7838731 DOI: 10.1021/acs.jproteome.8b00877] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Biofluid biomarkers of age-related macular degeneration (AMD) are still lacking, and their identification is challenging. Metabolomics is well-suited to address this need, and urine is a valuable accessible biofluid. This study aimed to characterize the urinary metabolomic signatures of patients with different stages of AMD and a control group (>50 years). It was a prospective, cross-sectional study, where subjects from two cohorts were included: 305 from Coimbra, Portugal (AMD patients n = 252; controls n = 53) and 194 from Boston, United States (AMD patients n = 147; controls n = 47). For all participants, we obtained color fundus photographs (for AMD staging) and fasting urine samples, which were analyzed using 1H nuclear magnetic resonance (NMR) spectroscopy. Our results revealed that in both cohorts, urinary metabolomic profiles differed mostly between controls and late AMD patients, but important differences were also found between controls and subjects with early AMD. Analysis of the metabolites responsible for these separations revealed that, even though distinct features were observed for each cohort, AMD was in general associated with depletion of excreted citrate and selected amino acids at some stage of the disease, suggesting enhanced energy requirements. In conclusion, NMR metabolomics enabled the identification of urinary signals of AMD and its severity stages, which might represent potential metabolomic biomarkers of the disease.
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Affiliation(s)
- Inês Laíns
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Daniela Duarte
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - António S. Barros
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ana Sofia Martins
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Tatiana J. Carneiro
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - João Q. Gil
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - John B. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Marco Marques
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Tânia S. Mesquita
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
| | - Ivana K. Kim
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Maria da Luz Cachulo
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Demetrios G. Vavvas
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Isabel M. Carreira
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
| | - Joaquim Neto Murta
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Rufino Silva
- Faculty of Medicine, University of Coimbra (FMUC), 3000-354 Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), 3000-548 Coimbra, Portugal
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 3075 Coimbra, Portugal
| | - Joan W. Miller
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Deeba Husain
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Ana M. Gil
- CICECO- Aveiro Institute of Materials (CICECO/UA), Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
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