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Hui BTK, Yeong JL, Peto T, Willoughby CE. Glucagon-like Peptide 1 Receptor Agonist use and the effect on diabetic retinopathy: An uncertain relationship. Peptides 2024; 178:171240. [PMID: 38705472 DOI: 10.1016/j.peptides.2024.171240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/27/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024]
Abstract
Glucagon-like Peptide 1 Receptor Agonists (GLP-1 RAs) are a group of relatively novel medications for the treatment of diabetes mellitus. These medications can mimic the naturally occurring incretins of the body, which promote the release of insulin in response to hyperglycaemia. The anti-glycaemic effects of these medications can be profound and carry other metabolic benefits such as promoting weight loss. Clinical trials have shown GLP-1 RAs are safe to use from a cardiovascular perspective. However, some trials have suggested a link between GLP-1 RA use and worsening diabetic retinopathy. The conclusions surrounding this link are poorly established as data is drawn primarily from cardiovascular outcome trials. If an association does exist, a possible explanation might be the observed phenomenon of early worsening diabetic retinopathy with rapid correction of hyperglycaemic states. Trials which look at diabetic retinopathy as a primary outcome in relation to use of GLP-1 RAs are sparse and warrant investigation given the growing use of this group of medications. Therefore currently, it is uncertain what effect, beneficial or adverse, GLP-1 RA use has on diabetic retinopathy. This article provides an overview of GLP-1 RA use as a treatment for diabetes mellitus and the current understanding of their relationship with diabetic retinopathy.
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Affiliation(s)
- Benjamin T K Hui
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - Jian Lee Yeong
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - Tunde Peto
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, Northern Ireland, UK; Institute of Clinical Science, Queens University, Belfast, Northern Ireland, UK
| | - Colin E Willoughby
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, Northern Ireland, UK; Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, UK.
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2
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Armstrong L, Willoughby CE, McKenna DJ. The Suppression of the Epithelial to Mesenchymal Transition in Prostate Cancer through the Targeting of MYO6 Using MiR-145-5p. Int J Mol Sci 2024; 25:4301. [PMID: 38673886 PMCID: PMC11050364 DOI: 10.3390/ijms25084301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Aberrant expression of miR-145-5p has been observed in prostate cancer where is has been suggested to play a tumor suppressor role. In other cancers, miR-145-5p acts as an inhibitor of epithelial-to-mesenchymal transition (EMT), a key molecular process for tumor progression. However, the interaction between miR-145-5p and EMT remains to be elucidated in prostate cancer. In this paper the link between miR-145-5p and EMT in prostate cancer was investigated using a combination of in silico and in vitro analyses. miR-145-5p expression was significantly lower in prostate cancer cell lines compared to normal prostate cells. Bioinformatic analysis of The Cancer Genome Atlas prostate adenocarcinoma (TCGA PRAD) data showed significant downregulation of miR-145-5p in prostate cancer, correlating with disease progression. Functional enrichment analysis significantly associated miR-145-5p and its target genes with EMT. MYO6, an EMT-associated gene, was identified and validated as a novel target of miR-145-5p in prostate cancer cells. In vitro manipulation of miR-145-5p levels significantly altered cell proliferation, clonogenicity, migration and expression of EMT-associated markers. Additional TCGA PRAD analysis suggested miR-145-5p tumor expression may be useful predictor of disease recurrence. In summary, this is the first study to report that miR-145-5p may inhibit EMT by targeting MYO6 in prostate cancer cells. The findings suggest miR-145-5p could be a useful diagnostic and prognostic biomarker for prostate cancer.
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Affiliation(s)
| | | | - Declan J. McKenna
- Genomic Medicine Research Group, Ulster University, Cromore Road, Coleraine BT52 1SA, UK; (L.A.); (C.E.W.)
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Mc Lean K, Bignotti S, Callea M, Cammarata-Scalisi F, Steger B, Armstrong D, Lagan M, Sinton J, Semeraro F, Kaye SB, Romano V, Willoughby CE. Ocular phenotype and therapeutic interventions in keratitis-ichthyosis-deafness (KID) syndrome. Ophthalmic Genet 2024; 45:16-22. [PMID: 37755702 DOI: 10.1080/13816810.2023.2258218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND To report ocular manifestations, clinical course, and therapeutic management of patients with molecular genetically confirmed keratitis-ichthyosis-deafness syndrome. METHODS Four patients, aged 19 to 46, with keratitis-ichthyosis-deafness syndrome from across the UK were recruited for a general and ocular examination and GJB2 (Cx26) mutational analysis. The ocular examination included best-corrected visual acuity, slit-lamp bio-microscopy, and ocular surface assessment. Mutational analysis of the coding region of GJB2 (Cx26) was performed by bidirectional Sanger sequencing. RESULTS All four individuals had the characteristic systemic features of keratitis-ichthyosis-deafness syndrome. Each patient was found to have a missense mutation, resulting in the substitution of aspartic acid with asparagine at codon 50 (p.D50N). Main ophthalmic features were vascularizing keratopathy, ocular surface disease, hyperkeratotic lid lesions, recurrent epithelial defects, and corneal stromal scarring. One patient had multiple surgical procedures, including superficial keratectomies and lamellar keratoplasty, which failed to prevent severe visual loss. In contrast, oral therapy with ketoconazole stabilized the corneal and skin disease in two other patients with keratitis-ichthyosis-deafness syndrome. The patient who underwent intracorneal bevacizumab injection showed a marked reduction in corneal vascularization following a single application. CONCLUSIONS Keratitis-ichthyosis-deafness syndrome is a rare ectodermal dysplasia caused by heterozygous mutations in GJB2 (Cx26) with a severe, progressive vascularizing keratopathy. Oral ketoconazole therapy may offer benefit in stabilizing the corneal and skin disease.
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Affiliation(s)
- Keri Mc Lean
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, UK
| | - Stefano Bignotti
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Brescia, Italy
| | - Michele Callea
- Pediatric Dentistry and Special Dental Care Unit, Meyer Children's University Hospital IRCCS, Florence, Italy
| | | | - Bernhard Steger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - David Armstrong
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK
| | - Maeve Lagan
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK
| | - Janet Sinton
- Department of Ophthalmology, Altnagelvin Area Hospital, Londonderry, UK
| | - Francesco Semeraro
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Brescia, Italy
| | - Stephen B Kaye
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, UK
| | - Vito Romano
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, UK
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Brescia, Italy
| | - Colin E Willoughby
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, UK
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Cammarata-Scalisi F, Matysiak U, Willoughby CE, Ruzaike G, Cárdenas Tadich A, Araya Castillo M, Zara-Chirinos C, Bracho A, Avendaño A, Jilani H, Callea M. A Severe Case of Spondylometaphyseal Dysplasia Algerian Type with Two Mutations in COL2A1. J Pediatr Genet 2023; 12:339-341. [PMID: 38162154 PMCID: PMC10756726 DOI: 10.1055/s-0041-1732474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/07/2021] [Indexed: 10/20/2022]
Abstract
Spondylometaphyseal dysplasia Algerian type (MIM no.: 184253) is an uncommon autosomal dominant skeletal dysplasia caused by heterozygous mutations in the COL2A1 gene (MIM no.: 120140). In this case based review, we reported a 5-year-old boy with short stature, severe dorsolumbar scoliosis, lumbar hyperlordosis, short trunk, and severe genu valgum . Radiological examination showed platyspondyly, irregular metaphyseal radiolucencies intermingled with radiodensities, and corner fractures. The patient has a c.3275G > A; p.Gly1092Asp mutation in exon 47 of the COL2A1 gene and a variant of unknown significance in c.1366-13C > A in intron 21. This latter sequence variant could partially or completely disrupt the natural splice acceptor site of intron 21/exon 22 in the COL2A1 gene leading to a potential modification of the phenotypic severity.
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Affiliation(s)
| | - Uta Matysiak
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Colin E. Willoughby
- Genomic Medicine, School of Biomedical Sciences, Ulster University, Northern Ireland, United Kingdom
| | - Gunda Ruzaike
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | | | - Carmen Zara-Chirinos
- Institute of Genetic Research, Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Ana Bracho
- Institute of Genetic Research, Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Andrea Avendaño
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of Los Andes, Mérida, Venezuela
| | - Houweyda Jilani
- Genetic Department, Mongi Slim Hospital, Marsa, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
| | - Michele Callea
- Division of Dentistry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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5
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Cammarata-Scalisi F, Callea M, Chaudhary AK, Tadich AC, Castillo MA, Morabito A, Bellacchio E, Pisaneschi E, Novelli A, Willoughby CE, Bashyam MD. Novel EDA mutations cause X-linked hypohidrotic ectodermal dysplasia: the first study from Venezuela. Clin Exp Dermatol 2023; 48:1409-1413. [PMID: 37379583 DOI: 10.1093/ced/llad218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/07/2023] [Accepted: 06/24/2023] [Indexed: 06/30/2023]
Abstract
We present what, to the best of our knowledge, is the first clinical and molecular genetic analysis of X-linked hypohidrotic ectodermal dysplasia from the Venezuelan population. We analysed two families exhibiting classic clinical symptoms and identified a novel hemizygous EDA deletion (c.111delG) in one and a novel missense likely pathogenic variant (p.Gly192Glu) in the other.
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Affiliation(s)
- Francisco Cammarata-Scalisi
- Unit of Genetic Medicine, Department of Childcare Pediatrics, University of Los Andes, Mérida, Venezuela
- Service of Pediatrics, Regional Hospital of Antofagasta, Antofagasta, Chile
| | - Michele Callea
- Meyer Children's Hospital IRCCS, Pediatric Dentistry and Special Dental Care unit, Florence, Italy
| | - Ajay Kumar Chaudhary
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
| | | | | | - Antonino Morabito
- Department of Pediatric Surgery, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Neurosciences, Psychology Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- School of Health and Society, University of Salford, Salford, UK
| | | | - Elisa Pisaneschi
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Novelli
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Colin E Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland
| | - Murali Dharan Bashyam
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
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6
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Kathirvel K, Fan X, Haribalaganesh R, Bharanidharan D, Sharmila R, Krishnadas R, Muthukkaruppan V, Willoughby CE, Senthilkumari S. Small RNA Sequencing Reveals a Distinct MicroRNA Signature between Glucocorticoid Responder and Glucocorticoid Non-Responder Primary Human Trabecular Meshwork Cells after Dexamethasone Treatment. Genes (Basel) 2023; 14:2012. [PMID: 38002955 PMCID: PMC10671261 DOI: 10.3390/genes14112012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Glucocorticoids (GCs) are known to regulate several physiological processes and are the mainstay in the management of inflammatory eye diseases. The long-term use of GC causes raised intraocular pressure (IOP) or ocular hypertension (OHT) in about 30-50% of the susceptible individuals depending on the route of administration, and can lead to steroid-induced secondary glaucoma. The present study aims to understand the role of microRNAs (miRNAs) in differential glucocorticoid (GC) responsiveness in human trabecular meshwork (HTM) cells using small RNA sequencing. The human organ-cultured anterior segment (HOCAS) model was used to identify whether donor eyes were from GC-responders (GC-R; n = 4) or GC-non-responders (GC-NR; n = 4) following treatment with either 100 nM dexamethasone (DEX) or ethanol (ETH) for 7 days. The total RNA was extracted from cultured HTM cells with known GC responsiveness, and the differentially expressed miRNAs (DEMIRs) were compared among the following five groups: Group #1: ETH vs. DEX-treated GC-R; #2: ETH vs. DEX-treated GC-NR; #3: overlapping DEGs between Group #1 and #2; #4: Unique DEMIRs of GC-R; #5: Unique DEMIRs of GC-NR; and validated by RT-qPCR. There were 13 and 21 DEMIRs identified in Group #1 and Group #2, respectively. Seven miRNAs were common miRNAs dysregulated in both GC-R and GC-NR (Group #3). This analysis allowed the identification of DEMIRs that were unique to GC-R (6 miRNAs) and GC-NR (14 miRNAs) HTM cells, respectively. Ingenuity Pathway Analysis identified enriched pathways and biological processes associated with differential GC responsiveness in HTM cells. This is the first study to reveal a unique miRNA signature between GC-R and GC-NR HTM cells, which raises the possibility of developing new molecular targets for the management of steroid-OHT/glaucoma.
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Affiliation(s)
- Kandasamy Kathirvel
- Department of Ocular Pharmacology, Aravind Medical Research Foundation #1, Anna Nagar, Madurai 625020, Tamilnadu, India
- Department of Bioinformatics, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India;
| | - Xiaochen Fan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 7ZX, UK;
| | - Ravinarayanan Haribalaganesh
- Department of Ocular Pharmacology, Aravind Medical Research Foundation #1, Anna Nagar, Madurai 625020, Tamilnadu, India
| | - Devarajan Bharanidharan
- Department of Bioinformatics, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India;
| | | | - Ramasamy Krishnadas
- Glaucoma Clinic, Aravind Eye Hospital, Madurai 625020, Tamilnadu, India (R.K.)
| | | | - Colin E. Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, BT52 1SA Coleraine, UK
| | - Srinivasan Senthilkumari
- Department of Ocular Pharmacology, Aravind Medical Research Foundation #1, Anna Nagar, Madurai 625020, Tamilnadu, India
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7
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Armstrong L, Willoughby CE, McKenna DJ. Targeting of AKT1 by miR-143-3p Suppresses Epithelial-to-Mesenchymal Transition in Prostate Cancer. Cells 2023; 12:2207. [PMID: 37759434 PMCID: PMC10526992 DOI: 10.3390/cells12182207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
An altered expression of miR-143-3p has been previously reported in prostate cancer where it is purported to play a tumor suppressor role. Evidence from other cancers suggests miR-143-3p acts as an inhibitor of epithelial-to-mesenchymal transition (EMT), a key biological process required for metastasis. However, in prostate cancer the interaction between miR-143-3p and EMT-associated mechanisms remains unclear. Therefore, this paper investigated the link between miR-143-3p and EMT in prostate cancer using in vitro and in silico analyses. PCR detected that miR-143-3p expression was significantly decreased in prostate cancer cell lines compared to normal prostate cells. Bioinformatic analysis of The Cancer Genome Atlas Prostate Adenocarcinoma (TCGA PRAD) data showed a significant downregulation of miR-143-3p in prostate cancer, correlating with pathological markers of advanced disease. Functional enrichment analysis confirmed the significant association of miR-143-3p and its target genes with EMT. The EMT-linked gene AKT1 was subsequently shown to be a novel target of miR-143-3p in prostate cancer cells. The in vitro manipulation of miR-143-3p levels significantly altered the cell proliferation, clonogenicity, migration and expression of EMT-associated markers. Further TCGA PRAD analysis suggested miR-143-3p tumor expression may be a useful predictor of disease recurrence. In summary, this is the first study to report that miR-143-3p overexpression in prostate cancer may inhibit EMT by targeting AKT1. The findings suggest miR-143-3p could be a useful diagnostic and prognostic biomarker for prostate cancer.
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Affiliation(s)
| | | | - Declan J. McKenna
- Genomic Medicine Research Group, Ulster University, Cromore Road, Coleraine BT52 1SA, UK; (L.A.); (C.E.W.)
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8
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Cammarata-Scalisi F, Diociaiuti A, Cárdenas Tadich A, Sandoval X, Oranges T, Filippeschi C, Araya Castillo M, Willoughby CE, Cerri A, Gervasini C, Callea M. Dermatological findings in Rubinstein-Taybi Syndrome. Ital J Dermatol Venerol 2023; 158:316-320. [PMID: 37282850 DOI: 10.23736/s2784-8671.23.07547-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Rubinstein-Taybi Syndrome is a rare congenital multisystem syndrome inherited in an autosomal dominant pattern caused by mutations in CREBBP and EP300 genes in approximately 60% and 10% respectively. These genes encode two highly evolutionarily conserved, ubiquitously expressed, and homologous lysine-acetyltransferases, that are involved in number of basic cellular activities, such as DNA repair, cell proliferation, growth, differentiation, apoptosis of cells, and tumor suppression. It is mainly characterized by global developmental delay, moderate to severe intellectual disability, postnatal retardation, microcephaly, skeletal anomalies including broad/short, angled thumbs and/or large first toes, short stature, and dysmorphic facial features. There is an increased risk to develop tumors mainly meningiomas and pilomatrixomas, without a clear genotype-phenotype correlation. Although not considered as characteristic manifestations, numerous cutaneous anomalies have also been reported in patients with this entity. Both susceptibility to the formation of keloids and pilomatricomas are the most often associated cutaneous features. In this review, we discuss the genetics, diagnosis, and clinical features in Rubinstein-Taybi Syndrome with a review of the major dermatological manifestations.
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Affiliation(s)
| | | | | | - Ximena Sandoval
- Pediatrics Service, Regional of Antofagasta Hospital, Antofagasta, Chile
| | - Teresa Oranges
- Unit of Dermatology, Department of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Cesare Filippeschi
- Unit of Dermatology, Department of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | | | - Amilcare Cerri
- Dermatological Clinic, Department of Health Sciences, AO Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Cristina Gervasini
- Medical Genetics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Michele Callea
- Pediatric Dentistry and Special Dental Care Unit, Meyer Children's Hospital IRCCS, Florence, Italy
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9
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Callea M, Bellacchio E, Cammarata Scalisi F, El Feghaly J, El-Ghandour RK, Avendaño A, Yavuz Y, Diociaiuti A, Digilio MC, DI Stazio M, Novelli A, Oranges T, Filippeschi C, Pisaneschi E, Jilani H, Gigola F, Willoughby CE, Morabito A. Next generation sequencing panel target genes: possible diagnostic tool for ectodermal dysplasia related diseases. Ital J Dermatol Venerol 2023; 158:32-38. [PMID: 36939501 DOI: 10.23736/s2784-8671.23.07540-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND Ectodermal dysplasias (EDs) are a large and complex group of disorders affecting the ectoderm-derived organs; the clinical and genetic heterogeneity of these conditions renders an accurate diagnosis more challenging. The aim of this study is to demonstrate the clinical utility of a targeted resequencing panel through enhancing the molecular and clinical diagnosis of EDs. Given the recent developments in gene and protein-based therapies for X-linked hypohidrotic ectodermal dysplasia, there is a re-emerging interest in identifying the genetic basis of EDs and the respective phenotypic presentations, in an aim to facilitate potential treatments for affected families. METHODS We assessed seventeen individuals, from three unrelated families, who presented with diverse phenotypes suggestive of ED. An extensive multidisciplinary clinical evaluation was performed followed by a targeted exome resequencing panel (including genes that are known to cause EDs). MiSeqTM data software was used, variants with Qscore >30 were accepted. RESULTS Three different previously reported hemizygous EDA mutations were found in the families. However, a complete genotype-phenotype correlation could not be established, neither in our patients nor in the previously reported patients. CONCLUSIONS Targeted exome resequencing can provide a rapid and accurate diagnosis of EDs, while further contributing to the existing ED genetic data. Moreover, the identification of the disease-causing mutation in an affected family is crucial for proper genetic counseling and the establishment of a genotype-phenotype correlation which will subsequently provide the affected individuals with a more suitable treatment plan.
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Affiliation(s)
- Michele Callea
- Unit of Pediatric Dentistry and Special Dental Care, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | | | - Jinia El Feghaly
- Department of Pediatric Dermatology, University of Rochester, Rochester, MN, USA
| | - Rabab K El-Ghandour
- Department of Pediatric Dentistry, Faculty of Dentistry, Pharos University, Alexandria, Egypt
| | - Andrea Avendaño
- Unit of Genetic Medicine, Department of Childcare Pediatrics, University of Los Andes, Mérida, Venezuela
| | - Yasemine Yavuz
- Department of Restorative Dentistry, Faculty of Dentistry, Harran University, Sanliurfa, Türkiye
| | - Andrea Diociaiuti
- Division of Dermatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria C Digilio
- Division of Genetics and Rare Diseases Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Antonio Novelli
- Division of Genetics and Rare Diseases Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | | | - Elisa Pisaneschi
- Division of Genetics and Rare Diseases Research, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Houweyda Jilani
- Department of Genetics, Mongi Slim Hospital, Marsa, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Francesca Gigola
- Department of Neurofarba, University of Florence, Florence, Italy -
- Department of Pediatric Surgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | - Antonino Morabito
- Department of Neurofarba, University of Florence, Florence, Italy
- Department of Pediatric Surgery, Meyer Children's Hospital IRCCS, Florence, Italy
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10
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Callaghan B, Vallabh NA, Willoughby CE. Deuterated polyunsaturated fatty acids provided protection against oxidative stress in ocular fibroblasts derived from glaucoma patients. Mech Ageing Dev 2023; 211:111778. [PMID: 36716826 DOI: 10.1016/j.mad.2023.111778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/09/2023] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
Glaucoma is a complex neurodegenerative disease of the optic nerve that leads to irreversible sight loss. Lowering intraocular pressure (IOP) medically or surgically represents the mainstay of treatment but despite adequate treatment optic nerve function can continue to deteriorate leading to blindness. There is significant clinical and experimental evidence that oxidative stress is involved in the pathogenesis of glaucoma. Decreasing the formation of lipid peroxidation products or scavenging them chemically could be beneficial in limiting the deleterious effects of oxidative stress in glaucoma. A solution to control the susceptibility of PUFAs to noxious lipid peroxidation reactions is by regioselective deuteration. Deuterium incorporated into PUFAs at bis-allylic positions (D-PUFAs) inhibits the rate-limiting step of lipid peroxidation. In this study, we have shown that Tenon's ocular fibroblasts from glaucoma patients have significantly increased basal oxidative stress compared to non-glaucomatous control patients. Furthermore, we have shown that deuterated polyunsaturated fatty acids (D-PUFAs) provide an enhanced rescue of menadione induced lipid peroxidation in both non-glaucomatous and glaucomatous Tenon's ocular fibroblasts using malondialdehyde (MDA) levels as a marker. Our study suggests that D-PUFAs may provide a potentially safe and effective method to reduce cytotoxic oxidative stress in glaucoma.
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Affiliation(s)
- Breedge Callaghan
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine Campus, Coleraine BT52 1SA, Northern Ireland, United Kingdom
| | - Neeru A Vallabh
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - Colin E Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine Campus, Coleraine BT52 1SA, Northern Ireland, United Kingdom; Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, United Kingdom.
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11
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Coan LJ, Williams BM, Krishna Adithya V, Upadhyaya S, Alkafri A, Czanner S, Venkatesh R, Willoughby CE, Kavitha S, Czanner G. Automatic detection of glaucoma via fundus imaging and artificial intelligence: A review. Surv Ophthalmol 2023; 68:17-41. [PMID: 35985360 DOI: 10.1016/j.survophthal.2022.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 02/01/2023]
Abstract
Glaucoma is a leading cause of irreversible vision impairment globally, and cases are continuously rising worldwide. Early detection is crucial, allowing timely intervention that can prevent further visual field loss. To detect glaucoma an examination of the optic nerve head via fundus imaging can be performed, at the center of which is the assessment of the optic cup and disc boundaries. Fundus imaging is noninvasive and low-cost; however, image examination relies on subjective, time-consuming, and costly expert assessments. A timely question to ask is: "Can artificial intelligence mimic glaucoma assessments made by experts?" Specifically, can artificial intelligence automatically find the boundaries of the optic cup and disc (providing a so-called segmented fundus image) and then use the segmented image to identify glaucoma with high accuracy? We conducted a comprehensive review on artificial intelligence-enabled glaucoma detection frameworks that produce and use segmented fundus images and summarized the advantages and disadvantages of such frameworks. We identified 36 relevant papers from 2011 to 2021 and 2 main approaches: 1) logical rule-based frameworks, based on a set of rules; and 2) machine learning/statistical modeling-based frameworks. We critically evaluated the state-of-art of the 2 approaches, identified gaps in the literature and pointed at areas for future research.
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Affiliation(s)
- Lauren J Coan
- School of Computer Science and Mathematics, Liverpool John Moores University, UK.
| | - Bryan M Williams
- School of Computing and Communications, Lancaster University, UK
| | | | - Swati Upadhyaya
- Department of Glaucoma, Aravind Eye Hospital, Pondicherry, India
| | - Ala Alkafri
- School of Computing, Engineering & Digital Technologies, Teesside University, UK
| | - Silvester Czanner
- School of Computer Science and Mathematics, Liverpool John Moores University, UK; Faculty of Informatics and Information Technologies, Slovak University of Technology, Slovakia
| | - Rengaraj Venkatesh
- Department of Glaucoma and Chief Medical Officer, Aravind Eye Hospital, Pondicherry, India
| | | | | | - Gabriela Czanner
- School of Computer Science and Mathematics, Liverpool John Moores University, UK; Faculty of Informatics and Information Technologies, Slovak University of Technology, Slovakia
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12
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Roodnat AW, Callaghan B, Doyle C, Henry M, Goljanek-Whysall K, Simpson DA, Sheridan C, Atkinson SD, Willoughby CE. Genome-Wide RNA Sequencing of Human Trabecular Meshwork Cells Treated with TGF-β1: Relevance to Pseudoexfoliation Glaucoma. Biomolecules 2022; 12:1693. [PMID: 36421707 PMCID: PMC9687758 DOI: 10.3390/biom12111693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/15/2022] [Accepted: 11/10/2022] [Indexed: 08/11/2023] Open
Abstract
Pseudoexfoliation glaucoma (XFG) is an aggressive form of secondary open angle glaucoma, characterised by the production of exfoliation material and is estimated to affect 30 million people worldwide. Activation of the TGF-β pathway by TGF-β1 has been implicated in the pathogenesis of pseudoexfoliation glaucoma. To further investigate the role of TGF-β1 in glaucomatous changes in the trabecular meshwork (TM), we used RNA-Seq to determine TGF-β1 induced changes in the transcriptome of normal human trabecular meshwork (HTM) cells. The main purpose of this study was to perform a hypothesis-independent RNA sequencing analysis to investigate genome-wide alterations in the transcriptome of normal HTMs stimulated with TGF-β1 and investigate possible pathophysiological mechanisms driving XFG. Our results identified multiple differentially expressed genes including several genes known to be present in exfoliation material. Significantly altered pathways, biological processes and molecular functions included extracellular matrix remodelling, Hippo and Wnt pathways, the unfolded protein response, oxidative stress, and the antioxidant system. This cellular model of pseudoexfoliation glaucoma can provide insight into disease pathogenesis and support the development of novel therapeutic interventions.
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Affiliation(s)
- Anton W. Roodnat
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine Campus, Coleraine BT52 1SA, Northern Ireland, UK
- Personalised Medicine Centre, Ulster University, Londonderry BT47 6SB, Northern Ireland, UK
| | - Breedge Callaghan
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine Campus, Coleraine BT52 1SA, Northern Ireland, UK
| | - Chelsey Doyle
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine Campus, Coleraine BT52 1SA, Northern Ireland, UK
| | - Megan Henry
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine Campus, Coleraine BT52 1SA, Northern Ireland, UK
| | - Katarzyna Goljanek-Whysall
- School of Medicine, Physiology, National University of Ireland Galway, H91 W5P7 Galway, Ireland
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, England, UK
| | - David A. Simpson
- The Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK
| | - Carl Sheridan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, England, UK
| | - Sarah D. Atkinson
- Personalised Medicine Centre, Ulster University, Londonderry BT47 6SB, Northern Ireland, UK
| | - Colin E. Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine Campus, Coleraine BT52 1SA, Northern Ireland, UK
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, England, UK
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13
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Weiss JS, Willoughby CE, Abad-Morales V, Turunen JA, Lisch W. Update on the Corneal Dystrophies-Genetic Testing and Therapy. Cornea 2022; 41:1337-1344. [PMID: 36219210 DOI: 10.1097/ico.0000000000002857] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/07/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT One major purpose of the IC3D Corneal Dystrophy Nomenclature Revision was to include genetic information with a goal of facilitating investigation into the pathogenesis, treatment, and perhaps even prevention of the corneal dystrophies, an ambitious goal. Over a decade has passed since the first publication of the IC3D Corneal Dystrophy Nomenclature Revision. Gene therapy is available for an early-onset form of inherited retinal degeneration called Leber congenital amaurosis, but not yet for corneal degenerations. We review the current state of affairs regarding our original ambitious goal. We discuss genetic testing, gene therapy [RNA interference (RNAi) and genome editing], and ocular delivery of corneal gene therapy for the corneal dystrophies. Why have gene therapy techniques not yet been introduced for the corneal dystrophies?
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Affiliation(s)
- Jayne S Weiss
- Department of Ophthalmology, Pathology and Pharmacology, Louisiana State University School of Medicine, New Orleans, LA
| | - Colin E Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Víctor Abad-Morales
- Fundació de Recerca de l'Institut de Microcirurgia Ocular, Barcelona, Spain
- Department of Genetics, Institut de Microcirurgia Ocular (IMO), Barcelona, Spain; Dr. Abad-Morales is now with the SpliceBio, Barcelona, Spain, Barcelona, Spain
| | - Joni A Turunen
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland; and
| | - Walter Lisch
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg, University Mainz, Mainz, Germany
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14
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Vallabh NA, Armstrong J, Czanner G, McDonagh B, Choudhary A, Criddle DN, Willoughby CE. Evidence of impaired mitochondrial cellular bioenergetics in ocular fibroblasts derived from glaucoma patients. Free Radic Biol Med 2022; 189:102-110. [PMID: 35872337 DOI: 10.1016/j.freeradbiomed.2022.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/29/2022] [Accepted: 07/12/2022] [Indexed: 11/20/2022]
Abstract
Glaucoma is a progressive optic neuropathy characterized by the neurodegeneration of the retinal ganglion cells (RGCs) resulting in irreversible visual impairment and eventual blindness. RGCs are extremely susceptible to mitochondrial compromise due to their marked bioenergetic requirements and morphology. There is increasing interest in therapies targeting mitochondrial health as a method of preventing visual loss in managing glaucoma. The bioenergetic profile of Tenon's ocular fibroblasts from glaucoma patients and controls was investigated using the Seahorse XF24 analyser. Impaired mitochondrial cellular bioenergetics was detected in glaucomatous ocular fibroblasts including basal respiration, maximal respiration and spare capacity. Spare respiratory capacity levels reflect mitochondrial bio-energetic adaptability in response to pathophysiological stress. Basal oxidative stress was elevated in glaucomatous Tenon's ocular fibroblasts and hydrogen peroxide (H2O2) induced reactive oxygen species (ROS) simulated the glaucomatous condition in normal Tenon's ocular fibroblasts. This work supports the role of therapeutic interventions to target oxidative stress or provide mitochondrial energetic support in glaucoma.
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Affiliation(s)
- Neeru A Vallabh
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L69 3BX, United Kingdom; St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, United Kingdom
| | - Jane Armstrong
- Institute of Systems, Molecular and Integrative Biology, Biosciences Building, University of Liverpool, Liverpool, L69 7BE, United Kingdom
| | - Gabriela Czanner
- School of Computer Science and Mathematics, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom; Faculty of Informatics and Information Technology, Slovak University of Technology, 842 16, Bratislava, Slovakia
| | - Brian McDonagh
- Discipline of Physiology, School of Medicine, National University of Ireland, Galway, Ireland
| | - Anshoo Choudhary
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, United Kingdom
| | - David N Criddle
- Institute of Systems, Molecular and Integrative Biology, Biosciences Building, University of Liverpool, Liverpool, L69 7BE, United Kingdom
| | - Colin E Willoughby
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L69 3BX, United Kingdom; Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, BT52 1SA, United Kingdom.
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15
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Callaghan B, Lester K, Lane B, Fan X, Goljanek-Whysall K, Simpson DA, Sheridan C, Willoughby CE. Genome-wide transcriptome profiling of human trabecular meshwork cells treated with TGF-β2. Sci Rep 2022; 12:9564. [PMID: 35689009 PMCID: PMC9187693 DOI: 10.1038/s41598-022-13573-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 05/13/2022] [Indexed: 12/30/2022] Open
Abstract
Glaucoma is a complex neurodegenerative disease resulting in progressive optic neuropathy and is a leading cause of irreversible blindness worldwide. Primary open angle glaucoma (POAG) is the predominant form affecting 65.5 million people globally. Despite the prevalence of POAG and the identification of over 120 glaucoma related genetic loci, the underlaying molecular mechanisms are still poorly understood. The transforming growth factor beta (TGF-β) signalling pathway is implicated in the molecular pathology of POAG. To gain a better understanding of the role TGF-β2 plays in the glaucomatous changes to the molecular pathology in the trabecular meshwork, we employed RNA-Seq to delineate the TGF-β2 induced changes in the transcriptome of normal primary human trabecular meshwork cells (HTM). We identified a significant number of differentially expressed genes and associated pathways that contribute to the pathogenesis of POAG. The differentially expressed genes were predominantly enriched in ECM regulation, TGF-β signalling, proliferation/apoptosis, inflammation/wound healing, MAPK signalling, oxidative stress and RHO signalling. Canonical pathway analysis confirmed the enrichment of RhoA signalling, inflammatory-related processes, ECM and cytoskeletal organisation in HTM cells in response to TGF-β2. We also identified novel genes and pathways that were affected after TGF-β2 treatment in the HTM, suggesting additional pathways are activated, including Nrf2, PI3K-Akt, MAPK and HIPPO signalling pathways. The identification and characterisation of TGF-β2 dependent differentially expressed genes and pathways in HTM cells is essential to understand the patho-physiology of glaucoma and to develop new therapeutic agents.
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Affiliation(s)
- Breedge Callaghan
- Genomic Medicine Group, Biomedical Sciences Research Institute, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Karen Lester
- Genomic Medicine Group, Biomedical Sciences Research Institute, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK.,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
| | - Brian Lane
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK.,Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust Hospital, Manchester, M20 4BX, UK
| | - Xiaochen Fan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
| | - Katarzyna Goljanek-Whysall
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK.,School of Medicine, Physiology, National University of Ireland Galway, Galway, H91 W5P7, Ireland
| | - David A Simpson
- The Wellcome - Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Carl Sheridan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
| | - Colin E Willoughby
- Genomic Medicine Group, Biomedical Sciences Research Institute, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK. .,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK.
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16
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Vallabh NA, Sambare C, Muszynska-Lyons D, Patiyal S, Kelkar A, Killedar M, Malani S, Prabhudesai M, Walimbe T, McKay GJ, Willoughby CE. Prevalence of risk alleles in the lysyl oxidase-like 1 gene in pseudoexfoliation glaucoma patients in India. Indian J Ophthalmol 2022; 70:2024-2028. [PMID: 35647973 PMCID: PMC9359290 DOI: 10.4103/ijo.ijo_2664_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: The purpose of this study was to genotype two previously identified SNPs (rs1048661:R141L, and rs3825942:G153D) in the lysyl oxidase-like 1 (LOXL1) gene and determine their association with pseudoexfoliation glaucoma (XFG) in patients from Pune, India. Methods: All subjects underwent detailed phenotyping, and DNA extraction was performed on blood samples by using standardized techniques. Exon 1 of the LOXL1 gene containing the SNPs (rs3825942:G153D; rs1048661:R141L) were Sanger sequenced, and the results were analyzed using sequence analysis software SeqScape 2.1.1. Results: Data were analyzed from 71 patients with XFG and 81 disease-negative, age-matched controls. There was a strong association between the G allele of rs3825942 and XFG with an odds ratio of 10.2 (CI: 3.92–26.6; P < 0.001). The G allele of rs1048661 also showed an increase in risk relative to the T allele (OR = 1.49; CI: 0.88–2.51; P = 0.13), but this was not significant. Haplotype combination frequencies were estimated for rs1048661 and rs3825942; the GG haplotype was associated with a significant increase in risk (OR = 3.91; CI: 2.27–6.73; P < 0.001). Both the GA and TG haplotypes were associated with decreased XFG risk, although the latter was not significant (GA: OR = 0.08; CI: 0.03–0.21; P < 0.001; TG: OR = 0.67; CI: 0.40–1.13; P = 0.13). Conclusion: The risk G allele in rs3852942 (G153D) is strongly associated with the development of XFG in the Western Indian population. Genetic screening strategies to identify LOXL1 risk alleles in the population can assist in case definition and early diagnosis, targeting precious resources to high-risk patients.
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Affiliation(s)
- Neeru A Vallabh
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool; Department of Ophthalmology, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Chitra Sambare
- Department of Ophthalmology, Shashwat Hospital, Kothrud, Pune, Maharashtra, India
| | - Dorota Muszynska-Lyons
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Sagarika Patiyal
- Departmen of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Aditya Kelkar
- Department of Ophthalmology, National Institute of Ophthalmology, Pune, Maharashtra, India
| | - Milind Killedar
- Department of Ophthalmology, Anuradha Eye Hospital, Sangali, Maharashtra, India
| | - Sangeeta Malani
- Department of Ophthalmology, Anuradha Eye Hospital, Sangali, Maharashtra, India
| | - Medha Prabhudesai
- Department of Ophthalmology, Prabhudesai Eye Clinic, Pune, Maharashtra, India
| | - Tejaswini Walimbe
- Department of Ophthalmology, Walimbe Eye Clinic, Pune, Maharashtra, India
| | - Gareth J McKay
- Department of Ophthalmology,Centre for Public Health, Queen's University, Belfast, United Kingdom
| | - Colin E Willoughby
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool; Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
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17
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Kathirvel K, Haribalaganesh R, Krishnadas R, Muthukkaruppan V, Willoughby CE, Bharanidharan D, Senthilkumari S. A Comparative Genome-Wide Transcriptome Analysis of Glucocorticoid Responder and Non-Responder Primary Human Trabecular Meshwork Cells. Genes (Basel) 2022; 13:882. [PMID: 35627267 PMCID: PMC9140469 DOI: 10.3390/genes13050882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
Aim: To investigate genes and pathways involved in differential glucocorticoid (GC) responsiveness in human trabecular meshwork (HTM) cells using RNA sequencing. Methods: Using paired human donor eyes, human organ-cultured anterior segment (HOCAS) was established in one eye to characterize GC responsiveness based on intra ocular pressure (IOP) change and, in the other eye, primary HTM cell culture was established. For RNA sequencing, total RNA extracted from GC-responder (GC-R) and non-responder (GC-NR) cells after dexamethasone (DEX) or ethanol (ETH) treatment for 7d was used. Differentially expressed genes (DEGs) were compared among five groups and validated. Results: In total, 616 and 216 genes were identified as significantly dysregulated in Group #1 and #2 (#1: ETH vs. DEX-treated GC-R; #2: ETH vs. DEX-treated GC-NR), respectively. Around 80 genes were commonly dysregulated in Group #3 (overlapping DEGs between #1 and #2), whereas 536 and 136 genes were uniquely expressed in GC-R (#4) and GC-NR HTM (#5) cells, respectively. Pathway analysis revealed that WNT signaling, drug metabolism cytochrome p450, cell adhesion, TGF-β signaling, and MAPK signaling were associated with GC responsiveness. Conclusion: This is the first study reporting distinct gene signatures and their associated pathways for GC-R and GC-NR HTM cells. WNT and MAPK signaling are potential therapeutic targets for the management of GC-induced glaucoma.
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Affiliation(s)
- Kandasamy Kathirvel
- Department of Ocular Pharmacology, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India; (K.K.); (R.H.)
- Department of Bioinformatics, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India;
| | - Ravinarayanan Haribalaganesh
- Department of Ocular Pharmacology, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India; (K.K.); (R.H.)
| | | | - Veerappan Muthukkaruppan
- Department of Immunology and Stem Cell Biology, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India;
| | - Colin E. Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Newtownabbey BT37 0QB, UK;
| | - Devarajan Bharanidharan
- Department of Bioinformatics, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India;
| | - Srinivasan Senthilkumari
- Department of Ocular Pharmacology, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India; (K.K.); (R.H.)
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18
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McDowell CM, Kizhatil K, Elliott MH, Overby DR, van Batenburg-Sherwood J, Millar JC, Kuehn MH, Zode G, Acott TS, Anderson MG, Bhattacharya SK, Bertrand JA, Borras T, Bovenkamp DE, Cheng L, Danias J, De Ieso ML, Du Y, Faralli JA, Fuchshofer R, Ganapathy PS, Gong H, Herberg S, Hernandez H, Humphries P, John SWM, Kaufman PL, Keller KE, Kelley MJ, Kelly RA, Krizaj D, Kumar A, Leonard BC, Lieberman RL, Liton P, Liu Y, Liu KC, Lopez NN, Mao W, Mavlyutov T, McDonnell F, McLellan GJ, Mzyk P, Nartey A, Pasquale LR, Patel GC, Pattabiraman PP, Peters DM, Raghunathan V, Rao PV, Rayana N, Raychaudhuri U, Reina-Torres E, Ren R, Rhee D, Chowdhury UR, Samples JR, Samples EG, Sharif N, Schuman JS, Sheffield VC, Stevenson CH, Soundararajan A, Subramanian P, Sugali CK, Sun Y, Toris CB, Torrejon KY, Vahabikashi A, Vranka JA, Wang T, Willoughby CE, Xin C, Yun H, Zhang HF, Fautsch MP, Tamm ER, Clark AF, Ethier CR, Stamer WD. Consensus Recommendation for Mouse Models of Ocular Hypertension to Study Aqueous Humor Outflow and Its Mechanisms. Invest Ophthalmol Vis Sci 2022; 63:12. [PMID: 35129590 PMCID: PMC8842499 DOI: 10.1167/iovs.63.2.12] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/08/2021] [Indexed: 01/07/2023] Open
Abstract
Due to their similarities in anatomy, physiology, and pharmacology to humans, mice are a valuable model system to study the generation and mechanisms modulating conventional outflow resistance and thus intraocular pressure. In addition, mouse models are critical for understanding the complex nature of conventional outflow homeostasis and dysfunction that results in ocular hypertension. In this review, we describe a set of minimum acceptable standards for developing, characterizing, and utilizing mouse models of open-angle ocular hypertension. We expect that this set of standard practices will increase scientific rigor when using mouse models and will better enable researchers to replicate and build upon previous findings.
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Affiliation(s)
- Colleen M. McDowell
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | | | - Michael H. Elliott
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Darryl R. Overby
- Department of Bioengineering, Imperial College London, United Kingdom
| | | | - J. Cameron Millar
- Department of Pharmacology & Neuroscience, and North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Markus H. Kuehn
- Department of Ophthalmology and Visual Sciences and Institute for Vision Research, The University of Iowa; Center for the Prevention and Treatment of Visual Loss, Veterans Affairs Medical Center, Iowa City, Iowa, United States
| | - Gulab Zode
- Department of Pharmacology & Neuroscience, and North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Ted S. Acott
- Ophthalmology and Biochemistry and Molecular Biology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Michael G. Anderson
- Department of Molecular Physiology and Biophysics and Department of Ophthalmology and Visual Sciences, The University of Iowa; Center for the Prevention and Treatment of Visual Loss, Veterans Affairs Medical Center, Iowa City, Iowa, United States
| | | | - Jacques A. Bertrand
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Terete Borras
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | | | - Lin Cheng
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
| | - John Danias
- SUNY Downstate Health Sciences University, Brooklyn, New York, United States
| | - Michael Lucio De Ieso
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, North Carolina, United States
| | - Yiqin Du
- Department of Ophthalmology, University of Pittsburgh, Pennsylvania, United States
| | - Jennifer A. Faralli
- Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Rudolf Fuchshofer
- Institute of Human Anatomy and Embryology, University of Regensburg, Regensburg, Germany
| | - Preethi S. Ganapathy
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, New York, United States
| | - Haiyan Gong
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Samuel Herberg
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, New York, United States
| | | | - Peter Humphries
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Simon W. M. John
- Department of Ophthalmology, Columbia University, New York, New York, United States
| | - Paul L. Kaufman
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Kate E. Keller
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Mary J. Kelley
- Department of Ophthalmology and Department of Integrative Biosciences, Oregon Health & Science University, Portland, Oregon, United States
| | - Ruth A. Kelly
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - David Krizaj
- Department of Ophthalmology, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Ajay Kumar
- Department of Ophthalmology, University of Pittsburgh, Pennsylvania, United States
| | - Brian C. Leonard
- Department of Surgical and Radiological Sciences, University of California, Davis, Davis, California, United States
| | - Raquel L. Lieberman
- Department of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia, United States
| | - Paloma Liton
- Department of Ophthalmology and Department of Pathology, Duke University, Durham, North Carolina, United States
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, James & Jean Culver Vision Discovery Institute, Augusta University, Augusta, Georgia, United States
| | - Katy C. Liu
- Duke Eye Center, Duke Health, Durham, North Carolina, United States
| | - Navita N. Lopez
- Department of Neurobiology, University of Utah, Salt Lake City, Utah, United States
| | - Weiming Mao
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Timur Mavlyutov
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Fiona McDonnell
- Duke Eye Center, Duke Health, Durham, North Carolina, United States
| | - Gillian J. McLellan
- Department of Surgical Sciences and Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Philip Mzyk
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Andrews Nartey
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Louis R. Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Gaurang C. Patel
- Ophthalmology Research, Regeneron Pharmaceuticals, Tarreytown, New York, United States
| | | | - Donna M. Peters
- Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | | | - Ponugoti Vasantha Rao
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, United States
| | - Naga Rayana
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Urmimala Raychaudhuri
- Department of Neurobiology, University of California, Irvine, Irvine, California, United States
| | - Ester Reina-Torres
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Ruiyi Ren
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Douglas Rhee
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Uttio Roy Chowdhury
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
| | - John R. Samples
- Washington State University, Floyd Elson College of Medicine, Spokane, Washington, United States
| | | | - Najam Sharif
- Santen Inc., Emeryville, California, United States
| | - Joel S. Schuman
- Department of Ophthalmology and Department of Physiology and Neuroscience, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States; Departments of Biomedical Engineering and Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States; Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States
| | - Val C. Sheffield
- Department of Pediatrics and Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | - Cooper H. Stevenson
- Department of Pharmacology & Neuroscience, and North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Avinash Soundararajan
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | | | - Chenna Kesavulu Sugali
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Yang Sun
- Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, California, United States
| | - Carol B. Toris
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska, United States; Department of Ophthalmology and Vision Sciences, The Ohio State University, Columbus, Ohio, United States
| | | | - Amir Vahabikashi
- Cell and Developmental Biology Department, Northwestern University, Chicago, Illinois, United States
| | - Janice A. Vranka
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Ting Wang
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Colin E. Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Chen Xin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hongmin Yun
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Hao F. Zhang
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois, United States
| | - Michael P. Fautsch
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois, United States
| | | | - Abbot F. Clark
- Department of Pharmacology and Neuroscience, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - C. Ross Ethier
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology; Emory University School of Medicine, Emory University, Atlanta, Georgia, United States
| | - W. Daniel Stamer
- Duke Ophthalmology, Duke University, Durham, North Carolina, United States
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19
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Fan X, Bilir EK, Kingston OA, Oldershaw RA, Kearns VR, Willoughby CE, Sheridan CM. Replacement of the Trabecular Meshwork Cells-A Way Ahead in IOP Control? Biomolecules 2021; 11:biom11091371. [PMID: 34572584 PMCID: PMC8464777 DOI: 10.3390/biom11091371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/11/2022] Open
Abstract
Glaucoma is one of the leading causes of vision loss worldwide, characterised with irreversible optic nerve damage and progressive vision loss. Primary open-angle glaucoma (POAG) is a subset of glaucoma, characterised by normal anterior chamber angle and raised intraocular pressure (IOP). Reducing IOP is the main modifiable factor in the treatment of POAG, and the trabecular meshwork (TM) is the primary site of aqueous humour outflow (AH) and the resistance to outflow. The structure and the composition of the TM are key to its function in regulating AH outflow. Dysfunction and loss of the TM cells found in the natural ageing process and more so in POAG can cause abnormal extracellular matrix (ECM) accumulation, increased TM stiffness, and increased IOP. Therefore, repair or regeneration of TM's structure and function is considered as a potential treatment for POAG. Cell transplantation is an attractive option to repopulate the TM cells in POAG, but to develop a cell replacement approach, various challenges are still to be addressed. The choice of cell replacement covers autologous or allogenic approaches, which led to investigations into TM progenitor cells, induced pluripotent stem cells (iPSCs), and mesenchymal stem cells (MSCs) as potential stem cell source candidates. However, the potential plasticity and the lack of definitive cell markers for the progenitor and the TM cell population compound the biological challenge. Morphological and differential gene expression of TM cells located within different regions of the TM may give rise to different cell replacement or regenerative approaches. As such, this review describes the different approaches taken to date investigating different cell sources and their differing cell isolation and differentiation methodologies. In addition, we highlighted how these approaches were evaluated in different animal and ex vivo model systems and the potential of these methods in future POAG treatment.
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Affiliation(s)
- Xiaochen Fan
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (X.F.); (E.K.B.); (O.A.K.); (V.R.K.)
| | - Emine K. Bilir
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (X.F.); (E.K.B.); (O.A.K.); (V.R.K.)
| | - Olivia A. Kingston
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (X.F.); (E.K.B.); (O.A.K.); (V.R.K.)
| | - Rachel A. Oldershaw
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK;
| | - Victoria R. Kearns
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (X.F.); (E.K.B.); (O.A.K.); (V.R.K.)
| | - Colin E. Willoughby
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (X.F.); (E.K.B.); (O.A.K.); (V.R.K.)
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, UK
- Correspondence: (C.E.W.); (C.M.S.); Tel.: +44-(28)-701-2338 (C.E.W.); +44-(151)-794-9031 (C.M.S.)
| | - Carl M. Sheridan
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (X.F.); (E.K.B.); (O.A.K.); (V.R.K.)
- Correspondence: (C.E.W.); (C.M.S.); Tel.: +44-(28)-701-2338 (C.E.W.); +44-(151)-794-9031 (C.M.S.)
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20
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Coyle S, Khan MN, Chemaly M, Callaghan B, Doyle C, Willoughby CE, Atkinson SD, Gregory-Ksander M, McGilligan V. Targeting the NLRP3 Inflammasome in Glaucoma. Biomolecules 2021; 11:biom11081239. [PMID: 34439904 PMCID: PMC8393362 DOI: 10.3390/biom11081239] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/16/2022] Open
Abstract
Glaucoma is a group of optic neuropathies characterised by the degeneration of retinal ganglion cells, resulting in damage to the optic nerve head (ONH) and loss of vision in one or both eyes. Increased intraocular pressure (IOP) is one of the major aetiological risk factors in glaucoma, and is currently the only modifiable risk factor. However, 30–40% of glaucoma patients do not present with elevated IOP and still proceed to lose vision. The pathophysiology of glaucoma is therefore not completely understood, and there is a need for the development of IOP-independent neuroprotective therapies to preserve vision. Neuroinflammation has been shown to play a key role in glaucoma and, specifically, the NLRP3 inflammasome, a key driver of inflammation, has recently been implicated. The NLRP3 inflammasome is expressed in the eye and its activation is reported in pre-clinical studies of glaucoma. Activation of the NLRP3 inflammasome results in IL-1β processing. This pro inflammatory cytokine is elevated in the blood of glaucoma patients and is believed to drive neurotoxic inflammation, resulting in axon degeneration and the death of retinal ganglion cells (RGCs). This review discusses glaucoma as an inflammatory disease and evaluates targeting the NLRP3 inflammasome as a therapeutic strategy. A hypothetical mechanism for the action of the NLRP3 inflammasome in glaucoma is presented.
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Affiliation(s)
- Sophie Coyle
- Northern Ireland Centre for Stratified Medicine, Ulster University, Londonderry BT47 6SB, UK; (S.C.); (M.N.K.); (S.D.A.)
| | - Mohammed Naeem Khan
- Northern Ireland Centre for Stratified Medicine, Ulster University, Londonderry BT47 6SB, UK; (S.C.); (M.N.K.); (S.D.A.)
| | - Melody Chemaly
- Department of Molecular Medicine and Surgery, Karolinska Institute, SE-171 76 Solna, Sweden;
| | - Breedge Callaghan
- Centre for Molecular Biosciences, Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, UK; (B.C.); (C.D.); (C.E.W.)
| | - Chelsey Doyle
- Centre for Molecular Biosciences, Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, UK; (B.C.); (C.D.); (C.E.W.)
| | - Colin E. Willoughby
- Centre for Molecular Biosciences, Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, UK; (B.C.); (C.D.); (C.E.W.)
| | - Sarah D. Atkinson
- Northern Ireland Centre for Stratified Medicine, Ulster University, Londonderry BT47 6SB, UK; (S.C.); (M.N.K.); (S.D.A.)
| | - Meredith Gregory-Ksander
- Department of Ophthalmology, Schepens Eye Research Institute, Massachusetts Eye & Ear Infirmary and Harvard Medical School, Boston, MA 02114, USA;
| | - Victoria McGilligan
- Northern Ireland Centre for Stratified Medicine, Ulster University, Londonderry BT47 6SB, UK; (S.C.); (M.N.K.); (S.D.A.)
- Correspondence:
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21
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Haneef A, Giridhara Gopalan RO, Rajendran DT, Nunes J, Kuppamuthu D, Radhakrishnan N, Young TH, Hsieh HY, Prajna NV, Willoughby CE, Williams R. Chemical Cross-Linking of Corneal Tissue to Reduce Progression of Loss of Sight in Patients With Keratoconus. Transl Vis Sci Technol 2021; 10:6. [PMID: 34003973 PMCID: PMC8088226 DOI: 10.1167/tvst.10.5.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We aimed to develop a novel chemical cross-linker treatment for keratoconus by reacting dicarboxylic acid spacer molecules and amine functional groups on protein structure of the tissue using carbodi-imide chemistry. We propose this as an alternative to conventional cross-linking treatment for keratoconus. Methods The study involved optimization of the cross-linker formulation. Mechanical stiffness of ex vivo porcine and human corneas after application of the cross-linker was measured. Histochemical analysis was performed to record changes in gross morphology after cross-linker treatment on ex vivo porcine and human and in vivo rabbit corneas. Terminal deoxynucleotidyl transferase-mediated dUTP-X nick-end-labeling (TUNEL) staining was performed to study apoptotic effects of cross-linker. Cytotoxicity potential of cross-linker was evaluated by studying explant cultures for cellular outgrowth and immunostaining assays on porcine and human corneas after treatment. Results We demonstrated a clinically relevant increase in stiffness in ex vivo experiments using porcine and human cornea without removal of corneal epithelium. Histological analysis showed no change in gross morphology of cornea and no evidence of apoptosis. In vivo treatment of rabbit eyes demonstrated initial thinning of corneal epithelium that recovered after seven days although with abnormal regularity of cells. Cellular outgrowth from corneal explant cultures after treatment further confirmed cell survival after treatment. Conclusions This chemical cross-linking of corneal tissue has potential advantages over current therapeutic options including lower cytotoxicity to stromal cells than ultraviolet A treatment. Translational Relevance The cross-linker has potential to become a treatment for keratoconus because it overcomes the need for procedures using specialized equipment and ensures accessibility to large populations.
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Affiliation(s)
- Atikah Haneef
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | | | | | - Jessica Nunes
- Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
| | | | | | - Tai-Horng Young
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Hao-Ying Hsieh
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | | | - Colin E Willoughby
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Rachel Williams
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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22
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Krishna Adithya V, Williams BM, Czanner S, Kavitha S, Friedman DS, Willoughby CE, Venkatesh R, Czanner G. EffUnet-SpaGen: An Efficient and Spatial Generative Approach to Glaucoma Detection. J Imaging 2021. [PMCID: PMC8321378 DOI: 10.3390/jimaging7060092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Current research in automated disease detection focuses on making algorithms “slimmer” reducing the need for large training datasets and accelerating recalibration for new data while achieving high accuracy. The development of slimmer models has become a hot research topic in medical imaging. In this work, we develop a two-phase model for glaucoma detection, identifying and exploiting a redundancy in fundus image data relating particularly to the geometry. We propose a novel algorithm for the cup and disc segmentation “EffUnet” with an efficient convolution block and combine this with an extended spatial generative approach for geometry modelling and classification, termed “SpaGen” We demonstrate the high accuracy achievable by EffUnet in detecting the optic disc and cup boundaries and show how our algorithm can be quickly trained with new data by recalibrating the EffUnet layer only. Our resulting glaucoma detection algorithm, “EffUnet-SpaGen”, is optimized to significantly reduce the computational burden while at the same time surpassing the current state-of-art in glaucoma detection algorithms with AUROC 0.997 and 0.969 in the benchmark online datasets ORIGA and DRISHTI, respectively. Our algorithm also allows deformed areas of the optic rim to be displayed and investigated, providing explainability, which is crucial to successful adoption and implementation in clinical settings.
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Affiliation(s)
- Venkatesh Krishna Adithya
- Department of Glaucoma, Aravind Eye Care System, Thavalakuppam, Pondicherry 605007, India; (V.K.A.); (S.K.); (R.V.)
| | - Bryan M. Williams
- School of Computing and Communications, Lancaster University, Bailrigg, Lancaster LA1 4WA, UK;
| | - Silvester Czanner
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool L3 3AF, UK;
| | - Srinivasan Kavitha
- Department of Glaucoma, Aravind Eye Care System, Thavalakuppam, Pondicherry 605007, India; (V.K.A.); (S.K.); (R.V.)
| | - David S. Friedman
- Glaucoma Center of Excellence, Harvard Medical School, Boston, MA 02114, USA;
| | - Colin E. Willoughby
- Biomedical Research Institute, Ulster University, Coleraine, Co. Londonderry BT52 1SA, UK;
| | - Rengaraj Venkatesh
- Department of Glaucoma, Aravind Eye Care System, Thavalakuppam, Pondicherry 605007, India; (V.K.A.); (S.K.); (R.V.)
| | - Gabriela Czanner
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool L3 3AF, UK;
- Correspondence:
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23
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Shinde V, Sobreira N, Wohler ES, Maiti G, Hu N, Silvestri G, George S, Jackson J, Chakravarti A, Willoughby CE, Chakravarti S. Pathogenic alleles in microtubule, secretory granule and extracellular matrix-related genes in familial keratoconus. Hum Mol Genet 2021; 30:658-671. [PMID: 33729517 DOI: 10.1093/hmg/ddab075] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 12/30/2022] Open
Abstract
Keratoconus is a common corneal defect with a complex genetic basis. By whole exome sequencing of affected members from 11 multiplex families of European ancestry, we identified 23 rare, heterozygous, potentially pathogenic variants in 8 genes. These include nonsynonymous single amino acid substitutions in HSPG2, EML6 and CENPF in two families each, and in NBEAL2, LRP1B, PIK3CG and MRGPRD in three families each; ITGAX had nonsynonymous single amino acid substitutions in two families and an indel with a base substitution producing a nonsense allele in the third family. Only HSPG2, EML6 and CENPF have been associated with ocular phenotypes previously. With the exception of MRGPRD and ITGAX, we detected the transcript and encoded protein of the remaining genes in the cornea and corneal cell cultures. Cultured stromal cells showed cytoplasmic punctate staining of NBEAL2, staining of the fibrillar cytoskeletal network by EML6, while CENPF localized to the basal body of primary cilia. We inhibited the expression of HSPG2, EML6, NBEAL2 and CENPF in stromal cell cultures and assayed for the expression of COL1A1 as a readout of corneal matrix production. An upregulation in COL1A1 after siRNA inhibition indicated their functional link to stromal cell biology. For ITGAX, encoding a leukocyte integrin, we assayed its level in the sera of 3 affected families compared with 10 unrelated controls to detect an increase in all affecteds. Our study identified genes that regulate the cytoskeleton, protein trafficking and secretion, barrier tissue function and response to injury and inflammation, as being relevant to keratoconus.
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Affiliation(s)
- Vishal Shinde
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Nara Sobreira
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Elizabeth S Wohler
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
| | - George Maiti
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Nan Hu
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Giuliana Silvestri
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast BT12 6BA UK
| | - Sonia George
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast BT12 6BA UK
| | - Jonathan Jackson
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast BT12 6BA UK
| | - Aravinda Chakravarti
- Center for Human Genetics and Genomics, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Colin E Willoughby
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast BT12 6BA UK.,Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, UK
| | - Shukti Chakravarti
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY 10016, USA.,Department of Pathology, NYU Grossman School of Medicine, New York, NY 10016, USA
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24
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Haribalaganesh R, Gowri Priya C, Sharmila R, Krishnadas S, Muthukkaruppan V, Willoughby CE, Senthilkumari S. Assessment of differential intraocular pressure response to dexamethasone treatment in perfusion cultured Indian cadaveric eyes. Sci Rep 2021; 11:605. [PMID: 33436790 PMCID: PMC7804010 DOI: 10.1038/s41598-020-80112-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/08/2020] [Indexed: 11/29/2022] Open
Abstract
The purpose of the present study was to assess the differential intraocular pressure response (IOP) to dexamethasone (DEX) treatment at two dose levels (100 or 500 nM) in perfusion cultured Indian cadaveric eyes to investigate glucocorticoid (GC) responsiveness. In a human organ-cultured anterior segment (HOCAS) set-up, the eye pressure was monitored for every 24 h post DEX infusion (100 or 500 nM) or 0.1% ethanol treatment for 7 days after baseline stabilization. The expression of DEX-inducible proteins such as myocilin and fibronectin in HOCAS-TM tissues was assessed by immunostaining. Elevated IOP was observed in 6/16 eyes [Mean ± SEM (mΔIOP): 15.50 ± 1.96 mmHg; 37.5% responders] and 3/15 eyes (Mean ± SEM mΔIOP: 10 ± 0.84 mmHg; 20% responders) in 100 nM and 500 nM dose groups respectively. Elevated IOP in GC responder eyes was substantiated with a significant increase in myocilin (11.8-fold; p = 0.0002) and fibronectin (eightfold; p = 0.04) expression as compared to vehicle-treated eyes by immunofluorescence analysis. This is the first study reporting the GC responsiveness in Indian cadaveric eyes. The observed GC response rate was comparable with the previous studies and hence, this model will enable us to investigate the relationship between differential gene expression and individual GC responsiveness in our population.
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Affiliation(s)
- Ravinarayanan Haribalaganesh
- Department of Ocular Pharmacology, Aravind Medical Research Foundation, #1, Anna Nagar, Madurai, Tamilnadu, 625020, India
| | - Chidambaranathan Gowri Priya
- Department of Immunology and Stem Cell Biology, Aravind Medical Research Foundation, #1, Anna Nagar, Madurai, 625020, India
| | | | - Subbaiah Krishnadas
- Glaucoma Clinic, Aravind Eye Hospital, #1, Anna Nagar, Madurai, 625020, India
| | - Veerappan Muthukkaruppan
- Department of Immunology and Stem Cell Biology, Aravind Medical Research Foundation, #1, Anna Nagar, Madurai, 625020, India
| | - Colin E Willoughby
- Genomic Medicine Group, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, UK
| | - Srinivasan Senthilkumari
- Department of Ocular Pharmacology, Aravind Medical Research Foundation, #1, Anna Nagar, Madurai, Tamilnadu, 625020, India.
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25
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McComish BJ, Sahebjada S, Bykhovskaya Y, Willoughby CE, Richardson AJ, Tenen A, Charlesworth JC, MacGregor S, Mitchell P, Lucas SEM, Mills RA, Mackey DA, Li X, Wang JJ, Jensen RA, Rotter JI, Taylor KD, Hewitt AW, Rabinowitz YS, Baird PN, Craig JE, Burdon KP. Association of Genetic Variation With Keratoconus. JAMA Ophthalmol 2020; 138:174-181. [PMID: 31855235 DOI: 10.1001/jamaophthalmol.2019.5293] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance Keratoconus is a condition in which the cornea progressively thins and protrudes in a conical shape, severely affecting refraction and vision. It is a major indication for corneal transplant. To discover new genetic loci associated with keratoconus and better understand the causative mechanism of this disease, we performed a genome-wide association study on patients with keratoconus. Objective To identify genetic susceptibility regions for keratoconus in the human genome. Design, Setting, and Participants This study was conducted with data from eye clinics in Australia, the United States, and Northern Ireland. The discovery cohort of individuals with keratoconus and control participants from Australia was genotyped using the Illumina HumanCoreExome single-nucleotide polymorphism array. After quality control and data cleaning, genotypes were imputed against the 1000 Genomes Project reference panel (phase III; version 5), and association analyses were completed using PLINK version 1.90. Single-nucleotide polymorphisms with P < 1.00 × 10-6 were assessed for replication in 3 additional cohorts. Control participants were drawn from the cohorts of the Blue Mountains Eye Study and a previous study of glaucoma. Replication cohorts were from a previous keratoconus genome-wide association study data set from the United States, a cohort of affected and control participants from Australia and Northern Ireland, and a case-control cohort from Victoria, Australia. Data were collected from January 2006 to March 2019. Main Outcomes and Measures Associations between keratoconus and 6 252 612 genetic variants were estimated using logistic regression after adjusting for ancestry using the first 3 principal components. Results The discovery cohort included 522 affected individuals and 655 control participants, while the replication cohorts included 818 affected individuals (222 from the United States, 331 from Australia and Northern Ireland, and 265 from Victoria, Australia) and 3858 control participants (2927 from the United States, 229 from Australia and Northern Ireland, and 702 from Victoria, Australia). Two novel loci reached genome-wide significance (defined as P < 5.00 × 10-8), with a P value of 7.46 × 10-9 at rs61876744 in patatin-like phospholipase domain-containing 2 gene (PNPLA2) on chromosome 11 and a P value of 6.35 × 10-12 at rs138380, 2.2 kb upstream of casein kinase I isoform epsilon gene (CSNK1E) on chromosome 22. One additional locus was identified with a P value less than 1.00 × 10-6 in mastermind-like transcriptional coactivator 2 (MAML2) on chromosome 11 (P = 3.91 × 10-7). The novel locus in PNPLA2 reached genome-wide significance in an analysis of all 4 cohorts (P = 2.45 × 10-8). Conclusions and Relevance In this relatively large keratoconus genome-wide association study, we identified a genome-wide significant locus for keratoconus in the region of PNPLA2 on chromosome 11.
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Affiliation(s)
- Bennet J McComish
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Srujana Sahebjada
- Centre for Eye Research Australia, Melbourne, Victoria, Australia.,Department of Surgery (Ophthalmology), Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Yelena Bykhovskaya
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.,Cornea Genetic Eye Institute, Beverly Hills, California.,Board of the Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Colin E Willoughby
- Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom.,Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | | | - Abi Tenen
- Vision Eye Institute, Melbourne, Victoria, Australia.,School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia.,Melbourne Stem Cell Centre, Melbourne, Victoria, Australia
| | - Jac C Charlesworth
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Sionne E M Lucas
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Richard A Mills
- Department of Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - David A Mackey
- Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Xiaohui Li
- Institute for Translational Genomics and Population Science, Los Angeles Biomedical Research Institute, Los Angeles, California.,Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California
| | - Jie Jin Wang
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Richard A Jensen
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Science, Los Angeles Biomedical Research Institute, Los Angeles, California.,Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California
| | - Kent D Taylor
- Institute for Translational Genomics and Population Science, Los Angeles Biomedical Research Institute, Los Angeles, California.,Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Centre for Eye Research Australia, Melbourne, Victoria, Australia
| | - Yaron S Rabinowitz
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.,Cornea Genetic Eye Institute, Beverly Hills, California.,Board of the Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Paul N Baird
- Centre for Eye Research Australia, Melbourne, Victoria, Australia.,Department of Surgery (Ophthalmology), Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Jamie E Craig
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Department of Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Kathryn P Burdon
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Department of Ophthalmology, Flinders University, Adelaide, South Australia, Australia
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26
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Qassim A, Souzeau E, Siggs OM, Hassall MM, Han X, Griffiths HL, Frost NA, Vallabh NA, Kirwan JF, Menon G, Cree AJ, Galanopoulos A, Agar A, Healey PR, Graham SL, Landers J, Casson RJ, Gharahkhani P, Willoughby CE, Hewitt AW, Lotery AJ, MacGregor S, Craig JE. An Intraocular Pressure Polygenic Risk Score Stratifies Multiple Primary Open-Angle Glaucoma Parameters Including Treatment Intensity. Ophthalmology 2020; 127:901-907. [PMID: 32081492 DOI: 10.1016/j.ophtha.2019.12.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the combined effects of common genetic variants associated with intraocular pressure (IOP) on primary open-angle glaucoma (POAG) phenotype using a polygenic risk score (PRS) stratification. DESIGN Cross-sectional study. PARTICIPANTS For the primary analysis, we examined the glaucoma phenotype of 2154 POAG patients enrolled in the Australian and New Zealand Registry of Advanced Glaucoma, including patients recruited from the United Kingdom. For replication, we examined an independent cohort of 624 early POAG patients. METHODS Using IOP genome-wide association study summary statistics, we developed a PRS derived solely from IOP-associated variants and stratified POAG patients into 3 risk tiers. The lowest and highest quintiles of the score were set as the low- and high-risk groups, respectively, and the other quintiles were set as the intermediate risk group. MAIN OUTCOME MEASURES Clinical glaucoma phenotype including maximum recorded IOP, age at diagnosis, number of family members affected by glaucoma, cup-to-disc ratio, visual field mean deviation, and treatment intensity. RESULTS A dose-response relationship was found between the IOP PRS and the maximum recorded IOP, with the high genetic risk group having a higher maximum IOP by 1.7 mmHg (standard deviation [SD], 0.62 mmHg) than the low genetic risk group (P = 0.006). Compared with the low genetic risk group, the high genetic risk group had a younger age of diagnosis by 3.7 years (SD, 1.0 years; P < 0.001), more family members affected by 0.46 members (SD, 0.11 members; P < 0.001), and higher rates of incisional surgery (odds ratio, 1.5; 95% confidence interval, 1.1-2.0; P = 0.007). No statistically significant difference was found in mean deviation. We further replicated the maximum IOP, number of family members affected by glaucoma, and treatment intensity (number of medications) results in the early POAG cohort (P ≤ 0.01). CONCLUSIONS The IOP PRS was correlated positively with maximum IOP, disease severity, need for surgery, and number of affected family members. Genes acting via IOP-mediated pathways, when considered in aggregate, have clinically important and reproducible implications for glaucoma patients and their close family members.
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Affiliation(s)
- Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia.
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mark M Hassall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Helen L Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - N Andrew Frost
- Department of Ophthalmology, Torbay Hospital, Torquay, Devon, United Kingdom
| | - Neeru A Vallabh
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - James F Kirwan
- Department of Ophthalmology, Portsmouth Hospitals, Portsmouth, United Kingdom
| | - Geeta Menon
- Department of Ophthalmology, Frimley Park Hospital NHS Foundation Trust, Frimley, United Kingdom
| | - Angela J Cree
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Anna Galanopoulos
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Ashish Agar
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia
| | - Paul R Healey
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Stuart L Graham
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Robert J Casson
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia
| | | | - Colin E Willoughby
- Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom; Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | | | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
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27
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Romano V, Steger B, Myneni J, Batterbury M, Willoughby CE, Kaye SB. Preparation of ultrathin grafts for Descemet-stripping endothelial keratoplasty with a single microkeratome pass. J Cataract Refract Surg 2019; 43:12-15. [PMID: 28317665 DOI: 10.1016/j.jcrs.2016.12.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 11/28/2022]
Abstract
We present a technique to achieve ultrathin Descemet-stripping automated endothelial keratoplasty (DSAEK). Using a simple method of controlling artificial anterior chamber pressure and drying the corneal surface, it was possible to thin the donor cornea at a rate of 11 μm a minute. When the donor cornea was between 500 μm and 510 μm, a single pass was made using a 350 μm microkeratome head followed by a peripheral dissection. The resulting mean graft thickness was 83.2 μm ± 14.9 (SD) (range 50 to 98 μm) with a mean peripheral graft edge thickness of 106.8 ± 10.9 μm (range 90 to 120 μm). There were no surgical complications, and all grafts remained attached. This is a reliable method for preparing ultrathin donor corneal lenticules for DSAEK in the operating room or eye bank without using multiple microkeratome heads or risking double passes.
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Affiliation(s)
- Vito Romano
- From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria.
| | - Bernhard Steger
- From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria
| | - Jayavani Myneni
- From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria
| | - Mark Batterbury
- From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria
| | - Colin E Willoughby
- From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria
| | - Stephen B Kaye
- From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria
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28
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Cammarata-Scalisi F, Matysiak U, Velten T, Callea M, Araque D, Willoughby CE, Galeotti A, Avendaño A. A Venezuelan Case of Schmid-Type Metaphyseal Chondrodysplasia with a Novel Mutation in COL10A1. Mol Syndromol 2019; 10:167-170. [PMID: 31191206 DOI: 10.1159/000496553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2018] [Indexed: 01/16/2023] Open
Abstract
Schmid-type metaphyseal chondrodysplasia (MIM 156500) is an uncommon autosomal dominant skeletal dysplasia caused by heterozygous mutations in the COL10A1 gene (MIM 120110) encoding the α1(X) chains of type X collagen. We report an 8-year-old girl with waddling gait, short stature, mild dorsal scoliosis, coxa vara, short lower limbs, bowing of the femurs, genu varum, and metaphyseal fraying and splaying, who is a carrier of a novel heterozygous 2-bp (c.1894_1895dupTA; p.Leu633Thrfs*45) duplication in exon 3 of the COL10A1 gene.
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Affiliation(s)
- Francisco Cammarata-Scalisi
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of Los Andes, Mérida, Venezuela
| | - Uta Matysiak
- Center for Pediatrics and Adolescent Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Tanja Velten
- Center for Pediatrics and Adolescent Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Michele Callea
- Unit of Dentistry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Dianora Araque
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of Los Andes, Mérida, Venezuela
| | - Colin E Willoughby
- Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, UK
| | - Angela Galeotti
- Unit of Dentistry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Avendaño
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of Los Andes, Mérida, Venezuela
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29
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Cammarata-Scalisi F, Rinelli M, Pisaneschi E, Diociaiuti A, Willoughby CE, Avendaño A, Digilio MC, Novelli A, Callea M. Novel clinical features associated with Clouston syndrome. Int J Dermatol 2019; 58:e143-e146. [PMID: 31165482 DOI: 10.1111/ijd.14507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/02/2019] [Accepted: 04/29/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Francisco Cammarata-Scalisi
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of the Andes, Merida, Venezuela
| | - Martina Rinelli
- Medical Genetics Laboratory, Bambino Gesù Children Hospital and Research Institute, Rome, Italy
| | - Elisa Pisaneschi
- Medical Genetics Laboratory, Bambino Gesù Children Hospital and Research Institute, Rome, Italy
| | - Andrea Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Colin E Willoughby
- Biomedical Sciences Research Institute, Ulster University, Northern Ireland, UK
| | - Andrea Avendaño
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of the Andes, Merida, Venezuela
| | - Maria C Digilio
- Department of Medical Genetics and Rare Diseases, Bambino Gesù Children Hospital and Research Institute, Rome, Italy
| | - Antonio Novelli
- Medical Genetics Laboratory, Bambino Gesù Children Hospital and Research Institute, Rome, Italy
| | - Michele Callea
- Unit of Dentistry, Bambino Gesù Children Hospital and Research Institute, Rome, Italy
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30
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Vinciguerra R, Rehman S, Vallabh NA, Batterbury M, Czanner G, Choudhary A, Cheeseman R, Elsheikh A, Willoughby CE. Corneal biomechanics and biomechanically corrected intraocular pressure in primary open-angle glaucoma, ocular hypertension and controls. Br J Ophthalmol 2019; 104:121-126. [PMID: 30923134 PMCID: PMC6922012 DOI: 10.1136/bjophthalmol-2018-313493] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/06/2019] [Accepted: 02/26/2019] [Indexed: 11/03/2022]
Abstract
AIMS To compare the biomechanically corrected intraocular pressure (IOP) estimate (bIOP) provided by the Corvis-ST with Goldmann applanation tonometry (GAT-IOP) in patients with high-tension and normal-tension primary open-angle glaucoma (POAG; HTG and NTG), ocular hypertension (OHT) and controls. Moreover, we compared dynamic corneal response parameters (DCRs) of the Corvis-ST in POAG, OHT and controls, evaluated the correlation between global visual field parameters mean deviation and pattern SD (MD and PSD) and DCRs in the POAG group. METHODS 156 eyes of 156 patients were included in this prospective, single-centre, observational study, namely 41 HTG and 33 NTG, 45 OHT cases and 37 controls. Central corneal thickness (CCT), GAT-IOP and bIOP were measured, GAT-IOP was also adjusted for CCT (GATAdj). DCRs provided by Corvis-ST were evaluated, MD and PSD were recorded by 24-2 full-threshold visual field. To evaluate the difference in DCRs between OHT, HTG and NTG, a general linear model was used with sex, medications and group as fixed factors and bIOP and age as covariates. RESULTS There was a significant difference between GAT-IOP, GATAdj and bIOP in NTG and HTG, OHT and controls. NTG corneas were significantly softer and more deformable compared with controls, OHT and HTG as demonstrated by significantly lower values of stiffness parameters A1 and highest concavity and higher values of inverse concave radius (all p<0.05). There was a significant correlation (p<0.05) between MD, PSD and many DCRs with POAG patients with softer or more compliant corneas more likely to show visual field defects. CONCLUSIONS Corneal biomechanics might be a significant confounding factor for IOP measurement that should be considered in clinical decision-making. The abnormality of corneal biomechanics in NTG and the significant correlation with visual field parameters might suggest a new risk factor for the development or progression of NTG.
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Affiliation(s)
- Riccardo Vinciguerra
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals, Birmingham, UK
| | - Salwah Rehman
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Neeru A Vallabh
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Mark Batterbury
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Gabriela Czanner
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Anshoo Choudhary
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Robert Cheeseman
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, UK
| | - Colin E Willoughby
- Biomedical Sciences Research Institute, University of Ulster, Coleraine, UK
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31
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MacCormick IJC, Williams BM, Zheng Y, Li K, Al-Bander B, Czanner S, Cheeseman R, Willoughby CE, Brown EN, Spaeth GL, Czanner G. Accurate, fast, data efficient and interpretable glaucoma diagnosis with automated spatial analysis of the whole cup to disc profile. PLoS One 2019; 14:e0209409. [PMID: 30629635 PMCID: PMC6328156 DOI: 10.1371/journal.pone.0209409] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 12/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background Glaucoma is the leading cause of irreversible blindness worldwide. It is a heterogeneous group of conditions with a common optic neuropathy and associated loss of peripheral vision. Both over and under-diagnosis carry high costs in terms of healthcare spending and preventable blindness. The characteristic clinical feature of glaucoma is asymmetrical optic nerve rim narrowing, which is difficult for humans to quantify reliably. Strategies to improve and automate optic disc assessment are therefore needed to prevent sight loss. Methods We developed a novel glaucoma detection algorithm that segments and analyses colour photographs to quantify optic nerve rim consistency around the whole disc at 15-degree intervals. This provides a profile of the cup/disc ratio, in contrast to the vertical cup/disc ratio in common use. We introduce a spatial probabilistic model, to account for the optic nerve shape, we then use this model to derive a disc deformation index and a decision rule for glaucoma. We tested our algorithm on two separate image datasets (ORIGA and RIM-ONE). Results The spatial algorithm accurately distinguished glaucomatous and healthy discs on internal and external validation (AUROC 99.6% and 91.0% respectively). It achieves this using a dataset 100-times smaller than that required for deep learning algorithms, is flexible to the type of cup and disc segmentation (automated or semi-automated), utilises images with missing data, and is correlated with the disc size (p = 0.02) and the rim-to-disc at the narrowest rim (p<0.001, in external validation). Discussion The spatial probabilistic algorithm is highly accurate, highly data efficient and it extends to any imaging hardware in which the boundaries of cup and disc can be segmented, thus making the algorithm particularly applicable to research into disease mechanisms, and also glaucoma screening in low resource settings.
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Affiliation(s)
- Ian J. C. MacCormick
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Edinburgh, United Kingdom
| | - Bryan M. Williams
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Yalin Zheng
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
- St Paul’s Eye Unit, Royal Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Kun Li
- Medical Information Engineering Department, Taishan Medical School, TaiAn City, ShanDong Province, China
| | - Baidaa Al-Bander
- Department of Electrical Engineering and Electronics, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
| | - Silvester Czanner
- School of Computing, Mathematics and Digital Technology, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, Manchester, United Kingdom
| | - Rob Cheeseman
- St Paul’s Eye Unit, Royal Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Colin E. Willoughby
- Biomedical Sciences Research Institute, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, Northern Ireland
| | - Emery N. Brown
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - George L. Spaeth
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States of America
| | - Gabriela Czanner
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
- St Paul’s Eye Unit, Royal Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
- Department of Applied Mathematics, Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool, United Kingdom
- * E-mail:
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32
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Iglesias AI, Mishra A, Vitart V, Bykhovskaya Y, Höhn R, Springelkamp H, Cuellar-Partida G, Gharahkhani P, Bailey JNC, Willoughby CE, Li X, Yazar S, Nag A, Khawaja AP, Polašek O, Siscovick D, Mitchell P, Tham YC, Haines JL, Kearns LS, Hayward C, Shi Y, van Leeuwen EM, Taylor KD, Bonnemaijer P, Rotter JI, Martin NG, Zeller T, Mills RA, Souzeau E, Staffieri SE, Jonas JB, Schmidtmann I, Boutin T, Kang JH, Lucas SEM, Wong TY, Beutel ME, Wilson JF, Uitterlinden AG, Vithana EN, Foster PJ, Hysi PG, Hewitt AW, Khor CC, Pasquale LR, Montgomery GW, Klaver CCW, Aung T, Pfeiffer N, Mackey DA, Hammond CJ, Cheng CY, Craig JE, Rabinowitz YS, Wiggs JL, Burdon KP, van Duijn CM, MacGregor S. Author Correction: Cross-ancestry genome-wide association analysis of corneal thickness strengthens link between complex and Mendelian eye diseases. Nat Commun 2019; 10:155. [PMID: 30622277 PMCID: PMC6325104 DOI: 10.1038/s41467-018-07819-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Adriana I Iglesias
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Aniket Mishra
- University of Bordeaux, Bordeaux Population Health Research Center, INSERM UMR 1219, F-33000, Bordeaux, France
| | - Veronique Vitart
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Yelena Bykhovskaya
- Regenerative Medicine Institute and Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,Cornea Genetic Eye Institute, Los Angeles, CA, 90048, USA
| | - René Höhn
- Department of Ophthalmology, University Medical Center Mainz, 55131, Mainz, Germany.,Department of Ophthalmology, Inselspital, University Hospital Bern, University of Bern, CH-3010, Bern, Switzerland
| | - Henriët Springelkamp
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Gabriel Cuellar-Partida
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA.,Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Colin E Willoughby
- Biomedical Sciences Research Institute, Ulster University, Belfast, Northern Ireland, BT52 1SA, UK.,Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland, BT12 6BA, UK
| | - Xiaohui Li
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90509, USA.,Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Seyhan Yazar
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, EH42XU, UK.,Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, WA, WA 6009, Australia
| | - Abhishek Nag
- Department of Twin Research and Genetic Epidemiology, King's College London, London, WC2R 2LS, UK
| | - Anthony P Khawaja
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SR, UK.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, EC1V 9EL, UK
| | - Ozren Polašek
- Faculty of Medicine, University of Split, HR-21000, Split, Croatia
| | - David Siscovick
- Departments of Medicine and Epidemiology and Cardiovascular Health Research Unit, University of Washington, Washington, WA, 98101, USA.,The New York Academy of Medicine, New York, NY, 10029, USA
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, 2145, Australia
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore
| | - Jonathan L Haines
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA.,Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Lisa S Kearns
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, 3002, Australia
| | - Caroline Hayward
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Yuan Shi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore
| | | | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90509, USA.,Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | | | - Pieter Bonnemaijer
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90509, USA.,Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Nicholas G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia
| | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart Center Hamburg, 20251, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20246, Hamburg, Germany
| | - Richard A Mills
- Department of Ophthalmology, Flinders University, Adelaide, SA 5042, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Adelaide, SA 5042, Australia
| | - Sandra E Staffieri
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, 3002, Australia
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, 68167, Mannheim, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, 55131, Mainz, Germany
| | - Thibaud Boutin
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Sionne E M Lucas
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore.,Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, 169857, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, 55131, Germany
| | - James F Wilson
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, EH42XU, UK.,Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | | | | | - André G Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands.,Netherlands Consortium for Healthy Ageing, Netherlands Genomics Initiative, 2593 HW, The Hague, The Netherlands
| | - Eranga N Vithana
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, EC1V 9EL, UK
| | - Pirro G Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, WC2R 2LS, UK
| | - Alex W Hewitt
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, 3002, Australia.,School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Chiea Chuen Khor
- Genome Institute of Singapore, 60 Biopolis Street, Singapore, 138672, Singapore
| | - Louis R Pasquale
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.,Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA, 02114, USA
| | - Grant W Montgomery
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia.,Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD 4067, Australia
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands.,Department of Ophthalmology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore.,Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, 169857, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, 55131, Mainz, Germany
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, WA, WA 6009, Australia
| | - Christopher J Hammond
- Department of Twin Research and Genetic Epidemiology, King's College London, London, WC2R 2LS, UK
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore.,Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, 169857, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Adelaide, SA 5042, Australia
| | - Yaron S Rabinowitz
- Regenerative Medicine Institute and Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,Cornea Genetic Eye Institute, Los Angeles, CA, 90048, USA
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA, 02114, USA
| | - Kathryn P Burdon
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia.
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Brunner M, Romano V, Steger B, Vinciguerra R, Lawman S, Williams B, Hicks N, Czanner G, Zheng Y, Willoughby CE, Kaye SB. Imaging of Corneal Neovascularization: Optical Coherence Tomography Angiography and Fluorescence Angiography. Invest Ophthalmol Vis Sci 2018; 59:1263-1269. [PMID: 29625447 DOI: 10.1167/iovs.17-22035] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) for the assessment of corneal neovascularization (CoNV). Methods Patients with CoNV extending at least 3 mm into the cornea were included. All patients underwent corneal imaging at the same visit. Images were recorded using the AngioVue OCTA system (Optovue, Inc.) with the long corneal adaptor module (CAM-L). ICGA images were recorded with fluorescent filters using the Heidelberg system (HRA2 Scanning Laser Ophthalmoscope; Heidelberg Engineering). Images were graded for quality by two independent observers. Vessel parameters: area, number, diameter, branch and end points, and tortuosity, were compared between devices. Bland-Altman plots were used to assess differences between parameters. Results Fifteen patients with CoNV predominantly associated with microbial keratitis were included. Mean subjective image quality score was better for ICGA (3.3 ± 0.9) than for OCTA (2.1 ± 1.2, P = 0.002), with almost perfect interobserver agreement for ICGA images (κ = 0.83) and substantial agreement for OCTA images (κ = 0.69). Agreement of grading of all investigated vessel parameters between ICGA and OCT images was slight to moderate, with significant differences found for vessel diameter (-8.98 μm, P = 0.01, 95% limits of agreement [LOA]: -15.89 to -2.07), number of branch (25.93, P = 0.09, 95% LOA: -4.31 to 56.17), and terminal points (49, P = 0.05, 95% LOA: 0.78 to 97.22). Conclusion Compared with ICGA, current OCTA systems are less precise in capturing small vessels in CoNV complexes, and validation studies are needed for OCTA segmentation software. OCTA, however, complements ICGA by providing evidence of red blood cell flow, which together with depth information, may be helpful when planning treatment of CoNV.
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Affiliation(s)
- Matthias Brunner
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.,Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Vito Romano
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.,Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Bernhard Steger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Riccardo Vinciguerra
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.,Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Samuel Lawman
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Bryan Williams
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Nicholas Hicks
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Gabriela Czanner
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom.,Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, United Kingdom
| | - Yalin Zheng
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Colin E Willoughby
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.,Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Stephen B Kaye
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.,Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
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34
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Chang SH, Mohammadvali A, Chen KJ, Ji YR, Young TH, Wang TJ, Willoughby CE, Hamill KJ, Elsheikh A. The Relationship Between Mechanical Properties, Ultrastructural Changes, and Intrafibrillar Bond Formation in Corneal UVA/Riboflavin Cross-linking Treatment for Keratoconus. J Refract Surg 2018; 34:264-272. [PMID: 29634842 DOI: 10.3928/1081597x-20180220-01] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/10/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the relationship between mechanical behavior in cross-linked corneas and changes in the corneal ultrastructure after corneal cross-linking (CXL). METHODS Porcine corneas were treated following the "Dresden" protocol, the current gold standard for clinical treatment, consisting of dropwise application of 0.1% riboflavin in 20% dextran followed by 30 minutes of ultraviolet-A (UVA) irradiation. The effect of CXL was assessed using uniaxial tensile testing, transmission electron microscopy, and Fourier transform infrared spectroscopy, with results compared against corneas treated with each of the treatment solution components individually. RESULTS UVA/riboflavin cross-linked corneas displayed 28% ± 17% increase in the material tangent modulus compared with dextran treatment alone, and altered collagen architecture within the first 300 µm of stromal depth consisting of 5% increase in the thickness of collagen fibrils, no significant changes to interfibrillar spacing, and an 8% to 12% decrease in number of fibrils per unit area. Fourier transform infrared spectroscopy confirmed formation of interfibrillar bonds (P = .012) induced by UVA-mediated CXL. CONCLUSIONS The data support a model wherein collagen fibril diameter and structural density are fundamental parameters in defining tissue stiffening following UVA/riboflavin CXL and provide benchmarks against which modifications to the Dresden CXL protocol can be evaluated. [J Refract Surg. 2018;34(4):264-272.].
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35
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Iglesias AI, Mishra A, Vitart V, Bykhovskaya Y, Höhn R, Springelkamp H, Cuellar-Partida G, Gharahkhani P, Bailey JNC, Willoughby CE, Li X, Yazar S, Nag A, Khawaja AP, Polašek O, Siscovick D, Mitchell P, Tham YC, Haines JL, Kearns LS, Hayward C, Shi Y, van Leeuwen EM, Taylor KD, Bonnemaijer P, Rotter JI, Martin NG, Zeller T, Mills RA, Souzeau E, Staffieri SE, Jonas JB, Schmidtmann I, Boutin T, Kang JH, Lucas SEM, Wong TY, Beutel ME, Wilson JF, Uitterlinden AG, Vithana EN, Foster PJ, Hysi PG, Hewitt AW, Khor CC, Pasquale LR, Montgomery GW, Klaver CCW, Aung T, Pfeiffer N, Mackey DA, Hammond CJ, Cheng CY, Craig JE, Rabinowitz YS, Wiggs JL, Burdon KP, van Duijn CM, MacGregor S. Cross-ancestry genome-wide association analysis of corneal thickness strengthens link between complex and Mendelian eye diseases. Nat Commun 2018; 9:1864. [PMID: 29760442 PMCID: PMC5951816 DOI: 10.1038/s41467-018-03646-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 03/02/2018] [Indexed: 12/17/2022] Open
Abstract
Central corneal thickness (CCT) is a highly heritable trait associated with complex eye diseases such as keratoconus and glaucoma. We perform a genome-wide association meta-analysis of CCT and identify 19 novel regions. In addition to adding support for known connective tissue-related pathways, pathway analyses uncover previously unreported gene sets. Remarkably, >20% of the CCT-loci are near or within Mendelian disorder genes. These included FBN1, ADAMTS2 and TGFB2 which associate with connective tissue disorders (Marfan, Ehlers-Danlos and Loeys-Dietz syndromes), and the LUM-DCN-KERA gene complex involved in myopia, corneal dystrophies and cornea plana. Using index CCT-increasing variants, we find a significant inverse correlation in effect sizes between CCT and keratoconus (r = -0.62, P = 5.30 × 10-5) but not between CCT and primary open-angle glaucoma (r = -0.17, P = 0.2). Our findings provide evidence for shared genetic influences between CCT and keratoconus, and implicate candidate genes acting in collagen and extracellular matrix regulation.
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MESH Headings
- ADAMTS Proteins/genetics
- ADAMTS Proteins/metabolism
- Asian People
- Cornea/abnormalities
- Cornea/metabolism
- Cornea/pathology
- Corneal Diseases/ethnology
- Corneal Diseases/genetics
- Corneal Diseases/metabolism
- Corneal Diseases/pathology
- Corneal Dystrophies, Hereditary/ethnology
- Corneal Dystrophies, Hereditary/genetics
- Corneal Dystrophies, Hereditary/metabolism
- Corneal Dystrophies, Hereditary/pathology
- Decorin/genetics
- Decorin/metabolism
- Ehlers-Danlos Syndrome/ethnology
- Ehlers-Danlos Syndrome/genetics
- Ehlers-Danlos Syndrome/metabolism
- Ehlers-Danlos Syndrome/pathology
- Eye Diseases, Hereditary/ethnology
- Eye Diseases, Hereditary/genetics
- Eye Diseases, Hereditary/metabolism
- Eye Diseases, Hereditary/pathology
- Fibrillin-1/genetics
- Fibrillin-1/metabolism
- Gene Expression
- Genome, Human
- Genome-Wide Association Study
- Glaucoma, Open-Angle/ethnology
- Glaucoma, Open-Angle/genetics
- Glaucoma, Open-Angle/metabolism
- Glaucoma, Open-Angle/pathology
- Humans
- Keratoconus/ethnology
- Keratoconus/genetics
- Keratoconus/metabolism
- Keratoconus/pathology
- Loeys-Dietz Syndrome/ethnology
- Loeys-Dietz Syndrome/genetics
- Loeys-Dietz Syndrome/metabolism
- Loeys-Dietz Syndrome/pathology
- Lumican/genetics
- Lumican/metabolism
- Marfan Syndrome/ethnology
- Marfan Syndrome/genetics
- Marfan Syndrome/metabolism
- Marfan Syndrome/pathology
- Mendelian Randomization Analysis
- Myopia/ethnology
- Myopia/genetics
- Myopia/metabolism
- Myopia/pathology
- Polymorphism, Single Nucleotide
- Proteoglycans/genetics
- Proteoglycans/metabolism
- Quantitative Trait Loci
- Quantitative Trait, Heritable
- Transforming Growth Factor beta2/genetics
- Transforming Growth Factor beta2/metabolism
- White People
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Affiliation(s)
- Adriana I Iglesias
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Aniket Mishra
- University of Bordeaux, Bordeaux Population Health Research Center, INSERM UMR 1219, F-33000, Bordeaux, France
| | - Veronique Vitart
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, EH42XU, Edinburgh, UK
| | - Yelena Bykhovskaya
- Regenerative Medicine Institute and Department of Surgery, Cedars-Sinai Medical Center, CA 90048, Los Angeles, CA, USA
- Cornea Genetic Eye Institute, CA 90048, Los Angeles, CA, USA
| | - René Höhn
- Department of Ophthalmology, University Medical Center Mainz, 55131, Mainz, Germany
- Department of Ophthalmology, Inselspital, University Hospital Bern, University of Bern, Bern, CH-3010, Switzerland
| | - Henriët Springelkamp
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Gabriel Cuellar-Partida
- Statistical Genetics, QIMR Berghofer Medical Research Institute, QLD 4029, Brisbane, Australia
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, QLD 4029, Brisbane, Australia
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, OH 44106, Cleveland, OH, USA
- Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Colin E Willoughby
- Biomedical Sciences Research Institute, Ulster University, BT52 1SA, Belfast, Northern Ireland, UK
- Royal Victoria Hospital, Belfast Health and Social Care Trust, BT12 6BA, Belfast, Northern Ireland, UK
| | - Xiaohui Li
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90509, CA, USA
- Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, CA, USA
| | - Seyhan Yazar
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, EH42XU, Edinburgh, UK
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, WA 6009, Perth, WA, Australia
| | - Abhishek Nag
- Department of Twin Research and Genetic Epidemiology, King's College London, WC2R 2LS, London, UK
| | - Anthony P Khawaja
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, CB2 0SR, Cambridge, UK
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, EC1V 9EL, London, UK
| | - Ozren Polašek
- Faculty of Medicine, University of Split, HR-21000, Split, Croatia
| | - David Siscovick
- Departments of Medicine and Epidemiology and Cardiovascular Health Research Unit, University of Washington, WA 98101, Washington, USA
- The New York Academy of Medicine, NY 10029, New York, NY, USA
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, NSW 2145, Sydney, NSW, Australia
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore, Singapore
| | - Jonathan L Haines
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, OH 44106, Cleveland, OH, USA
- Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Lisa S Kearns
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, VIC 3002, East Melbourne, Australia
| | - Caroline Hayward
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, EH42XU, Edinburgh, UK
| | - Yuan Shi
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore, Singapore
| | | | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90509, CA, USA
- Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, CA, USA
| | - Pieter Bonnemaijer
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90509, CA, USA
- Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, CA, USA
| | - Nicholas G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, QLD 4029, Brisbane, Australia
| | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart Center Hamburg, 20251, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20246, Hamburg, Germany
| | - Richard A Mills
- Department of Ophthalmology, Flinders University, SA 5042, Adelaide, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, SA 5042, Adelaide, Australia
| | - Sandra E Staffieri
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, VIC 3002, East Melbourne, Australia
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, 68167, Mannheim, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, 55131, Mainz, Germany
| | - Thibaud Boutin
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, EH42XU, Edinburgh, UK
| | - Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, MA, USA
| | - Sionne E M Lucas
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7005, TAS, Australia
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, 169857, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, 55131, Germany
| | - James F Wilson
- Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, EH42XU, Edinburgh, UK
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, EH16 4UX, Edinburgh, UK
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Initiative, 2593 HW, The Hague, The Netherlands
| | - Eranga N Vithana
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore, Singapore
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, EC1V 9EL, London, UK
| | - Pirro G Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, WC2R 2LS, London, UK
| | - Alex W Hewitt
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, VIC 3002, East Melbourne, Australia
- School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7005, TAS, Australia
| | - Chiea Chuen Khor
- Genome Institute of Singapore, 60 Biopolis Street, Singapore, 138672, Singapore
| | - Louis R Pasquale
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, MA, USA
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA 02114, MA, USA
| | - Grant W Montgomery
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, QLD 4029, Brisbane, Australia
- Institute for Molecular Bioscience, University of Queensland, QLD 4067, Brisbane, Australia
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, 169857, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, 55131, Mainz, Germany
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, WA 6009, Perth, WA, Australia
| | - Christopher J Hammond
- Department of Twin Research and Genetic Epidemiology, King's College London, WC2R 2LS, London, UK
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, 169857, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, SA 5042, Adelaide, Australia
| | - Yaron S Rabinowitz
- Regenerative Medicine Institute and Department of Surgery, Cedars-Sinai Medical Center, CA 90048, Los Angeles, CA, USA
- Cornea Genetic Eye Institute, CA 90048, Los Angeles, CA, USA
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA 02114, MA, USA
| | - Kathryn P Burdon
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7005, TAS, Australia
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, QLD 4029, Brisbane, Australia.
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36
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Liu S, Romano V, Steger B, Kaye SB, Hamill KJ, Willoughby CE. Gene-based antiangiogenic applications for corneal neovascularization. Surv Ophthalmol 2018; 63:193-213. [DOI: 10.1016/j.survophthal.2017.10.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 12/22/2022]
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37
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Vinciguerra R, Romano V, Arbabi EM, Brunner M, Willoughby CE, Batterbury M, Kaye SB. In Vivo Early Corneal Biomechanical Changes After Corneal Cross-linking in Patients With Progressive Keratoconus. J Refract Surg 2018; 33:840-846. [PMID: 29227513 DOI: 10.3928/1081597x-20170922-02] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 08/25/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To report early corneal biomechanical changes after corneal cross-linking (CXL) in patients with keratoconus. METHODS Thirty-four eyes of 34 patients undergoing CXL for progressive keratoconus were included in this prospective clinical study. Dynamic corneal response (DCR) parameters obtained with the Corvis ST (OCULUS Optikgeräte GmbH; Wetzlar, Germany) were assessed at baseline (day of CXL) and after 1 month of follow-up; conversely, corneal tomography with the Pentacam (OCULUS Optikgeräte GmbH) was assessed at baseline and at 1, 3, and 6 months after CXL. RESULTS At the last follow-up visit (123.7 ± 69.6 days), all morphological parameters including steepest point (Kmax) and thinnest corneal thickness (ThCT) indicated stabilization of keratoconus (P > .05). Comparative analyses showed a rise of corneal stiffness demonstrated by a significant increase of Stiffness Parameter A1 (SP-A1) and Highest Concavity (SP-HC) and a significant decrease of Inverse Concave Radius (1/R) and Deformation Amplitude Ratio (DA Ratio) (P < .05). There was a significant correlation between the preoperative keratoconus characteristics (Kmax, Belin/Ambrósio final D value [BAD-D], and ThCT) and the DCR parameters (P < .05). Kmax and BAD-D showed a significant positive correlation with DA Ratio, Deflection Amplitude (DefA), and 1/R and a significant negative correlation with SPA1 and SP-HC. ThCT showed a significant positive correlation with SP-A1 and SP-HC and a significant negative correlation with DA Ratio, DefA, and 1/R. CONCLUSIONS This study suggests that the new DCR parameters of the Corvis ST are able to detect early changes in biomechanics following CXL and those that are measurable before corneal shape modifications take place. Based on these results, the authors suggest the use of these metrics to assess the early efficacy of cross-linking. [J Refract Surg. 2017;33(12):840-846.].
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Lawman S, Madden PW, Romano V, Dong Y, Mason S, Williams BM, Kaye SB, Willoughby CE, Harding SP, Shen YC, Zheng Y. Deformation velocity imaging using optical coherence tomography and its applications to the cornea. Biomed Opt Express 2017; 8:5579-5593. [PMID: 29296489 PMCID: PMC5745104 DOI: 10.1364/boe.8.005579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 05/07/2023]
Abstract
Optical coherence tomography (OCT) can monitor human donor corneas non-invasively during the de-swelling process following storage for corneal transplantation, but currently only resultant thickness as a function of time is extracted. To visualize and quantify the mechanism of de-swelling, we present a method exploiting the nanometer sensitivity of the Fourier phase in OCT data to image deformation velocities. The technique was demonstrated by non-invasively showing during de-swelling that osmotic flow through an intact epithelium is negligible and removing the endothelium approximately doubled the initial flow at that interface. The increased functional data further enabled the validation of a mathematical model of the cornea. Included is an efficient method of measuring high temporal resolution (1 minute demonstrated) corneal thickness, using automated collection and semi-automated graph search segmentation. These methods expand OCT capabilities to measure volume change processes for tissues and materials.
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Affiliation(s)
- Samuel Lawman
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool, L69 3GJ, UK
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
| | - Peter W. Madden
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
| | - Vito Romano
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK
| | - Yue Dong
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool, L69 3GJ, UK
| | - Sharon Mason
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
| | - Bryan M. Williams
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
| | - Stephen B. Kaye
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK
| | - Colin E. Willoughby
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK
| | - Simon P. Harding
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK
| | - Yao-Chun Shen
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool, L69 3GJ, UK
| | - Yalin Zheng
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK
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Romano V, Parekh M, Ruzza A, Willoughby CE, Ferrari S, Ponzin D, Kaye SB, Levis HJ. Comparison of preservation and transportation protocols for preloaded Descemet membrane endothelial keratoplasty. Br J Ophthalmol 2017; 102:549-555. [PMID: 29133296 PMCID: PMC5890643 DOI: 10.1136/bjophthalmol-2017-310906] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/06/2017] [Accepted: 10/20/2017] [Indexed: 11/25/2022]
Abstract
Background/aims Descemet membrane endothelial keratoplasty (DMEK) preparation is technically demanding and is a limiting factor for uptake of this kind of surgery. Supply methods that simplify the procedure for surgeons are key to increasing uptake. This study compares two different shipping protocols for DMEK. Methods An 8.5 mm DMEK graft was punched, marked and loaded for transportation in two different conditions: (A) endothelium trifolded inwards in organ culture conditions (n=7) and (B) endothelium rolled outwards in hypothermic conditions (n=7). Tissues were shipped from Italy to the UK, then analysed for orientation, endothelial cell density, denuded areas, cell mortality, triple viability staining (Hoechst/ethidium homodimer/calcein AM (HEC)), immunolocalisation of ZO-1 and Na/K-ATPase proteins, visualisation of actin filaments using phalloidin and histological analysis using H&E on paraffin-embedded sections. Results All tissues clearly showed the mark used for graft orientation. After shipping in condition A, there was an increase in cell mortality of 8.1% and in denuded areas of 22.4%, whereas for condition B there was an increase in cell mortality of 14.2% and in denuded areas of 34.3% after shipping. HEC staining revealed areas of viable cells and apoptotic cells, with large denuded areas found in the periphery for condition B and within folds for condition A. Conclusions Prestripped preloaded DMEK grafts retained sufficient viable cells for transplantation, with condition A (endothelium-in) offering the advantage of greater flexibility of use due to a longer shelf-life. HEC analysis provides further detailed information as to the status of DMEK grafts and should be used in future similar studies.
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Affiliation(s)
- Vito Romano
- Department of Ophthalmology, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Instituto Universitario Fernandez-Vega, Universidad de Oviedo and Fundacion de Investigacion on Oftalmologica, Oviedo, Spain
| | - Mohit Parekh
- International Center for Ocular Physiopathology, Veneto Eye Bank Foundation, Venice, Italy
| | - Alessandro Ruzza
- International Center for Ocular Physiopathology, Veneto Eye Bank Foundation, Venice, Italy
| | - Colin E Willoughby
- Department of Ophthalmology, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, University of Liverpool Institute of Ageing and Chronic Disease, Liverpool, UK
| | - Stefano Ferrari
- International Center for Ocular Physiopathology, Veneto Eye Bank Foundation, Venice, Italy
| | - Diego Ponzin
- International Center for Ocular Physiopathology, Veneto Eye Bank Foundation, Venice, Italy
| | - Stephen B Kaye
- Department of Ophthalmology, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, University of Liverpool Institute of Ageing and Chronic Disease, Liverpool, UK
| | - Hannah J Levis
- Department of Eye and Vision Science, University of Liverpool Institute of Ageing and Chronic Disease, Liverpool, UK
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Romano V, Steger B, Brunner M, Kaye A, Zheng Y, Willoughby CE, Kaye SB. Detecting Change in Conjunctival Hyperemia Using a Pixel Densitometry Index. Ocul Immunol Inflamm 2017; 27:276-281. [DOI: 10.1080/09273948.2017.1387276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Vito Romano
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
| | - Bernhard Steger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Matthias Brunner
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
| | - Abigail Kaye
- Department of Ophthalmology, Worthing Hospital, Worthing, UK
| | - Yalin Zheng
- Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Colin E. Willoughby
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
| | - Stephen B. Kaye
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
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Vallabh NA, Romano V, Willoughby CE. Mitochondrial dysfunction and oxidative stress in corneal disease. Mitochondrion 2017; 36:103-113. [PMID: 28549842 DOI: 10.1016/j.mito.2017.05.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/23/2017] [Accepted: 05/18/2017] [Indexed: 12/13/2022]
Abstract
The cornea is the anterior transparent surface and the main refracting structure of the eye. Mitochondrial dysfunction and oxidative stress are implicated in the pathogenesis of inherited (e.g. Kearns Sayre Syndrome) and acquired corneal diseases (e.g. keratoconus and Fuchs endothelial corneal dystrophy). Both antioxidants and reactive oxygen species are found in the healthy cornea. There is increasing evidence of imbalance in the oxidative balance and mitochondrial function in the cornea in disease states. The cornea is vulnerable to mitochondrial dysfunction and oxidative stress due to its highly exposed position to ultraviolet radiation and high oxygen tension. The corneal endothelium is vulnerable to accumulating mitochondrial DNA (mtDNA) damage due to the post- mitotic nature of endothelial cells, yet their mitochondrial genome is continually replicating and mtDNA mutations can develop and accumulate with age. The unique physiology of the cornea predisposes this structure to oxidative damage, and there is interplay between inherited and acquired mitochondrial dysfunction, oxidative damage and a number of corneal diseases. By targeting mitochondrial dysfunction in corneal disease, emerging treatments may prevent or reduce visual loss.
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Affiliation(s)
- Neeru A Vallabh
- Corneal and External Eye Service, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom; Institute of Ageing and Chronic Disease, Department of Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom
| | - Vito Romano
- Corneal and External Eye Service, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Colin E Willoughby
- Corneal and External Eye Service, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom; Institute of Ageing and Chronic Disease, Department of Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom.
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Chiam PJ, Cheeseman R, Ho VW, Romano V, Choudhary A, Batterbury M, Kaye SB, Willoughby CE. Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve. Graefes Arch Clin Exp Ophthalmol 2017; 255:987-993. [DOI: 10.1007/s00417-017-3612-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/24/2017] [Accepted: 02/06/2017] [Indexed: 11/30/2022] Open
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Willoughby CE, Kaye SB. Facilitating a close interaction between basic, translational and clinical science: BMJ Open Ophthalmology. BMJ Open Ophthalmol 2016; 1:e000001. [PMID: 29354690 PMCID: PMC5759396 DOI: 10.1136/bmjophth-2016-000001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 05/25/2016] [Indexed: 11/04/2022] Open
Affiliation(s)
- Colin E Willoughby
- Dept of Eye and Vision Science, Institute of Ageing and Chronic Disease, United Kingdom and St. Paul's Eye Unit, University of Liverpool, Liverpool, United Kingdom
| | - Stephen B Kaye
- Dept of Eye and Vision Science, Institute of Ageing and Chronic Disease, United Kingdom and St. Paul's Eye Unit, University of Liverpool, Liverpool, United Kingdom
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Ansari M, Rainger J, Hanson IM, Williamson KA, Sharkey F, Harewood L, Sandilands A, Clayton-Smith J, Dollfus H, Bitoun P, Meire F, Fantes J, Franco B, Lorenz B, Taylor DS, Stewart F, Willoughby CE, McEntagart M, Khaw PT, Clericuzio C, Van Maldergem L, Williams D, Newbury-Ecob R, Traboulsi EI, Silva ED, Madlom MM, Goudie DR, Fleck BW, Wieczorek D, Kohlhase J, McTrusty AD, Gardiner C, Yale C, Moore AT, Russell-Eggitt I, Islam L, Lees M, Beales PL, Tuft SJ, Solano JB, Splitt M, Hertz JM, Prescott TE, Shears DJ, Nischal KK, Doco-Fenzy M, Prieur F, Temple IK, Lachlan KL, Damante G, Morrison DA, van Heyningen V, FitzPatrick DR. Genetic Analysis of 'PAX6-Negative' Individuals with Aniridia or Gillespie Syndrome. PLoS One 2016; 11:e0153757. [PMID: 27124303 PMCID: PMC4849793 DOI: 10.1371/journal.pone.0153757] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/04/2016] [Indexed: 12/26/2022] Open
Abstract
We report molecular genetic analysis of 42 affected individuals referred with a diagnosis of aniridia who previously screened as negative for intragenic PAX6 mutations. Of these 42, the diagnoses were 31 individuals with aniridia and 11 individuals referred with a diagnosis of Gillespie syndrome (iris hypoplasia, ataxia and mild to moderate developmental delay). Array-based comparative genomic hybridization identified six whole gene deletions: four encompassing PAX6 and two encompassing FOXC1. Six deletions with plausible cis-regulatory effects were identified: five that were 3' (telomeric) to PAX6 and one within a gene desert 5' (telomeric) to PITX2. Sequence analysis of the FOXC1 and PITX2 coding regions identified two plausibly pathogenic de novo FOXC1 missense mutations (p.Pro79Thr and p.Leu101Pro). No intragenic mutations were detected in PITX2. FISH mapping in an individual with Gillespie-like syndrome with an apparently balanced X;11 reciprocal translocation revealed disruption of a gene at each breakpoint: ARHGAP6 on the X chromosome and PHF21A on chromosome 11. In the other individuals with Gillespie syndrome no mutations were identified in either of these genes, or in HCCS which lies close to the Xp breakpoint. Disruption of PHF21A has previously been implicated in the causation of intellectual disability (but not aniridia). Plausibly causative mutations were identified in 15 out of 42 individuals (12/32 aniridia; 3/11 Gillespie syndrome). Fourteen of these mutations presented in the known aniridia genes; PAX6, FOXC1 and PITX2. The large number of individuals in the cohort with no mutation identified suggests greater locus heterogeneity may exist in both isolated and syndromic aniridia than was previously appreciated.
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Affiliation(s)
- Morad Ansari
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Jacqueline Rainger
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Isabel M. Hanson
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Kathleen A. Williamson
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Freddie Sharkey
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Louise Harewood
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Angela Sandilands
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Jill Clayton-Smith
- Faculty of Medical and Human Sciences, Manchester Centre for Genomic Medicine, Institute of Human Development, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
| | - Helene Dollfus
- Service de Génétique Médicale, Hôpital de Haute-Pierre, Strasbourg, France
| | - Pierre Bitoun
- Medical Genetics Departments, University Hospital Jean Verdier, Bondy, France
| | - Francoise Meire
- Department of ophthalmopediatrics, Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgium
| | - Judy Fantes
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Brunella Franco
- Medical Genetics, Department of Medical Translational Sciences, Federico II University, Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Birgit Lorenz
- Department of Ophthalmology, Justus-Liebig-University Giessen, Universitaetsklinikum Giessen and Marburg UKGM, Giessen, Germany
| | - David S. Taylor
- Institute of Child Health, University College London, UK and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Fiona Stewart
- Northern Ireland Regional Genetics Service (NIRGS), Belfast City Hospital, Belfast, United Kingdom
| | - Colin E. Willoughby
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Meriel McEntagart
- Medical Genetics Unit, St George's University of London, London, United Kingdom
| | - Peng Tee Khaw
- Moorfields Eye Hospital, London, UK and University College London, Institute of Ophthalmology, London, United Kingdom
| | - Carol Clericuzio
- Department of Pediatric Genetics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | | | - Denise Williams
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham, United Kingdom
| | - Ruth Newbury-Ecob
- Department of Clinical Genetics, University Hospitals, Bristol, United Kingdom
| | - Elias I. Traboulsi
- Center for Genetic Eye Diseases, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, United States of America
| | - Eduardo D. Silva
- Department Ophthalmology, University Hospital of Coimbra, Coimbra, Portugal
| | - Mukhlis M. Madlom
- Children's Hospital, Doncaster Royal Infirmary, Doncaster, United Kingdom
| | - David R. Goudie
- Human Genetics Unit, University of Dundee College of Medicine, Dentistry and Nursing, Ninewells Hospital, Dundee, United Kingdom
| | - Brian W. Fleck
- Department of Ophthalmology, Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh, United Kingdom
| | - Dagmar Wieczorek
- Institut für Humangenetik, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
- Institut für Humangenetik, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | | | - Alice D. McTrusty
- Department of Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Carol Gardiner
- Clinical Genetics, Southern General Hospital, Glasgow, United Kingdom
| | - Christopher Yale
- Department of Paediatrics and Child Health, Ipswich Hospital, Ipswich, United Kingdom
| | - Anthony T. Moore
- Moorfields Eye Hospital, London, UK and University College London, Institute of Ophthalmology, London, United Kingdom
| | - Isabelle Russell-Eggitt
- Institute of Child Health, University College London, UK and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Lily Islam
- Institute of Child Health, University College London, UK and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Melissa Lees
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street Hospital, London, United Kingdom
| | - Philip L. Beales
- Institute of Child Health, University College London, UK and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Stephen J. Tuft
- Moorfields Eye Hospital, London, UK and University College London, Institute of Ophthalmology, London, United Kingdom
| | - Juan B. Solano
- Ruber International Hospital, Medical Genetics Unit, Mirasierra, Madrid, Spain
| | - Miranda Splitt
- Northern Genetics Service, Institute of Genetic Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Jens Michael Hertz
- Department of Clinical Genetics, Odense University Hospital, Odense C, Denmark
| | - Trine E. Prescott
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Deborah J. Shears
- Department of Clinical Genetics, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Ken K. Nischal
- UPMC Eye Center, Children's Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | | | - Fabienne Prieur
- CHU de Saint Etienne, Service de génétique médicale, Saint-Etienne, France
| | - I. Karen Temple
- Academic Unit of Genetic Medicine, Division of Human Genetics, University of Southampton, Southampton, United Kingdom
| | - Katherine L. Lachlan
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Giuseppe Damante
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Danny A. Morrison
- St. Thomas’ Hospital, Westminster Bridge Road, London, United Kingdom
| | - Veronica van Heyningen
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - David R. FitzPatrick
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
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Napier ML, Durga D, Wolsley CJ, Chamney S, Alexander S, Brennan R, Simpson DA, Silvestri G, Willoughby CE. Mutational Analysis of the Rhodopsin Gene in Sector Retinitis Pigmentosa. Ophthalmic Genet 2016; 36:239-43. [PMID: 25265376 DOI: 10.3109/13816810.2014.958862] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To determine the role of rhodopsin (RHO) gene mutations in patients with sector retinitis pigmentosa (RP) from Northern Ireland. DESIGN A case series of sector RP in a tertiary ocular genetics clinic. PARTICIPANTS Four patients with sector RP were recruited from the Royal Victoria Hospital (Belfast, Northern Ireland) and Altnagelvin Hospital (Londonderry, Northern Ireland) following informed consent. METHODS The diagnosis of sector RP was based on clinical examination, International Society for Clinical Electrophysiology of Vision (ISCEV) standard electrophysiology, and visual field analysis. DNA was extracted from peripheral blood leucocytes and the coding regions and adjacent flanking intronic sequences of the RHO gene were polymerase chain reaction (PCR) amplified and cycle sequenced. MAIN OUTCOME MEASURE Rhodopsin mutational status. RESULTS A heterozygous missense mutation in RHO (c.173C > T) resulting in a non-conservative substitution of threonine to methionine (p. Thr58Met) was identified in one patient and was absent from 360 control individuals. This non-conservative substitution (p.Thr58Met) replaces a highly evolutionary conserved polar hydrophilic threonine residue with a non-polar hydrophobic methionine residue at position 58 near the cytoplasmic border of helix A of RHO. CONCLUSIONS The study identified a RHO gene mutation (p.Thr58Met) not previously reported in RP in a patient with sector RP. These findings outline the phenotypic variability associated with RHO mutations. It has been proposed that the regional effects of RHO mutations are likely to result from interplay between mutant alleles and other genetic, epigenetic and environmental factors.
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Affiliation(s)
- Maria L Napier
- a Department of Ophthalmology , Belfast Health and Social Care Trust, Royal Victoria Hospital , Belfast , Northern Ireland , UK
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Oliver VF, van Bysterveldt KA, Cadzow M, Steger B, Romano V, Markie D, Hewitt AW, Mackey DA, Willoughby CE, Sherwin T, Crosier PS, McGhee CN, Vincent AL. A COL17A1 Splice-Altering Mutation Is Prevalent in Inherited Recurrent Corneal Erosions. Ophthalmology 2016; 123:709-22. [PMID: 26786512 DOI: 10.1016/j.ophtha.2015.12.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/06/2015] [Accepted: 12/05/2015] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Corneal dystrophies are a genetically heterogeneous group of disorders. We previously described a family with an autosomal dominant epithelial recurrent erosion dystrophy (ERED). We aimed to identify the underlying genetic cause of ERED in this family and 3 additional ERED families. We sought to characterize the potential function of the candidate genes using the human and zebrafish cornea. DESIGN Case series study of 4 white families with a similar ERED. An experimental study was performed on human and zebrafish tissue to examine the putative biological function of candidate genes. PARTICIPANTS Four ERED families, including 28 affected and 17 unaffected individuals. METHODS HumanLinkage-12 arrays (Illumina, San Diego, CA) were used to genotype 17 family members. Next-generation exome sequencing was performed on an uncle-niece pair. Segregation of potential causative mutations was confirmed using Sanger sequencing. Protein expression was determined using immunohistochemistry in human and zebrafish cornea. Gene expression in zebrafish was assessed using whole-mount in situ hybridization. Morpholino-induced transient gene knockdown was performed in zebrafish embryos. MAIN OUTCOME MEASURES Linkage microarray, exome analysis, DNA sequence analysis, immunohistochemistry, in situ hybridization, and morpholino-induced genetic knockdown results. RESULTS Linkage microarray analysis identified a candidate region on chromosome chr10:12,576,562-112,763,135, and exploration of exome sequencing data identified 8 putative pathogenic variants in this linkage region. Two variants segregated in 06NZ-TRB1 with ERED: COL17A1 c.3156C→T and DNAJC9 c.334G→A. The COL17A1 c.3156C→T variant segregated in all 4 ERED families. We showed biologically relevant expression of these proteins in human cornea. Both proteins are expressed in the cornea of zebrafish embryos and adults. Zebrafish lacking Col17a1a and Dnajc9 during development show no gross corneal phenotype. CONCLUSIONS The COL17A1 c.3156C→T variant is the likely causative mutation in our recurrent corneal erosion families, and its presence in 4 independent families suggests that it is prevalent in ERED. This same COL17A1 c.3156C→T variant recently was identified in a separate pedigree with ERED. Our study expands the phenotypic spectrum of COL17A1 disease from autosomal recessive epidermolysis bullosa to autosomal dominant ERED and identifies COL17A1 as a key protein in maintaining integrity of the corneal epithelium.
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Affiliation(s)
- Verity F Oliver
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Katherine A van Bysterveldt
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Murray Cadzow
- Department of Biochemistry, Dunedin School of Medicine, Otago University, Dunedin, New Zealand
| | - Bernhard Steger
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Vito Romano
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - David Markie
- Pathology Department, Dunedin School of Medicine, Otago University, Dunedin, New Zealand
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Lions Eye Institute, University of Western Australia, Perth, Australia
| | - David A Mackey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Colin E Willoughby
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom; Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Trevor Sherwin
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Philip S Crosier
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Charles N McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Eye Department, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Andrea L Vincent
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Eye Department, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
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47
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Barbaro V, Nasti AA, Del Vecchio C, Ferrari S, Migliorati A, Raffa P, Lariccia V, Nespeca P, Biasolo M, Willoughby CE, Ponzin D, Palù G, Parolin C, Di Iorio E. Correction of Mutant p63 in EEC Syndrome Using siRNA Mediated Allele-Specific Silencing Restores Defective Stem Cell Function. Stem Cells 2016; 34:1588-600. [PMID: 26891374 DOI: 10.1002/stem.2343] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 12/14/2015] [Accepted: 01/01/2016] [Indexed: 12/19/2022]
Abstract
Ectrodactyly-Ectodermal dysplasia-Clefting (EEC) syndrome is a rare autosomal dominant disease caused by heterozygous mutations in the p63 gene and characterized by limb defects, orofacial clefting, ectodermal dysplasia, and ocular defects. Patients develop progressive total bilateral limbal stem cell deficiency, which eventually results in corneal blindness. Medical and surgical treatments are ineffective and of limited benefit. Oral mucosa epithelial stem cells (OMESCs) represent an alternative source of stem cells capable of regenerating the corneal epithelium and, combined with gene therapy, could provide an attractive therapeutic avenue. OMESCs from EEC patients carrying the most severe p63 mutations (p.R279H and p.R304Q) were characterized and the genetic defect of p.R279H silenced using allele-specific (AS) small interfering RNAs (siRNAs). Systematic screening of locked nucleic acid (LNA)-siRNAs against R279H-p63 allele in (i) stable WT-ΔNp63α-RFP and R279H-ΔNp63α-EGFP cell lines, (ii) transient doubly transfected cell lines, and (iii) p.R279H OMESCs, identified a number of potent siRNA inhibitors for the mutant allele, which had no effect on wild-type p63. In addition, siRNA treatment led to longer acquired life span of mutated stem cells compared to controls, less accelerated stem cell differentiation in vitro, reduced proliferation properties, and effective ability in correcting the epithelial hypoplasia, thus giving rise to full thickness stratified and differentiated epithelia. This study demonstrates the phenotypic correction of mutant stem cells (OMESCs) in EEC syndrome by means of siRNA mediated AS silencing with restoration of function. The application of siRNA, alone or in combination with cell-based therapies, offers a therapeutic strategy for corneal blindness in EEC syndrome. Stem Cells 2016;34:1588-1600.
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Affiliation(s)
- Vanessa Barbaro
- Research Centre, Fondazione Banca degli Occhi del Veneto, 30174, Venice, Italy
| | - Annamaria A Nasti
- Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
| | | | - Stefano Ferrari
- Research Centre, Fondazione Banca degli Occhi del Veneto, 30174, Venice, Italy
| | - Angelo Migliorati
- Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
| | - Paolo Raffa
- Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
| | - Vincenzo Lariccia
- Department of Biomedical Sciences and Public Health, School of Medicine, University "Politecnica delle Marche", 60120, Ancona, Italy
| | - Patrizia Nespeca
- Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
| | - Mariangela Biasolo
- Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
| | - Colin E Willoughby
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Diego Ponzin
- Research Centre, Fondazione Banca degli Occhi del Veneto, 30174, Venice, Italy
| | - Giorgio Palù
- Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
| | - Cristina Parolin
- Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
| | - Enzo Di Iorio
- Research Centre, Fondazione Banca degli Occhi del Veneto, 30174, Venice, Italy.,Department of Molecular Medicine, University of Padua, 35121, Padua, Italy
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Affiliation(s)
- Vito Romano
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Bernhard Steger
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Adriana Kovacova
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Stephen B. Kaye
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Colin E. Willoughby
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
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49
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Chamney S, Cartmill B, Earley O, McConnell V, Willoughby CE. The ocular phenotype of stiff-skin syndrome. Eye (Lond) 2015; 30:156-9. [PMID: 26471116 DOI: 10.1038/eye.2015.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 05/08/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Stiff skin syndrome (SSS; MIM#184900) is a rare autosomal dominantly inherited Mendelian disorder characterised by thickened and stone-hard indurations of the skin, mild hypertrichosis, and limitation of joint mobility with flexion contractures. It is autosomal dominant with high penetrance and results from mutations in the fibrillin 1 (FBN1; MIM*134797) gene. Here we present the associated ocular phenotype in a two generation nonconsanguineous Northern Irish family.METHODS The affected patients underwent complete ophthalmic and orthoptic assessment and genetic testing.RESULTS All three patients had ophthalmoplegia of varying degrees. Direct sequencing of the FBN1 gene detected a heterozygous pathogenic mutation (c.4710G>C; p.Trp1570Cys) in all affected patients.CONCLUSIONS This is the first report of ophthalmoplegia in association with SSS.
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Affiliation(s)
- S Chamney
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK
| | - B Cartmill
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK
| | - O Earley
- Department of Ophthalmology, Mater Hospital, Belfast, UK
| | - V McConnell
- Northern Ireland Regional Genetics Department, Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK
| | - C E Willoughby
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
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50
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Spiteri N, Romano V, Zheng Y, Yadav S, Dwivedi R, Chen J, Ahmad S, Willoughby CE, Kaye SB. Corneal Angiography for Guiding and Evaluating Fine-Needle Diathermy Treatment of Corneal Neovascularization. Ophthalmology 2015; 122:1079-84. [DOI: 10.1016/j.ophtha.2015.02.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/04/2015] [Accepted: 02/05/2015] [Indexed: 11/17/2022] Open
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