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Hudson N, Celkova L, Hopkins A, Greene C, Storti F, Ozaki E, Fahey E, Theodoropoulou S, Kenna PF, Humphries MM, Curtis AM, Demmons E, Browne A, Liddie S, Lawrence MS, Grimm C, Cahill MT, Humphries P, Doyle SL, Campbell M. Dysregulated claudin-5 cycling in the inner retina causes retinal pigment epithelial cell atrophy. JCI Insight 2019; 4:130273. [PMID: 31391341 PMCID: PMC6693834 DOI: 10.1172/jci.insight.130273] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 05/15/2019] [Accepted: 06/27/2019] [Indexed: 11/17/2022] Open
Abstract
Age-related macular degeneration (AMD) is the leading cause of central retinal vision loss worldwide, with an estimated 1 in 10 people over the age of 55 showing early signs of the condition. There are currently no forms of therapy available for the end stage of dry AMD, geographic atrophy (GA). Here, we show that the inner blood-retina barrier (iBRB) is highly dynamic and may play a contributory role in GA development. We have discovered that the gene CLDN5, which encodes claudin-5, a tight junction protein abundantly expressed at the iBRB, is regulated by BMAL1 and the circadian clock. Persistent suppression of claudin-5 expression in mice exposed to a cholesterol-enriched diet induced striking retinal pigment epithelium (RPE) cell atrophy, and persistent targeted suppression of claudin-5 in the macular region of nonhuman primates induced RPE cell atrophy. Moreover, fundus fluorescein angiography in human and nonhuman primate subjects showed increased retinal vascular permeability in the evening compared with the morning. These findings implicate an inner retina-derived component in the early pathophysiological changes observed in AMD, and we suggest that restoring the integrity of the iBRB may represent a novel therapeutic target for the prevention and treatment of GA secondary to dry AMD.
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Affiliation(s)
- Natalie Hudson
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Lucia Celkova
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Alan Hopkins
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Chris Greene
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Federica Storti
- Lab for Retinal Cell Biology, Department of Ophthalmology, University of Zürich, Zürich, Switzerland
| | - Ema Ozaki
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Erin Fahey
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sofia Theodoropoulou
- Academic Unit of Ophthalmology, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Paul F. Kenna
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | | | - Annie M. Curtis
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | | | | | - Christian Grimm
- Lab for Retinal Cell Biology, Department of Ophthalmology, University of Zürich, Zürich, Switzerland
| | - Mark T. Cahill
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Pete Humphries
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Sarah L. Doyle
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Matthew Campbell
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
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Małecki A, Skipor-Lahuta J, Toborek M, Abbott NJ, Antonetti DA, Su EJ, Lawrence DA, Atış M, Akcan U, Yılmaz CU, Orhan N, Düzgün P, Ceylan UD, Arıcan N, Karahüseyinoğlu S, Şahin GN, Ahıshalı B, Kaya M, Aydin S, Klopstein A, Engelhardt B, Baumann J, Tsao CC, Huang SF, Ogunshola O, Boytsova EB, Morgun AV, Khilazheva ED, Pozhilenkova EA, Gorina YV, Martynova GP, Salmina AB, Bueno D, Garcia-Fernàndez J, Castro V, Skowronska M, Toborek M, Chupel MU, Minuzzi LG, Filaire E, Teixeira AM, Corsi M, Versele R, Fuso A, Sevin E, Di Lorenzo C, Businaro R, Fenart L, Gosselet F, Candela P, Deli MA, Delaney C, O’Keefe E, Farrell M, Doyle S, Campbell M, Drewes LR, Appelt-Menzel A, Cubukova A, Metzger M, Fischer R, Francisco DMF, Bruggmann R, Fries A, Blecharz KG, Wagner J, Winkler L, Schneider U, Vajkoczy P, Furuse M, Gabbert L, Dilling C, Sisario D, Soukhoroukov V, Burek M, Guérit S, Fidan E, Devraj K, Czupalla CJ, Macas J, Thom S, Plate KH, Gerhardt H, Liebner S, Harazin A, Bocsik A, Váradi J, Fenyvesi F, Tubak V, Vecsernyés M, Helms HC, Waagepetersen HS, Nielsen CU, Brodin B, Hoyk Z, Tóth ME, Lénárt N, Dukay B, Kittel Á, Vígh J, Veszelka S, Walter F, Zvara Á, Puskás L, Sántha M, Engelhardt S, Ogunshola OO, Huber A, Reitner A, Osmen S, Hahn K, Bounzina N, Gerhartl A, Schönegger A, Steinkellner H, Laccone F, Neuhaus W, Hudson N, Celkova L, Iltzsche A, Drndarski S, Begley DJ, Janiurek MM, Kucharz K, Christoffersen C, Nielsen LB, Lauritzen M, Johnson RH, Kho DT, O’Carroll SJ, Angel CE, Graham ES, Pereira J, Karali CS, Cheng V, Zarghami N, Soto MS, Couch Y, Anthony DC, Sibson NR, Kealy J, Keep RF, Routhe LJ, Xiang J, Ye H, Hua Y, Moos T, Xi G, Kristensen M, Bach A, Strømgaard K, Kutuzov N, Lopes-Pinheiro MA, Lim J, Kamermans A, van Horssen J, Unger WW, Fontijn R, de Vries HE, Majerova P, Garruto RM, Marchetti L, Francisco D, Gruber I, Lyck R, Mészáros M, Porkoláb G, Kiss L, Pilbat AM, Török Z, Bozsó Z, Fülöp L, Michalicova A, Galba J, Mihaljevic S, Novak M, Kovac A, Morofuji Y, Fujimoto T, Watanabe D, Nakagawa S, Ujifuku K, Horie N, Izumo T, Anda T, Matsuo T, Niu F, Buch S, Nyúl-Tóth Á, Kozma M, Nagyőszi P, Nagy K, Fazakas C, Haskó J, Molnár K, Farkas AE, Galajda P, Wilhelm I, Krizbai IA, Kelly E, Wallace E, Greene C, Hughes S, Kealy J, Doyle N, Humphries MM, Grant GA, Friedman A, Veksler R, Molloy MG, Meaney JF, Pender N, Doherty CP, Park M, Liskiewicz A, Przybyla M, Kasprowska-Liśkiewicz D, Nowacka-Chmielewska M, Malecki A, Pombero A, Garcia-Lopez R, Martinez-Morga M, Martinez S, Prager O, Solomon-Kamintsky L, Schoknecht K, Bar-Klein G, Milikovsky D, Vazana U, Rosenbach D, Kovács R, Friedman A, Radak Z, Rodríguez-Lorenzo S, Bruggmann R, Kooij G, de Vries HE, Oxana SG, Denis B, Elena V, Anna A, Alla S, Vladimir S, Andrey M, Nataliya M, Elena K, Elizaveta B, Alexander S, Nikita N, Alla B, Yirong Y, Arkady A, Artem G, Mariya U, Anastasia S, Madina B, Artem S, Alexander K, Esmat SA, Valery P, Artem T, Jürgen K, de Abreu MS, Calpena AC, Espina M, García ML, Romero IA, Male D, Storck S, Hartz A, Pahnke J, Surma CU, Surma M, Giżejewski Z, Zieliński H, Szczepkowska A, Kowalewska M, Krawczynska A, Herman AP, Skipor J, Kachappilly N, Veenstra M, Rivera RL, Williams DW, Morgello S, Berman JW, Wyneken U, Batiz LF, Temizyürek A, Khodadust R, Küçük M, Gürses C, Emik S, Zielińska M, Obara-Michlewska M, Milewski K, Skonieczna E, Fręśko I, Neuwelt EA, Maria ARS, Bras AR, Lipka D, Valkai S, Kincses A, Dér A, Deli MA. Abstracts from the 20th International Symposium on Signal Transduction at the Blood-Brain Barriers. Fluids Barriers CNS 2017. [PMCID: PMC5667590 DOI: 10.1186/s12987-017-0071-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Doyle SL, López FJ, Celkova L, Brennan K, Mulfaul K, Ozaki E, Kenna PF, Kurali E, Hudson N, Doggett T, Ferguson TA, Humphries P, Adamson P, Campbell M. IL-18 Immunotherapy for Neovascular AMD: Tolerability and Efficacy in Nonhuman Primates. Invest Ophthalmol Vis Sci 2015; 56:5424-30. [PMID: 26284546 DOI: 10.1167/iovs.15-17264] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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 Age-related macular degeneration is the most common form of central retinal blindness in the elderly. Of the two end stages of disease, neovascular AMD-although the minority form-is the most severe. Current therapies are highly successful at controlling progression of neovascular lesions; however, a significant number of patients remain refractory to treatment and the development of alternative and additive therapies to anti-VEGFs is essential. METHODS In order to address the translational potential of interleukin (IL)-18 for use in neovascular AMD, we initiated a nonhuman primate tolerability and efficacy study for the use of intravitreally (IVT) administered clinical grade human IL-18 (SB-485232). Cynomolgus monkeys were injected IVT with increasing doses of human IL-18 (two each at 1000, 3000, and 10,000 ng per eye). In tandem, 21 monkeys were administered nine laser burns in each eye prior to receiving IL-18 as an IVT injection at a range of doses. Fundus fluorescein angiography (FFA) was performed on days 8, 15, and 22 post injection and the development of neovascular lesions was assessed. RESULTS We show intravitreal, mature, recombinant human IL-18 is safe and can reduce choroidal neovascular lesion development in cynomolgus monkeys. CONCLUSIONS Based on our data comparing human IL-18 to current anti-VEGF-based therapy, clinical deployment of IL-18 for neovascular AMD has the potential to lead to a new adjuvant immunotherapy-based treatment for this severe form of central blindness.
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Affiliation(s)
- Sarah L Doyle
- Department of Clinical Medicine School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Francisco J López
- Ophthalmology Discovery Performance Unit, GlaxoSmithKline, King of Prussia, Pennsylvania, United States
| | - Lucia Celkova
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Kiva Brennan
- Department of Clinical Medicine School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Kelly Mulfaul
- Department of Clinical Medicine School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Ema Ozaki
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Paul F Kenna
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland 4The Research Foundation, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, Ireland
| | - Edit Kurali
- Statistics Consulting Group, Quantitative Science, PTS, GlaxoSmithKline, King of Prussia, Pennsylvania, United States
| | - Natalie Hudson
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Teresa Doggett
- Department of Ophthalmology and Visual Science, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Thomas A Ferguson
- Department of Ophthalmology and Visual Science, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Peter Humphries
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Peter Adamson
- Ophthalmology Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom 8Ocular Biology and Therapeutics, Institute of Ophthalmology, University College London, London, United Kingdom
| | - Matthew Campbell
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
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