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Jiang H, Foroozandeh P, Kaplan N, Xu D, Yang W, Qi X, Nalbant EK, Clutter ED, Zhu Y, Xu J, Schipma MJ, Ren Z, Peng H. IFITM1/OVOL1 Axis Is a Novel Regulator of the Expansion of the Limbal Epithelial Stem/Early Transient Amplifying Cell Population. FASEB J 2025; 39:e70648. [PMID: 40372397 PMCID: PMC12090970 DOI: 10.1096/fj.202500783r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2025] [Revised: 04/18/2025] [Accepted: 05/07/2025] [Indexed: 05/16/2025]
Abstract
Limbal epithelial stem cells (LESCs), located in the basal layer of the limbal epithelium, rarely proliferate under normal conditions. Upon proliferation, LESCs give rise to early transient amplifying (eTA) cells, which are thought to be morphologically and phenotypically indistinguishable from LESCs. Following corneal epithelial wounding, LESCs are activated to repair the corneal epithelium via expansion of eTA cells, a process crucial for maintaining corneal epithelial homeostasis and tissue transparency as well as essential for clear vision. To understand how this process is regulated, we conducted a single cell RNA sequencing assay of mouse corneal rims with and without injury and observed an expansion of the stem/eTA cell cluster after corneal injury. Interestingly, we found that Interferon Induced Transmembrane Protein 1 (IFITM1) was predominantly expressed in stem/eTA cells and was positively associated with such stem/eTA cell expansion after corneal wounding. In vivo knockdown of IFITM1 using an AAV (adeno-associated virus) vector significantly attenuated stem/eTA cell expansion and activation of stem/eTA cells to proliferate after mouse corneal wounding. In human limbal epithelial cell cultures, IFITM1 positively impacted the proliferation of stem/eTA cell-enriched limbal epithelial cells, contributing to expansion of the stem/eTA cell population. Such expansion was due, in part, to inhibition of OVOL1 (Ovo like zinc finger 1), a negative regulator of epithelial cell proliferation. These results provide key molecular insights into how stem cell activation and eTA cell expansion are regulated. Elucidating the IFITM1/OVOL1 pathway that governs stem/eTA cell proliferation not only deepens our knowledge of tissue homeostasis but also opens avenues for developing novel regenerative therapies.
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Affiliation(s)
- Huimin Jiang
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of OphthalmologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Parisa Foroozandeh
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Nihal Kaplan
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Dan Xu
- Microbiology‐Immunology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Wending Yang
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Xiaolin Qi
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Elif Kayaalp Nalbant
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Elwin D. Clutter
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Yongling Zhu
- Department of Ophthalmology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Jian Xu
- Department of Neuroscience, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Matthew John Schipma
- Department of Biochemistry and Molecular Genetics, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Ziyou Ren
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Han Peng
- Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
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Kayaalp Nalbant E, Feliciano TJ, Mohammadlou A, Xiong VL, Trujillo JE, Calvert AE, Kaplan N, Foroozandeh P, Kim J, Bai EM, Qi X, Tobias F, Roth EW, Dravid VP, Lu KQ, Nguyen ST, Shad Thaxton C, Peng H, Lavker RM. A novel therapy to ameliorate nitrogen mustard-induced limbal stem cell deficiency using lipoprotein-like nanoparticles. NPJ Regen Med 2025; 10:14. [PMID: 40113808 PMCID: PMC11926173 DOI: 10.1038/s41536-025-00402-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Accepted: 03/06/2025] [Indexed: 03/22/2025] Open
Abstract
Chronic corneal inflammation, a component of sulfur mustard (SM) and nitrogen mustard (NM) injuries frequently leads to limbal stem cell deficiency (LSCD), which can compromise vision. Corneal conjunctivalization, neovascularization, and persistent inflammation are hallmarks of LSCD. Ocular exposure to SM and NM results in an acute and delayed phase of corneal disruption, culminating in LSCD. Available therapies for mustard keratopathy (e.g., topical corticosteroids) often have adverse side effects, and generally are ineffective in preventing the development of LSCD. We developed a novel, optically transparent HDL nanoparticle (NP) with an organic core (oc) molecular scaffold. This unique oc-HDL NP: (i) markedly improved corneal haze during the acute and delayed phases in vivo; (ii) significantly reduced the inflammatory response; and (iii) blunted conjunctivalization and corneal neovascularization during the delayed phase. These findings strongly suggest that our HDL NP is an ideal treatment for mustard keratopathy and other chronic corneal inflammatory diseases.
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Affiliation(s)
- Elif Kayaalp Nalbant
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Timothy J Feliciano
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Simpson Querrey Institute for BioNanotechnology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Vincent L Xiong
- Department of Chemistry, Northwestern University, Evanston, IL, USA
| | - Jacquelyn E Trujillo
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrea E Calvert
- Simpson Querrey Institute for BioNanotechnology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nihal Kaplan
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Parisa Foroozandeh
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jayden Kim
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emma M Bai
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Xiaolin Qi
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Fernando Tobias
- Department of Chemistry, Northwestern University, Evanston, IL, USA
| | - Eric W Roth
- Department of Materials Science, Northwestern University, Evanston, IL, USA
| | - Vinayak P Dravid
- Department of Materials Science, Northwestern University, Evanston, IL, USA
| | - Kurt Q Lu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - SonBinh T Nguyen
- Department of Chemistry, Northwestern University, Evanston, IL, USA.
| | - C Shad Thaxton
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Simpson Querrey Institute for BioNanotechnology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Han Peng
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Robert M Lavker
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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3
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Peng H, Kaplan N, Liu M, Jiang H, Lavker RM. Keeping an Eye Out for Autophagy in the Cornea: Sample Preparation for Single-Cell RNA-Sequencing. Methods Mol Biol 2025; 2879:113-122. [PMID: 37930627 PMCID: PMC11162605 DOI: 10.1007/7651_2023_502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Single-cell RNA-sequencing (scRNA-seq) is a powerful technique that can barcode individual cells and thus used to obtain a gene expression profile for every individual cell within a tissue. This makes scRNA-seq an excellent method for characterizing rare cell populations such as stem cells. We describe how scRNA-seq can be utilized to examine limbal epithelial stem cell population as well as investigate the contribution of autophagy to the function of limbal epithelial stem cells. To accomplish this, we used the Beclin1 heterozygous (Beclin1 het) mouse, a well-established model of autophagy deficiency. We provide a protocol that we developed for the isolation of viable, single-cell suspensions of limbal/corneal tissues, as well as the analysis of scRNA-seq data.
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Affiliation(s)
- Han Peng
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - Nihal Kaplan
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - Min Liu
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - Huimin Jiang
- Department of Dermatology, Northwestern University, Chicago, IL, USA
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Robert M Lavker
- Department of Dermatology, Northwestern University, Chicago, IL, USA.
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4
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Reichert D, Sharma R, May-Simera H, Bharti K. Role of Primary Cilia in the Eye. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2025; 1468:441-445. [PMID: 39930235 DOI: 10.1007/978-3-031-76550-6_72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2025]
Abstract
Primary cilia are evolutionarily conserved organelles that regulate various aspects of cell development, differentiation, and function. Defects in primary cilia lead to diseases known as ciliopathies, with vision loss as one of the most frequent manifestations. Increasing evidence suggests that in addition to the connecting cilium of photoreceptors in the retina, ciliary defects in other ocular tissues contribute toward the vision loss phenotype seen in ciliopathy patients. This review explores the current literature on the role of primary cilia in the anterior chamber, including the cornea, trabecular meshwork, iris, and ciliary body, and in retinal non-photoreceptor cells, and retinal pigment epithelium.
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Affiliation(s)
- Dominik Reichert
- Ocular and Stem Cell Translational Research Section, National Eye Institute, Bethesda, MD, USA
- Institute of Molecular Physiology, Johannes Gutenberg Universität, Mainz, Germany
| | - Ruchi Sharma
- Ocular and Stem Cell Translational Research Section, National Eye Institute, Bethesda, MD, USA
| | - Helen May-Simera
- Institute of Molecular Physiology, Johannes Gutenberg Universität, Mainz, Germany
| | - Kapil Bharti
- Ocular and Stem Cell Translational Research Section, National Eye Institute, Bethesda, MD, USA.
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Jiang H, Liu M, Yang W, Hong YK, Xu D, Nalbant EK, Clutter ED, Foroozandeh P, Kaplan N, Wysocki J, Batlle D, Miller SD, Lu K, Peng H. Activation of limbal epithelial proliferation is partly controlled by the ACE2-LCN2 pathway. iScience 2024; 27:110534. [PMID: 39175771 PMCID: PMC11338997 DOI: 10.1016/j.isci.2024.110534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/19/2024] [Accepted: 07/15/2024] [Indexed: 08/24/2024] Open
Abstract
In response to corneal injury, an activation of corneal epithelial stem cells and their direct progeny the early transit amplifying (eTA) cells to rapidly proliferate is critical for proper re-epithelialization. Thus, it is important to understand how such stem/eTA cell activation is regulated. Angiotensin-converting enzyme 2 (ACE2) is predominantly expressed in the stem/eTA-enriched limbal epithelium but its role in the limbal epithelium was unclear. Single cell RNA sequencing (scRNA-seq) suggested that Ace2 involved the proliferation of the stem/eTA cells. Ace2 was reduced following corneal injury. Such reduction enhanced limbal epithelial proliferation and downregulated LCN2, a negative regulator of proliferation in a variety of tissues, via upregulating TGFA and consequently activating epidermal growth factor receptor (EGFR). Inhibition of EGFR or overexpression of LCN2 reversed the increased proliferation in limbal epithelial cells lacking ACE2. Our findings demonstrate that after corneal injury, ACE2 is downregulated, which activates limbal epithelial cell proliferation via a TGFA/EGFR/LCN2 pathway.
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Affiliation(s)
- Huimin Jiang
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei 230601, China
| | - Min Liu
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Wending Yang
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Yi-Kai Hong
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Dan Xu
- Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Elif Kayaalp Nalbant
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Elwin D. Clutter
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Parisa Foroozandeh
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Nihal Kaplan
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Jan Wysocki
- Medicine (Nephrology and Hypertension), Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Daniel Batlle
- Medicine (Nephrology and Hypertension), Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Stephen D. Miller
- Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Kurt Lu
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Han Peng
- Departments of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Shi Y, Wu Z, Zeng P, Song J, Guo J, Yang X, Zhou J, Liu J, Hou L. Seneca valley virus 3C protease blocks EphA2-Mediated mTOR activation to facilitate viral replication. Microb Pathog 2024; 191:106673. [PMID: 38705218 DOI: 10.1016/j.micpath.2024.106673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024]
Abstract
The Seneca Valley virus (SVV) is a recently discovered porcine pathogen that causes vesicular diseases and poses a significant threat to the pig industry worldwide. Erythropoietin-producing hepatoma receptor A2 (EphA2) is involved in the activation of the AKT/mTOR signaling pathway, which is involved in autophagy. However, the regulatory relationship between SVV and EphA2 remains unclear. In this study, we demonstrated that EphA2 is proteolysed in SVV-infected BHK-21 and PK-15 cells. Overexpression of EphA2 significantly inhibited SVV replication, as evidenced by decreased viral protein expression, viral titers, and viral load, suggesting an antiviral function of EphA2. Subsequently, viral proteins involved in the proteolysis of EphA2 were screened, and the SVV 3C protease (3Cpro) was found to be responsible for this cleavage, depending on its protease activity. However, the protease activity sites of 3Cpro did not affect the interactions between 3Cpro and EphA2. We further determined that EphA2 overexpression inhibited autophagy by activating the mTOR pathway and suppressing SVV replication. Taken together, these results indicate that SVV 3Cpro targets EphA2 for cleavage to impair its EphA2-mediated antiviral activity and emphasize the potential of the molecular interactions involved in developing antiviral strategies against SVV infection.
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Affiliation(s)
- Yongyan Shi
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Zhi Wu
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Penghui Zeng
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Jiangwei Song
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, China
| | - Jinshuo Guo
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Xiaoyu Yang
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Jianwei Zhou
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Jue Liu
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Lei Hou
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China.
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Geng Y, Han Y, Wang S, Qi J, Bi X. Screening and Validation of Key Genes of Autophagy in Acute Myocardial Infarction Based on Bioinformatics. Evol Bioinform Online 2024; 20:11769343241227331. [PMID: 38314309 PMCID: PMC10832399 DOI: 10.1177/11769343241227331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/04/2024] [Indexed: 02/06/2024] Open
Abstract
Aims Autophagy plays a significant role in the development of acute myocardial infarction (AMI), and cardiomyocyte autophagy is of major importance in maintaining cardiac function. We aimed to identify key genes associated with autophagy in AMI through bioinformatics analysis and verify them through clinical validation. Materials and Methods We downloaded an AMI expression profile dataset GSE166780 from Gene Expression Omnibus (GEO). Autophagy-associated genes potentially differentially expressed in AMI were screened using R software. Then, to identify key autophagy-related genes, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, protein-protein interaction (PPI) analysis, Receiver Operating Characteristic (ROC) curve analysis, and correlation analysis were performed on the differentially expressed autophagy-related genes in AMI. Finally, we used quantificational real-time polymerase chain reaction (qRT-PCR) to verify the RNA expression of the screened key genes. Results TSC2, HSPA8, and HIF1A were screened out as key autophagy-related genes. qRT-PCR results showed that the expression levels of HSPA8 and TSC2 in AMI blood samples were lower, while the expression level of HIF1A was higher than that in the healthy controls. Conclusions TSC2, HSPA8, and HIF1A were identified as key autophagy-related genes in this study. They may influence the development of AMI through autophagy. These findings may help deepen our understanding of AMI and may be useful for the treatment of AMI.
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Affiliation(s)
- Yingjie Geng
- Department of Cardiology, Zibo Central Hospital, Zibo, Shandong Province, China
| | - Yu’e Han
- Department of Pulmonary and Critical Care Medicine, Zibo Central Hospital, Zibo, Shandong Province, China
| | - Shujuan Wang
- Department of Cardiology, Zibo Central Hospital, Zibo, Shandong Province, China
| | - Jia Qi
- Department of Cardiology, Zibo Central Hospital, Zibo, Shandong Province, China
| | - Xiaoli Bi
- Department of Cardiology, Zibo First Hospital, Zibo, Shandong Province, China
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Dias-Teixeira KL, Sharifian Gh M, Romano J, Norouzi F, Laurie GW. Autophagy in the normal and diseased cornea. Exp Eye Res 2022; 225:109274. [PMID: 36252655 PMCID: PMC10083687 DOI: 10.1016/j.exer.2022.109274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 01/18/2023]
Abstract
The cornea and covering tear film are together the 'objective lens' of the eye through which 80% of light is refracted. Despite exposure to a physically harsh and at times infectious or toxic environment, transparency essential for sight is in most cases maintained. Such resiliency makes the avascular cornea a superb model for the exploration of autophagy in the regulation of homeostasis with relevancy to all organs. Nonetheless, missense mutations and inflammation respectively clog or apparently overwhelm autophagic flux to create dystrophies much like in neurodegenerative diseases or further exacerbate inflammation. Here there is opportunity to generate novel topical therapies towards the restoration of homeostasis with potential broad application.
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Affiliation(s)
| | | | - Jeff Romano
- Department of Cell Biology, University of Virginia, Charlottesville, VA, USA
| | - Fatemeh Norouzi
- Department of Cell Biology, University of Virginia, Charlottesville, VA, USA
| | - Gordon W Laurie
- Department of Cell Biology, University of Virginia, Charlottesville, VA, USA; Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA; Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA.
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