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Ng QX, Tang ASP, Chan KE, Chan HW, Howard N, Koh GCH. Lived experiences of patients, families and caregivers affected by inherited retinal diseases: A qualitative systematic review. Disabil Health J 2025; 18:101826. [PMID: 40148154 DOI: 10.1016/j.dhjo.2025.101826] [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: 09/29/2024] [Revised: 02/28/2025] [Accepted: 03/19/2025] [Indexed: 03/29/2025]
Abstract
BACKGROUND Inherited retinal diseases (IRDs) are a heterogeneous group of genetic disorders, and a leading cause of vision impairment or blindness, affecting millions worldwide. Despite advances in understanding its phenotype, the physical and psychological impacts of IRDs on patients and their families and caregivers remain underexplored. OBJECTIVE This review thus aimed to summarize the existing literature in this area. METHODS Following PRISMA guidelines and using search terms such as "inherited retinal disease", "psychological impact", "social impact", and "qualitative research", a systematic search was conducted across PubMed Central, EMBASE, Scopus, and PsycINFO databases up to February 29, 2024, for qualitative studies on the impact of IRDs. The findings were then synthesized narratively to provide a cohesive interpretation. RESULTS A total of 20 studies involving 474 participants across six countries (Australia, Belgium, Italy, Sweden, the UK, and the US) were included. Key themes included the significant impact on daily living and independence, work and professional life, coping strategies and resilience, and the emotional burden on families and caregivers. Genetic testing and its implications (reproductive decisions and insurance discrimination) also emerged as an area of concern. IRDs profoundly affect patients and their families and caregivers, influencing daily life, well-being, and societal participation. CONCLUSIONS Despite the challenges, resilience and adaptability are prominent, and the findings emphasize the need for comprehensive care that includes psychological support, work adjustments and policies that address the needs of this population. Understanding these quality-of-life issues and areas of unmet need is relevant for healthcare providers, policymakers, and researchers globally.
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Affiliation(s)
- Qin Xiang Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Health Services Research Unit, Singapore General Hospital, Singapore.
| | - Ansel Shao Pin Tang
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kai En Chan
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hwei Wuen Chan
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Ophthalmology, National University Hospital, Singapore
| | - Natasha Howard
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Gerald Choon Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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2
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Getachew H, Mehrotra S, Kaur T, Fernandez-Godino R, Pierce EA, Garita-Hernandez M. The RNA content of extracellular vesicles from gene-edited PRPF31 +/- hiPSC-RPE show potential as biomarkers of retinal degeneration. Mol Ther Methods Clin Dev 2025; 33:101452. [PMID: 40231248 PMCID: PMC11995067 DOI: 10.1016/j.omtm.2025.101452] [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: 10/01/2024] [Accepted: 03/13/2025] [Indexed: 04/16/2025]
Abstract
Retinitis pigmentosa (RP) is the most common inherited retinal degeneration (IRD), causing vision loss via the dysfunction and death of photoreceptors and retinal pigment epithelium (RPE). Mutations in the PRPF31 gene are associated with autosomal dominant RP, impairing RPE function. While adeno-associated virus (AAV)-mediated gene therapy shows promise for treating IRDs, the slow progression of these diseases often makes timely measurement of clinical efficacy challenging. Extracellular vesicles (EVs) are lipid enclosed vesicles secreted by cells, and their RNA contents are being explored as circulating biomarkers for other diseases. We hypothesize that EV RNAs could serve as biomarkers of the health status of the neural retina and RPE. To test this, we used PRPF31 +/+ and PRPF31 +/- human induced pluripotent stem cell (hiPSC)-derived RPE (hi-RPE) to investigate the RNAs contained in RPE-derived EVs and how they change in disease. We also compared the RNA contents of RPE-EVs with the RNAs of the hi-RPE cells themselves. We found that EVs from mutant PRPF31 hi-RPE cells have distinct RNA profiles compared to those from control cells, suggesting that EV RNA contents change during disease. Additionally, we identified 18 miRNAs and 865 poly(A) RNAs enriched in EVs from PRPF31 +/- hi-RPE, which could serve as biomarkers for RPE degeneration.
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Affiliation(s)
- Heran Getachew
- Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Sudeep Mehrotra
- Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Tarandeep Kaur
- Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Rosario Fernandez-Godino
- Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Eric A. Pierce
- Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Marcela Garita-Hernandez
- Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
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3
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Murphy DP, Kolesnikov AV, Montana CL, Khaja ZM, Liu Y, Kefalov VJ, Corbo JC. Mechanisms of photoreceptor protection upon targeting the Nrl-Nr2e3 pathway. Proc Natl Acad Sci U S A 2025; 122:e2500446122. [PMID: 40397675 DOI: 10.1073/pnas.2500446122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Accepted: 04/07/2025] [Indexed: 05/23/2025] Open
Abstract
Acute knockout of the rod photoreceptor transcription factor Nrl delays retinal degeneration in multiple mouse models of blindness, but the downstream transcriptomic changes that mediate these therapeutic effects are unknown. Here, we show that acute Nrl knockout causes upregulation of a subset of cone genes in rods as well as downregulation of rod genes, including the rod-specific transcriptional repressor Nr2e3. We hypothesized that Nr2e3 downregulation might mediate some of the therapeutic effects of Nrl knockout. Indeed, acute knockout of Nr2e3 prevents photoreceptor degeneration and preserves visual function in mice with mutations in the catalytic subunit of the rod-specific phosphodiesterase (Pde6brd10/rd10). Upregulation of Pde6c, the cone-specific paralog of Pde6b, in Nr2e3-knockout rods is required to prevent degeneration in Pde6brd10/rd10 mice, suggesting that this therapeutic effect is mediated, at least in part, by a gene-replacement mechanism. In contrast, acute Nr2e3 knockout fails to prevent degeneration caused by loss- or gain-of-function mutations in Rhodopsin (Rho-/- and RhoP23H/P23H), whereas acute Nrl knockout delays degeneration in both models. Surprisingly, the therapeutic effect of acute Nrl knockout in Pde6brd10/rd10 mice does not depend on Pde6c upregulation. These results suggest that acute Nrl knockout may exert its therapeutic effects via a mechanism independent of Nr2e3 downregulation, perhaps by downregulating other rod genes. We conclude that acute NRL knockout may be a promising gene-independent strategy for preventing photoreceptor degeneration in human patients.
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Affiliation(s)
- Daniel P Murphy
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110
| | - Alexander V Kolesnikov
- Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, CA 92617
| | - Cynthia L Montana
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110
- Department of Ophthalmology, Washington University School of Medicine, St. Louis, MO 63110
| | - Zaid M Khaja
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110
- Saint Louis University School of Medicine, St. Louis, MO 63104
| | - Yu Liu
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110
| | - Vladimir J Kefalov
- Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, CA 92617
- Department of Physiology and Biophysics, University of California, Irvine, CA 92617
| | - Joseph C Corbo
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110
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Nebbioso M, Artico M, Gharbiya M, Mannocci A, Limoli PG, Iannetta D, Donato L. State of the Art on Inherited Retinal Dystrophies: Management and Molecular Genetics. J Clin Med 2025; 14:3526. [PMID: 40429522 PMCID: PMC12112326 DOI: 10.3390/jcm14103526] [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: 04/19/2025] [Revised: 05/12/2025] [Accepted: 05/16/2025] [Indexed: 05/29/2025] Open
Abstract
Inherited retinal dystrophies (IRDs) represent a group of heterogeneous disorders caused by gene mutations primarily affecting retinal photoreceptors. In addition to vision loss, other symptoms may lead to visual impairment, such as altered visual fields, hemeralopia, glare sensitivity, and impaired color vision. These conditions almost always complicate with the onset of cataracts, macular edema or atrophy, glaucoma, etc. A brief overview of key genes involved in the most common and well-known IRDs is provided, followed by clinical and diagnostic implications. The study of IRDs has seen a significant acceleration in recent decades, owing to advances in molecular genetics with the introduction of exome sequencing (WES) and genome-wide association studies (GWASs), which have facilitated the identification of a broad spectrum of genes associated with IRDs. This has led to the classification of five genetic variants, based on the criteria of the American College of Medical Genetics and Genomics (ACMG), serving as a guide for interpreting genetic reports. Next, approaches to genomic editing therapies and research directions regarding artificial intelligence (AI) and machine learning (ML) are discussed. The paper concludes with an examination of the inevitable ethical and regulatory issues, typically driven by regulatory bodies such as the Food and Drug Administration (FDA).
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Affiliation(s)
- Marcella Nebbioso
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy; (M.A.); (M.G.); (D.I.)
| | - Marco Artico
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy; (M.A.); (M.G.); (D.I.)
| | - Magda Gharbiya
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy; (M.A.); (M.G.); (D.I.)
| | - Alice Mannocci
- Department for the Promotion of Human Sciences and Quality of Life, University San Raffaele, 00166 Rome, Italy;
- Clinical and Molecular Epidemiology, IRCCS San Raffaele, 00163 Rome, Italy
| | | | - Danilo Iannetta
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy; (M.A.); (M.G.); (D.I.)
| | - Luigi Donato
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, 98125 Messina, Italy;
- Department of Biomolecular Strategies, Genetics and Cutting-Edge Therapies, Istituto Euro Mediterraneo di Scienza e Tecnologia (I.E.ME.S.T.), 90139 Palermo, Italy
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5
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Wong W, Sumodhee D, Morris T, Tailor B, Hollyhead C, Woof WA, Archer S, Veal C, Lobo L, Al-Khuzaei S, Varela MD, C de Guimaraes TA, Gomes M, Shah M, Moosajee M, Downes SM, Madhusudhan S, Mahroo OA, Webster AR, Michaelides M, Pontikos N. Inherited retinal disease pathway in the UK: a patient perspective and the potential of AI. Br J Ophthalmol 2025:bjo-2024-327074. [PMID: 40345840 DOI: 10.1136/bjo-2024-327074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2025] [Accepted: 04/17/2025] [Indexed: 05/11/2025]
Abstract
BACKGROUND Inherited retinal diseases (IRDs) are the leading cause of blindness in young people in the UK. Despite significant improvements in genomics medicine, the diagnosis of these conditions remains challenging, and around 40% do not receive a definite genetic diagnosis after extensive genetic testing. This survey aims to investigate the experience of individuals affected by IRDs, their relatives, friends and caregivers, focusing on their care and diagnostic journey. Additionally, it explores the potential acceptability of artificial intelligence (AI) technologies, such as Eye2Gene, that predict causative genes from retinal images of patients with IRDs. METHODS This cross-sectional survey included Likert scale and open-ended questions and was distributed electronically using the Qualtrics platform between April and August 2024. The survey included questions on respondent demographics; their journey to receive specialist care and genetic testing; their information needs and their attitude towards AI-augmented diagnosis. Descriptive statistics and content analysis were used to interpret the survey responses. RESULTS The survey had 247 responses, of which 242 were analysed after removing four duplicates and one without consent; 80.2% were patients and the remainder were relatives, friends or caregivers. There was substantial variability in patient diagnostic journeys in terms of waiting times to see a specialist (IQR, 1-4 years), commute required (IQR, 10-74 miles) and number of visits to reach a diagnosis (IQR, 2-4). A substantial proportion of patients (35.8%) had a change in diagnosis. The majority of respondents (>90%) were overwhelmingly in favour of the integration of AI into the IRD pathway to accelerate genetic diagnosis and improve care. CONCLUSION This survey identifies several key gaps and disparities in the IRD care pathway which may potentially be bridged with AI. The survey also reveals a favourable attitude towards incorporating AI into diagnostic testing of IRDs.
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Affiliation(s)
- Wendy Wong
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Department of Ophthalmology, Centre for Innovation, Singapore
| | - Dayyanah Sumodhee
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Bhavna Tailor
- Eye2Gene Patient Advisory Group, London, UK
- Stargardt's Connected, Waltham Cross, UK
| | | | - William A Woof
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Eye2Gene Patient Advisory Group, London, UK
| | | | - Carl Veal
- Eye2Gene Patient Advisory Group, London, UK
| | - Loy Lobo
- Eye2Gene Patient Advisory Group, London, UK
| | | | - Malena Daich Varela
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Thales A C de Guimaraes
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Department of Ophthalmology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | | | - Mital Shah
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mariya Moosajee
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | | | - Omar A Mahroo
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Andrew R Webster
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Michel Michaelides
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Nikolas Pontikos
- University College London Institute of Ophthalmology, London, UK
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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6
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Parekh B, Peck-Dimit N, Duncan JL, Samarakoon L, Abalem MF, Andrews CA, Audo I, Ayala AR, Bradley C, Cheetham JK, Dagnelie G, Durham TA, Huckfeldt RM, Lacy GD, Malbin B, Michaelides M, Musch DC, Stingl K, Weng CY, Zmejkoski AZ, Melia M, Jayasundera KT, Foundation Fighting Blindness Clinical Consortium Investigator Group. Functional Vision Assessment Over 4 Years in USH2A Using the Veteran Affairs Low-Vision Visual Functioning Questionnaire. Invest Ophthalmol Vis Sci 2025; 66:39. [PMID: 40423621 PMCID: PMC12124157 DOI: 10.1167/iovs.66.5.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 04/24/2025] [Indexed: 05/28/2025] Open
Abstract
Purpose The purpose of this study was to evaluate the validity of the Veterans Affairs Low Vision Visual Functioning Questionnaire (VALVVFQ-48) functional vision scores (FVS) in patients with USH2A-associated retinal degeneration. In addition, to correlate the change in the VALVVFQ-48 FVS with the change in visual function (VF) measurements. Methods The VALVVFQ-48 was administered verbally to participants ≥18 years of age at baseline, and after 2 and 4 years. Associations among changes in FVS and changes in VF measures were assessed using the Spearman correlation coefficients. Mixed effects regression models with a random intercept were used to estimate annual rates of change of FVS and their responsiveness to change in VF measurements. Results All domain scores (except visual motor) showed significant decline over 4 years. Changes in the VALVVFQ-48 domain scores were negligibly to strongly correlated with changes in clinical measures of vision function over 4 years (|r| = 0.02 to 0.61). All domains showed evidence of responsiveness to changes in some VF measures, particularly the visual field. Participants with improvement and worsening in FVS beyond the coefficient of repeatability (CoR) ranged between 17% and 46% across all domains. Ceiling effects at baseline precluded accurate calculation of change over time in 19% to 36% of participants in 3 domains. Conclusions The VALVVFQ-48 may not be a sensitive measure for evaluating longitudinal outcomes in all persons with USH2A-associated retinal degeneration.
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Affiliation(s)
- Bela Parekh
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
- University of Michigan, Medical School, Ann Arbor, Michigan, United States
| | - Nicholas Peck-Dimit
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
| | - Jacque L Duncan
- University of California, San Francisco, San Francisco, California, United States
| | | | - Maria Fernanda Abalem
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
| | - Chris A Andrews
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
| | - Isabelle Audo
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and INSERM-DGOS CIC1423, Paris, France
| | - Allison R Ayala
- Jaeb Center for Health Research, Tampa, Florida, United States
| | - Chris Bradley
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
| | - Janet K Cheetham
- Foundation Fighting Blindness, Columbia, Maryland, United States
| | - Gislin Dagnelie
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
| | - Todd A Durham
- Foundation Fighting Blindness, Columbia, Maryland, United States
| | | | - Gabrielle D Lacy
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
| | - Brett Malbin
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Michel Michaelides
- Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United Staes
| | - Katarina Stingl
- University Eye Hospital, Center for Ophthalmology, University of Tübingen, Tübingen, Germany
- Center for Rare Eye Diseases, University of Tübingen, Tübingen, Germany
| | | | - Alex Z Zmejkoski
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
| | - Michele Melia
- Jaeb Center for Health Research, Tampa, Florida, United States
| | - K Thiran Jayasundera
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
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Zaluski J, Bassetto M, Kiser PD, Tochtrop GP. Advances and therapeutic opportunities in visual cycle modulation. Prog Retin Eye Res 2025; 106:101360. [PMID: 40280538 PMCID: PMC12147667 DOI: 10.1016/j.preteyeres.2025.101360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2025] [Revised: 04/19/2025] [Accepted: 04/21/2025] [Indexed: 04/29/2025]
Abstract
The visual cycle is a metabolic pathway that enables continuous vision by regenerating the 11-cis-retinal chromophore for photoreceptors opsins. Although integral to normal visual function, the flux of retinoids through this cycle can contribute to a range of retinal pathologies, including Stargardt disease, age-related macular degeneration, and diabetic retinopathy. In such conditions, intermediates and byproducts of the visual cycle, such as bisretinoid components of lipofuscin, can accumulate, concomitant with cellular damage and eventual photoreceptor loss. This has inspired efforts to modulate the visual cycle, aiming to slow or prevent the formation of these toxic intermediates and thus preserve retinal structure and function. Over the past two decades, multiple strategies to modulate the visual cycle have emerged. These include both intrinsic approaches, targeting key enzymes, retinoid-binding proteins, or receptors within the pigment epithelium or photoreceptors (e.g., RPE65, CRBP1, and rhodopsin inhibitors/antagonists) and extrinsic strategies that indirectly alter retinoid availability within the retina (e.g., RBP4 antagonists). Many of these agents have shown promise in animal models of visual cycle-associated retinal diseases, reducing pathological changes, and improving retinal survival. Several have advanced into clinical studies, although none are currently FDA-approved. Challenges remain in optimizing drug specificity and duration of action while minimizing side effects such as nyctalopia. In this review, we comprehensively examine current and emerging visual cycle modulators, discuss their medicinal chemistry, mechanisms of action, efficacy in preclinical and clinical studies, and highlight future opportunities for drug discovery aimed at safely and effectively preserving vision through modulation of this biochemical pathway.
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Affiliation(s)
- Jordan Zaluski
- Department of Chemistry, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Marco Bassetto
- Department of Physiology and Biophysics, School of Medicine, University of California- Irvine, Irvine, CA, 92697, USA; Department of Ophthalmology, Gavin Herbert Eye Institute, Center for Translational Vision Research, School of Medicine, University of California- Irvine, Irvine, CA, 92697, USA; Research Service, VA Long Beach Healthcare System, Long Beach, CA, 90822, USA
| | - Philip D Kiser
- Department of Physiology and Biophysics, School of Medicine, University of California- Irvine, Irvine, CA, 92697, USA; Department of Ophthalmology, Gavin Herbert Eye Institute, Center for Translational Vision Research, School of Medicine, University of California- Irvine, Irvine, CA, 92697, USA; Research Service, VA Long Beach Healthcare System, Long Beach, CA, 90822, USA; Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California - Irvine, Irvine, CA, 92697, USA.
| | - Gregory P Tochtrop
- Department of Chemistry, Case Western Reserve University, Cleveland, OH, 44106, USA.
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8
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De Geer K, Löfgren S, Lindstrand A, Kvarnung M, Björck E. The value of age of onset and family history as predictors of molecular diagnosis in a Swedish cohort of inherited retinal disease. Acta Ophthalmol 2025; 103:327-338. [PMID: 39643591 PMCID: PMC11986402 DOI: 10.1111/aos.16804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Accepted: 11/18/2024] [Indexed: 12/09/2024]
Abstract
PURPOSE This study aimed to characterize clinical and genetic findings in a Swedish cohort with inherited retinal disease (IRD), identify predictors for achieving a molecular diagnosis and evaluate the effects of increased genetic testing over time. METHODS Clinical and genetic data from 324 nonrelated IRD index individuals referred for genetic testing in the Stockholm region between 2016 and 2023 were collected retrospectively and analysed by clinical subtype, age of onset and testing period (2016-2020 vs. 2021-2023). Logistic regression was used to calculate odds ratios for age of onset and family history on the likelihood of achieving a molecular diagnosis. RESULTS The diagnostic yield was 55% and involved 56 genes. In 10% of solved individuals, the molecular diagnosis refined the clinical diagnosis. For each 1-year increase in age of onset, the odds of achieving a molecular diagnosis decreased by 3% (odds ratio 0.97, 95% confidence interval 0.96-0.98). A positive family history doubled the odds (odds ratio 2.1, 95% confidence interval 1.3-3.4). The use of genetic testing increased 2.1-fold and the number of molecular diagnoses increased 1.6-fold relative to the population of the Stockholm region between the two testing periods. CONCLUSION This study adds to the knowledge of the clinical and genetic landscape of IRDs in Sweden and establishes age of onset and family history as significant predictors for achieving a molecular diagnosis. Increased genetic testing on a population level substantially increased the number of individuals receiving a molecular diagnosis with a high diagnostic yield compared to other rare diseases.
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Affiliation(s)
- Karl De Geer
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
- Department of Clinical Genetics and GenomicsKarolinska University HospitalStockholmSweden
| | - Stefan Löfgren
- Department of Clinical Neuroscience, Division of Ophthalmology and VisionKarolinska InstitutetStockholmSweden
- St Erik Eye HospitalStockholmSweden
| | - Anna Lindstrand
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
- Department of Clinical Genetics and GenomicsKarolinska University HospitalStockholmSweden
| | - Malin Kvarnung
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
- Department of Clinical Genetics and GenomicsKarolinska University HospitalStockholmSweden
| | - Erik Björck
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
- Department of Clinical Genetics and GenomicsKarolinska University HospitalStockholmSweden
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9
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Zhang P, Xu Z. The advancements in precision medicine for Leber congenital amaurosis: Breakthroughs from genetic diagnosis to therapy. Surv Ophthalmol 2025:S0039-6257(25)00070-0. [PMID: 40311816 DOI: 10.1016/j.survophthal.2025.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 04/15/2025] [Accepted: 04/28/2025] [Indexed: 05/03/2025]
Abstract
Leber congenital amaurosis (LCA) is a hereditary retinal disease, typically manifesting as severe vision impairment in infancy. With the advancement of precision medicine, genetic diagnosis and targeted therapies offer new hope for LCA patients, significantly improving both diagnostic accuracy and therapeutic efficacy. We summarize the epidemiological characteristics, clinical manifestations, and molecular genetics underlying LCA. It also highlights recent developments in precision treatment strategies, including gene replacement therapy, CRISPR/Cas9-mediated gene editing, and antisense oligonucleotide therapies. In addition, we discuss the applications of induced pluripotent stem cells and retinal organoids in LCA treatment research. Furthermore, we explore preventive strategies and future treatment directions for LCA, including the development of novel gene therapy vectors, the optimization of combinatorial treatment strategies, and the formulation of personalized treatment approaches. These advancements hold significant potential to offer improved treatment options and enhance the quality of life for LCA patients.
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Affiliation(s)
- Pei Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhuping Xu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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10
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Kaminska K, Cancellieri F, Quinodoz M, Moye AR, Bauwens M, Lin S, Janeschitz-Kriegl L, Hayman T, Barberán-Martínez P, Schlaeger R, Van den Broeck F, Ávila Fernández A, Fernández-Caballero L, Perea-Romero I, García-García G, Salom D, Mazzola P, Zuleger T, Poths K, Haack TB, Jacob J, Vermeer S, Terbeek F, Feltgen N, Moulin AP, Koutroumanou L, Papadakis G, Browning AC, Madhusudhan S, Gränse L, Banin E, Sousa AB, Coutinho Santos L, Kuehlewein L, De Angeli P, Leroy BP, Mahroo OA, Sedgwick F, Eden J, Pfau M, Andréasson S, Scholl HPN, Ayuso C, Millán JM, Sharon D, Tsilimbaris MK, Vaclavik V, Tran HV, Ben-Yosef T, De Baere E, Webster AR, Arno G, Sergouniotis PI, Kohl S, Santos C, Rivolta C. Bi-allelic variants in three genes encoding distinct subunits of the vesicular AP-5 complex cause hereditary macular dystrophy. Am J Hum Genet 2025; 112:808-828. [PMID: 40081374 DOI: 10.1016/j.ajhg.2025.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 02/11/2025] [Accepted: 02/13/2025] [Indexed: 03/16/2025] Open
Abstract
Inherited retinal diseases (IRDs) are a genetically heterogeneous group of Mendelian disorders that often lead to progressive vision loss and involve approximately 300 distinct genes. Although variants in these loci account for the majority of molecular diagnoses, other genes associated with IRD await molecular identification. In this study, we uncover bi-allelic assortments of 23 different (22 loss-of-function) variants in AP5Z1, AP5M1, and AP5B1 as independent causes of recessive IRD in members of 19 families from nine countries. Affected individuals, regardless of their genotypes, exhibit a specific form of macular degeneration, sometimes presenting in association with extraocular features. All three genes encode different subunits of the vesicular fifth adaptor protein (AP-5) complex, a component of the intracellular trafficking system involved in maintaining cellular homeostasis and ensuring the proper functioning of lysosomal pathways. The retinal pigment epithelium (RPE), a cellular monolayer located posteriorly to the neural retina, is characterized by intense lysosomal and phagocytic activity. Immunostaining of RPE cells revealed a punctate pattern of AP5Z1, AP5M1, and AP5B1 staining and co-localization with markers of late endosomes and the Golgi, suggesting a role of AP-5 in the normal physiology of this tissue. Overall, the identification of independently acting variants in three distinct proteins within the same macromolecular complex reveals AP-5 as having an important function in the preservation and maintenance of normal macular functions.
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Affiliation(s)
- Karolina Kaminska
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland
| | - Francesca Cancellieri
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland
| | - Mathieu Quinodoz
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland; Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
| | - Abigail R Moye
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland
| | - Miriam Bauwens
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium; Department of Biomolecular Medicine, Ghent University, 9000 Ghent, Belgium
| | - Siying Lin
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9P, UK; NIHR Biomedical Research Centre, Moorfields Eye Hospital and the UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Lucas Janeschitz-Kriegl
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland
| | - Tamar Hayman
- Department of Ophthalmology, Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Pilar Barberán-Martínez
- Molecular, Cellular, and Genomic Biomedicine Group, IIS-La Fe, 46012 Valencia, Spain; Joint Unit CIPF-IIS La Fe Molecular, Cellular and Genomic Biomedicine, IIS-La Fe, 46012 Valencia, Spain
| | - Regina Schlaeger
- Department of Neurology, University Hospital Basel, 4031 Basel, Switzerland
| | - Filip Van den Broeck
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium; Department of Head & Skin, Ghent University Hospital, 9000 Ghent, Belgium; Department of Ophthalmology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Almudena Ávila Fernández
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Lidia Fernández-Caballero
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Irene Perea-Romero
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Gema García-García
- Molecular, Cellular, and Genomic Biomedicine Group, IIS-La Fe, 46012 Valencia, Spain; Joint Unit CIPF-IIS La Fe Molecular, Cellular and Genomic Biomedicine, IIS-La Fe, 46012 Valencia, Spain; Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - David Salom
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pascale Mazzola
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, 72076 Tübingen, Germany
| | - Theresia Zuleger
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, 72076 Tübingen, Germany
| | - Karin Poths
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, 72076 Tübingen, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, 72076 Tübingen, Germany; Centre for Rare Diseases, University of Tübingen, 72072 Tübingen, Germany
| | - Julie Jacob
- Department of Ophthalmology, Universitair Ziekenhuis Leuven (UZ Leuven), 3000 Leuven, Belgium
| | - Sascha Vermeer
- Center for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | | | - Nicolas Feltgen
- Department of Ophthalmology, University Hospital Basel, 4031 Basel, Switzerland
| | - Alexandre P Moulin
- Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, 1004 Lausanne, Switzerland
| | | | | | - Andrew C Browning
- Ophthalmology Department, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Savita Madhusudhan
- St. Paul's Eye Department, Royal Liverpool University Hospital, Liverpool L7 8XP, UK; Department of Eye and Vision Sciences, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK
| | - Lotta Gränse
- Department of Ophthalmology, Lund University, 223 62 Lund, Sweden
| | - Eyal Banin
- Department of Ophthalmology, Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ana Berta Sousa
- Department of Medical Genetics, Hospital Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-035 Lisbon, Portugal; Medical Genetics University Clinic, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Luisa Coutinho Santos
- Department of Ophthalmology, Instituto de Oftalmologia Dr Gama Pinto (IOGP), 1169-019 Lisbon, Portugal
| | - Laura Kuehlewein
- University Eye Hospital, Center for Ophthalmology, University of Tübingen, 72076 Tübingen, Germany
| | - Pietro De Angeli
- Institute for Ophthalmic Research, Center for Ophthalmology, University of Tübingen, 72076 Tübingen, Germany
| | - Bart P Leroy
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium; Department of Head & Skin, Ghent University Hospital, 9000 Ghent, Belgium; Department of Ophthalmology, Ghent University Hospital, 9000 Ghent, Belgium; Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Omar A Mahroo
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and the UCL Institute of Ophthalmology, London EC1V 9EL, UK; UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK; Department of Ophthalmology, St Thomas' Hospital, London SE1 7EH, UK
| | - Fay Sedgwick
- Eye Team, North West Genomic Laboratory Hub, St Mary's Hospital, Manchester M13 9WL, UK
| | - James Eden
- Eye Team, North West Genomic Laboratory Hub, St Mary's Hospital, Manchester M13 9WL, UK
| | - Maximilian Pfau
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University Hospital Basel, 4031 Basel, Switzerland
| | - Sten Andréasson
- Department of Ophthalmology, Lund University, 223 62 Lund, Sweden
| | - Hendrik P N Scholl
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; Pallas Kliniken AG, Pallas Klinik Zürich, 8005 Zürich, Switzerland; European Vision Institute, 4056 Basel, Switzerland
| | - Carmen Ayuso
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José M Millán
- Molecular, Cellular, and Genomic Biomedicine Group, IIS-La Fe, 46012 Valencia, Spain; Joint Unit CIPF-IIS La Fe Molecular, Cellular and Genomic Biomedicine, IIS-La Fe, 46012 Valencia, Spain; Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain; University and Polytechnic La Fe Hospital of Valencia, 46026 Valencia, Spain
| | - Dror Sharon
- Department of Ophthalmology, Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Veronika Vaclavik
- Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, 1004 Lausanne, Switzerland
| | - Hoai V Tran
- Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, 1004 Lausanne, Switzerland; Centre for Gene Therapy and Regenerative Medicine, King's College London, London WC2R 2LS, UK
| | - Tamar Ben-Yosef
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
| | - Elfride De Baere
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium; Department of Biomolecular Medicine, Ghent University, 9000 Ghent, Belgium
| | - Andrew R Webster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and the UCL Institute of Ophthalmology, London EC1V 9EL, UK; UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Gavin Arno
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and the UCL Institute of Ophthalmology, London EC1V 9EL, UK; UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK; Division of Research, Greenwood Genetic Center, Greenwood, SC 29646, USA
| | - Panagiotis I Sergouniotis
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9P, UK; Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
| | - Susanne Kohl
- Institute for Ophthalmic Research, Center for Ophthalmology, University of Tübingen, 72076 Tübingen, Germany
| | - Cristina Santos
- Department of Ophthalmology, Instituto de Oftalmologia Dr Gama Pinto (IOGP), 1169-019 Lisbon, Portugal; iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, 1099-085 Lisbon, Portugal
| | - Carlo Rivolta
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland; Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK.
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11
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Huchzermeyer C, Stingl K, Kremers J. Multidimensional Functional Phenotyping Based on Photoreceptor-Directed Temporal Contrast Sensitivity Defects in Inherited Retinal Diseases. Invest Ophthalmol Vis Sci 2025; 66:25. [PMID: 40208579 PMCID: PMC11993126 DOI: 10.1167/iovs.66.4.25] [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: 11/24/2024] [Accepted: 03/13/2025] [Indexed: 04/11/2025] Open
Abstract
Purpose To identify patterns of functional defects in perifoveal photoreceptor-directed temporal contrast sensitivities (tCSs) in patients with inherited retinal diseases. Methods We retrospectively studied patients with RP1L1-associated occult macular dystrophy (OMD), Stargardt disease (STGD), and RP. Photoreceptor-directed tCS directed at L-, M-, S-cones and rods at different temporal frequencies were measured using a four-primary LED-stimulator with an annular test field (2° inner diameter and 12° outer diameter). Mean defects (MDs) were calculated by subtracting sensitivities from age-correlated normal values and averaging defects in frequency ranges where single postreceptoral pathways mediate flicker detection. Each patient was characterized by 6 MD values (one value each for S-cones [SMD] rods [RMD]; two values each for L- [LMDlow/high] and M-cones [MMDlow/high], where low refers to 1-6 Hz and high to 8-20 Hz temporal frequency ranges). Groups of similar phenotypes were identified with (supervised) decision trees and (unsupervised) hierarchical classification trees (based on nearest neighbors) and compared with the clinical diagnoses. Results The pruned decision tree used RMD for separating RP/STGD from normal/OMD, LMDlow for separating OMD from normal, and SMD for discriminating between RP and STGD. The accuracy was 66%. The hierarchical tree (independent of clinical diagnosis) was cut to four clusters, resulting in one cluster containing mainly normal participants, one cluster with severe L- and M-cone defects caused by OMD or STGD, one cluster with severe rod defects (4/5 with RP) and a large cluster with intermediate rod and cone defects that was dominated by RP and STGD patients. Conclusions LMDlow, SMD, and RMD were the most important parameters. Photoreceptor-directed tCSs allow sophisticated functional phenotyping of inherited retinal diseases and complement other structural and functional parameters for genotype-phenotype correlations.
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Affiliation(s)
- Cord Huchzermeyer
- Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
| | - Katarina Stingl
- Center for Ophthalmology, University Hospital, University of Tübingen, Tübingen, Germany
| | - Jan Kremers
- Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
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12
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Hung JH, Jain T, Khatri A, Nguyen BT, Nguyen CDT, Yavari N, Mobasserian A, Karaca I, Saeed Mohammadi S, Gupta AS, Or CMC, Akhavanrezayat A, Yasar C, Saengsirinavin AO, Than NTT, Anover FA, Elaraby O, El Feky D, Yoo WS, Zhang X, Thng ZX, Do DV, Nguyen QD. Inherited retinal disease-associated uveitis. Surv Ophthalmol 2025:S0039-6257(25)00057-8. [PMID: 40157547 DOI: 10.1016/j.survophthal.2025.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 03/18/2025] [Accepted: 03/24/2025] [Indexed: 04/01/2025]
Abstract
Inherited retinal diseases (IRDs) are genetic disorders characterized by progressive photoreceptor function loss, often leading to significant visual impairment. Uveitis has been increasingly recognized in the clinical course of some IRDs. Despite advances in understanding the genetic causes and pathophysiology of IRDs, gaps remain in understanding the roles of inflammation and autoimmunity in IRD and IRD-associated uveitis. This review discusses IRD-associated uveitis, including anterior, intermediate, posterior, and panuveitis, as well as complications such as cystoid macular edema and retinal vasculitis. In patients with IRD-associated uveitis, mutations affecting protein function in cilia or photoreceptor outer segments suggest a universal autoimmune mechanism triggered by the immunogenicity of shedding photoreceptor discs. Notably, in patients where uveitis is the initial sign, CRB1 mutations are often implicated, likely due to the compromised blood-retina barrier function or alterations in the external limiting membrane. Other mechanisms leading to uveitis preceding IRD diagnosis include ALPK1 mutations, which activate the proinflammatory NF-κB pathway, CAPN5 mutations, which lead to dysfunction of the innate and adaptive immune systems, and VCAN1 mutations, which elicit immunogenicity due to irregularities in vitreous modeling. Understanding these mechanisms could enhance the development of innovative treatments that target personalized inflammation pathways in IRDs.
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Affiliation(s)
- Jia-Horung Hung
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Genomic Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tanya Jain
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Anadi Khatri
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; Birat Eye Hospital, Biratnagar, Nepal; Gautam Buddha Eye care centre, Lumbini, Nepal
| | - Ba Trung Nguyen
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Ophthalmology, Viet Nam National Children's Hospital, Ha Noi, Viet Nam
| | | | - Negin Yavari
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Azadeh Mobasserian
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Irmak Karaca
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; John A. Moran Eye Center, University of Utah, Salt Lake City, UT, US
| | - S Saeed Mohammadi
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Ankur Sudhir Gupta
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Chi Mong Christopher Or
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Amir Akhavanrezayat
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Cigdem Yasar
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Aim-On Saengsirinavin
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; Police General Hospital, Bangkok, Thailand
| | - Ngoc Trong Tuong Than
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Frances Andrea Anover
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; Batangas Medical Center, Batangas, Philippines
| | - Osama Elaraby
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Dalia El Feky
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Woong-Sun Yoo
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Ophthalmology, Gyeongsang National University College of Medicine, and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Xiaoyan Zhang
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Zheng Xian Thng
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Diana V Do
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Quan Dong Nguyen
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
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Bianco L, Navarro J, Michiels C, Sangermano R, Condroyer C, Antonio A, Antropoli A, Andrieu C, Place EM, Pierce EA, El Shamieh S, Smirnov V, Kalatzis V, Mansard L, Roux AF, Bocquet B, Sahel JA, Meunier I, Bujakowska KM, Audo I, Zeitz C. Identification of IDH3G, encoding the gamma subunit of mitochondrial isocitrate dehydrogenase, as a novel candidate gene for X-linked retinitis pigmentosa. Genet Med 2025; 27:101418. [PMID: 40119724 DOI: 10.1016/j.gim.2025.101418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 03/10/2025] [Accepted: 03/13/2025] [Indexed: 03/24/2025] Open
Abstract
PURPOSE Retinitis pigmentosa (RP) is a genetically heterogeneous group of retinal degenerative disorders characterized by the loss of rod and cone photoreceptors, leading to visual impairment and blindness. To date, to our knowledge, X-linked RP has been associated with variants in 3 genes (RPGR, RP2, and OFD1), whereas genetic defects at 3 loci (RP6, RP24, and RP34) are yet unidentified. The aim of this study was to identify a novel candidate gene underlying X-linked RP. METHODS Participants were identified from cohorts of genetically unsolved male individuals affected by RP, who underwent genome sequencing, exome sequencing, or candidate gene screening via direct Sanger sequencing at 3 referral centers. Specifically, 2 probands were identified at the National Reference Centre for Rare Retinal Diseases (Paris, France), 2 at the Massachusetts Eye and Ear Hospital (Boston, MA), and 1 at the National Reference Centre for Inherited Sensory Diseases (Montpellier, France). The pathogenicity of the identified variants was assessed using bioinformatic predictions, protein expression analyses, and mitochondrial function assays. RESULTS We identified 4 rare single-nucleotide variants in IDH3G (HGNC:5386), located at the RP34 locus on the X chromosome, and a complete gene deletion, in 5 unrelated male individuals affected with nonsyndromic RP. The variants segregated with the phenotype in all available family members. In all cases, the disease severity was intermediate. None had high myopia. IDH3G encodes the γ subunit of mitochondrial isocitrate dehydrogenase (IDH3), an enzyme involved in the citric acid cycle, which is expressed in the inner segments of photoreceptors. Variants in IDH3A and IDH3B, encoding the other subunits of IDH3, have already been associated with nonsyndromic autosomal recessive RP. Bioinformatic predictions and functional assays support a pathogenic role for the variants identified in this study, possibly through partial loss of enzymatic activity and mitochondrial function. CONCLUSION Our findings suggest that variants in IDH3G are a novel cause of X-linked RP.
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Affiliation(s)
- Lorenzo Bianco
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and INSERM-DGOS CIC 1423, Paris, France; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Julien Navarro
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | - Riccardo Sangermano
- Ocular Genomics Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | | | - Aline Antonio
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Alessio Antropoli
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and INSERM-DGOS CIC 1423, Paris, France; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camille Andrieu
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emily M Place
- Ocular Genomics Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | - Eric A Pierce
- Ocular Genomics Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | - Said El Shamieh
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Molecular Testing Laboratory, Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Vasily Smirnov
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Exploration de la Vision et Neuro-Ophtalmologie, CHU de Lille, Lille, France
| | - Vasiliki Kalatzis
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
| | - Luke Mansard
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
| | - Anne-Françoise Roux
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
| | - Béatrice Bocquet
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France; National Reference Centre for Inherited Sensory Diseases, University of Montpellier, CHU, Montpellier, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and INSERM-DGOS CIC 1423, Paris, France; Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburg, PA
| | - Isabelle Meunier
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France; National Reference Centre for Inherited Sensory Diseases, University of Montpellier, CHU, Montpellier, France
| | - Kinga M Bujakowska
- Ocular Genomics Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and INSERM-DGOS CIC 1423, Paris, France.
| | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.
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14
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Siles L, Pomares E. Rescue of the disease-associated phenotype in CRISPR-corrected hiPSCs as a therapeutic approach for inherited retinal dystrophies. MOLECULAR THERAPY. NUCLEIC ACIDS 2025; 36:102482. [PMID: 40083649 PMCID: PMC11903799 DOI: 10.1016/j.omtn.2025.102482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 02/06/2025] [Indexed: 03/16/2025]
Abstract
Inherited retinal dystrophies (IRDs), such as retinitis pigmentosa and Stargardt disease, are a group of rare diseases caused by mutations in more than 300 genes that currently have no treatment in most cases. They commonly trigger blindness and other ocular affectations due to retinal cell degeneration. Gene editing has emerged as a promising and powerful strategy for the development of IRD therapies, allowing the permanent correction of pathogenic variants. Using clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 and transcription activator-like effector nucleases (TALEN) gene-editing tools, we precisely corrected seven hiPS cell lines derived from IRD patients carrying mutations in ABCA4, BEST1, PDE6A, PDE6C, RHO, or USH2A. Homozygous mutations and point insertions/deletions resulted in the highest homology-directed repair efficiencies, with at least half of the clones repaired properly without off-target effects. Strikingly, correction of a heterozygous pathogenic variant was achieved using the wild-type allele of the patient as the template for DNA repair. These results suggest the unexpected potential application of CRISPR as a donor template-free strategy for single-nucleotide modifications. Additionally, the corrected clones exhibited a reversion of the disease-associated phenotype in retinal cellular models. These data strengthen the study and application of gene editing-based approaches for IRD treatment.
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Affiliation(s)
- Laura Siles
- Departament de Genètica, Institut de Microcirurgia Ocular, IMO Grupo Miranza, 08035 Barcelona, Spain
| | - Esther Pomares
- Departament de Genètica, Institut de Microcirurgia Ocular, IMO Grupo Miranza, 08035 Barcelona, Spain
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15
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Zhang J, Wang J, Zhou Q, Chen Z, Zhuang J, Zhao X, Gan Z, Wang Y, Wang C, Molday RS, Yang YT, Li X, Zhao XM. Spatiotemporally resolved transcriptomics reveals the cellular dynamics of human retinal development. Nat Commun 2025; 16:2307. [PMID: 40055379 PMCID: PMC11889126 DOI: 10.1038/s41467-025-57625-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 02/24/2025] [Indexed: 05/13/2025] Open
Abstract
The morphogenesis and cellular interactions in developing retina are incompletely characterized. The full understanding needs a precise mapping of the gene expression with a single-cell spatial resolution. Here, we present a spatial transcriptomic (ST) resource for the developing human retina at six developmental stages. Combining the spatial and single-cell transcriptomic data enables characterization of the cell-type-specific expression profiles at distinct anatomical regions at each developmental stage, highlighting the spatiotemporal dynamics of cellular composition during retinal development. All the ST spots are catalogued into consensus spatial domains, which are further associated to their specific expression signatures and biological functions associated with neuron and eye development. We prioritize a set of critical regulatory genes for the transitions of spatial domains during retinal development. Differentially expressed genes from different spatial domains are associated with distinct retinal diseases, indicating the biological relevance and clinical significance of the spatially defined gene expression. Finally, we reconstruct the spatial cellular communication networks, and highlight critical ligand-receptor interactions during retinal development. Overall, our study reports the spatiotemporal dynamics of gene expression and cellular profiles during retinal development, and provides a rich resource for the future studies on retinogenesis.
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Affiliation(s)
- Jinglong Zhang
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Jiao Wang
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Qiongjie Zhou
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zixin Chen
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Junyi Zhuang
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Xingzhong Zhao
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Ziquan Gan
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yinan Wang
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chunxiu Wang
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Robert S Molday
- Department of Biochemistry & Molecular Biology, University of British Columbia, Vancouver, BC, Canada
- Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Yucheng T Yang
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
| | - Xiaotian Li
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
- Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China.
| | - Xing-Ming Zhao
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang, China.
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China.
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16
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Ng QX, Chan HW, Lim RBT, Koh GCH. “This is life”: An interpretative phenomenological analysis of the lived experience of working-age adults with inherited retinal diseases in Singapore. Disabil Health J 2025:101819. [DOI: 10.1016/j.dhjo.2025.101819] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2025]
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17
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Ardehaie RM, Eslahi A, Alerasool M, Rad EK, Shoeibi N, Sedaghat MR, Avan A, Pasdar A, Mojarrad M. Deciphering the Genetic and Epidemiological Landscape of Inherited Retinal Diseases (IRDs) in a Cohort of Eastern Iranian Patients. Clin Genet 2025; 107:300-310. [PMID: 39761966 DOI: 10.1111/cge.14662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 10/23/2024] [Accepted: 11/19/2024] [Indexed: 02/05/2025]
Abstract
Inherited retinal diseases (IRDs) may have significant diagnostic challenges due to their genetic complexity and diverse inheritance patterns. Advanced genotyping tools like exome sequencing (ES) offer promising opportunities for identifying causative variants and improving disease management. This retrospective study was aimed to present prevalent pathogenic and novel variants in patients diagnosed with IRDs using ES. We investigated 154 patients diagnosed clinically with IRDs, of which non-syndromic IRDs were more prevalent than syndromic form (~56% vs. ~44%). Out of 154 unrelated patients, 133 (~86%) were genetically resolved, where retinitis pigmentosa was the most common subtype (26% of all resolved patients). Fifty-three previously known and also 56 novel variants across known IRD genes were identified. Autosomal recessive inheritance predominated in both resolved forms (112/133, 84.21%), with 46 novel variants. This could be due to high rate of consanguinity in the studied families (114/133 patients, 85.71%). The two previously reported ancestral founder pathogenic variants in TMEM67 (c.725A > G) and BBS2 (c.471G > A) genes, as well as the most common variant in AIPL1 gene (c.834G > A), were also prevalent in our patients. Interestingly, identical novel compound heterozygote of the CEP290 gene (c.3167C > A and c.7024C > T) were identified in two unrelated cases. This retrospective study was the first attempt in terms of sample size and diversity to add more to our current knowledge of the genetic makeup of IRDs in a population from the East of Iran. Our findings can facilitate genetic counselling and subtype classification of IRDs, especially in challenging cases.
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Affiliation(s)
- Reza Mousavi Ardehaie
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetic Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atieh Eslahi
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetic Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoome Alerasool
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetic Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- Genetic Foundation of Khorasan Razavi, Mashhad, Iran
| | | | - Nasser Shoeibi
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Amir Avan
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Pasdar
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetic Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Mojarrad
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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18
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Priglinger C, Stingl K. Pharmakotherapie von hereditären Netzhautdystrophien. Klin Monbl Augenheilkd 2025; 242:189-190. [PMID: 40127652 DOI: 10.1055/a-2511-6878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2025]
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19
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Gensheimer T, Veerman D, van Oosten EM, Segerink L, Garanto A, van der Meer AD. Retina-on-chip: engineering functional in vitro models of the human retina using organ-on-chip technology. LAB ON A CHIP 2025; 25:996-1014. [PMID: 39882574 DOI: 10.1039/d4lc00823e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2025]
Abstract
The retina is a complex and highly metabolic tissue in the back of the eye essential for human vision. Retinal diseases can lead to loss of vision in early and late stages of life, significantly affecting patients' quality of life. Due to its accessibility for surgical interventions and its isolated nature, the retina is an attractive target for novel genetic therapies and stem cell-based regenerative medicine. Understanding disease mechanisms and evaluating new treatments require relevant and robust experimental models. Retina-on-chip models are microfluidic organ-on-chip systems based on human tissue that capture multi-cellular interactions and tissue-level functions in vitro. Various retina-on-chip models have been described in literature. Some of them capture basic retinal barrier functions while others replicate key events underlying vision. In addition, some of these cellular systems have also been used in studies to explore their added value in retinal disease modeling. Most existing retina-on-chip models capture limited aspects of the phenotypic complexity of human diseases. This limitation arises primarily from the challenges related to controlled recapitulation of retinal function, including the relevant multi-cellular interactions and functional read-outs. In this review, we provide an update on recent advancements in the field of retina-on-chip, and we discuss the biotechnical strategies to further enhance the physiological relevance of the models. We emphasize that developers and researchers should prioritize the incorporation of the full spectrum of retinal complexity to effectuate a direct impact of retina-on-chip models in disease modeling and development of therapeutic strategies.
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Affiliation(s)
- Tarek Gensheimer
- Applied Stem Cell Technologies Group, Department of Bioengineering Technologies, University of Twente, Enschede, The Netherlands.
| | - Devin Veerman
- Applied Stem Cell Technologies Group, Department of Bioengineering Technologies, University of Twente, Enschede, The Netherlands.
- BIOS Lab on a Chip group, MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands
| | - Edwin M van Oosten
- Department of Pediatrics, Amalia Children's hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Loes Segerink
- BIOS Lab on a Chip group, MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands
| | - Alejandro Garanto
- Department of Pediatrics, Amalia Children's hospital, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andries D van der Meer
- Applied Stem Cell Technologies Group, Department of Bioengineering Technologies, University of Twente, Enschede, The Netherlands.
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20
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VandenBosch LS, Cherry TJ. Machine Learning Prediction of Non-Coding Variant Impact in Cell-Class-Specific Human Retinal Cis-Regulatory Elements. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2025:2025.02.22.638679. [PMID: 40060626 PMCID: PMC11888276 DOI: 10.1101/2025.02.22.638679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/20/2025]
Abstract
Non-coding variants in cis-regulatory elements such as promoters and enhancers contribute to inherited retinal diseases (IRDs), however, characterizing the functional impact of most regulatory variants remains challenging. To improve identification of variants of interest, we implemented machine learning using a gapped k-mer support vector machine approach trained on single nucleus ATAC-seq data from specific cell classes of the adult and developing human retina. We developed 18 distinct ML models to predict the impact of non-coding variants on 39,437 cell-class-specific regulatory elements. These models demonstrate accuracy over 90% and a high degree of cell class specificity. Variant Impact Prediction (VIP) scores highlight specific sequences within candidate CREs, including putative transcription factor (TF) binding motifs, that are predicted to alter CRE function if mutated. Correlations to massively parallel reporter assays support the predictive value of VIP scores to model single nucleotide variants and indels in a cell-class-specific manner. These analyses demonstrate the capacity for single nucleus epigenomic data to predict the impact of non-coding sequence variants and allow for rapid prioritization of patient variants for further functional analysis.
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Affiliation(s)
- Leah S VandenBosch
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA
| | - Timothy J Cherry
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA
- University of Washington Department of Pediatrics, Seattle, Washington, USA
- Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA
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21
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Branham K, Samarakoon L, Audo I, Ayala AR, Cheetham JK, Daiger SP, Dhooge P, Duncan JL, Durham TA, Fahim AT, Huckfeldt RM, Hufnagel RB, Kohl S, Maldonado RS, Melia M, Michaelides M, Pennesi ME, Sahel JA, Sallum JMF, Singh MS, Sharon D, Stepien K, Jones K, Weng CY. Characterizing the Genetic Basis for Inherited Retinal Disease: Lessons Learned From the Foundation Fighting Blindness Clinical Consortium's Gene Poll. Invest Ophthalmol Vis Sci 2025; 66:12. [PMID: 39908130 PMCID: PMC11804890 DOI: 10.1167/iovs.66.2.12] [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: 10/04/2024] [Accepted: 01/07/2025] [Indexed: 02/07/2025] Open
Abstract
Purpose The Foundation Fighting Blindness (FFB) Consortium is a collaboration of 41 international clinical centers that manage patients affected with inherited retinal diseases (IRDs). The annual Consortium gene poll was initiated in 2020 to capture the genetic cause of disease in patients with IRD and associated clinical practices of Consortium sites. Data from the 2022 gene poll are reported here. Methods In 2022, academic, private practice, and government ophthalmology clinics that are members of the Consortium centers were polled to identify per-case IRD genetic causality from a list of 387 syndromic and nonsyndromic IRD genes. The survey also assessed how genetic testing was obtained and clinical practices of the sites. Results Thirty centers responded and reported genetic data from 33,834 patients (27,561 families). Disease-causing variants were reported in 293 of 387 genes. The most common genetic etiologies were ABCA4 (17%), USH2A (9%), RPGR (6%), PRPH2 (5%), and RHO (4%). The top 100 genes accounted for the genetic cause of disease in 94.4% of patients. Two-thirds of the centers had at least one genetic counselor. In the 21 US sites, genetic testing was commonly obtained through sponsored programs (95%, FFB-My Retina Tracker Programs or Spark-ID Your IRD), whereas in the 9 non-US sites, genetic testing was commonly obtained using either patient- or public health system-funded testing pipelines. Clinical work-up of patients with IRD most commonly included updating history, eye examination, and optical coherence tomography. Conclusions This report provides the largest assessment of genetic causality in the IRD patient population across multiple continents to date.
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Affiliation(s)
- Kari Branham
- University of Michigan, Kellogg Eye Center, Department of Ophthalmology and Vision Sciences, Ann Arbor, Michigan, United States
| | | | - Isabelle Audo
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de référence maladies rares REFERET and INSERM-DGOS CIC1423, Paris, France
| | - Allison R Ayala
- Jaeb Center for Health Research, Tampa, Florida, United States
| | - Janet K Cheetham
- Foundation Fighting Blindness, Columbia, Maryland, United States
| | - Stephen P Daiger
- The University of Texas, Health Science Center, Houston, Texas, United States
- Human Genetics Center, Department of Epidemiology, School of Public Health, Houston, Texas, United States
| | | | - Jacque L Duncan
- University of California, San Francisco, San Francisco, California, United States
| | - Todd A Durham
- Foundation Fighting Blindness, Columbia, Maryland, United States
| | - Abigail T Fahim
- University of Michigan, Kellogg Eye Center, Department of Ophthalmology and Vision Sciences, Ann Arbor, Michigan, United States
| | - Rachel M Huckfeldt
- Mass Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Robert B Hufnagel
- Center for Integrated Healthcare Research, Kaiser Permanente, Honolulu, Hawaii, United States
| | - Susanne Kohl
- Institute for Ophthalmic Research, Center for Ophthalmology, University of Tübingen, Tübingen, Germany
| | | | - Michele Melia
- Jaeb Center for Health Research, Tampa, Florida, United States
| | | | - Mark E Pennesi
- Casey Eye Institute - Oregon Health & Science University, Portland, Oregon, United States
- Retina Foundation of the Southwest, Dallas, Texas, United States
| | - José-Alain Sahel
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de référence maladies rares REFERET and INSERM-DGOS CIC1423, Paris, France
- Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | | | - Mandeep S Singh
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, United States
- Department of Genetic Medicine, Johns Hopkins Hospital, Baltimore, Maryland, United States
| | - Dror Sharon
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Kimberly Stepien
- Department of Ophthalmology & Visual Sciences, University of WI School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Kaylie Jones
- Retina Foundation of the Southwest, Dallas, Texas, United States
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22
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Fan X, Li Z, Sha L, Sheng X, Rong W. Genotype-phenotype correlations for 17 Chinese families with inherited retinal dystrophies due to homozygous variants. Sci Rep 2025; 15:3043. [PMID: 39856360 PMCID: PMC11759671 DOI: 10.1038/s41598-025-87844-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 01/22/2025] [Indexed: 01/27/2025] Open
Abstract
In this study, patients with inherited retinal dystrophies (IRDs) who visited Ningxia Eye Hospital from January 2015 to September 2023 were analyzed. Through Whole Exome Sequencing (WES) and Sanger verification, 17 probands carrying homozygous variants were detected. The association between the genotype and clinical phenotype of patients with homozygous variants was analyzed. Among all the patients, 3 patients (17.6%) had a family history of consanguineous marriage, and the onset age of 5 patients(29.4%) was less than 10 years. According to 12 patients (70.6% ), they had the best corrected visual acuity (monocular) < 0.3. 3 were blind, 9 with moderate to severe visual impairment, and 2 with mild visual impairment. 16 homozygous variants were detected in 9 different genes, of which 7 were novel homozygous variants, including frameshift variants, missense variants, and a copy number variant. These variants are related to clinical phenotypes such as Usher syndrome type II (USH2), Stargardt disease (STGD), retinitis pigmentosa (RP), Leber congenital amaurosis (LCA), and Bardet-Biedl syndrome (BBS) respectively. The results of the study indicate that more than 80% of persons with homozygous variant originated from non-consanguineous families, emphasizing the significance of genetic screening for individuals who lack a family history of consanguineous marriage and no obvious clinical phenotypes, but who may carry genetic pathogenic variants for genetic diseases. Furthermore, by analyzing the genotypes and clinical phenotypes of IRD patients from these 17 Chinese families, we have expanded the spectrum of variants in known pathogenic genes for IRDs and the range of clinical phenotypes associated with variants in these genes. We have identified couples at high risk of having affected offspring and individuals with moderate to severe IRDs, providing a basis for genetic counseling, reproductive decision-making, disease prevention, and management. Our findings highlight the association between homozygous variants and more severe clinical phenotypes within these families, thus laying the groundwork for future genetic screening and intervention strategies.
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Affiliation(s)
- Xue Fan
- People's Hospital of Ningxia Hui Autonomous Region, The Third Clinical Medical College of Ningxia Medical University, Yinchuan, 750001, China
| | - Zhen Li
- Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, 936 Huanghe East Road, Jinfeng District, Yinchuan, 750004, China
| | - Lingzhi Sha
- People's Hospital of Ningxia Hui Autonomous Region, The Third Clinical Medical College of Ningxia Medical University, Yinchuan, 750001, China
| | - Xunlun Sheng
- Gansu Aier Ophthalmology and Optometry Hospital, 1228 Guazhou Road, Qilihe District, Lanzhou, 730050, China.
| | - Weining Rong
- Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, 936 Huanghe East Road, Jinfeng District, Yinchuan, 750004, China.
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23
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Hollingsworth TJ, Meshkat B, Wang X, White WA, Marquez-Wilkins E, Jablonski MM. The BXD32 Mouse: A High-Fidelity Model of Chronic Retinal Inflammation and Photoreceptor Degeneration. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2025; 1468:45-50. [PMID: 39930171 DOI: 10.1007/978-3-031-76550-6_8] [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
The study of retinal degenerations (RDs) is a field involving all aspects of retinal anatomy, physiology, and genetics. RDs are heterogeneous involving many genes and systems underlying their pathogeneses. To understand these processes, animal models act as surrogates for human studies; however, an ever-existent issue is few models offer high-fidelity and direct correlations to the human condition. Our recent work has established an animal model that is able to fill both needs. The BXD32 mouse exhibits a polygenic inherited retinal dystrophy (IRD) that correlates to human disease through aberrant disc formation and chronic retinal inflammation working in concert with the genetic underliers to advance the disease. This model can serve to test anti-inflammatory treatments directly to affected tissue avoiding systemic issues as well as understanding the pathophysiology of human IRDs.
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Affiliation(s)
- T J Hollingsworth
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA.
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA.
- Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA.
- Hamilton Eye Institute, Memphis, TN, USA.
| | - Bahar Meshkat
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Physiology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Xiangdi Wang
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - William A White
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Esther Marquez-Wilkins
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Monica M Jablonski
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA
- Hamilton Eye Institute, Memphis, TN, USA
- Department of Physiology, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
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24
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Mazzeo L, Arsenijevic Y, Berger A. Exploring Histone Modifications in Inherited Retinal Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2025; 1468:189-193. [PMID: 39930194 DOI: 10.1007/978-3-031-76550-6_31] [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
Inherited retinal disorders (IRD) represent a heterogeneous group of retinal diseases, mainly leading to a progressive photoreceptor cell death, and for which almost no treatment exists. Despite the diversity in genetic components of IRD, several studies evidence the activation of common cellular pathways, regulated by epigenetic modifications. Since these ones are reversible, a growing interest emerges in proposing a gene-agnostic approach to treat IRD through epigenetic modulation. Among the epigenetic mechanisms, this review focuses on post-translational modifications of histones, which are key players in gene expression regulation, through their interaction with transcription regulators and their role in chromatin compaction. Mechanistic studies and efficiency assessment of histone mark modifiers, mainly conducted on IRD animal models, revealed a promising potential of this approach to further understand photoreceptor degeneration and treat IRD in humans.
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Affiliation(s)
- Luigi Mazzeo
- Department of Ophthalmology, Unit of Epigenetics of ocular diseases, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Yvan Arsenijevic
- Department of Ophthalmology, Unit of Retinal Degeneration and Regeneration, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Adeline Berger
- Department of Ophthalmology, Unit of Epigenetics of ocular diseases, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
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25
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Holtes LK, de Bruijn SE, Cremers FPM, Roosing S. Dual inheritance patterns: A spectrum of non-syndromic inherited retinal disease phenotypes with varying molecular mechanisms. Prog Retin Eye Res 2025; 104:101308. [PMID: 39486507 DOI: 10.1016/j.preteyeres.2024.101308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 10/25/2024] [Accepted: 10/29/2024] [Indexed: 11/04/2024]
Abstract
Inherited retinal diseases (IRDs) encompass a variety of disease phenotypes and are known to display both clinical and genetic heterogeneity. A further complexity is that for several IRD-associated genes, pathogenic variants have been reported to cause either autosomal dominant (AD) or autosomal recessive (AR) diseases. The possibility of dual inheritance can create a challenge for variant interpretation as well as the genetic counselling of patients. This review aims to determine whether the molecular mechanisms behind the dual inheritance of each IRD-associated gene is well established, not yet properly understood, or if the association is questionable. Each gene is discussed individually in detail due to different protein structures and functions, but there are overlapping characteristics. For example, eight genes only have a limited number of reported pathogenic variants or a hotspot region implicated in the second inheritance pattern. Whereas CRX and RP1 display distinct spatial patterns for AR and AD pathogenic variants based on the variant type and/or location. The genes with a questionable dual inheritance, namely AIPL1, CRB1, and RCBTB1 highlight the importance of carefully considering allele frequency data. Finally, the crucial role relevant functional studies in animal and cell models play in validating a variant's biochemical or molecular effect is emphasised.
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Affiliation(s)
- Lara K Holtes
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzanne E de Bruijn
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Frans P M Cremers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.
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26
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Chukwunalu O, Ambrósio AF, Carvalho AL, Quinn PMJ, Marques JP, Alves CH. Genetic Landscape of Nonsyndromic Retinitis Pigmentosa in Portugal. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2025; 1468:81-86. [PMID: 39930177 DOI: 10.1007/978-3-031-76550-6_14] [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
Inherited retinal degenerations (IRDs) comprise a heterogeneous group of disorders that cause severe vision loss or even blindness. With an estimated prevalence of 1:4000, Retinitis Pigmentosa (RP) is the most prevalent IRD. RP is characterized by progressive centripetal degeneration of rods, followed by degeneration of cone photoreceptors. Clinically, RP presents with nyctalopia of variable age of onset and progressive narrowing of the peripheral visual field. Most patients eventually experience some degree of central vision loss, leading to legal blindness. We have evaluated the most common RP-causing genes in a Portuguese IRD registry (IRD-PT, www.retina.com.pt ).
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Affiliation(s)
- Oluji Chukwunalu
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
| | - António Francisco Ambrósio
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Ana Luísa Carvalho
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Medical Genetics Unit, Unidade Local de Saúde de Coimbra (ULS de Coimbra), Coimbra, Portugal
- Univ Coimbra, Clinic of Medical Genetics, Faculty of Medicine, Coimbra, Portugal
| | - Peter M J Quinn
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA
- FM Kirby Center for Molecular Ophthalmology, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - João Pedro Marques
- Ophthalmology Unit, Unidade Local de Saúde de Coimbra (ULS de Coimbra), Coimbra, Portugal
- Univ Coimbra, University Clinic of Ophthalmology, Faculty of Medicine, Coimbra, Portugal
| | - C Henrique Alves
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Coimbra, Portugal.
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal.
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal.
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.
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27
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O'Brien J, Colucci P, Alvarez Y, Kennedy BN. Uncovering Novel Drugs that Restore Vision Using Orthogonal Pooling in Zebrafish. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2025; 1468:491-495. [PMID: 39930243 DOI: 10.1007/978-3-031-76550-6_80] [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
Photoreceptor and retinal pigment epithelium (RPE) dysfunction in inherited retinal degenerations (IRDs) and age-related macular degeneration (AMD) necessitate innovative therapies to preserve vision. Vision impairment incurs a substantial global economic burden, with the World Health Organization reporting an annual global productivity loss of approximately $411 billion. Current treatments are limited, underscoring the urgency for novel solutions. Leveraging new screening techniques, novel drugs restoring vision can be uncovered. Here, a workflow is described utilising orthogonal pooling to screen randomised library compounds for drug hits restoring vision and assessing the optokinetic response (OKR) in the atp6v0e1-/- zebrafish model of inherited blindness.
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Affiliation(s)
- Justine O'Brien
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland
| | - Patrizia Colucci
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland
| | - Yolanda Alvarez
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland
| | - Breandán N Kennedy
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland.
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28
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Murphy R, Martin KR. Genetic engineering and the eye. Eye (Lond) 2025; 39:57-68. [PMID: 39516652 PMCID: PMC11733221 DOI: 10.1038/s41433-024-03441-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 07/22/2024] [Accepted: 10/22/2024] [Indexed: 11/16/2024] Open
Abstract
The transformative potential of genetic engineering in ophthalmology is remarkable, promising new treatments for a wide range of blinding eye diseases. The eye is an attractive target organ for genetic engineering approaches, in part due to its relatively immune-privileged status, its accessibility, and the ease of monitoring of efficacy and safety. Consequently, the eye has been at the forefront of genetic engineering advances in recent years. The development of Clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9), base editors, prime editors, and transposases have enabled efficient and specific gene modification. Ocular gene therapy continues to progress, with recent advances in delivery systems using viral / non-viral vectors and novel promoters and enhancers. New strategies to achieve neuroprotection and neuroregeneration are evolving, including direct in-vivo cell reprogramming and optogenetic approaches. In this review, we discuss recent advances in ocular genetic engineering, examine their current therapeutic roles, and explore their potential use in future strategies to reduce the growing burden of vision loss and blindness.
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Affiliation(s)
- Rory Murphy
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
- Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Keith R Martin
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
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29
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Karuntu JS, Almushattat H, Nguyen XTA, Plomp AS, Wanders RJA, Hoyng CB, van Schooneveld MJ, Schalij-Delfos NE, Brands MM, Leroy BP, van Karnebeek CDM, Bergen AA, van Genderen MM, Boon CJF. Syndromic retinitis pigmentosa. Prog Retin Eye Res 2024; 107:101324. [PMID: 39733931 DOI: 10.1016/j.preteyeres.2024.101324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 12/13/2024] [Accepted: 12/16/2024] [Indexed: 12/31/2024]
Abstract
Retinitis pigmentosa (RP) is a progressive inherited retinal dystrophy, characterized by the degeneration of photoreceptors, presenting as a rod-cone dystrophy. Approximately 20-30% of patients with RP also exhibit extra-ocular manifestations in the context of a syndrome. This manuscript discusses the broad spectrum of syndromes associated with RP, pathogenic mechanisms, clinical manifestations, differential diagnoses, clinical management approaches, and future perspectives. Given the diverse clinical and genetic landscape of syndromic RP, the diagnosis may be challenging. However, an accurate and timely diagnosis is essential for optimal clinical management, prognostication, and potential treatment. Broadly, the syndromes associated with RP can be categorized into ciliopathies, inherited metabolic disorders, mitochondrial disorders, and miscellaneous syndromes. Among the ciliopathies associated with RP, Usher syndrome and Bardet-Biedl syndrome are the most well-known. Less common ciliopathies include Cohen syndrome, Joubert syndrome, cranioectodermal dysplasia, asphyxiating thoracic dystrophy, Mainzer-Saldino syndrome, and RHYNS syndrome. Several inherited metabolic disorders can present with RP, including Zellweger spectrum disorders, adult Refsum disease, α-methylacyl-CoA racemase deficiency, certain mucopolysaccharidoses, ataxia with vitamin E deficiency, abetalipoproteinemia, several neuronal ceroid lipofuscinoses, mevalonic aciduria, PKAN/HARP syndrome, PHARC syndrome, and methylmalonic acidaemia with homocystinuria type cobalamin (cbl) C disease. Due to the mitochondria's essential role in supplying continuous energy to the retina, disruption of mitochondrial function can lead to RP, as seen in Kearns-Sayre syndrome, NARP syndrome, primary coenzyme Q10 deficiency, SSBP1-associated disease, and long chain 3-hydroxyacyl-CoA dehydrogenase deficiency. Lastly, Cockayne syndrome and PERCHING syndrome can present with RP, but they do not fit the abovementioned hierarchy and are thus categorized as miscellaneous. Several first-in-human clinical trials are underway or in preparation for some of these syndromic forms of RP.
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Affiliation(s)
- Jessica S Karuntu
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hind Almushattat
- Department of Ophthalmology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Xuan-Thanh-An Nguyen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Astrid S Plomp
- Department of Human Genetics, Amsterdam Reproduction & Development, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Ronald J A Wanders
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam, the Netherlands; Department of Laboratory Medicine, Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam, the Netherlands
| | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mary J van Schooneveld
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, the Netherlands; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Marion M Brands
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Bart P Leroy
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium; Department of Head & Skin, Ghent University, Ghent, Belgium; Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium; Division of Ophthalmology and Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Clara D M van Karnebeek
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Emma Center for Personalized Medicine, Amsterdam UMC, Amsterdam, the Netherlands
| | - Arthur A Bergen
- Emma Center for Personalized Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Human Genetics, Section Ophthalmogenetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Maria M van Genderen
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, the Netherlands; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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30
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Parameswarappa DC, Kulkarni A, Sahoo NK, Padhy SK, Singh SR, Héon E, Chhablani J. From Cellular to Metabolic: Advances in Imaging of Inherited Retinal Diseases. Diagnostics (Basel) 2024; 15:28. [PMID: 39795556 PMCID: PMC11720060 DOI: 10.3390/diagnostics15010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 12/19/2024] [Accepted: 12/24/2024] [Indexed: 01/13/2025] Open
Abstract
Background: Inherited retinal diseases (IRDs) are a genetically complex group of disorders, usually resulting in progressive vision loss due to retinal degeneration. Traditional imaging methods help in structural assessments, but limitations exist in early functional cellular-level detection that are crucial for guiding new therapies. Methods: This review includes a systematic search of PubMed and Google Scholar for studies on advanced imaging techniques for IRDs. Results: Key modalities covered are adaptive optics, fluorescence lifetime imaging ophthalmoscopy, polarization-sensitive optical coherence tomography, optoretinography, mitochondrial imaging, flavoprotein fluorescence imaging, and retinal oximetry. Each imaging method covers its principles, acquisition techniques, data from healthy eyes, applications in IRDs with specific examples, and current challenges and future directions. Conclusions: Emerging technologies, including adaptive optics and metabolic imaging, offer promising potential for cellular-level imaging and functional correlation in IRDs, allowing for earlier intervention and improved therapeutic targeting. Their integration into clinical practice may significantly improve IRD management and patient outcomes.
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Affiliation(s)
- Deepika C. Parameswarappa
- Ophthalmology and Vision Sciences, Hospital for Sick Children, University of Toronto, Toronto, ON M5S 1E8, Canada
| | - Ashwini Kulkarni
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Vijayawada 521134, India
| | - Niroj Kumar Sahoo
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Vijayawada 521134, India
| | - Srikanta Kumar Padhy
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar 751024, India
| | | | - Elise Héon
- Ophthalmology and Vision Sciences, Hospital for Sick Children, University of Toronto, Toronto, ON M5S 1E8, Canada
- Genetics and Genome Biology, SickKids Research Institute, Toronto, ON M5G 1E8, Canada
| | - Jay Chhablani
- UPMC Eye Centre and Choroidal Analysis and Research (CAR) Lab, University of Pittsburgh, Pittsburgh, PA 15213, USA
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31
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Hu S, Chen Y, Zhou Y, Cao T, Liu S, Ding C, Xie D, Liang P, Huang L, Liu H, Huang J. In vivo adenine base editing ameliorates Rho-associated autosomal dominant retinitis pigmentosa. J Genet Genomics 2024:S1673-8527(24)00365-5. [PMID: 39725189 DOI: 10.1016/j.jgg.2024.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 12/15/2024] [Accepted: 12/16/2024] [Indexed: 12/28/2024]
Abstract
Mutations in the Rhodopsin (RHO) gene are the main cause of autosomal dominant retinitis pigmentosa (adRP), 84% of which are pathogenic gain-of-function point mutations. Treatment strategies for adRP typically involve silencing or ablating the pathogenic allele, while normal RHO protein replacement has no meaningful therapeutic benefit. Here, we present an adenine base editor (ABE)-mediated therapeutic approach for adRP caused by RHO point mutations in vivo. The correctable pathogenic mutations are screened and verified, including T17M, Q344ter, and P347L. Two adRP animal models are created carrying the class 1 (Q344ter) and class 2 (T17M) mutations, and dual AAV-delivered ABE can effectively repair both mutations in vivo. The early intervention of ABE8e efficiently corrects the Q344ter mutation that causes a severe form of adRP, delays photoreceptor death, and restores retinal function and visual behavior. These results suggest that ABE is a promising alternative to treat RHO mutation-associated adRP. Our work provides an effective spacer-mediated point mutation correction therapy approach for dominantly inherited ocular disorders.
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Affiliation(s)
- Sihui Hu
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Yuxi Chen
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Yitong Zhou
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Tianqi Cao
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Simiao Liu
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Chenhui Ding
- Key Laboratory of Reproductive Medicine of Guangdong Province, the First Affiliated Hospital and School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Dongchun Xie
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Puping Liang
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Li Huang
- The State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Haiying Liu
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Junjiu Huang
- MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China; Key Laboratory of Reproductive Medicine of Guangdong Province, the First Affiliated Hospital and School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China.
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Onishi A, Tsunekawa Y, Mandai M, Ishimaru A, Ohigashi Y, Sho J, Yasuda K, Suzuki K, Izpisua Belmonte JC, Matsuzaki F, Takahashi M. Optimization of HITI-Mediated Gene Insertion for Rhodopsin and Peripherin-2 in Mouse Rod Photoreceptors: Targeting Dominant Retinitis Pigmentosa. Invest Ophthalmol Vis Sci 2024; 65:38. [PMID: 39556087 DOI: 10.1167/iovs.65.13.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2024] Open
Abstract
Purpose Among the genome-editing methods for repairing disease-causing mutations resulting in autosomal dominant retinitis pigmentosa, homology-independent targeted integration (HITI)-mediated gene insertion of the normal form of the causative gene is useful because it allows the development of mutation-agnostic therapeutic products. In this study, we aimed for the rapid optimization and validation of HITI-treatment gene constructs of this approach in developing HITI-treatment constructs for various causative target genes in mouse models of retinal degeneration. Methods We constructed the Cas9-driven HITI gene cassettes in plasmid vectors to treat the mouse Rho gene. A workflow utilizing in vivo electroporation was established to validate the efficacy of these constructs. Single-cell genotyping was conducted to evaluate allelic donor gene insertion. The therapeutic potency of HITI-treatment plasmid and adeno-associated virus (AAV) vectors was examined by section immunohistochemistry and optomotor response (OMR) in Rho+/P23H mutant mice. We also targeted mouse Prph2 to examine the workflow. Results The optimized HITI-treatment constructs for mouse Rho genes achieved gene insertion in 80% to 90% of transduced mouse rod photoreceptor cells. This construct effectively suppressed degeneration and induced visual restoration in mutant mice. HITI-treatment constructs for the Rhodopsin gene demonstrated efficacy in AAV vectors and are adaptable for the mouse Prph2 gene locus. Conclusions The study showcases a workflow for the rapid optimization and validation of highly effective HITI-treatment gene constructs against dominant-negative inheritance in inherited retinal dystrophy. These findings suggest the potential utility of this approach in developing HITI-treatment constructs for various target genes, advancing gene therapy products for diverse genetic disorders.
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Affiliation(s)
- Akishi Onishi
- Laboratory for Retinal Regeneration, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Cell and Gene Therapy in Ophthalmology Laboratory, RIKEN Baton Zone Program, Kobe, Japan
- Kobe City Eye Hospital Research Center, Kobe, Japan
- VCGT Inc., Kobe, Japan
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, Japan
| | - Yuji Tsunekawa
- Laboratory for Cell Asymmetry, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Division of Molecular and Medical Genetics, Center for Gene and Cell Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Michiko Mandai
- Laboratory for Retinal Regeneration, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Kobe City Eye Hospital Research Center, Kobe, Japan
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, Japan
| | - Aiko Ishimaru
- Laboratory for Retinal Regeneration, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- VCGT Inc., Kobe, Japan
| | - Yoko Ohigashi
- Laboratory for Retinal Regeneration, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Cell and Gene Therapy in Ophthalmology Laboratory, RIKEN Baton Zone Program, Kobe, Japan
- Vision Care Inc., Kobe, Japan
| | - Junki Sho
- Laboratory for Retinal Regeneration, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Cell and Gene Therapy in Ophthalmology Laboratory, RIKEN Baton Zone Program, Kobe, Japan
- Vision Care Inc., Kobe, Japan
| | - Kazushi Yasuda
- Cell and Gene Therapy in Ophthalmology Laboratory, RIKEN Baton Zone Program, Kobe, Japan
- VCGT Inc., Kobe, Japan
| | - Keiichiro Suzuki
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, United States
- Institute for Advanced Co-Creation Studies, Osaka University, Suita, Japan
- Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
| | - Juan Carlos Izpisua Belmonte
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, United States
- Altos Labs, Inc., San Diego, California, United States
| | - Fumio Matsuzaki
- Laboratory for Cell Asymmetry, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Department of Aging Science and Medicine, Medical Innovation Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masayo Takahashi
- Laboratory for Retinal Regeneration, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Cell and Gene Therapy in Ophthalmology Laboratory, RIKEN Baton Zone Program, Kobe, Japan
- Kobe City Eye Hospital Research Center, Kobe, Japan
- VCGT Inc., Kobe, Japan
- Vision Care Inc., Kobe, Japan
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, Japan
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Zhang Y, Shi Y, Khan MM, Xiao F, Chen W, Tao W, Yao K, Kong N. Ocular RNA nanomedicine: engineered delivery nanoplatforms in treating eye diseases. Trends Biotechnol 2024; 42:1439-1452. [PMID: 38821834 DOI: 10.1016/j.tibtech.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 06/02/2024]
Abstract
Ocular disorders remain a major global health challenge with unmet medical needs. RNA nanomedicine has shown significant therapeutic benefits and safety profiles in patients with complex eye disorders, already benefiting numerous patients with gene-related eye disorders. The effective delivery of RNA to the unique structure of the eye is challenging owing to RNA instability, off-target effects, and ocular physiological barriers. Specifically tailored RNA medication, coupled with sophisticated engineered delivery platforms, is crucial to guide and advance developments in treatments for oculopathy. Herein we review recent advances in RNA-based nanomedicine, innovative delivery strategies, and current clinical progress and present challenges in ocular disease therapy.
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Affiliation(s)
- Yiming Zhang
- Liangzhu Laboratory, Zhejiang University Medical Center and Zhejiang Provincial Key Lab of Ophthalmology, Eye Center of The Second Affiliated Hospital, Zhejiang University, Hangzhou, China; Center for Nanomedicine and Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yesi Shi
- Center for Nanomedicine and Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Muhammad M Khan
- Center for Nanomedicine and Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Fan Xiao
- Liangzhu Laboratory, Zhejiang University Medical Center and Zhejiang Provincial Key Lab of Ophthalmology, Eye Center of The Second Affiliated Hospital, Zhejiang University, Hangzhou, China; Center for Nanomedicine and Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wei Chen
- Center for Nanomedicine and Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wei Tao
- Center for Nanomedicine and Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Ke Yao
- Liangzhu Laboratory, Zhejiang University Medical Center and Zhejiang Provincial Key Lab of Ophthalmology, Eye Center of The Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
| | - Na Kong
- Liangzhu Laboratory, Zhejiang University Medical Center and Zhejiang Provincial Key Lab of Ophthalmology, Eye Center of The Second Affiliated Hospital, Zhejiang University, Hangzhou, China; Center for Nanomedicine and Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Moseley J, Leest T, Larsson K, Magrelli A, Stoyanova-Beninska V. Inherited retinal dystrophies and orphan designations in the European Union. Eur J Ophthalmol 2024; 34:1631-1641. [PMID: 38500388 PMCID: PMC11542323 DOI: 10.1177/11206721241236214] [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: 10/02/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024]
Abstract
Inherited Retinal Dystrophies (IRD) are diverse rare diseases that affect the retina and lead to visual impairment or blindness. Research in this field is ongoing, with over 60 EU orphan medicinal products designated in this therapeutic area by the Committee for Orphan Medicinal Products (COMP) at the European Medicines Agency (EMA). Up to now, COMP has used traditional disease terms, like retinitis pigmentosa, for orphan designation regardless of the product's mechanism of action. The COMP reviewed the designation approach for IRDs taking into account all previous Orphan Designations (OD) experience in IRDs, the most relevant up to date scientific literature and input from patients and clinical experts. Following the review, the COMP decided that there should be three options available for orphan designation concerning the condition: i) an amended set of OD groups for therapies that might be used in a broad spectrum of conditions, ii) a gene-specific designation for targeted therapies, and iii) an occasional term for products that do not fit in the above two categories. The change in the approach to orphan designation in IRDs caters for different scenarios to allow an optimum approach for future OD applications including the option of a gene-specific designation. By applying this new approach, the COMP increases the regulatory clarity, efficiency, and predictability for sponsors, aligns EU regulatory tools with the latest scientific and medical developments in the field of IRDs, and ensures that all potentially treatable patients will be included in the scope of an OD.
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Affiliation(s)
- Jane Moseley
- European Medicines Agency, Amsterdam, The Netherlands
| | - Tim Leest
- Committee for Orphan Medicinal Products at the European Medicines Agency, Amsterdam, The Netherlands
- Federal Agency for Medicines and Health Products, Brussels, Belgium
| | | | - Armando Magrelli
- Committee for Orphan Medicinal Products at the European Medicines Agency, Amsterdam, The Netherlands
- National Center for Drug Research and Evaluation- Istituto Superiore di Sanità, Rome, Italy
| | - Violeta Stoyanova-Beninska
- Committee for Orphan Medicinal Products at the European Medicines Agency, Amsterdam, The Netherlands
- Medicines Evaluation Board (MEB), Utrecht, The Netherlands
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Elasal MA, Khateb S, Panneman DM, Roosing S, Cremers FPM, Banin E, Sharon D, Sarma AS. A Leaky Deep Intronic Splice Variant in CLRN1 Is Associated with Non-Syndromic Retinitis Pigmentosa. Genes (Basel) 2024; 15:1363. [PMID: 39596563 PMCID: PMC11593374 DOI: 10.3390/genes15111363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/15/2024] [Accepted: 10/21/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND Inherited retinal diseases (IRDs) are clinically complex and genetically heterogeneous visual impairment disorders with varying penetrance and severity. Disease-causing variants in at least 289 nuclear and mitochondrial genes have been implicated in their pathogenesis. METHODS Whole exome sequencing results were analyzed using established pipelines and the results were further confirmed by Sanger sequencing and minigene splicing assay. RESULTS Exome sequencing in a 51-year-old Ashkenazi Jewish patient with non-syndromic retinitis pigmentosa (RP) identified compound heterozygous variants in the CLRN1 gene: a known pathogenic missense [p.(N48K)] and a novel deep intronic variant c.254-643G>T. A minigene splicing assay that was performed aiming to study the effect of the c.254-643G>T variant on CLRN1 pre-mRNA splicing revealed the inclusion of a pseudo-exon that was also reported to be included in the transcript due to an adjacent variant, c.254-649T>G. However, unlike the reported c.254-649T>G variant, c.254-643G>T showed aberrant splicing in a leaky manner, implying that the identified variant is not totally penetrant. CONCLUSION We report on a novel deep intronic variant in CLRN1 causing non-syndromic RP. The non-syndromic phenotype observed in this index case may be attributed to the leaky nature of this variant, which is causing some normal transcripts to be produced.
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Affiliation(s)
- Maria Abu Elasal
- Division of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.E.); (S.K.); (E.B.); (A.S.S.)
| | - Samer Khateb
- Division of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.E.); (S.K.); (E.B.); (A.S.S.)
| | - Daan M. Panneman
- Department of Human Genetics, Radboud University Medical Center, 6525 Nijmegen, The Netherlands; (D.M.P.); (S.R.); (F.P.M.C.)
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, 6525 Nijmegen, The Netherlands; (D.M.P.); (S.R.); (F.P.M.C.)
| | - Frans P. M. Cremers
- Department of Human Genetics, Radboud University Medical Center, 6525 Nijmegen, The Netherlands; (D.M.P.); (S.R.); (F.P.M.C.)
| | - Eyal Banin
- Division of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.E.); (S.K.); (E.B.); (A.S.S.)
| | - Dror Sharon
- Division of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.E.); (S.K.); (E.B.); (A.S.S.)
| | - Asodu Sandeep Sarma
- Division of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.E.); (S.K.); (E.B.); (A.S.S.)
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Iglesias-Romero AB, Kaminska K, Quinodoz M, Folcher M, Lin S, Arno G, Calado J, Webster AR, Moulin A, Sousa AB, Coutinho-Santos L, Santos C, Rivolta C. Bi-allelic variants in COQ8B, a gene involved in the biosynthesis of coenzyme Q10, lead to non-syndromic retinitis pigmentosa. Am J Hum Genet 2024; 111:2299-2306. [PMID: 39226897 PMCID: PMC11480794 DOI: 10.1016/j.ajhg.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 08/02/2024] [Accepted: 08/08/2024] [Indexed: 09/05/2024] Open
Abstract
Retinitis pigmentosa (RP) is a Mendelian disease characterized by gradual loss of vision, due to the progressive degeneration of retinal cells. Genetically, it is highly heterogeneous, with pathogenic variants identified in more than 100 genes so far. Following a large-scale sequencing screening, we identified five individuals (four families) with recessive and non-syndromic RP, carrying as well bi-allelic DNA changes in COQ8B, a gene involved in the biosynthesis of coenzyme Q10. Specifically, we detected compound heterozygous assortments of five disease-causing variants (c.187C>T [p.Arg63Trp], c.566G>A [p.Trp189Ter], c.1156G>A [p.Asp386Asn], c.1324G>A [p.Val442Met], and c.1560G>A [p.Trp520Ter]), all segregating with disease according to a recessive pattern of inheritance. Cell-based analysis of recombinant proteins deriving from these genotypes, performed by target engagement assays, showed in all cases a significant decrease in ligand-protein interaction compared to the wild type. Our results indicate that variants in COQ8B lead to recessive non-syndromic RP, possibly by impairing the biosynthesis of coenzyme Q10, a key component of oxidative phosphorylation in the mitochondria.
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Affiliation(s)
- Ana Belén Iglesias-Romero
- Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland; Department of Ophthalmology, Universität Basel, 4031 Basel, Switzerland
| | - Karolina Kaminska
- Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland; Department of Ophthalmology, Universität Basel, 4031 Basel, Switzerland
| | - Mathieu Quinodoz
- Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland; Department of Ophthalmology, Universität Basel, 4031 Basel, Switzerland; Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
| | - Marc Folcher
- Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland; Department of Ophthalmology, Universität Basel, 4031 Basel, Switzerland
| | - Siying Lin
- National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital and the Institute of Ophthalmology, London, UK; Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Gavin Arno
- National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital and the Institute of Ophthalmology, London, UK; Institute of Ophthalmology, University College London, London EC1V 9EL, UK; Greenwood Genetic Center, Greenwood, SC 29646, USA
| | - Joaquim Calado
- ToxOmics, NOVA Medical School, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
| | - Andrew R Webster
- National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital and the Institute of Ophthalmology, London, UK; Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Alexandre Moulin
- Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, 1004 Lausanne, Switzerland
| | - Ana Berta Sousa
- Department of Medical Genetics, Centro Hospitalar Universitario Lisboa Norte EPE, 1649-028 Lisboa, Portugal; Laboratory of Basic Immunology, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | | | - Cristina Santos
- Instituto de Oftalmologia Dr. Gama Pinto, 1150-255 Lisboa, Portugal; iNOVA4Health, Universidade NOVA de Lisboa NOVA Medical School, 1150-082 Lisboa, Portugal
| | - Carlo Rivolta
- Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland; Department of Ophthalmology, Universität Basel, 4031 Basel, Switzerland; Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK.
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Akiba R, Tu HY, Hashiguchi T, Takahashi Y, Toyooka K, Tsukamoto Y, Baba T, Takahashi M, Mandai M. Host-Graft Synapses Form Functional Microstructures and Shape the Host Light Responses After Stem Cell-Derived Retinal Sheet Transplantation. Invest Ophthalmol Vis Sci 2024; 65:8. [PMID: 39374009 PMCID: PMC11463710 DOI: 10.1167/iovs.65.12.8] [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: 07/17/2024] [Accepted: 09/15/2024] [Indexed: 10/08/2024] Open
Abstract
Purpose Retinitis pigmentosa represents a leading cause of blindness in developed countries, yet effective treatments for the disease remain unestablished. Previous studies have demonstrated the potential of stem cell-derived retinal organoid (SC-RO) sheet transplantation to form host-graft synapses and to improve light responsiveness in animal models of retinal degeneration. However, the detailed microstructures of these de novo synapses and their functional contribution have not been well elucidated. This study aims to (1) elucidate the microstructures of the host-graft synapse, and (2) investigate the overall distribution and contribution of these synapses to host retinal light responses. Methods We identified host-graft synapses using a reporter system in mouse SC-RO and rd1 mice, a well-established model of end-stage retinal degeneration. Correlative array tomography was used to reveal the microstructure of host-graft synapses. Furthermore, we developed a semi-automated algorithm that robustly detects the host-graft photoreceptor synapses in the overall grafted area using the same reporter system in flat-mount retinas. We then integrated the spatial distribution of the host-graft synapses with light responses detected by multi-electrode array recording. Results Correlative array tomography revealed that host-graft synapses recapitulate the developmental process of photoreceptor synapse formation involving horizontal cells first and then rod bipolar cells. By integrating the spatial distribution of host-graft synapse and multi-electrode array recording, we showed that the number of light-responsive host retinal ganglion cells is positively correlated with the local density of host-graft synapses. Conclusions De novo host-graft synapses recapitulate the developmental microstructure of the photoreceptor synapse, and their formation contributes to the light responsiveness after SC-RO transplantation.
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Affiliation(s)
- Ryutaro Akiba
- Chiba University Graduate School of Medicine, Department of Ophthalmology, Chuo-ku, Chiba, Japan
- RIKEN Center for Biosystems Dynamics Research, Laboratory for Retinal Regeneration, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
| | - Hung-Ya Tu
- RIKEN Center for Biosystems Dynamics Research, Laboratory for Retinal Regeneration, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
- Institute for Protein Research, Osaka University, Suita-shi, Osaka, Japan
| | - Tomoyo Hashiguchi
- RIKEN Center for Biosystems Dynamics Research, Laboratory for Retinal Regeneration, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
| | - Yoshiko Takahashi
- RIKEN Center for Biosystems Dynamics Research, Laboratory for Retinal Regeneration, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
| | - Kiminori Toyooka
- RIKEN Center for Sustainable Resource Science, Tsurumi-ku, Yokohama, Kanagawa, Japan
| | | | - Takayuki Baba
- Chiba University Graduate School of Medicine, Department of Ophthalmology, Chuo-ku, Chiba, Japan
| | - Masayo Takahashi
- RIKEN Center for Biosystems Dynamics Research, Laboratory for Retinal Regeneration, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
- Kobe City Eye Hospital Research Center, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
| | - Michiko Mandai
- RIKEN Center for Biosystems Dynamics Research, Laboratory for Retinal Regeneration, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
- Kobe City Eye Hospital Research Center, Minato-jima, Chuo-ku, Kobe, Hyogo, Japan
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Ozguc Caliskan B, Uslu K, Sinim Kahraman N, Erkilic K, Oner A, Dundar M. Beyond the phenotype: Exploring inherited retinal diseases with targeted next-generation sequencing in a Turkish cohort. Clin Genet 2024; 106:258-266. [PMID: 38576124 DOI: 10.1111/cge.14529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/23/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
This research aims to compile recent clinical and genetic data from Turkish patients with inherited retinal disorders and evaluate the effectiveness of targeted Next-generation sequencing panels. The study included Turkish individuals with hereditary retinal diseases who visited the Medical Genetic Department of Erciyes University between 2019 and 2022. One proband per family was selected based on eligibility. We used Hereditary Disorder Solution (HDS) by Sophia Genetics and performed next-generation sequencing (NGS) with Illumina NextSeq-500. Bioinformatics analysis using Sophia DDM® SaaS algorithms and ACMG guidelines classified genomic changes. The study involved 354 probands. Disease-causing variants were found in 58.1% of patients, with ABCA4, USH2A, RDH12, and EYS being the most frequently implicated genes. Forty-eight novel variants were detected. This study enhances the knowledge of clinical diagnoses, symptom onset, inheritance patterns, and genetic details for Turkish individuals with hereditary retinal disease. It contributes to broader health strategies by enabling comparisons with other studies.
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Affiliation(s)
- Busra Ozguc Caliskan
- Faculty of Medicine, Department of Medical Genetics, Erciyes University, Kayseri, Turkey
| | - Kubra Uslu
- Faculty of Medicine, Department of Medical Genetics, Erciyes University, Kayseri, Turkey
| | | | - Kuddusi Erkilic
- Faculty of Medicine, Department of Ophthalmology, Erciyes University, Kayseri, Turkey
| | - Ayse Oner
- Department of Ophthalmology, Acibadem Kayseri Hospital, Kayseri, Turkey
| | - Munis Dundar
- Faculty of Medicine, Department of Medical Genetics, Erciyes University, Kayseri, Turkey
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Yang H, Zhang YJ, Zhu L, Zheng WY, Shi MY, Zhao WR, Zhao HC. A novel compound heterozygous PCDH15 variants is associated with arRP in a Chinese pedigree. BMC Ophthalmol 2024; 24:373. [PMID: 39187782 PMCID: PMC11345949 DOI: 10.1186/s12886-024-03640-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 08/14/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Retinitis pigmentosa (RP) is a heterogeneous group of inherited retinal diseases. However, it is still not well understand about the relationship between PCDH15 variants and RP. METHODS In this study, we enrolled a Chinese autosomal recessive retinitis pigmentosa (arRP) pedigree and identified the causative gene in the proband by targeted whole exome sequencing (WES). The variants were validated in the family members by Sanger sequencing and co-segregation analysis. RESULTS Novel compound heterozygous, Frame shift variants of the PCDH15 gene, NM_001384140.1:c.4368 - 2147_4368-2131del and NM_001384140.1:c exon19:c.2505del: p. T836Lfs*6 were identified in the arRP pedigree, which co-segregated with the clinical RP phenotypes. The PCDH15 protein is highly conserved among species. CONCLUSION This is the first study to identify novel compound heterozygous variants c.4368 - 2147_4368-2131del and c.2505del(p.T836Lfs*6) in the PCDH15 gene which might be disease-causing variants, and extending the variant spectra. All above findings may be contribute to genetic counseling, molecular diagnosis and clinical management of arRP disease.
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Affiliation(s)
- Hong Yang
- Department of Ophthalmology, Eye, ENT Hospital of Fudan University, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment, Restoration, Fudan University, Shanghai, 200031, China
- Sixth Affiliated Hospital of Kunming Medical University, Yun Nan, 653100, China
| | - Ya-Juan Zhang
- Sixth Affiliated Hospital of Kunming Medical University, Yun Nan, 653100, China
| | - Li Zhu
- Sixth Affiliated Hospital of Kunming Medical University, Yun Nan, 653100, China
| | - Wei-Yi Zheng
- Sixth Affiliated Hospital of Kunming Medical University, Yun Nan, 653100, China
| | - Mei-Yu Shi
- Sixth Affiliated Hospital of Kunming Medical University, Yun Nan, 653100, China
| | | | - Hong-Chao Zhao
- Sixth Affiliated Hospital of Kunming Medical University, Yun Nan, 653100, China.
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Gowda DAA, Birappa G, Rajkumar S, Ajaykumar CB, Srikanth B, Kim SL, Singh V, Jayachandran A, Lee J, Ramakrishna S. Recent progress in CRISPR/Cas9 system for eye disorders. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2024; 210:21-46. [PMID: 39824582 DOI: 10.1016/bs.pmbts.2024.07.018] [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: 01/20/2025]
Abstract
Ocular disorders encompass a broad spectrum of phenotypic and clinical symptoms resulting from several genetic variants and environmental factors. The unique anatomy and physiology of the eye facilitate validation of cutting-edge gene editing treatments. Genome editing developments have allowed researchers to treat a variety of diseases, including ocular disorders. The clustered regularly interspaced short palindromic repeats (CRISPR/Cas9) system holds considerable promise for therapeutic applications in the field of ophthalmology, including repair of aberrant genes and treatment of retinal illnesses related to the genome or epigenome. Application of CRISPR/Cas9 systems to the study of ocular disease and visual sciences have yielded innovations including correction of harmful mutations in patient-derived cells and gene modifications in several mammalian models of eye development and disease. In this study, we discuss the generation of several ocular disease models in mammalian cell lines and in vivo systems using a CRISPR/Cas9 system. We also provide an overview of current uses of CRISPR/Cas9 technologies for the treatment of ocular pathologies, as well as future challenges.
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Affiliation(s)
- D A Ayush Gowda
- Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, South Korea
| | - Girish Birappa
- Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, South Korea
| | - Sripriya Rajkumar
- Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, South Korea
| | - C Bindu Ajaykumar
- Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, South Korea
| | | | - Sammy L Kim
- Department of Biological Science, College of Sang-Huh Life Science, Department of Biological Science, Konkuk University, Seoul, South Korea
| | - Vijai Singh
- Department of Biosciences, School of Science, Indrashil University, Rajpur, Mehsana, Gujarat, India
| | - Aparna Jayachandran
- Fiona Elsey Cancer Research Institute, VIC, Australia; Federation University, VIC, Australia.
| | - Junwon Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
| | - Suresh Ramakrishna
- Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, South Korea; College of Medicine, Hanyang University, Seoul, South Korea.
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Di Iorio E, Adamo GG, Sorrentino U, De Nadai K, Barbaro V, Mura M, Pellegrini M, Boaretto F, Tavolato M, Suppiej A, Nasini F, Salviati L, Parmeggiani F. Pseudodominant inheritance of retinitis pigmentosa in a family with mutations in the Eyes Shut Homolog (EYS) gene. Sci Rep 2024; 14:18580. [PMID: 39127808 PMCID: PMC11316741 DOI: 10.1038/s41598-024-69640-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024] Open
Abstract
Sequence variants in Eyes Shut Homolog (EYS) gene are one of the most frequent causes of autosomal recessive retinitis pigmentosa (RP). Herein, we describe an Italian RP family characterized by EYS-related pseudodominant inheritance. The female proband, her brother, and both her sons showed typical RP, with diminished or non-recordable full-field electroretinogram, narrowing of visual field, and variable losses of central vision. To investigate this apparently autosomal dominant pedigree, next generation sequencing (NGS) of a custom panel of RP-related genes was performed, further enhanced by bioinformatic detection of copy-number variations (CNVs). Unexpectedly, all patients had a compound heterozygosity involving two known pathogenic EYS variants i.e., the exon 33 frameshift mutation c.6714delT and the exon 29 deletion c.(5927þ1_5928-1)_(6078þ1_6079-1)del, with the exception of the youngest son who was homozygous for the above-detailed frameshift mutation. No pathologic eye conditions were instead observed in the proband's husband, who was a heterozygous healthy carrier of the same c.6714delT variant in exon 33 of EYS gene. These findings provide evidence that pseudodominant pattern of inheritance can hide an autosomal recessive RP partially or totally due to CNVs, recommending CNVs study in those pedigrees which remain genetically unsolved after the completion of NGS or whole exome sequencing analysis.
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Affiliation(s)
- Enzo Di Iorio
- Department of Molecular Medicine, University of Padova, 35121, Padova, Italy
- Clinical Genetics Unit, Azienda Ospedaliero Universitaria di Padova, 35121, Padova, Italy
| | - Ginevra Giovanna Adamo
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Ugo Sorrentino
- Clinical Genetics Unit, Azienda Ospedaliero Universitaria di Padova, 35121, Padova, Italy
- Department of Women and Children's Health, University of Padova, 35121, Padova, Italy
| | - Katia De Nadai
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
- ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, Camposampiero Hospital, Azienda ULSS 6 Euganea, 35012, Camposampiero, Padova, Italy
| | | | - Marco Mura
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
- King Khaled Eye Specialist Hospital, 11462, Riyadh, Saudi Arabia
| | - Marco Pellegrini
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Francesca Boaretto
- Clinical Genetics Unit, Azienda Ospedaliero Universitaria di Padova, 35121, Padova, Italy
| | - Marco Tavolato
- ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, Camposampiero Hospital, Azienda ULSS 6 Euganea, 35012, Camposampiero, Padova, Italy
| | - Agnese Suppiej
- ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, Camposampiero Hospital, Azienda ULSS 6 Euganea, 35012, Camposampiero, Padova, Italy
- Department of Medical Sciences, University of Ferrara, 44121, Ferrara, Italy
| | - Francesco Nasini
- Ophthalmic Unit, Azienda Ospedaliero Universitaria di Ferrara, 44124, Cona, Ferrara, Italy
| | - Leonardo Salviati
- Clinical Genetics Unit, Azienda Ospedaliero Universitaria di Padova, 35121, Padova, Italy
- Department of Women and Children's Health, University of Padova, 35121, Padova, Italy
| | - Francesco Parmeggiani
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy.
- ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, Camposampiero Hospital, Azienda ULSS 6 Euganea, 35012, Camposampiero, Padova, Italy.
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Heutinck PAT, van den Born LI, Vermeer M, Iglesias Gonzales AI, Hoyng CB, Pott JWR, Kroes HY, van Schooneveld MJ, Boon CJF, van Genderen MM, Plomp AS, de Jong-Hesse Y, van Egmond-Ebbeling MB, Hoefsloot LH, A. Bergen A, Klaver CCW, Meester-Smoor MA, Thiadens AAHJ, Verhoeven VJM. Frequency and Genetic Spectrum of Inherited Retinal Dystrophies in a Large Dutch Pediatric Cohort: The RD5000 Consortium. Invest Ophthalmol Vis Sci 2024; 65:40. [PMID: 39189993 PMCID: PMC11361385 DOI: 10.1167/iovs.65.10.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 08/03/2024] [Indexed: 08/28/2024] Open
Abstract
Purpose Gene-based therapies for inherited retinal dystrophies (IRDs) are upcoming. Treatment before substantial vision loss will optimize outcomes. It is crucial to identify common phenotypes and causative genes in children. This study investigated the frequency of these in pediatric IRD with the aim of highlighting relevant groups for future therapy. Methods Diagnostic, genetic, and demographic data, collected from medical charts of patients with IRD aged up to 20 years (n = 624, 63% male), registered in the Dutch RD5000 database, were analyzed to determine frequencies of phenotypes and genetic causes. Phenotypes were categorized as nonsyndromic (progressive and stationary IRD) and syndromic IRD. Genetic causes, mostly determined by whole-exome sequencing (WES), were examined. Additionally, we investigated the utility of periodic reanalysis of WES data in genetically unresolved cases. Results Median age at registration was 13 years (interquartile range, 9-16). Retinitis pigmentosa (RP; n = 123, 20%), Leber congenital amaurosis (LCA; n = 97, 16%), X-linked retinoschisis (n = 64, 10%), and achromatopsia (n = 63, 10%) were the most frequent phenotypes. The genetic cause was identified in 76% of the genetically examined patients (n = 473). The most frequently disease-causing genes were RS1 (n = 32, 9%), CEP290 (n = 28, 8%), CNGB3 (n = 21, 6%), and CRB1 (n = 17, 5%). Diagnostic yield after reanalysis of genetic data increased by 7%. Conclusions As in most countries, RP and LCA are the most prominent pediatric IRDs in the Netherlands, and variants in RS1 and CEP290 were the most prominent IRD genotypes. Our findings can guide therapy development to target the diseases and genes with the greatest needs in young patients.
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Affiliation(s)
- Pam A. T. Heutinck
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | - Maikel Vermeer
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- The Rotterdam Eye Hospital and Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands
| | | | - Carel B. Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan Willem R. Pott
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Hester Y. Kroes
- Department of Clinical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mary J. van Schooneveld
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, the Netherlands
| | - Camiel J. F. Boon
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maria M. van Genderen
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, the Netherlands
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Astrid S. Plomp
- Department of Human Genetics, Amsterdam Reproduction & Development, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Yvonne de Jong-Hesse
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Lies H. Hoefsloot
- Department of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Arthur A. Bergen
- Department of Human Genetics, Amsterdam Reproduction & Development, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Caroline C. W. Klaver
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- The Rotterdam Eye Hospital and Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Magda A. Meester-Smoor
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- The Rotterdam Eye Hospital and Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands
| | | | - Virginie J. M. Verhoeven
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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Yang T, Wang W, Xie L, Chen S, Ye X, Shen S, Chen H, Qi L, Cui Z, Xiong W, Guo Y, Chen J. Investigating retinal explant models cultured in static and perfused systems to test the performance of exosomes secreted from retinal organoids. J Neurosci Methods 2024; 408:110181. [PMID: 38823594 DOI: 10.1016/j.jneumeth.2024.110181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/05/2024] [Accepted: 05/22/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Ex vivo cultures of retinal explants are appropriate models for translational research. However, one of the difficult problems of retinal explants ex vivo culture is that their nutrient supply needs cannot be constantly met. NEW METHOD This study evaluated the effect of perfused culture on the survival of retinal explants, addressing the challenge of insufficient nutrition in static culture. Furthermore, exosomes secreted from retinal organoids (RO-Exos) were stained with PKH26 to track their uptake in retinal explants to mimic the efficacy of exosomal drugs in vivo. RESULTS We found that the retinal explants cultured with perfusion exhibited significantly higher viability, increased NeuN+ cells, and reduced apoptosis compared to the static culture group at Days Ex Vivo (DEV) 4, 7, and 14. The perfusion-cultured retinal explants exhibited reduced mRNA markers for gliosis and microglial activation, along with lower expression of GFAP and Iba1, as revealed by immunostaining. Additionally, RNA-sequencing analysis showed that perfusion culture mainly upregulated genes associated with visual perception and photoreceptor cell maintenance while downregulating the immune system process and immune response. RO-Exos promoted the uptake of PKH26-labelled exosomes and the growth of retinal explants in perfusion culture. COMPARISON WITH EXISTING METHODS Our perfusion culture system can provide a continuous supply of culture medium to achieve steady-state equilibrium in retinal explant culture. Compared to traditional static culture, it better preserves the vitality, provides better neuroprotection, and reduces glial activation. CONCLUSIONS This study provides a promising ex vivo model for further studies on degenerative retinal diseases and drug screening.
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Affiliation(s)
- Tingting Yang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China; Department of Ophthalmology, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, China
| | - Wenxuan Wang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Linyao Xie
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Sihui Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Xiuhong Ye
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Shuhao Shen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Hang Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Ling Qi
- Central Laboratory, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, China
| | - Zekai Cui
- Aier Eye Institute, Changsha, Hunan, China
| | - Wei Xiong
- Key Laboratory for Regenerative Medicine, Ministry of Education, Jinan University, Guangzhou, China
| | - Yonglong Guo
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China.
| | - Jiansu Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China; Institute of Ophthalmology, Medical College, Jinan University, Guangzhou, China; Key Laboratory for Regenerative Medicine, Ministry of Education, Jinan University, Guangzhou, China; Aier Eye Institute, Changsha, Hunan, China.
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44
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Mondal AK, Gaur M, Advani J, Swaroop A. Epigenome-metabolism nexus in the retina: implications for aging and disease. Trends Genet 2024; 40:718-729. [PMID: 38782642 PMCID: PMC11303112 DOI: 10.1016/j.tig.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
Intimate links between epigenome modifications and metabolites allude to a crucial role of cellular metabolism in transcriptional regulation. Retina, being a highly metabolic tissue, adapts by integrating inputs from genetic, epigenetic, and extracellular signals. Precise global epigenomic signatures guide development and homeostasis of the intricate retinal structure and function. Epigenomic and metabolic realignment are hallmarks of aging and highlight a link of the epigenome-metabolism nexus with aging-associated multifactorial traits affecting the retina, including age-related macular degeneration and glaucoma. Here, we focus on emerging principles of epigenomic and metabolic control of retinal gene regulation, with emphasis on their contribution to human disease. In addition, we discuss potential mitigation strategies involving lifestyle changes that target the epigenome-metabolome relationship for maintaining retinal function.
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Affiliation(s)
- Anupam K Mondal
- Neurobiology, Neurodegeneration, and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mohita Gaur
- Neurobiology, Neurodegeneration, and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jayshree Advani
- Neurobiology, Neurodegeneration, and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Anand Swaroop
- Neurobiology, Neurodegeneration, and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Zeuli R, Karali M, de Bruijn SE, Rodenburg K, Scarpato M, Capasso D, Astuti GDN, Gilissen C, Rodríguez-Hidalgo M, Ruiz-Ederra J, Testa F, Simonelli F, Cremers FPM, Banfi S, Roosing S. Whole genome sequencing identifies elusive variants in genetically unsolved Italian inherited retinal disease patients. HGG ADVANCES 2024; 5:100314. [PMID: 38816995 PMCID: PMC11225895 DOI: 10.1016/j.xhgg.2024.100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/01/2024] Open
Abstract
Inherited retinal diseases (IRDs) are a group of rare monogenic diseases with high genetic heterogeneity (pathogenic variants identified in over 280 causative genes). The genetic diagnostic rate for IRDs is around 60%, mainly thanks to the routine application of next-generation sequencing (NGS) approaches such as extensive gene panels or whole exome analyses. Whole-genome sequencing (WGS) has been reported to improve this diagnostic rate by revealing elusive variants, such as structural variants (SVs) and deep intronic variants (DIVs). We performed WGS on 33 unsolved cases with suspected autosomal recessive IRD, aiming to identify causative genetic variants in non-coding regions or to detect SVs that were unexplored in the initial screening. Most of the selected cases (30 of 33, 90.9%) carried monoallelic pathogenic variants in genes associated with their clinical presentation, hence we first analyzed the non-coding regions of these candidate genes. Whenever additional pathogenic variants were not identified with this approach, we extended the search for SVs and DIVs to all IRD-associated genes. Overall, we identified the missing causative variants in 11 patients (11 of 33, 33.3%). These included three DIVs in ABCA4, CEP290 and RPGRIP1; one non-canonical splice site (NCSS) variant in PROM1 and three SVs (large deletions) in EYS, PCDH15 and USH2A. For the previously unreported DIV in CEP290 and for the NCCS variant in PROM1, we confirmed the effect on splicing by reverse transcription (RT)-PCR on patient-derived RNA. This study demonstrates the power and clinical utility of WGS as an all-in-one test to identify disease-causing variants missed by standard NGS diagnostic methodologies.
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Affiliation(s)
- Roberta Zeuli
- Medical Genetics, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Marianthi Karali
- Medical Genetics, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy; Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Suzanne E de Bruijn
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kim Rodenburg
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Margherita Scarpato
- Medical Genetics, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Dalila Capasso
- Telethon Institute of Genetics and Medicine, Pozzuoli, Italy; Scuola Superiore Meridionale (SSM, School of Advanced Studies), Genomic and Experimental Medicine Program, Naples, Italy
| | - Galuh D N Astuti
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Christian Gilissen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - María Rodríguez-Hidalgo
- Department of Neuroscience, Biogipuzkoa Health Research Institute, Donostia-San Sebastián, Spain; Department of Dermatology, Ophthalmology, and Otorhinolaryngology, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain
| | - Javier Ruiz-Ederra
- Department of Neuroscience, Biogipuzkoa Health Research Institute, Donostia-San Sebastián, Spain; Department of Dermatology, Ophthalmology, and Otorhinolaryngology, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Frans P M Cremers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sandro Banfi
- Medical Genetics, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy.
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.
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Abu Elasal M, Mousa S, Salameh M, Blumenfeld A, Khateb S, Banin E, Sharon D. Genetic Analysis of 252 Index Cases with Inherited Retinal Diseases Using a Panel of 351 Retinal Genes. Genes (Basel) 2024; 15:926. [PMID: 39062705 PMCID: PMC11276581 DOI: 10.3390/genes15070926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/01/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Inherited retinal diseases (IRDs) are extremely heterogeneous with at least 350 causative genes, complicating the process of genetic diagnosis. We analyzed samples of 252 index cases with IRDs using the Blueprint Genetics panel for "Retinal Dystrophy" that includes 351 genes. The cause of disease could be identified in 55% of cases. A clear difference was obtained between newly recruited cases (74% solved) and cases that were previously analyzed by panels or whole exome sequencing (26% solved). As for the mode of inheritance, 75% of solved cases were autosomal recessive (AR), 10% were X-linked, 8% were autosomal dominant, and 7% were mitochondrial. Interestingly, in 12% of solved cases, structural variants (SVs) were identified as the cause of disease. The most commonly identified genes were ABCA4, EYS and USH2A, and the most common mutations were MAK-c.1297_1298ins353 and FAM161A-c.1355_1356del. In line with our previous IRD carrier analysis, we identified heterozygous AR mutations that were not the cause of disease in 36% of cases. The studied IRD panel was found to be efficient in gene identification. Some variants were misinterpreted by the pipeline, and therefore, multiple analysis tools are recommended to obtain a more accurate annotation of potential disease-causing variants.
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Affiliation(s)
| | | | | | | | | | | | - Dror Sharon
- Division of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.E.); (S.M.); (M.S.); (A.B.); (S.K.)
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Hu H, Liu F, Gao P, Huang Y, Jia D, Reilly J, Chen X, Han Y, Sun K, Luo J, Li P, Zhang Z, Wang Q, Lu Q, Luo D, Shu X, Tang Z, Liu M, Ren X. Cross-species single-cell landscapes identify the pathogenic gene characteristics of inherited retinal diseases. Front Genet 2024; 15:1409016. [PMID: 39055259 PMCID: PMC11269129 DOI: 10.3389/fgene.2024.1409016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/30/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction Inherited retinal diseases (IRDs) affect ∼4.5 million people worldwide. Elusive pathogenic variants in over 280 genes are associated with one or more clinical forms of IRDs. It is necessary to understand the complex interaction among retinal cell types and pathogenic genes by constructing a regulatory network. In this study, we attempt to establish a panoramic expression view of the cooperative work in retinal cells to understand the clinical manifestations and pathogenic bases underlying IRDs. Methods Single-cell RNA sequencing (scRNA-seq) data on the retinas from 35 retina samples of 3 species (human, mouse, and zebrafish) including 259,087 cells were adopted to perform a comparative analysis across species. Bioinformatic tools were used to conduct weighted gene co-expression network analysis (WGCNA), single-cell regulatory network analysis, cell-cell communication analysis, and trajectory inference analysis. Results The cross-species comparison revealed shared or species-specific gene expression patterns at single-cell resolution, such as the stathmin family genes, which were highly expressed specifically in zebrafish Müller glias (MGs). Thirteen gene modules were identified, of which nine were associated with retinal cell types, and Gene Ontology (GO) enrichment of module genes was consistent with cell-specific highly expressed genes. Many IRD genes were identified as hub genes and cell-specific regulons. Most IRDs, especially the retinitis pigmentosa (RP) genes, were enriched in rod-specific regulons. Integrated expression and transcription regulatory network genes, such as congenital stationary night blindness (CSNB) genes GRK1, PDE6B, and TRPM1, showed cell-specific expression and transcription characteristics in either rods or bipolar cells (BCs). IRD genes showed evolutionary conservation (GNAT2, PDE6G, and SAG) and divergence (GNAT2, MT-ND4, and PDE6A) along the trajectory of photoreceptors (PRs) among species. In particular, the Leber congenital amaurosis (LCA) gene OTX2 showed high expression at the beginning of the trajectory of both PRs and BCs. Conclusion We identified molecular pathways and cell types closely connected with IRDs, bridging the gap between gene expression, genetics, and pathogenesis. The IRD genes enriched in cell-specific modules and regulons suggest that these diseases share common etiological bases. Overall, mining of interspecies transcriptome data reveals conserved transcriptomic features of retinas across species and promising applications in both normal retina anatomy and retina pathology.
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Affiliation(s)
- Hualei Hu
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Liu
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, The Innovative Academy of Seed Design, Hubei Hongshan Laboratory, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Pan Gao
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Yuwen Huang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Danna Jia
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Jamas Reilly
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Xiang Chen
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Yunqiao Han
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Kui Sun
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Jiong Luo
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Pei Li
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Zuxiao Zhang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Wang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Qunwei Lu
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Daji Luo
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, The Innovative Academy of Seed Design, Hubei Hongshan Laboratory, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xinhua Shu
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Zhaohui Tang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Mugen Liu
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Ren
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
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Shalom S, Ben-Yosef T, Sher I, Zag A, Rotenstreich Y, Poleg T, Birk OS, Gradstein L, Ehrenberg M, Deitch I, Mezer E, Hecht I, Pras E, Ramon D, Khateb S, Zur D, Newman H, Kharouba R, Goldenberg-Cohen N, Leibu R, Soudry S, Perlman I, Banin E, Sharon D. Nationwide Prevalence of Inherited Retinal Diseases in the Israeli Population. JAMA Ophthalmol 2024; 142:609-616. [PMID: 38753338 PMCID: PMC11099844 DOI: 10.1001/jamaophthalmol.2024.1461] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/15/2024] [Indexed: 05/19/2024]
Abstract
Importance Data regarding the prevalence of various inherited retinal diseases (IRDs) are limited and vary across populations; moreover, nationwide prevalence studies may be limited to a specific IRD phenotype, potentially leading to inaccurate prevalence estimations. Therefore, nationwide prevalence data are needed. Objective To determine the prevalence of 67 IRD phenotypes in the Israeli population. Design, Setting, and Participants This cohort study collected nationwide data regarding the number of individuals affected with IRD phenotypes assessed in 10 clinical and academic centers in Israel as part of the research activity of the Israeli inherited retinal disease consortium. Data were collected in May 2023 on 9396 individuals residing in Israel who were diagnosed by an ophthalmologist with an IRD using either electroretinography or retinal imaging where included. Individuals with retinal diseases known to have a nonmendelian basis or without a clear genetic basis and those who were reported as deceased at the time of data collection were excluded from this study. Main Outcomes and Measures Prevalence of 67 IRD phenotypes. Results Among the 9396 participants in our cohort, the most common IRD in Israel was retinitis pigmentosa with a disease prevalence of approximately 1:2400 individuals, followed by cone-rod dystrophy (approximately 1:14 000), Stargardt disease (approximately 1:16 000), Usher syndrome (approximately 1:16,000), and congenital stationary night blindness (approximately 1:18 000). The prevalence of all IRDs combined was 1:1043 individuals. Conclusions and Relevance The current study provides large prevalence dataset of 67 IRD phenotypes, some of which are extremely rare, with only a single identified case. This analysis highlights the potential importance of performing additional nationwide prevalence studies to potentially assist with determining the prevalence of IRDs worldwide.
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Affiliation(s)
- Sapir Shalom
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Military Medicine and Tzameret, Faculty of Medicine, Hebrew University of Jerusalem and Medical Corps, Israel Defense Forces, Jerusalem, Israel
| | - Tamar Ben-Yosef
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Ifat Sher
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Amir Zag
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ygal Rotenstreich
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Tomer Poleg
- Genetics Institute at Soroka Medical Center and the Morris Kahn Laboratory of Human Genetics, Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
| | - Ohad S. Birk
- Genetics Institute at Soroka Medical Center and the Morris Kahn Laboratory of Human Genetics, Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
| | - Libe Gradstein
- Department of Ophthalmology, Soroka Medical Center and Clalit Health Services, Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Miriam Ehrenberg
- Ophthalmology Unit, Schneider Children’s Medical Center in Israel, Petach Tikva, Israel
| | - Iris Deitch
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Eedy Mezer
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Department of Ophthalmology, Rambam Healthcare Campus, Haifa, Israel
| | - Idan Hecht
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
- The Matlow’s Ophthalmo-genetics Laboratory, Shamir Medical Center, Zerifin, Israel
| | - Eran Pras
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
- The Matlow’s Ophthalmo-genetics Laboratory, Shamir Medical Center, Zerifin, Israel
| | - Dan Ramon
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- Ophthalmology Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Samer Khateb
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dinah Zur
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- Ophthalmology Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Hadas Newman
- Faculty of medicine, Tel Aviv university, Tel Aviv, Israel
- Ophthalmology Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Rawan Kharouba
- The Krieger Eye Research Laboratory, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Department of Ophthalmology, Bnai-Zion Medical Center, Haifa, Israel
| | - Nitza Goldenberg-Cohen
- The Krieger Eye Research Laboratory, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Department of Ophthalmology, Bnai-Zion Medical Center, Haifa, Israel
| | - Rina Leibu
- Department of Ophthalmology, Rambam Healthcare Campus, Haifa, Israel
| | - Shiri Soudry
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
- Department of Ophthalmology, Rambam Healthcare Campus, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Ido Perlman
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Ophthalmology Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Eyal Banin
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dror Sharon
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Sundaresan Y, Rivera A, Obolensky A, Gopalakrishnan P, Ohayon Hadad H, Shemesh A, Khateb S, Ross M, Ofri R, Durst S, Newman H, Leibu R, Soudry S, Zur D, Ben-Yosef T, Banin E, Sharon D. Genetic and Clinical Analyses of the KIZ-c.226C>T Variant Resulting in a Dual Mutational Mechanism. Genes (Basel) 2024; 15:804. [PMID: 38927740 PMCID: PMC11202946 DOI: 10.3390/genes15060804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
Retinitis pigmentosa (RP) is a heterogeneous inherited retinal disorder. Mutations in KIZ cause autosomal recessive (AR) RP. We aimed to characterize the genotype, expression pattern, and phenotype in a large cohort of KIZ cases. Sanger and whole exome sequencing were used to identify the KIZ variants. Medical records were reviewed and analyzed. Thirty-one patients with biallelic KIZ mutations were identified: 28 homozygous for c.226C>T (p.R76*), 2 compound heterozygous for p.R76* and c.3G>A (p.M1?), and one homozygous for c.247C>T (p.R83*). c.226C>T is a founder mutation among patients of Jewish descent. The clinical parameters were less severe in KIZ compared to DHDDS and FAM161A cases. RT-PCR analysis in fibroblast cells revealed the presence of four different transcripts in both WT and mutant samples with a lower percentage of the WT transcript in patients. Sequence analysis identified an exonic sequence enhancer (ESE) that includes the c.226 position which is affected by the mutation. KIZ mutations are an uncommon cause of IRD worldwide but are not rare among Ashkenazi Jews. Our data indicate that p.R76* affect an ESE which in turn results in the pronounced skipping of exon 3. Therefore, RNA-based therapies might show low efficacy since the mutant transcripts are spliced.
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Affiliation(s)
- Yogapriya Sundaresan
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Antonio Rivera
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Alexey Obolensky
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Prakadeeswari Gopalakrishnan
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Hanit Ohayon Hadad
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Aya Shemesh
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Samer Khateb
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Maya Ross
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - Ron Ofri
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - Sharon Durst
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Hadas Newman
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Affiliated to Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Rina Leibu
- Department of Ophthalmology, Rambam Health Care Center, Haifa 31096, Israel
| | - Shiri Soudry
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Dinah Zur
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Affiliated to Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Tamar Ben-Yosef
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
| | - Eyal Banin
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
| | - Dror Sharon
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (Y.S.); (A.R.); (P.G.); (E.B.)
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Chan J, Holdstock J, Shovelton J, Reid J, Speight G, Molha D, Pullabhatla V, Carpenter S, Uddin E, Washio T, Sato H, Izumi Y, Watanabe R, Niiro H, Fukushima Y, Ashida N, Hirose T, Maeda A. Clinical and analytical validation of an 82-gene comprehensive genome-profiling panel for identifying and interpreting variants responsible for inherited retinal dystrophies. PLoS One 2024; 19:e0305422. [PMID: 38870140 PMCID: PMC11175448 DOI: 10.1371/journal.pone.0305422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/30/2024] [Indexed: 06/15/2024] Open
Abstract
Inherited retinal dystrophies comprise a clinically complex and heterogenous group of diseases characterized by visual impairment due to pathogenic variants of over 300 different genes. Accurately identifying the causative gene and associated variant is crucial for the definitive diagnosis and subsequent selection of precise treatments. Consequently, well-validated genetic tests are required in the clinical practice. Here, we report the analytical and clinical validation of a next-generation sequencing targeted gene panel, the PrismGuide IRD Panel System. This system enables comprehensive genome profiling of 82 genes related to inherited retinal dystrophies. The PrismGuide IRD Panel System demonstrated 100% (n = 43) concordance with Sanger sequencing in detecting single-nucleotide variants, small insertions, and small deletions in the target genes and also in assessing their zygosity. It also identified copy-number loss in four out of five cases. When assessing precision, we evaluated the reproducibility of variant detection with 2,160 variants in 144 replicates and found 100% agreement in terms of single-nucleotide variants (n = 1,584) and small insertions and deletions (n = 576). Furthermore, the PrismGuide IRD Panel System generated sufficient read depth for variant calls across the purine-rich and highly repetitive open-reading frame 15 region of RPGR and detected all five variants tested. These results show that the PrismGuide IRD Panel System can accurately and consistently detect single-nucleotide variants and small insertions and deletions. Thus, the PrismGuide IRD Panel System could serve as useful tool that is applicable in clinical practice for identifying the causative genes based on the detection and interpretation of variants in patients with inherited retinal dystrophies and can contribute to a precise molecular diagnosis and targeted treatments.
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Affiliation(s)
- Jacqueline Chan
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - Jolyon Holdstock
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - John Shovelton
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - James Reid
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - Graham Speight
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - Duarte Molha
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - Venu Pullabhatla
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - Stephanie Carpenter
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - Ezam Uddin
- Oxford Gene Technology Operations Limited, Kidlington, Oxfordshire, United Kingdom
| | - Takanori Washio
- Life Innovation Center, Riken Genesis Co. LTD, Kawasaki, Kanagawa, Japan
- Division of Clinical Cancer Genomics, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Hiroko Sato
- Life Innovation Center, Riken Genesis Co. LTD, Kawasaki, Kanagawa, Japan
| | - Yuuki Izumi
- Technology Innovation, Sysmex Corporation, Kobe, Hyogo, Japan
| | - Reiko Watanabe
- Medical & Scientific Affairs, Sysmex Corporation, Kobe, Hyogo, Japan
| | - Hayato Niiro
- Medical & Scientific Affairs, Sysmex Corporation, Kobe, Hyogo, Japan
| | | | - Naoko Ashida
- Medical & Scientific Affairs, Sysmex Corporation, Kobe, Hyogo, Japan
| | - Takashi Hirose
- Medical & Scientific Affairs, Sysmex Corporation, Kobe, Hyogo, Japan
| | - Akiko Maeda
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo, Japan
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