Retinal degeneration in retinitis pigmentosa and neuronal ceroid lipofuscinosis: An overview

Retinal degeneration is an early consequence of the group of lysosomal storage diseases collectively referred to as the neuronal ceroid lipofuscinoses (NCLs). This review details specialized techniques that have evolved for retinal assessment in patients with hereditary retinal degeneration. A standard ERG protocol is described for assessing rod- and cone-mediated function. Standardization will be crucial for planning and implementing multicenter trials as rational therapeutic intervention becomes available. In recent years, there has been a dramatic increase in knowledge of the molecular biological bases of retinitis pigmentosa and allied retinal degenerations. Rather than attempting a comprehensive summary, this review stresses the concepts of genetic, allelic, and clinical heterogeneity, which have obvious parallels in the NCLs. Many of the mutations that cause retinal degeneration are in genes that encode photoreceptor cascade proteins; others are in genes that encode photoreceptor structural proteins. Recent advances in linking the retinal degeneration slow (RDS) and ATP-binding cassette transporter retina (ABCR) genes to a variety of disease phenotypes will be summarized. Clinical heterogeneity even among family members with the same mutation raises the possibility that modifying factors, either genetic or environmental, could influence the severity of the disease. Here, we focus on vitamin A and docosahexaenoic acid, two potential nutritional modifiers that have received considerable attention in recent years.     

Retinal degeneration triggered by inactivation of PTEN in the retinal pigment epithelium

Adhesion between epithelial cells mediates apical–basal polarization, cell proliferation, and survival, and defects in adhesion junctions are associated with abnormalities from degeneration to cancer. We found that the maintenance of specialized adhesions between cells of the retinal pigment epithelium (RPE) requires the phosphatase PTEN. RPE-specific deletion of the mouse pten gene results in RPE cells that fail to maintain basolateral adhesions, undergo an epithelial-to-mesenchymal transition (EMT), and subsequently migrate out of the retina entirely. These events in turn lead to the progressive death of photoreceptors. The C-terminal PSD-95/Dlg/ZO-1 (PDZ)-binding domain of PTEN is essential for the maintenance of RPE cell junctional integrity. Inactivation of PTEN, and loss of its interaction with junctional proteins, are also evident in RPE cells isolated from ccr2^−/− mice and from mice subjected to oxidative damage, both of which display age-related macular degeneration (AMD). Together, these results highlight an essential role for PTEN in normal RPE cell function and in the response of these cells to oxidative stress.     

Circulating anti-retinal antibodies as immune markers in age-related macular degeneration

Age-related macular maculopathy (ARM) and age-related macular degeneration (AMD) are the leading causes of blindness in the Western world. Despite the magnitude of this clinical problem, very little is known about the pathogenesis of the disease. In this study, we analysed the sera (using indirect immunohistochemistry and Western blot analysis) from a very large cohort of such patients and normal age-matched controls to detect circulating anti-retinal antibodies. Patients with bilateral drusen (n = 64) and with chorioretinal neovascularization (CNV) (n = 51) were recruited in addition to age-matched control subjects (n = 39). The sera were analysed for anti-retinal immunoglobulins on retinal sections. The data were then correlated with the clinical features graded according to the International Classification and Grading System of ARM and AMD. The sera of patients with drusen (93.75%) and CNV (82.27%) were found to have a significantly (P = 0.02) higher titre of autoantibodies to the retina in comparison with controls (8.69%), indicating significant evidence of involvement of the immune process in early stages of AMD. Subsequent statistical analysis of the drusen group showed significant progressive staining (P = 0.0009) in the nuclei layers from early to late stages of ARM. Western blotting confirmed the presence of anti-retinal immunoglobulins to retinal antigens. As anti-retinal immunoglobulins are present in patients with bilateral drusen and exudative AMD, these antibodies could play a significant role in the pathogenesis of AMD. Whilst we do not have evidence that these antibodies precede disease onset, the possibility that their presence might contribute to disease progression needs to be investigated. Finally, the eventual identification of the target antigens detected by these antibodies may permit the future development of new diagnostic methods for ARM and AMD.     

The Importance of Specific IgG and IgE Autoantibodies to Retinal S Antigen, Total Serum IgE, and sCD23 Levels in Autoimmune and Infectious Uveitis

Autoimmunity plays an important role in the development of uveitis. The uveitis are linked to Th1 or Th2 lymphocyte activation. We studied 41 patients with uveitis, divided into autoimmune uveitis (n = 32) and infectious uveitis (n = 9), 30 normal controls, and 20 asthmatic atopic without ocular diseases. The infectious uveitis patients were separated into bacterial (n = 6) and toxoplasmic (n = 3) retinochoroiditis. We measured IgE and sCD23 serum levels and specific IgG and IgE to retinal S antigen by ELISA tests. The IgE levels were 500 ± 325 kU/L in autoimmune uveitis, 57 ± 35 kU/L in bacterial uveitis, 280 ± 38 kU/L in toxoplasmic retinochoroiditis, 75 ± 32 kU/L in the controls, and 557 ± 243 kU/L in atopics (P < 0.0005). The sCD23 levels were 10.4 ± 5.4 ng/ml in autoimmune uveitis, 3.7 ± 1.17 ng/ml in bacterial uveitis, 6.76 ± 1.36 ng/ml in toxoplasmic retinochoroiditis, 3.4 ± 1 ng/ml in controls, and 8.35 ± 2.2 ng/ml in atopic patients (P < 0.005). The specific IgG to retinal S antigen was positive in 27 of 32 cases, and the specific IgE to retinal S antigen was positive in 22 of 32 autoimmune uveitis. The bacterial uveitis patients as well as the controls were negative for both autoantibodies to retinal S antigen. The toxoplasmic retinochoroiditis patients presented specific IgG and IgE to retinal S antigen in two of three cases, respectively, one of them with overlap of both antibodies. These results suggest the importance of specific IgG and IgE to retinal S antigen in autoimmune uveitis, which, along with higher IgE and sCD23 levels, reveal Th2 activation.     

Alternative splicing and retinal degeneration

Alternative splicing is highly regulated in tissue‐specific and development‐specific patterns, and it has been estimated that 15% of disease‐causing point mutations affect pre‐mRNA splicing. In this review, we consider the cis‐acting splice site and trans‐acting splicing factor mutations that affect pre‐mRNA splicing and contribute to retinal degeneration. Numerous splice site mutations have been identified in retinitis pigmentosa (RP) and various cone‐rod dystrophies. Mutations in alternatively spliced retina‐specific exons of the widely expressed RPGR and COL2A1 genes lead primarily to X‐linked RP and ocular variants of Stickler syndrome, respectively. Furthermore, mutations in general pre‐mRNA splicing factors, such as PRPF31, PRPF8, and PRPF3, predominantly cause autosomal dominant RP. These findings suggest an important role for pre‐mRNA splicing in retinal homeostasis and the pathogenesis of retinal degenerative diseases. The development of novel therapeutic strategies to modulate aberrant splicing, including small molecule‐based therapies, has the potential to lead to new treatments for retinal degenerative diseases.     

Development and degeneration of retina in rds mutant mice: the electroretinogram

In mice, homozygous for the retinal degeneration slow (rds) gene, the photoreceptor cells lack outer segment disc structures, contain low amounts of rhodopsin, and degenerate slowly, while the inner retinal layers remain intact. The electroretinogram (ERG) from 1-month-old mutant mice shows a lower than normal amplitude but the time-to-peak is normal. The ERGs from mutant mice of 2-3 months and 6-7 months of age show a further decline in response amplitude as the receptor cell population is depleted with progress of degeneration while the time-to-peak increases. The ERG is absent in 1-year-old mutant mice which have lost their receptor cells completely. The possible morphological correlations of the ERG and its components in the rds mutant mice are discussed.     

Mutations and polymorphisms in the human peripherin-RDS gene and their involvement in inherited retinal degeneration

The RDS gene codes for the protein peripherin-RDS, which is an integral membrane glycoprotein found in the outer segment of both rod and cone photoreceptor cells. It is thought to function as a structural protein involved in the maintenance of the flattened form of the disc lamellae. The RDS gene has been implicated in the mouse phenotype retinal degeneration slow, and mutations in the human homologue are now known to be associated with both central and peripheral retinal degenerations. In all, 43 sequence variants have been described in the human gene, including 30 missense mutations, two single base substitutions producing termination codons, 7 small in-frame deletions, and 4 insertion/deletion events, which break the reading frame. Of these, 39 are associated with retinal phenotypes, which can be grouped into four broad categories: dominant retinitis pigmentosa, progressive macular degeneration, digenic RP, and pattern dystrophies. The mutations underlying dominant RP and severe macular degeneration are largely missense or small in-frame deletions in a large intradiscal loop between the third and fourth transmembrane domains. In contrast, those associated with the milder pattern phenotypes or with digenic RP are scattered more evenly through the gene and are often nonsense mutations. This observation correlates with the hypothesis that the large loop is an important site of interaction between RDS molecules and other protein components in the disc. © 1996 Wiley-Liss, Inc.     

Towards a Neurotransmitter-Based Retinal Prosthesis Using an Inkjet Print-head

Electronic chips that provide a patterned stimulus to cells in the retina may provide a viable treatment for age-related macular degeneration. A surrogate MEMS device, in the form of a print-head from a desktop printer, has been used to eject a pattern of neurotransmitters (bradykinin) onto living rat pheochromocytoma (PC12) cells. Fluorescent calcium imaging was used to measure the patterned stimulation of individual cells. The chemical stimulation of cells by directed microfluidic delivery may have applications in retinal prosthetic devices, and in other prosthetic implants in the nervous system.     

Identification of a Suppressor of Retinal Degeneration in Drosophila Photoreceptors

During sensory transduction, Drosophila photoreceptors experience substantial increases in intracellular Ca²⁺ levels ([Ca²⁺]_i). Nevertheless in a number of mutants associated with excessive Ca²⁺ influx through transient receptor potential (TRP) channels, Drosophila photoreceptors undergo loss of normal cellular structure manifest as a retinal degeneration. However, the molecular mechanisms that underpin this degeneration process remain unclear. The authors previously isolated a mutant, su(40), that is able to suppress the retinal degeneration seen in photoreceptors from loss-of-function alleles of rdgA that are known to have constitutively active TRP channels. Here the authors report the genetic mapping of su(40) as well the isolation of additional alleles of su(40). Studies of su(40) as well as these new alleles should facilitate the understanding of the mechanisms by which excessive Ca²⁺ influx results in retinal degeneration.     

Pigmentary degeneration indwed by N-methyl-N-nitrosourea and the fate of pigment epithelial cells in the rat retina

Pigmentary degeneration of the retina was induced by a single intraperitoneal Injection of 75mgkg of N-methyl-N-nitrosourea (MNU) In female Brown-Norway colored rats at 50 days of age, which were then observed at 24, 48 and 72 h and 7, 21,35 and 150 days after the treatment. MNU-treated rats showed selective destruction of the photoreceptor cells by an apoptotic mechanlsm 24 h after the treatment, and the destruction was completed by day 7. During the photoreceptor cell degeneration, proliferation of Miller cells and infiltratlon of macrophages was prominent 72h and 21 days aRttr the treatment, respectively. Müller cell proliferation and macrophage infiltratbn corresponded to degenerative photo-receptor cell phagocytosis, and prollferating Müller cell processes responded to stabilize the damaged retina. Pigment epithelial cell detachment from the Bruch's membrane was seen 72 h after the treatment, and migration within all layers of the retina was seen at day 7 when photoreceptor Cells were lost. At 21, 35 and 150 days after the treatment, lack of photoreceptor cells and deposition of pigment epithelial cells within the retina but not in contact to vascular endothe-lial cells were characteristic. MNU-induced photoreceptor apoptosis followed by Miiller cell and macrophage reaction then pigment epithellal cells deposition withln the retina partially resembles retinitis pigmentosa in humans.     

Cone loss is delayed relative to rod loss during induced retinal degeneration in the diurnal cone-rich rodent Arvicanthis ansorgei

Cone photoreceptor breakdown underlies functional vision loss in many blinding diseases. Cone loss is often secondary to that of rods, but little experimental data are available on the relationship between the two populations. Because of its high cone numbers, we used the diurnal rodent Arvicanthis ansorgei to explore changes in rod and cone survival and function during chemically-induced retinal degeneration. Adult animals received intraperitoneal injections of N-methyl-N-nitrosourea (MNU), and changes in retinal fundus appearance, histology, phenotype, apoptosis (TUNEL staining) and functionality (scotopic and photopic electroretinography) were monitored as a function of post-treatment time and retinal topography. Relative to control animals injected with vehicle only, MNU-injected animals showed time-, region- and population-specific changes as measured by morphological and immunochemical criteria. Histological (gradual thinning of photoreceptor layer) and phenotypical (reduced immunostaining of rhodopsin and rod transducin, and mid wavelength cone opsin and cone arrestin) modifications were first observed in superior central retina at 11 days post-injection. These degenerative changes spread into the superior peripheral and inferior hemisphere during the following 10 days. Rod loss preceded that of cones as visualized by differential immunolabelling and presence of apoptotic cells in rod but not cone cells. By 3 months post-injection, degeneration of the photoreceptor layer was complete in the superior hemisphere, but only partial in the inferior hemisphere. Despite the persistence of cone photoreceptors, scotopic and photopic electroretinography performed at 90 days post-treatment showed that both rod and cone function were severely compromised. In conclusion, MNU-induced retinal degeneration in Arvicanthis follows a predictable spatial and temporal pattern allowing clear separation of rod- and cone-specific pathogenic mechanisms. Compared to other rodents in which MNU has been used, Arvicanthis ansorgei demonstrates pronounced resistance to photoreceptor cell loss.     

Proteins of the retina and its pigmented epithelium in hereditary degeneration of the retina

The assortments of water-soluble and membrane proteins of the retina and its pigmented epithelium in Campbell (albino) rats with hereditary degeneration of the retina and in healthy Wistar rats were studied by electrophoresis in polyacrylamide gel. Early changes were shown to be detectable in the assortment of retinal proteins of the diseased animals; the first proteins to undergo changes were found to be neither cyclic nucleotide phosphodiesterase noropsin. Changes in the set of proteins of the pigmented epithelium were observed much later.Laboratory of the Biochemical Basis of Reception, I. M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Academy of Sciences of the USSR, Leningrad. (Presented by Academician of the Academy of Medical Sciences of the USSR A. N. Klimov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 89, No. 2, pp. 211–213, February, 1980.     

Retinal blood vessels are damaged in a rat model of NMDA-induced retinal degeneration

Retinal ischemia–reperfusion causes capillary degeneration but the mechanisms of damage are not well understood. The NMDA receptor plays an important role in neuronal damage after ischemia–reperfusion. Therefore, we determined whether retinal blood vessels are damaged structurally and functionally in a rat model of retinal degeneration induced by NMDA. At 7 days after a single intravitreal injection of NMDA (200 nmol) into the eye, loss of retinal ganglion cells and thinning of the inner plexiform layer were observed. Endothelial cells disappeared in some regressing vessels and empty basement membrane sleeves were left as remnants of the vessels. The number of basement membrane sleeves was increased in the NMDA-treated retina and non-perfused vessels were found in the injured retina. These results indicate that retinal blood vessels are damaged in the NMDA-induced retinal degeneration model. Neuronal cells may play a role in maintaining normal structure and function of the vasculature in the retina.     

Time-specific action of N-methyl-N-nitrosourea in the occurrence of retinal dysplasia and retinal degeneration in neonatal mice

The morphologic response of neonatal mouse retina to the alkylating agent N -methyl- N -nitrosourea (MNU) was examined at different periods of retinal development. A dose of 60 mg/kg N -methyl- N -nitrosourea was injected intraperitoneally to neonatal C₅₇BL mice at 0, 3, 5, 8, 11, 14, 17, and 20 days of age and to C₃H mice at 0 days of age, and the retinas were examined sequentially. In the C₆₇BL mice, MNU evoked a time-dependent occurrence of retinal dysplasia and retinal degeneration. With MNU treatment at day 0 and day 3 (the stage of retinal cell proliferation), retinal dysplasia characterized by the progressive disorganization of neuroblasts, which led to the formation of rosettes, was found in the outer neuroblastic/nuclear layer above the normal pigment epithelial cells during days 8–20, but decreased at day 50. The rosettes were surrounded by photoreceptor segments and Muller cell processes, and by photoreceptor nuclei. The MNU response was related to retinal differentiation; following MNU treatment at day 5 or 8 (the stage of retinal cell differentiation) the cells were much less sensitive (i.e. no retinal response was found). However, with MNU treatment at days 11, 14, 17, and 20 (after cellular differentiation), retinal degeneration characterized by selective photoreceptor apoptosis was seen. These results suggest that there is a critical period for the time of MNU administration in the development of mouse retinal lesions. In C₃H ( rd/rd ) mice, MNU treatment at day 0 resulted in retinal degeneration with only slight rosette formation at the peripheral retina.     

Significant photoreceptor rescue by treatment with a combination of antioxidants in an animal model for retinal degeneration

The purpose of this study was to investigate the presence of oxidative DNA damage in the photoreceptors of the rd1 mouse, an animal model for retinitis pigmentosa, and to determine if antioxidants could delay the progress of photoreceptor cell death. Retinas of rd1 mice and congenic wild type controls were examined for DNA oxidation and fragmentation. To study the rescue effect of antioxidants on retinal degeneration, rd1 retinas were studied in vitro and in vivo using lutein, zeaxanthin, alpha lipoic acid and reduced l-glutathione. For the in vitro studies, antioxidants were added to the culture medium. For the in vivo studies, postnatal day (PN3) pups of rd1 mice were fed antioxidants either individually or in combination and control rd1 animals received vehicle alone. Histological evaluation was performed using hematoxylin/eosin and avidin staining, as well as terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. Many of the rd1 rod photoreceptors at PN11 displayed oxidative DNA damage and TUNEL positive reaction which co-localized in a subset of rod photoreceptors. Avidin-labeled rod photoreceptors were more abundant than the TUNEL positive photoreceptors of the rd1 mouse, indicating that oxidative DNA damage precedes fragmentation. The number of TUNEL positive and avidin positive cells was considerably decreased upon treatment with the combination of the antioxidants. Rescue of rd1 photoreceptors was significant at PN18 and PN17, respectively, in the in vitro and in vivo studies. In conclusion individual antioxidants had no significant rescue effect but the combination slowed down the rd1 rod photoreceptor degeneration, indicating an additive or synergistic effect.     

XLPRA: A canine retinal degeneration inherited as an X-linked trait

Breeding studies are reported of a previously undescribed hereditary retinal degeneration identified in the Siberian Husky breed of dog. This disorder clinically resembles the previously reported autosomal recessive canine hereditary retinal degenerations collectively termed progressive retinal atrophy (PRA). However, the pedigree of the propositus, a male Siberian Husky, exhibited an X-linked pattern of transmission. This dog was outcrossed to three phenotypically normal female laboratory Beagles and two of their F1 daughters were bred to a phenotypically normal male Beagle, producing affected males in the F2 generation. Subsequent inbreedings produced further affected males and affected females as well. X-linked transmission was established by exclusion of alternative modes of inheritance and, consequently, the disease has been termed X-linked progressive retinal atrophy (XLPRA). This is the first reported X-linked retinal degeneration in an animal. Because of the many similarities of PRA in dogs to retinitis pigmentosa (RP) in humans, this new disease may not only represent the first animal model of X-linked RP (XLRP) but may well be a true homolog of one of the XLRP loci (RP2, RP3, RP6). It is the first retinal degeneration in dogs that can be assigned to an identified canine chromosome, and the first for which linkage mapping offers a realistic approach to proceed by positional cloning towards identifying the responsible gene locus. © 1994 Wiley-Liss, Inc.     

高脂诱导肥胖小鼠视网膜变性的形态学改变

目的 探讨高脂饮食建立的C57BL/6小鼠肥胖模型的视网膜变性的超微结构改变.方法 高脂饲料喂养19周后,小鼠分为肥胖抵抗(DIO-R)组和肥胖倾向(DIO)组,同时对照组小鼠给予基础饲料喂养.应用光镜,透射电镜及TUNEL法检测三组小鼠视网膜超微结构的改变及凋亡情况.结果 与对照组及DIO-R组比较,DIO组小鼠视网...     

Biosynthesis of melatonin during early postnatal ontogeny in pineal gland of healthy rats and animals with hereditary retinal degeneration

The content of melatonin and its precursors in the pineal gland of healthy rats and rats with hereditary retinal degeneration is studied on days 20 and 40 of postnatal development. The measurements are performed between 02:30 and 03:00, when the content of melatonin is maximal. In December, the content of melatonin and N-acetylserotonin in 20-day-old rats with hereditary retinal degeneration is 1.9- and 3.2-fold higher than in healthy controls. The content of norepinephrine in the pineal gland of these rats is increased 1.8-fold. On postnatal day 40, no differences in the pineal content of indolamines are noted. An increase in the content of melatonin in 20-day-old rats with hereditary retinal degeneration in comparison with healthy controls is also observed in May. A decrease in the maximum nocturnal level of melatonin in May in comparison with December is shown both in rats with hereditary retinal degeneration (by 46%) and healthy controls (by 41%) only on postnatal day 40. Translated fromByulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 123, No. 2, pp. 131–134, February, 1997