Dow Coad Thomas, Harley Calvin B
McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA; Chippewa Valley Eye Clinic, Eau Claire, Wisconsin, WI, USA.
Independent Telomere Biology Consultant, Murphys, CA, USA.
Clin Ophthalmol. 2016 Jan 28;10:243-9. doi: 10.2147/OPTH.S100042. eCollection 2016.
Telomere attrition and corresponding cellular senescence of the retinal pigment epithelium contribute to the changes of age-related macular degeneration. Activation of the enzyme telomerase can add telomeric DNA to retinal pigment epithelium chromosomal ends and has been proposed as a treatment for age-related macular degeneration. We report the use of a small molecule, oral telomerase activator (TA)-65 in early macular degeneration. This study, focusing on early macular degeneration, provides a model for the use of TAs in age-related disease.
Thirty-eight (38) patients were randomly assigned to a 1-year, double-blinded, placebo-controlled interventional study with arms for oral TA-65 or placebo. Macular functions via micro-perimetry were the primary measured outcomes.
The macular function in the arm receiving the TA-65 showed significant improvement relative to the placebo control. The improvement was manifest at 6 months and was maintained at 1 year: macular threshold sensitivity (measured as average dB [logarithmic decibel scale of light attenuation]) improved 0.97 dB compared to placebo (P-value 0.02) and percent reduced thresholds lessened 8.2% compared to the placebo arm (P-value 0.04).
The oral TA significantly improved the macular function of treatment subjects compared to controls. Although this study was a pilot and a larger study is being planned, it is noteworthy in that it is, to our knowledge, the first randomized placebo-controlled study of a TA supplement.
视网膜色素上皮细胞的端粒损耗及相应的细胞衰老促成了年龄相关性黄斑变性的变化。端粒酶的激活可将端粒DNA添加到视网膜色素上皮细胞染色体末端,并且已被提议作为年龄相关性黄斑变性的一种治疗方法。我们报告了小分子口服端粒酶激活剂(TA)-65在早期黄斑变性中的应用。这项聚焦于早期黄斑变性的研究为端粒酶激活剂在年龄相关性疾病中的应用提供了一个模型。
38名患者被随机分配到一项为期1年的双盲、安慰剂对照干预研究中,分为口服TA-65组或安慰剂组。通过微视野检查法测量黄斑功能是主要的测量结果。
接受TA-65治疗组的黄斑功能相对于安慰剂对照组有显著改善。这种改善在6个月时显现,并在1年时维持:黄斑阈值敏感性(以平均分贝[光衰减的对数分贝标度]衡量)与安慰剂相比提高了0.97分贝(P值为0.02),与安慰剂组相比阈值降低百分比减少了8.2%(P值为0.04)。
与对照组相比,口服TA显著改善了治疗对象的黄斑功能。尽管这项研究是一项试点研究,且正在计划进行一项更大规模的研究,但据我们所知,它是第一项关于TA补充剂的随机安慰剂对照研究,这一点值得注意。