Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China.
Autophagy. 2023 Oct;19(10):2668-2681. doi: 10.1080/15548627.2023.2220540. Epub 2023 Jun 5.
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness among the elderly, and there is currently no clinical treatment targeting the primary impairment of AMD. The earliest clinical hallmark of AMD is drusen, which are yellowish spots mainly composed of lipid droplets (LDs) accumulated under the retinal pigment epithelium (RPE). However, the potential pathogenic role of this excessive LD accumulation in AMD is yet to be determined, partially due to a lack of chemical tools to manipulate LDs specifically. Here, we employed our recently developed Lipid Droplets·AuTophagy Tethering Compounds (LD∙ATTECs) to degrade LDs and to evaluate its consequence on the AMD-like phenotypes in apoe (apolipoprotein E; B6/JGpt-Apoe/Gpt) mouse model. apoe mice fed with high-fat diet (apoe-HFD) exhibited excessive LD accumulation in the retina, particularly with AMD-like phenotypes including RPE degeneration, Bruch's membrane (BrM) thickening, drusen-like deposits, and photoreceptor dysfunction. LD·ATTEC treatment significantly cleared LDs in RPE/choroidal tissues without perturbing lipid synthesis-related proteins and rescued RPE degeneration and photoreceptor dysfunction in apoe-HFD mice. This observation implied a causal relationship between LD accumulation and AMD-relevant phenotypes. Mechanically, the apoe-HFD mice exhibited elevated oxidative stress and inflammatory signals, both of which were mitigated by the LD·ATTEC treatment. Collectively, this study demonstrated that LD accumulation was a trigger for the process of AMD and provided entry points for the treatment of the initial insult of AMD by degrading LDs. AMD: age-related macular degeneration; : apolipoprotein E; ATTECs: autophagy-tethering compounds; BODIPY: boron-dipyrromethene; BrM: Bruch's membrane; ERG: electroretinogram; HFD: high-fat diet; LD·ATTECs: Lipid Droplets·AuTophagy Tethering Compounds; LDs: lipid droplets; OA: oleic acid; OPL: outer plexiform layer; ROS: reactive oxygen species; RPE: retinal pigment epithelium.
年龄相关性黄斑变性(AMD)是老年人不可逆性失明的主要原因,目前尚无针对 AMD 主要损伤的临床治疗方法。AMD 的最早临床标志是玻璃膜疣,其主要由视网膜色素上皮(RPE)下积累的类脂滴(LDs)组成。然而,这种 LD 过度积累在 AMD 中的潜在致病作用尚未确定,部分原因是缺乏专门操纵 LD 的化学工具。在这里,我们使用最近开发的脂滴·自噬连接化合物(LD·ATTECs)来降解 LD,并评估其对载脂蛋白 E(apolipoprotein E;B6/JGpt-Apoe/Gpt)小鼠模型中类似 AMD 表型的影响。用高脂肪饮食(apoe-HFD)喂养的 apoE 小鼠在视网膜中表现出大量 LD 积累,特别是出现了包括 RPE 变性、Bruch 膜(BrM)增厚、玻璃膜疣样沉积物和光感受器功能障碍在内的类似 AMD 的表型。LD·ATTEC 治疗可显著清除 RPE/脉络膜组织中的 LD,而不会干扰与脂质合成相关的蛋白,并可挽救 apoE-HFD 小鼠的 RPE 变性和光感受器功能障碍。这一观察结果暗示了 LD 积累与 AMD 相关表型之间存在因果关系。从机制上讲,apoE-HFD 小鼠表现出氧化应激和炎症信号升高,而这两种信号都可通过 LD·ATTEC 治疗得到缓解。总的来说,这项研究表明 LD 积累是 AMD 发病过程的一个触发因素,并为通过降解 LD 来治疗 AMD 的初始损伤提供了切入点。AMD:年龄相关性黄斑变性;apoE:载脂蛋白 E;ATTECs:自噬连接化合物;BODIPY:硼二吡咯甲烷;BrM:Bruch 膜;ERG:视网膜电图;HFD:高脂肪饮食;LD·ATTECs:脂滴·自噬连接化合物;LDs:脂滴;OA:油酸;OPL:外丛状层;ROS:活性氧;RPE:视网膜色素上皮。
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