Department of Medicine, Clinical Medicine Unit, University of Eastern Finland Institute of Clinical Medicine, Kuopio, Northern Savonia, Finland.
Acta Ophthalmol. 2024 Mar;102 Suppl 282:3-53. doi: 10.1111/aos.16661.
Age-related macular degeneration (AMD) is a devastating eye disease that causes permanent vision loss in the central part of the retina, known as the macula. Patients with such severe visual loss face a reduced quality of life and are at a 1.5 times greater risk of death compared to the general population. Currently, there is no cure for or effective treatment for dry AMD. There are several mechanisms thought to underlie the disease, for example, ageing-associated chronic oxidative stress, mitochondrial damage, harmful protein aggregation and inflammation. As a way of gaining a better understanding of the molecular mechanisms behind AMD and thus developing new therapies, we have created a peroxisome proliferator-activated receptor gamma coactivator 1-alpha and nuclear factor erythroid 2-related factor 2 (PGC1α/NFE2L2) double-knockout (dKO) mouse model that mimics many of the clinical features of dry AMD, including elevated levels of oxidative stress markers, damaged mitochondria, accumulating lysosomal lipofuscin and extracellular drusen-like structures in retinal pigment epithelial cells (RPE). In addition, a human RPE cell-based model was established to examine the impact of non-functional intracellular clearance systems on inflammasome activation. In this study, we found that there was a disturbance in the autolysosomal machinery responsible for clearing mitochondria in the RPE cells of one-year-old PGC1α/NFE2L2-deficient mice. The confocal immunohistochemical analysis revealed an increase in autophagosome marker microtubule-associated proteins 1A/1B light chain 3B (LC3B) as well as multiple mitophagy markers such as PTE-induced putative kinase 1 (PINK1) and E3 ubiquitin ligase (PARKIN), along with signs of damaged mitochondria. However, no increase in autolysosome formation was detected, nor was there a colocalization of the lysosomal marker LAMP2 or the mitochondrial marker, ATP synthase β. There was an upregulation of late autolysosomal fusion Ras-related protein (Rab7) in the perinuclear space of RPE cells, together with autofluorescent aggregates. Additionally, we observed an increase in the numbers of Toll-like receptors 3 and 9, while those of NOD-like receptor 3 were decreased in PGC1α/NFE2L2 dKO retinal specimens compared to wild-type animals. There was a trend towards increased complement component C5a and increased involvement of the serine protease enzyme, thrombin, in enhancing the terminal pathway producing C5a, independent of C3. The levels of primary acute phase C-reactive protein and receptor for advanced glycation end products were also increased in the PGC1α/NFE2L2 dKO retina. Furthermore, selective proteasome inhibition with epoxomicin promoted both nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and mitochondrial-mediated oxidative stress, leading to the release of mitochondrial DNA to the cytosol, resulting in potassium efflux-dependent activation of the absent in melanoma 2 (AIM2) inflammasome and the subsequent secretion of interleukin-1β in ARPE-19 cells. In conclusion, the data suggest that there is at least a relative decrease in mitophagy, increases in the amounts of C5 and thrombin and decreased C3 levels in this dry AMD-like model. Moreover, selective proteasome inhibition evoked mitochondrial damage and AIM2 inflammasome activation in ARPE-19 cells.
年龄相关性黄斑变性(AMD)是一种破坏性的眼部疾病,可导致视网膜中央部分(即黄斑)的永久性视力丧失。与一般人群相比,患有严重视力丧失的患者生活质量降低,死亡风险增加 1.5 倍。目前,干性 AMD 尚无治愈方法或有效治疗方法。有几种机制被认为是导致这种疾病的原因,例如与年龄相关的慢性氧化应激、线粒体损伤、有害蛋白质聚集和炎症。为了更好地了解 AMD 背后的分子机制并开发新的治疗方法,我们创建了过氧化物酶体增殖物激活受体γ共激活因子 1 阿尔法和核因子红细胞 2 相关因子 2(PGC1α/NFE2L2)双重敲除(dKO)小鼠模型,该模型模拟了干性 AMD 的许多临床特征,包括氧化应激标志物水平升高、受损的线粒体、在视网膜色素上皮细胞(RPE)中积累溶酶体脂褐素和细胞外 drusen 样结构。此外,还建立了基于人 RPE 细胞的模型,以研究功能失调的细胞内清除系统对炎症小体激活的影响。在这项研究中,我们发现 RPE 细胞中负责清除线粒体的自噬体机制在一岁的 PGC1α/NFE2L2 缺陷小鼠中受到干扰。共聚焦免疫组织化学分析显示自噬体标志物微管相关蛋白 1A/1B 轻链 3B(LC3B)以及多种线粒体自噬标志物(如 PTE 诱导的假定激酶 1(PINK1)和 E3 泛素连接酶(PARKIN))增加,同时伴有线粒体损伤的迹象。然而,未检测到自噬体形成增加,也未检测到溶酶体标记物 LAMP2 或线粒体标记物 ATP 合酶β的共定位。在 RPE 细胞的核周空间中,晚期自噬体融合 Ras 相关蛋白(Rab7)上调,同时伴有自发荧光聚集物。此外,我们观察到 Toll 样受体 3 和 9 的数量增加,而 NOD 样受体 3 的数量在 PGC1α/NFE2L2 dKO 视网膜标本中比野生型动物减少。补体成分 C5a 的水平呈增加趋势,丝氨酸蛋白酶酶凝血酶的参与增加,增强了产生 C5a 的终末途径,而与 C3 无关。PGC1α/NFE2L2 dKO 视网膜中的主要急性期 C-反应蛋白和晚期糖基化终产物受体的水平也升高。此外,用环氧酶米抑制剂选择性抑制蛋白酶体可促进烟酰胺腺嘌呤二核苷酸磷酸(NADPH)氧化酶和线粒体介导的氧化应激,导致线粒体 DNA 释放到细胞质中,导致黑色素瘤 2(AIM2)炎症小体的钾外流依赖性激活,随后在 ARPE-19 细胞中分泌白细胞介素-1β。总之,数据表明,在这种干性 AMD 样模型中,至少存在线粒体自噬相对减少、C5 和凝血酶增加以及 C3 水平降低的情况。此外,选择性蛋白酶体抑制可诱发 ARPE-19 细胞中线粒体损伤和 AIM2 炎症小体的激活。