4.6 Article

Human RGR Gene and Associated Features of Age-Related Macular Degeneration in Models of Retina-Choriocapillaris Atrophy

Journal

AMERICAN JOURNAL OF PATHOLOGY
Volume 191, Issue 8, Pages 1454-1473

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.ajpath.2021.05.003

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Age-related macular degeneration is a progressive eye disease that is the leading cause of blindness in elderly individuals. The disease is characterized by the formation of extracellular deposits known as drusen between the retinal pigment epithelium and Bruch membrane. Research suggests that abnormal RGR proteins, such as RGR-d, may play a pathogenic role in the degeneration of the choriocapillaris, retinal pigment epithelium, and photoreceptors, leading to potential vision loss.
Age-related macular degeneration (AMD) is a progressive eye disease and the most common cause of blindness among the elderly. AMD is characterized by early atrophy of the choriocapillaris and retinal pigment epithelium (RPE). Although AMD is a multifactorial disease with many environmental and genetic risk factors, a hallmark of the disease is the origination of extracellular deposits, or drusen, between the RPE and Bruch membrane. Human retinal G-protein-coupled receptor (RGR) gene generates an exon-skipping splice variant of RGR-opsin (RGR-d; NP_001012740) that is a persistent component of small and large drusen. Herein, the findings show that abnormal RGR proteins, including RGR-d, are pathogenic in an animal retina with degeneration of the choriocapillaris, RPE, and photoreceptors. A frameshift truncating mutation resulted in severe retinal degeneration with a continuous band of basal deposits along the Bruch membrane. RGR-d produced less severe disease with choriocapillaris and RPE atrophy, including focal accumulation of abnormal RGR-d protein at the basal boundary of the RPE. Degeneration of the choriocapillaris was marked by a decrease in endothelial CD31 protein and choriocapillaris breakdown at the ultrastructural level. Fundus lesions with patchy depigmentation were characteristic of old RGR-d mice. RGR-d was mislocalized in cultured cells and caused a strong cell growth defect. These results uphold the notion of a potential hidden link between AMD and a high-frequency RGR allele.

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