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Research represents major breakthrough in macular degeneration

August 9, 2012 — University of Kentucky researchers, led by Dr. Jayakrishna Ambati, have made an exciting finding in the "dry" form of age-related macular degeneration known as geographic atrophy (GA).

GA is an untreatable condition that causes blindness in millions of individuals due to death of retinal pigmented epithelial cells. The paper, "ERK1/2 Activation is a Therapeutic Target in Age-Related Macular Degeneration" appears in the current online issue of the premier journal Proceedings of the National Academy of Sciences.

Ambati, professor of physiology, and professor and vice chair of ophthalmology and visual sciences at UK, is a leader in the field of macular degeneration research.

Previous research from the Ambati laboratory published in the journal Nature showed that in human eyes with geographic atrophy there is a deficiency of the enzyme DICER1, leading to accumulation of toxic Alu RNA molecules in the retinal pigmented epithelium.

Another paper published in the journal Cell showed that when these RNAs build up in the eye they trigger activation of an immune complex known as the NLRP3 inflammasome. In turn, this leads to the production of a molecule known as IL-18, which causes death of retinal pigmented epithelial cells and vision loss by activating a critical protein known as MyD88.

Importantly, Ambati and colleagues found evidence that activity of the inflammasome, IL-18, and MyD88 were all increased in human eyes with GA.

They then showed that blocking any of these components could prevent retinal degeneration in multiple disease models.

The researchers are excited that blocking these pathways could herald a new potential therapy for GA, for which there is no approved treatment.

In the current paper, the authors show that Alu RNA, which increases following DICER1 deficit, activates a family of enzymes known as extracellular-signal-regulated kinases (ERK) 1/2. ERK 1/2, which are also known as classical mitogen-activated protein kinases (MAPKs), were found to be increased in the RPE of human eyes with GA and shown to be key mediators of RPE cell death. This work further defines the mechanisms of cell death in human GA and identifies a new therapeutic target for the dry form of AMD.

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Ambati is working with iVeena Pharmaceuticals, Inc. of Salt Lake City to commercialize therapies for geographic atrophy.

Authors on the paper include Ambati as well as: Sami Dridi, Yoshio Hirano, Valeria Tarallo, Younghee Kim, Benjamin J. Fowler, Sasha Bogdanovich, Mark E. Kleinman, Bradley D. Gelfand and Judit Z. Baffi, all of the University of Kentucky Department of Opthalmology and Visual Sciences; Balamurali K. Ambati of the Moran Eye Center at the University of Utah School of Medicine and Veterans Affairs Salt Lake City Healthcare System; Vince A. Chiodo and William W. Hauswirth of the University of Utal School of Medicine; Jennifer F. Kugel, James A. Goodrich and Steven L. Ponicsan of the Department of Chemistry and Biochemistry, University of Colorado at Boulder; and David R. Hinton of The Arnold and Mabel Beckman Macular Research Center at the Doheny Eye Institute, University of Southern California - Los Angeles.

Ambati is also the Dr. E. Vernon and Eloise C. Smith Endowed Chair in Macular Degeneration Research.

This research was supported by the National Eye Institute, the Doris Duke Distinguished Clinical Scientist Award, the Burroughs Wellcome Translational Research Scientist Award, and Research to Prevent Blindness.