Ganesh Satyanarayana

Purpose: Age-related macular degeneration (AMD) is a multifactorial disease in which dysfunction and loss of retinal pigment epithelial (RPE) cells contribute to disease progression. Besides genetics, cigarette smoking and high fat diet are important environmental and metabolic risk factors for AMD and are associated with RPE dysfunction. However, the effects of combined environmental and metabolic stress on AMD-derived RPE cells remain poorly understood. In this study, we used patient-derived induced pluripotent stem cell-derived RPE (iPSC-RPE) cells to examine the effects of cigarette smoke extract (CSE) and palmitic acid (PA) on RPE cell function. Methods: iPSCs derived from non-AMD and AMD donors were differentiated into RPE cells and characterized based on morphology, RPE-specific marker expression, polarity, gene expression, and barrier function. Mature iPSC-RPE cells were exposed to different concentrations of CSE and PA to determine experimental conditions. Cell death, epithelial-to-mesenchymal transition (EMT)-like morphological changes, stress-related gene expression, RPE polarity, TEER, VEGF-A and PEDF secretion, and intracellular lipid accumulation were then evaluated following CSE, PA, or combined CSE and PA exposure. Results: Differentiated iPSC-RPE cells developed typical pigmented, hexagonal morphology, expressed RPE-specific markers, and formed polarized monolayers. Both CSE and PA increased cell death in a dose-dependent manner in the control and AMD-iPSC-RPE, with AMD-iPSC-RPE exhibiting greater susceptibility, particularly those from patients with dry AMD. CSE and PA also induced also induced EMT-like morphological changes and increased the expression of ZEB1 , NQO1 , and IL8 . Furthermore, CSE and PA disrupted the polarized distribution of ZO-1 and Best1, significantly reduced the polarity ratio, decreased PEDF and VEGF-A secretion and increased intracellular lipid accumulation. Combined CSE and PA treatment produced more pronounced effects than either treatment alone in AMD lines. Conclusions: AMD-iPSC-RPE cells, particularly those derived from dry AMD donors, exhibit increased susceptibility to environmental and metabolic stress. Exposure to CSE and PA revealed this vulnerability through alterations in cell survival, stress responses, epithelial morphology, polarity, secretory function, and intracellular lipid accumulation. These findings highlight the effects of CSE and lipid stress on RPE metabolism and underscore the utility of patient-derived iPSC-RPE cells as a model for investigating how environmental and metabolic factors contribute to RPE dysfunction and AMD pathogenesis.

Dry age-related macular degeneration (AMD) is a leading cause of blindness in the elderly, and treatment options are limited. Cigarette smoke (CS), the primary modifiable environmental risk factor for AMD, damages the retinal pigment epithelium (RPE) by inducing oxidative stress, which in turn activates multiple stress response pathways. Low levels of stress induce autophagy, a cell-recycling mechanism; moderate stress induces epithelial-mesenchymal transition (EMT); and high, sustained stress, once other cytoprotective pathways are exhausted, leads to cell death. All three pathways are implicated in AMD pathogenesis. Although CS is known to induce oxidative stress, its impact on these distinct stress response pathways remains understudied, and few studies have directly compared mouse and human RPE responses to the same stressor. Here, we examined the effect of varying concentrations and durations of cigarette smoke condensate (CSC) exposure on oxidative stress, autophagy, EMT, and cell death in ARPE-19 (human) and mouse RPE (MRPE) cells. Understanding which stress response pathways predominate at which CSC exposure levels may help guide the development of AMD treatments stratified by smoking history.

Age-related macular degeneration (AMD) is a progressive complex eye disease and one of the leading causes of blindness. AMD progression is marked by molecular changes in the retinal pigmented epithelium (RPE) which include increased reactive oxygen species (ROS) accumulation, mitochondrial dysfunction - eventually leading to dysfunctional RPE. Mitophagy regulator, Pink1, is reduced in the RPE of AMD patients and Pink1 loss leads to a shift from mitochondrial respiration to glycolysis. Serine is a non-essential amino acid which is de novo synthesized from glycolytic intermediate 3-PG via the rate limiting enzyme PHGDH. Serine is tightly integrated into anabolic processes like glutathione (GSH) cycling, maintaining NADH/NADPH pools leading to changes in AMPK signaling. Here, we show that Pink1 loss leads to a reduction in PHGDH and serine levels in the RPE leading to impaired mitochondrial structure and function, increased ROS mediated damage, increased inflammation, and hampered retinal function. Serine supplementation rescued ROS accumulation, balanced GSH abundance, and increased retinal function. Overall, our study highlights the potential of dietary serine in ROS management in AMD.

Epithelial-mesenchymal transition (EMT), which is well known for its role in embryonic development, malignant transformation, and tumor progression, has also been implicated in a variety of retinal diseases, including proliferative vitreoretinopathy (PVR), age-related macular degeneration (AMD), and diabetic retinopathy. EMT of the retinal pigment epithelium (RPE), although important in the pathogenesis of these retinal conditions, is not well understood at the molecular level. We and others have shown that a variety of molecules, including the co-treatment of human stem cell-derived RPE monolayer cultures with transforming growth factor beta (TGF–β) and the inflammatory cytokine tumor necrosis factor alpha (TNF–α), can induce RPE–EMT; however, small molecule inhibitors of RPE–EMT have been less well studied. Here, we demonstrate that BAY651942, a small molecule inhibitor of nuclear factor kapa-B kinase subunit beta (IKKβ) that selectively targets NF-κB signaling, can modulate TGF–β/TNF–α-induced RPE–EMT. Next, we performed RNA-seq studies on BAY651942 treated hRPE monolayers to dissect altered biological pathways and signaling events. Further, we validated the effect of IKKβ inhibition on RPE–EMT-associated factors using a second IKKβ inhibitor, BMS345541, with RPE monolayers derived from an independent stem cell line. Our data highlights the fact that pharmacological inhibition of RPE–EMT restores RPE identity and may provide a promising approach for treating retinal diseases that involve RPE dedifferentiation and EMT.

Coronary microvascular dysfunction (CMD) refers to a subset of structural and/or functional disorders of coronary microcirculation that lead to impaired coronary blood flow and eventually myocardial ischemia. Amid the growing knowledge of the pathophysiological mechanisms and the development of advanced tools for assessment, CMD has emerged as a prevalent cause of a broad spectrum of cardiovascular diseases (CVDs), including obstructive and nonobstructive coronary artery disease, diabetic cardiomyopathy, and heart failure with preserved ejection fraction. Of note, the endothelium exerts vital functions in regulating coronary microvascular and cardiac function. Importantly, insufficient or uncontrolled activation of endothelial autophagy facilitates the pathogenesis of CMD in diverse CVDs. Here, we review the progress in understanding the pathophysiological mechanisms of autophagy in coronary endothelial cells and discuss their potential role in CMD and CVDs.

Fibrotic tumor stroma plays an important role in facilitating triple-negative breast cancer (TNBC) progression and chemotherapeutic resistance. We previously reported a rationally designed protein (ProAgio) that targets integrin αvβ3 at a novel site. ProAgio induces apoptosis via the integrin. Cancer-associated fibroblasts (CAFs) and angiogenic endothelial cells (aECs) in TNBC tumor express high levels of integrin αvβ3. ProAgio effectively induces apoptosis in CAFs and aECs. The depletion of CAFs by ProAgio reduces intratumoral collagen and decreases growth factors released from CAFs in the tumor, resulting in decreased cancer cell proliferation and apoptotic resistance. ProAgio also eliminates leaky tumor angiogenic vessels, which consequently reduces tumor hypoxia and improves drug delivery. The depletion of CAFs and reduction in hypoxia by ProAgio decreases lysyl oxidase (LOX) secretion, which may play a role in the reduction of metastasis. ProAgio stand-alone or in combination with a chemotherapeutic agent provides survival benefit in TNBC murine models, highlighting the therapeutic potential of ProAgio as a treatment strategy.