Therapy and mechanism of Mendelian eye diseases

Retinal degenerative diseases cause varying degrees of irreversible vision loss in millions of people worldwide. Common to all retinal degenerative diseases is the malfunction or demise of photoreceptor cells or its supportive cells, retinal pigment epithelium cell in the retina. A considerable part of these diseases were resulted from the inherited mutations of essential genes expressed in these retinal cells. The understanding of pathologic mechanism as well as developing of therapeutic treatment for these diseases were discussed in this study. A cutting-edge therapeutic genome editing technology is studied in the first part of study. This technology was invented to treat retinitis pigmentosa via engineered nucleases, which has great clinical potential for autosomal dominant genetic disorders that were previously irreparable by conventional gene therapy interventions. Though customizable gene editing tools can be engineered to target specific mutation sites, however it is too daunting for diseases like retinitis pigmentosa, a progressive retinal degenerative condition associated with more than 150 mutations in the rhodopsin gene alone. Here in this study, we present an “ablate-and-replace” combination strategy that 1) destroys expression of the endogenous gene by CRISPR/Cas9 in a mutation-independent manner, and 2) enables expression of wild-type protein through exogenous cDNA. As proof of concept, we show that our CRISPR-based therapeutic machinery efficiently ablates mRho in vivo, and when combined with gene replacement therapy, ameliorates rod photoreceptor degeneration and improves visual function in two genetically distinct autosomal dominant retinitis pigmentosa animal models. This mutation-independent, ablate-and-replace strategy represents the first electrophysiological recovery by a CRISPR-mediated therapy in an autosomal dominant disorder and it offers a clinically relevant, universal strategy to overcome allelic heterogeneity in debilitating inherited conditions. For the second part of the study, gene editing technology was used to study the pathogenesis of Doyne honey comb dystrophy, another Mendelian disease with extensive similarities to age-related macular degeneration. This monogenic disorder is caused by a unique point mutation on an extracellular matrix protein EFEMP1, expressed by retinal pigment epithelium cell. To precisely gauge the physiological effect resulted from this mutation, CRISPR-mediated gene correction was used to create isogeneic cell pairs from patient donated tissue-derived stem cells. These stem cells were differentiated into retinal pigment epithelium cell before analysis. We found unfolded protein response and immune response were not involved in the pathogenesis, which contradicts existing theories. Via proteomics analysis, we found expression level of a cholesterol catabolic enzyme was affected by the EFEMP1 mutation while those proteins controlling the cholesterol transport remains constant. This result provides supportive evidence to explain the aberrant intracellular accumulation of cholesterol found in patient retinal pigment epithelium cells. This imbalance in lipid homeostasis also suggests Doyne honey comb dystrophy is a retinal pigment epithelium cell-autonomous disease

Systemic Associations with Residual Subretinal Fluid after Ranibizumab in Diabetic Macular Edema

Purpose. To investigate the impact of systemic diseases on the occurrence of subretinal fluid (SRF) in diabetic macular edema (DME) and prognostic factors for residual SRF following three consecutive monthly intravitreal ranibizumab. Methods. Ninety-seven eyes from 68 patients with DME who completed 3 consecutive monthly injections of ranibizumab were enrolled. Systemic parameters mainly included chronic kidney disease (CKD), hypertension, HbA1c, and insulin dependence. Renal parameters for CKD were serum creatinine, estimated glomerular filtration rate (eGFR), and serum albumin. Ocular factors were baseline central macular thickness (CMT), severity of diabetic retinopathy (DR), and status of panretinal photocoagulation (PRP). Results. Chronic kidney disease had significant correlation with baseline SRF (R=0.397, p<0.001 after partial correlation with adjustment for age and DR severity). As for CKD, lower serum albumin, but not eGFR or serum creatinine, was associated with baseline presence of SRF (p=0.026, p=0.08 and p=0.53, resp., after adjustment for age and DR severity). Overall, lower eGFR and lower HbA1c values, contrary to popular belief, predicted the presence of residual SRF following intravitreal injections (p=0.016 and p<0.001, resp.). Conclusions. Tight sugar control and poorer baseline kidney function may slow the resorption of SRF after anti-VEGF injections in patients with DME in the short term

Genotoxicity Assessment of Multispecies Probiotics Using Reverse Mutation, Mammalian Chromosomal Aberration, and Rodent Micronucleus Tests

Genotoxicity assessment is carried out on freeze dried powder of cultured probiotics containing Lactobacillus rhamnosus LCR177, Bifidobacterium adolescentis BA286, and Pediococcus acidilactici PA318. Ames tests, in vitro mammalian chromosome aberration assay, and micronucleus tests in mouse peripheral blood are performed. For 5 strains of Salmonella Typhimurium, the Ames tests show no increased reverse mutation upon exposure to the test substance. In CHO cells, the frequency of chromosome aberration does not increase in responding to the treatment of probiotics. Likewise, the frequency of micronucleated reticulocytes in probiotics-fed mice is indistinguishable from that in the negative control group. Taken together, the toxicity assessment studies suggest that the multispecies probiotic mixture does not have mutagenic effects on various organisms

A 90-DAY SUBCHRONIC TOXICOLOGICAL ASSESSMENT of DEINOCOCCUS GRANDIS FERMENTED SOYMILK IN SPRAGUE-DAWLEY RATS

Objective: Despite the fact that there was no adverse effect observed in previous animal safety studies of Deinococcus grandis (D. grandis) fermented soymilk, including acute oral toxicity assay, 3 different test systems of genotoxicity test and teratogenicity study, whether D. grandis fermented soymilk is safe for long-term use remains unknown. Therefore, the study was conducted further to clarify the edible safety of D. grandis fermented soymilk for long term use.Methods: Eighty Sprague-Dawley (SD) rats were divided into four groups, each consisting of ten male and ten female rats. Rats were orally administrated with reverse osmosis water (control) or 1,000, 2,000 and 3,000 mg/kg b.w./d freeze dried D. grandis fermented soymilk powder for 90 consecutive days. Clinical observation of the rats was carried out daily. The body weight and feed intake of the rats were recorded weekly. At the end of the study, all rats were sacrificed and the blood and organs were collected for hematology, clinical biochemistry and histopathological examination.Results: During the study period, no abnormality occurred in clinical signs, body weight, and ophthalmological examination. There were no significant differences in urinalysis, hematology and clinical biochemistry parameters between the treatment and control group. Necropsy and histopathological examination showed no treatment-related change.Conclusion: According to the results, the no-observed-adverse-effect level (NOAEL) of D. grandis fermented soymilk was greater than 3,000 mg/kg b.w./d in SD rats.Keywords: Deinococcus grandis (D. grandis), 90-day subchronic toxicity, NOAEL, Safety assessment, GKB-Aid 199

Preventive and therapeutic role of traditional Chinese herbal medicine in hepatocellular carcinoma

AbstractHepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide. The clinical management of HCC remains a substantial challenge. Although surgical resection of tumor tissues seems promising, a high recurrence and/or metastasis rate accounting for disease-related death has led to an urgent need for improved postsurgical preventive/therapeutic clinical intervention. Developing advanced target-therapy agents such as sorafenib appears to be the only effective clinical intervention for patients with HCC to date, but only limited trials have been conducted in this regard. Because of their enhanced preventive/therapeutic effects, traditional Chinese herbal medicine (CHM)-derived compounds are considered suitable agents for HCC treatment. The CHM-derived compounds also possess multilevel, multitarget, and coordinated intervention effects, making them ideal candidates for inhibition of tumor progression and HCC metastasis. This article reviews the anticancer activity of various CHMs with the hope of providing a better understanding of how to best use CHM for HCC treatment

3D-PL: Domain Adaptive Depth Estimation with 3D-aware Pseudo-Labeling

For monocular depth estimation, acquiring ground truths for real data is not easy, and thus domain adaptation methods are commonly adopted using the supervised synthetic data. However, this may still incur a large domain gap due to the lack of supervision from the real data. In this paper, we develop a domain adaptation framework via generating reliable pseudo ground truths of depth from real data to provide direct supervisions. Specifically, we propose two mechanisms for pseudo-labeling: 1) 2D-based pseudo-labels via measuring the consistency of depth predictions when images are with the same content but different styles; 2) 3D-aware pseudo-labels via a point cloud completion network that learns to complete the depth values in the 3D space, thus providing more structural information in a scene to refine and generate more reliable pseudo-labels. In experiments, we show that our pseudo-labeling methods improve depth estimation in various settings, including the usage of stereo pairs during training. Furthermore, the proposed method performs favorably against several state-of-the-art unsupervised domain adaptation approaches in real-world datasets.Comment: Accepted in ECCV 2022. Project page: https://ccc870206.github.io/3D-PL