title: A local complement response by RPE causes early-stage macular degeneration.
abstract: Inherited and age-related macular degenerations (AMDs) are important causes of vision loss. An early hallmark of these disorders is the formation of sub-retinal pigment epithelium (RPE) basal deposits. A role for the complement system in MDs was suggested by genetic association studies, but direct functional connections between alterations in the complement system and the pathogenesis of MD remain to be defined. We used primary RPE cells from a mouse model of inherited MD due to a p.R345W mutation in EGF-containing fibulin-like extracellular matrix protein 1 (EFEMP1) to investigate the role of the RPE in early MD pathogenesis. Efemp1(R345W) RPE cells recapitulate the basal deposit formation observed in vivo by producing sub-RPE deposits in vitro. The deposits share features with basal deposits, and their formation was mediated by EFEMP1(R345W) or complement component 3a (C3a), but not by complement component 5a (C5a). Increased activation of complement appears to occur in response to an abnormal extracellular matrix (ECM), generated by the mutant EFEMP1(R345W) protein and reduced ECM turnover due to inhibition of matrix metalloproteinase 2 by EFEMP1(R345W) and C3a. Increased production of C3a also stimulated the release of cytokines such as interleukin (IL)-6 and IL-1B, which appear to have a role in deposit formation, albeit downstream of C3a. These studies provide the first direct indication that complement components produced locally by the RPE are involved in the formation of basal deposits. Furthermore, these results suggest that C3a generated by RPE is a potential therapeutic target for the treatment of EFEMP1-associated MD as well as AMD.
authors.affiliation: Ocular Genomics Institute, Department of Ophthalmology and.
authors.forename: Rosario
authors.initials: R
authors.lastname: Fernandez-Godino
authors.affiliation: Ocular Genomics Institute, Department of Ophthalmology and.
authors.forename: Donita L
authors.initials: DL
authors.lastname: Garland
authors.affiliation: Ocular Genomics Institute, Department of Ophthalmology and Berman-Gund Laboratory for the Study of Retinal Degenerations, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA eric_pierce@meei.harvard.edu.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Pierce
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D015926:Complement C3a / Q000378:metabolism*; D015936:Complement C5a / Q000378:metabolism; D004195:Disease Models, Animal; D005109:Extracellular Matrix / Q000378:metabolism; D016326:Extracellular Matrix Proteins / Q000235:genetics* / Q000378:metabolism; D008268:Macular Degeneration / Q000235:genetics* / Q000276:immunology / Q000473:pathology*; D020782:Matrix Metalloproteinases / Q000378:metabolism; D051379:Mice; D009154:Mutation; D055213:Retinal Pigment Epithelium / Q000276:immunology*
chemical_list: C492278:Efemp1 protein, mouse; D016326:Extracellular Matrix Proteins; D015926:Complement C3a; D015936:Complement C5a; D020782:Matrix Metalloproteinases