title: Lutein, zeaxanthin, and meso-zeaxanthin: The basic and clinical science underlying carotenoid-based nutritional interventions against ocular disease.
abstract: The human macula uniquely concentrates three carotenoids: lutein, zeaxanthin, and meso-zeaxanthin. Lutein and zeaxanthin must be obtained from dietary sources such as green leafy vegetables and orange and yellow fruits and vegetables, while meso-zeaxanthin is rarely found in diet and is believed to be formed at the macula by metabolic transformations of ingested carotenoids. Epidemiological studies and large-scale clinical trials such as AREDS2 have brought attention to the potential ocular health and functional benefits of these three xanthophyll carotenoids consumed through the diet or supplements, but the basic science and clinical research underlying recommendations for nutritional interventions against age-related macular degeneration and other eye diseases are underappreciated by clinicians and vision researchers alike. In this review article, we first examine the chemistry, biochemistry, biophysics, and physiology of these yellow pigments that are specifically concentrated in the macula lutea through the means of high-affinity binding proteins and specialized transport and metabolic proteins where they play important roles as short-wavelength (blue) light-absorbers and localized, efficient antioxidants in a region at high risk for light-induced oxidative stress. Next, we turn to clinical evidence supporting functional benefits of these carotenoids in normal eyes and for their potential protective actions against ocular disease from infancy to old age.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA. Electronic address: paul.bernstein@hsc.utah.edu.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Bernstein
authors.affiliation: Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA. Electronic address: binxing.li@hsc.utah.edu.
authors.forename: Binxing
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA. Electronic address: preejith.vachali@hsc.utah.edu.
authors.forename: Preejith P
authors.initials: PP
authors.lastname: Vachali
authors.affiliation: Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA. Electronic address: aruna.gorusupudi@utah.edu.
authors.forename: Aruna
authors.initials: A
authors.lastname: Gorusupudi
authors.affiliation: Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA. Electronic address: r.shyam@utah.edu.
authors.forename: Rajalekshmy
authors.initials: R
authors.lastname: Shyam
authors.affiliation: Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA. Electronic address: brad.henriksen@hsc.utah.edu.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Henriksen
authors.affiliation: Macular Pigment Research Group, Vision Research Centre, School of Health Science, Carriganore House, Waterford Institute of Technology West Campus, Carriganore, Waterford, Ireland. Electronic address: jmnolan@wit.ie.
authors.forename: John M
authors.initials: JM
authors.lastname: Nolan
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000502:physiology; D004032:Diet; D005128:Eye Diseases / Q000209:etiology / Q000517:prevention & control*; D000882:Haplorhini; D006801:Humans; D014975:Lutein / Q000008:administration & dosage / Q000737:chemistry / Q000502:physiology*; D008266:Macula Lutea / Q000378:metabolism*; D008268:Macular Degeneration / Q000378:metabolism; D012168:Retinal Pigments / Q000378:metabolism; D065146:Zeaxanthins / Q000008:administration & dosage / Q000737:chemistry / Q000378:metabolism / Q000502:physiology*
chemical_list: D000975:Antioxidants; D012168:Retinal Pigments; D065146:Zeaxanthins; C584722:meso-zeaxanthin; D014975:Lutein
keywords: Age-related macular degeneration; Carotenoid; Lutein; Macular pigment; Nutrition; Zeaxanthin