title: Autophagy and Mitochondrial Dysfunction in Tenon Fibroblasts from Exfoliation Glaucoma Patients.
abstract: OBJECTIVE
  To test the hypothesis that autophagy dysfunction is involved in exfoliation syndrome (XFS), a systemic disorder of extracellular elastic matrices that causes a distinct form of human glaucoma.
  
  
  METHODS
  Fibroblasts derived from tenon tissue discards (TFs) from filtration surgery to relieve intraocular pressure in XFS patients were compared against age-matched TFs derived from surgery in primary open-angle glaucoma (POAG) patients or from strabismus surgery. Differential interference contrast light, and electron microscopy were used to examine structural cell features. Immunocytochemistry was used to visualize LOXL1 and Fibulin-5, lysosomes, endosomes, Golgi, and microtubules. Light scatter, Cyto-IDTM and JC1 flow cytometry were used to measure relative cell size, autophagic flux rate and mitochondrial membrane potential (MMPT), respectively. Enhanced autophagy was induced by serum withdrawal.
  
  
  RESULTS
  In culture, XFS-TFs were 1.38-fold larger (by light scatter ratio, p = 0.05), proliferated 42% slower (p = 0.026), and were morphologically distinct in 2D and 3D culture compared to their POAG counterparts. In extended 3D cultures, XFS-TFs accumulated 8-10 times more Fibulin-5 than the POAG-TFs, and upon serum withdrawal, there were marked deficiencies in relocation of endosomes and lysosomes to the perinuclear area. Correspondingly, the XFS-TFs displayed significant accumulation of the autophagasome marker LC3 II (3.9 fold increase compared to POAG levels, p = 0.0001) and autophagic flux rate as measured by Cyto-ID dye was 53% lower in XFS-TFs than in POAG-TFs (p = 0.01), indicating reduced clearance of autophagasomes. Finally the percent of cells with diminished MMPT was 3-8 times larger in the XFS-TFs than in POAG-TFs (p = 0.02).
  
  
  CONCLUSIONS
  Our results provide for the first time a link between XFS pathology to autophagy dysfunction, a major contributor to multiple age related diseases systemically throughout the body, in the brain and in the retina. A diminished capacity for degradation of denatured protein and aging cellular organelles may underpin the development of extracellular protein aggregates in XFS.
authors.affiliation: Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: Andrew
authors.initials: A
authors.lastname: Want
authors.affiliation: Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.|Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Gillespie
authors.affiliation: Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: Ronald
authors.initials: R
authors.lastname: Gordon
authors.affiliation: Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: Carlo
authors.initials: C
authors.lastname: Iomini
authors.affiliation: Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, 10003, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
authors.affiliation: Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: J Mario
authors.initials: JM
authors.lastname: Wolosin
authors.affiliation: Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.|Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: Audrey M
authors.initials: AM
authors.lastname: Bernstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000594:Amino Acid Oxidoreductases / Q000235:genetics; D001343:Autophagy; D002675:Child, Preschool; D017889:Exfoliation Syndrome / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005347:Fibroblasts / Q000378:metabolism*; D005902:Glaucoma, Open-Angle / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008027:Light; D008297:Male; D008564:Membrane Potentials; D008875:Middle Aged; D051336:Mitochondrial Membranes / Q000378:metabolism; D012542:Scattering, Radiation; D013285:Strabismus / Q000601:surgery
chemical_list: D000594:Amino Acid Oxidoreductases