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2017 ; 58
(ä): 70-88
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English Wikipedia
Bestrophinopathy: An RPE-photoreceptor interface disease
#MMPMID28111324
Guziewicz KE
; Sinha D
; Gómez NM
; Zorych K
; Dutrow EV
; Dhingra A
; Mullins RF
; Stone EM
; Gamm DM
; Boesze-Battaglia K
; Aguirre GD
Prog Retin Eye Res
2017[May]; 58
(ä): 70-88
PMID28111324
show ga
Bestrophinopathies, one of the most common forms of inherited macular
degenerations, are caused by mutations in the BEST1 gene expressed in the retinal
pigment epithelium (RPE). Both human and canine BEST1-linked maculopathies are
characterized by abnormal accumulation of autofluorescent material within RPE
cells and bilateral macular or multifocal lesions; however, the specific
mechanism leading to the formation of these lesions remains unclear. We now
provide an overview of the current state of knowledge on the molecular pathology
of bestrophinopathies, and explore factors promoting formation of
RPE-neuroretinal separations, using the first spontaneous animal model of
BEST1-associated retinopathies, canine Best (cBest). Here, we characterize the
nature of the autofluorescent RPE cell inclusions and report matching spectral
signatures of RPE-associated fluorophores between human and canine retinae,
indicating an analogous composition of endogenous RPE deposits in Best
Vitelliform Macular Dystrophy (BVMD) patients and its canine disease model. This
study also exposes a range of biochemical and structural abnormalities at the
RPE-photoreceptor interface related to the impaired cone-associated microvillar
ensheathment and compromised insoluble interphotoreceptor matrix (IPM), the major
pathological culprits responsible for weakening of the RPE-neuroretina
interactions, and consequently, formation of vitelliform lesions. These salient
alterations detected at the RPE apical domain in cBest as well as in BVMD- and
ARB-hiPSC-RPE model systems provide novel insights into the pathological
mechanism of BEST1-linked disorders that will allow for development of critical
outcome measures guiding therapeutic strategies for bestrophinopathies.