The metabolic environment is important for neuronal cells, such as photoreceptors. When photoreceptors undergo degeneration, as occurs during retinitis pigmentosa (RP), patients have progressive loss of vision that proceeds to full blindness. Currently, there are no available treatments for the majority of RP diseases. We performed metabolic profiling of the neural retina in a preclinical model of RP and found that tricarboxylic acid (TCA) cycle intermediates were reduced during disease. We then determined that, 1) promoting citrate production within the TCA cycle in retinal neurons during disease progression protects the photoreceptors from cell death and prolongs visual function, 2) that supplementation with single metabolites within the TCA cycle can provide this therapeutic effect in vivo over time, and, 3) that this therapeutic effect is not specific to a particular genetic mutation but has broad applicability for patients with RP and other retinal degenerative diseases. Overall, targeting TCA cycle activity in the neural retina promotes photoreceptor survival and visual function during neurodegenerative disease.
Ashley A. Rowe, Pinkal D. Patel, Ruth Gordillo, Katherine J. Wert