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Vitamin A treatment restores vision failures arising from Leber’s hereditary optic neuropathy–linked mtDNA mutation
Cheng Ai, … , Yimin Zhu, Min-Xin Guan
Cheng Ai, … , Yimin Zhu, Min-Xin Guan
Published March 4, 2025
Citation Information: JCI Insight. 2025;10(8):e188962. https://doi.org/10.1172/jci.insight.188962.
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Research Article Genetics Metabolism Ophthalmology

Vitamin A treatment restores vision failures arising from Leber’s hereditary optic neuropathy–linked mtDNA mutation

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Abstract

Leber hereditary optic neuropathy (LHON) is a paradigm for mitochondrial retinopathy due to mitochondrial DNA (mtDNA) mutations. However, the mechanism underlying retinal cell–specific effects of LHON-linked mtDNA mutations remains poorly understood, and there has been no effective treatment or cure for this disorder. Using a mouse model bearing an LHON-linked ND6P25L mutation, we demonstrated that the mutation caused retinal cell–specific deficiencies, especially in retinal ganglion cells (RGCs), rods, and Müller cells. Single-cell RNA sequencing revealed cell-specific dysregulation of oxidative phosphorylation and visual signaling pathways in the mutant retina. Strikingly, ND6 mutation–induced dysfunctions caused abnormal vitamin A (VA) metabolism essential for visual function. VA supplementation remarkably alleviated retinal deficiencies, including reduced fundus lesion and retinal thickness and increased numbers of RGCs, photoreceptors, and Müller cell neurites. The restoration of visual functions with VA treatment were further evidenced by correcting dysregulations of phototransduction cascade and neurotransmitter transmission and restoring electrophysiological properties. Interestingly, VA supplementation markedly rescued the abnormal mitochondrial morphologies and functions in the mutant retina. These findings provide insight into retina-specific pathophysiology of mitochondrial retinopathy arising from VA deficiency and mitochondrial dysfunction induced by mtDNA mutation and a step toward therapeutic intervention for LHON and other mitochondrial retinopathies.

Authors

Cheng Ai, Huiying Li, Chunyan Wang, Yanchun Ji, Douglas C. Wallace, Junbin Qian, Yimin Zhu, Min-Xin Guan

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Figure 1

Mouse retinal compositional and transcriptional profiles.

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Mouse retinal compositional and transcriptional profiles.
(A) Uniform ma...
(A) Uniform manifold approximation and projection (UMAP) map of 83,672 merged retinal cells from WT and mutant (MT) mice color coded for the indicated cell type. BC, bipolar cell; RPC, retina progenitor cell; HC, horizontal cell; AC_Gly, glycinergic amacrine cell; AC_GABA, GABAergic amacrine cell. (B) UMAP plots showing the expression of marker genes for each cell type. (C) The expression of transcription factors for each cell type. (D) UMAP plots of retina cells from WT (left) and MT (right) mice. (E) Box plots showing the fractions of cells for each cell type in each mouse. Box plots show the interquartile range, median (line), and minimum and maximum (whiskers). (F and H) Pseudotime trajectories of Rod1, Rod2 (F), Muller1, and Muller2 (H) based on Slingshot and gene expression dynamics along the trajectory. Genes clustered into 5 gene sets, each characterized by specific expression profiles, as depicted by a selection of marker genes characteristic for each cluster. (G and I) Plots showing cell density of Rod1, Rod2 (G), Muller1, and Muller2 (I) along the trajectory comparing WT and MT.

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