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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 4

The recovery of retinal deficiency with VA supplementation.

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The recovery of retinal deficiency with VA supplementation.
(A) Image-gu...
(A) Image-guided OCT analysis was performed at 2 months (baseline), 3 months, and 4 months of age. The left panel for each age shows the fundus image, and the black arrowed line indicates the location of the OCT scans. The white arrow indicates the fundus lesion. The right panel for each age shows the corresponding OCT images, and the white arrow indicates abnormalities in the photoreceptor and RPE. (B) Quantification of changes (logFC) from baseline of lesion areas comparing MT (n = 7) and MT+VA mice (n = 6). (C) Quantification of retinal thickness changes from baseline in WT (n = 8), MT (n = 6), MT+VA (n = 5) mice. (D) Immunofluorescence staining of cryosection showing retinal section stained with Brn3a (red) with DAPI (blue) for RGC, Vimentin (green) with DAPI for MG, rhodopsin (red) with DAPI for rod. Scale bar: 50 μm (Brn3a), 100 μm (Vimentin and rhodopsin). GCL, ganglion cell layer; IPL, inner plexiform layer; INL, inner nuclear layer; MG, Müller glia. (E–G) Quantification of ratios of Brn3a-positive RGC (E), relative numbers of Müller dendrites in IPL (F), and relative number of photoreceptors (counts of DAPI-positive nuclei in ONL) (G) in WT, MT, and MT+VA mouse retina. n = 3–5 for Brn3a staining; n = 5–6 for Vimentin staining; n = 8–15 for photoreceptor counts. Data in B and C are shown as mean ± SEM. *P < 0.05, **P < 0.01 by 2-tailed unpaired Welch’s t test comparing MT and MT+VA mice. Data in E–G are shown as mean ± SEM. ***P < 0.001, ****P < 0.0001 by 1-way ANOVA followed by Tukey post hoc test.

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