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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 6

Mitochondrial morphology and function.

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Mitochondrial morphology and function.
(A) Representative transmission e...
(A) Representative transmission electron micrographs of mitochondria from GCL and ISL of retina in WT, MT, and MT+VA mice. Scale bars: 1 μm in GCL, 2 μm in ISL. The arrow indicates mitochondria. The right panel shows the quantification of mitochondrial size (n = 86–319 mitochondria) and relative mitochondrial number (n = 4–6 mice) in GCL and ISL of mouse retina. (B and C) Assessment of mitochondrial function by enzyme histochemistry staining for COX and SDH in the frozen sections of retinas (B) and brains (C) in WT, MT, and MT+VA mice. scale bar: 50 μm in retina; 100 μm in brain. OPL, outer plexiform layer. (D) In-gel activity of respiratory chain complexes I, II, IV, and V. Twenty micrograms of mitochondrial protein from brains of WT, MT, and MT+VA mice was used for BN-PAGE, and the activities of complexes were measured in the presence of specific substrates. Coomassie staining was used as a loading control. SC, super complexes. (E) ATP levels among brains of WT (n = 8), MT (n = 8), and MT+VA (n = 8) mice were measured using a luciferin/luciferase assay. Absolute level of total cellular ATP was shown. (F) Western blot analysis of antioxidant proteins. Total cellular proteins in WT, MT, and MT+VA retinas were electrophoresed with PAGE and hybridized with catalase, SOD1, and SOD2 antibodies and GAPDH as a loading control, respectively. (G) Quantification of catalase, SOD1, and SOD2 in WT, MT, and MT+VA retina. Representative of 3 to 4 independent experiments. Data in A, E, and G are represented as mean ± SEM. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001 by 1-way ANOVA followed by Tukey’s post hoc test.

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