Beneficial effect of antioxidants in retinopathies: a new hypothesis

The retina is the most oxygen consuming tissue of the body. Rod and cone photoreceptors efficiently carry out visual cascades, which are energetically costly processes. Data has recently been published that suggests that the metabolic support to phototransduction in the rod outer segment (OS) may originate directly in the OS, which is able to conduct aerobic metabolism. This oxygen-handling activity of the rod OS, which was never suspected before, appears to be a primary cause of the generation of reactive oxygen species directly inside the OS. Oxidative stress has been hypothesised to contribute to most of the neurodegenerative retinal pathologies, such as diabetic retinopathy, age-related macular degeneration, retinitis pigmentosa and photoreceptor cell death after retinal detachment. Many natural antioxidant compounds are routinely used in experimental or human therapies for preventing or delaying photoreceptor degeneration in those pathologies. Here it is proposed that the ultimate reason for the beneficial actions of antioxidants in preventing or retarding the effect on the retinal degenerative pathologies can be found in their action on reactive oxygen species generated by the ectopic mitochondrial electron transport chain (ETC) coupled to FoF1-ATP synthase in rod OS disks. In fact, if not adequately coupled, the ETC generates reactive oxygen species that, in turn, can act on the polyunsaturated fatty acids which the rod OS is rich in. If correct, the mechanism put forward here would provide a potential for the molecular basis of therapies with antioxidants for retinal degenerative diseases.