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Published on: July 14, 2016
MMP9 Genotype and Systemic T-Cell Subsets Correlate With Structural and Functional Outcomes in Neovascular
Thomas L Martinez1, Zeb R Zacharias2, Kyungmoo Lee3
1Department of Ophthalmology and Visual Sciences, University of Iowa Health Care, Iowa City, Iowa, United States.
Purpose:
Genetic studies implicate the matrix metalloproteinase-9 (MMP9) locus in neovascular age-related macular degeneration (nvAMD) risk but genotype-phenotype associations of MMP9 with nvAMD are lacking. This study aimed to investigate the influence of MMP9 genotype and T-cell subset frequency on structural and functional treatment outcomes in nvAMD.
Methods:
We reanalyzed single-cell RNA sequencing data and used ELISA and flow cytometry in THP-1-derived monocytes to measure immune cell expression of MMP9 within human choroids. In a clinical nvAMD cohort of 38 patients, we genotyped the nvAMD risk single nucleotide polymorphism (SNP; rs4810482) and quantified retinal fluid using deep-learning-based optical coherence tomography (OCT) image analysis. On a subset of nine patients, we performed high-dimensional immunophenotyping.
Results:
MMP9 is predominantly expressed in mature THP-1-derived dendritic-like cells (ELISA, P = 0.009; flow cytometry, P = 0.001). Patients with the TC genotype of MMP9 exhibited greater disease severity compared to CC or TT genotypes with a significantly higher total retinal fluid volume (P = 0.009). Immunophenotyping revealed that higher proportions of circulating CD8+ effector memory T cells re-expressing CD45RA (TEMRA) were associated with increased residual subretinal fluid (P = 0.03), indicating persistent disease activity.
Conclusions:
MMP9 genotype affects structural and functional outcomes in patients with nvAMD. Along with the observed systemic immune dysregulation, these findings support the role of a MMP9-dendritic-T-cell axis in nvAMD immunopathogenesis and highlight this as a potential therapeutic target.
Insights
Matrix metalloproteinase-9 (MMP9) genotype influences neovascular age-related macular degeneration (nvAMD) outcomes. MMP9
Area of Science:
- Ophthalmology
- Immunology
- Genetics
Background:
- Genetic studies link the matrix metalloproteinase-9 (MMP9) gene to neovascular age-related macular degeneration (nvAMD) risk.
- However, genotype-phenotype associations between MMP9 and nvAMD remain unclear.
Purpose of the Study:
- To investigate how MMP9 genotype and T-cell subsets affect structural and functional outcomes in nvAMD patients.
- To explore the role of MMP9 in the immunopathogenesis of nvAMD.
Main Methods:
- Reanalyzed single-cell RNA sequencing data and used ELISA/flow cytometry to measure MMP9 expression in human choroids.
- Genotyped the nvAMD risk SNP (rs4810482) in 38 nvAMD patients and quantified retinal fluid using OCT image analysis.
- Performed high-dimensional immunophenotyping on a subset of nine patients.
Main Results:
- MMP9 expression was predominant in mature THP-1-derived dendritic-like cells.
- Patients with the TC genotype of MMP9 showed greater disease severity and higher retinal fluid volume compared to CC or TT genotypes.
- Increased circulating CD8+ effector memory T cells re-expressing CD45RA (TEMRA) correlated with residual subretinal fluid, indicating persistent disease activity.
Conclusions:
- MMP9 genotype significantly impacts structural and functional outcomes in nvAMD.
- Systemic immune dysregulation and a MMP9-dendritic-T-cell axis are implicated in nvAMD immunopathogenesis.
- This axis represents a potential therapeutic target for nvAMD.
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