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.

Abstract

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.