Mitochondrial Revolution: New Hope for AMD and Aging Diseases

How many times have we heard: “This field has been thoroughly studied, and we know all there is to know; there is no reason to continue investigating, because there is nothing more to find out on the subject”? This has been the attitude of some researchers with respect to the importance of mitochondria and diseases. For more than 50 years, we have known that mitochondria, which are the “batteries” of the cell, are critical for energy production. But many believed they did not have other major roles in the health of the cell, so when it came to developing drugs against diseases, mitochondria were overlooked.

That idea has now been turned on its head.

Mitochondria

Led by Discovery Eye Foundation (DEF) Research Director Dr. Cristina Kenney, the Mitochondria Research Group believed that, to really discover something new, you have to look in novel areas. This group has done just that. Using the transmitochondrial cybrid model, which are cell lines with identical nuclei, but with each line containing mitochondria from a different person, they have shown that the mitochondria have major regulation powers over cell behavior and expression of disease-related pathways. This is significant, because the mitochondria then become a target for therapies to combat diseases.

Kenney’s group is investigating various drugs and substances that will keep the mitochondria healthy and, ultimately, improve the health of the retinal cells in age-related macular degeneration (AMD). But it does not stop there. This same approach to developing mitochondria-targeting drugs is being pursued for drugs to treat Parkinson’s disease, Alzheimer’s disease, leukemia, various cancers, heart failure, thrombosis, stroke, diabetic retinopathy, Leber hereditary optic neuropathy, and even liver toxicity from acetaminophen.

The continued support from DEF, especially in the early stages of the mitochondria research, has fostered a new area to be opened up, specifically for AMD and diabetic retinopathy. In turn, this has allowed new collaborations among Kenney and researchers from the eye field, and laboratories studying the brain and neurodegeneration, cardiology, cancer therapies and methods to reduce side effects from cancer drugs. Kenney’s discoveries using cybrids have revolutionized the field of mitochondrial research, showing that mitochondria have wide-ranging biological effects never imagined and opening up the field of mitochondrial therapy to careful investigation.

You can help make a difference by supporting DEF’s sight saving research. Help our researchers advance AMD research by donating today! 

DonateNow

 

Lauren HauptmanLauren Hauptman
Lauren Hauptman Ink

AMD and a Healthy Diet: How they Relate

While there is still no concrete answer as to why some do not develop age-related macular degeneration (AMD) and other’s do, significant studies have proven the importance of a healthy diet and the mitochondria.

AMD is the leading cause of vision loss for those over 60 years of age in the developing countries. For decades we have studies that show the genetics and environmental factors associated with AMD. There have been over 20 genetics modification associated with AMD but there is no single gene that “causes AMD in all cases.” The genes most highly associated with AMD are found in the complement system, an important system related to controlling the inflammation in our body. A change in the complement factor H (CFH) gene from a low risk gene to a high risk gene has been associated with 43% of those developing AMD.

However, some people who have this high risk CFH gene but never develop AMD. This leads us to believe that the genetics are not the entire answer. The other factor has to do with the environment. Smoking is the leading risk factor, along with aging, exposure to sunlight and higher body mass index (obesity). But again there are obese people that smoke and never develop AMD. So, while the environmental risk factors are important, they do not answer the entire question of “why do some people get AMD but others do not?”

Recently, researchers have recognized that a major factor in the dry form of AMD is that the retinal cells begin to die off. Therefore, they have looked at important factors that keep cells alive. The mitochondria are one of the most important elements that protect the cells in the body. These subunits or organelles, produce energy for the cells, acting like batteries for the cells. And just like the batteries in a flashlight – if the batteries are not working then the flashlight dies. The same thing happens with cells – when the mitochondria are not healthy, then the cells eventually will die. Therefore to protect ourselves, it is important to keep the mitochondria healthy. One way to do this is to eat healthy foods. Over the past 20 years, the National Eye Institute (NEI) has conducted a series of studies that have identified foods and supplements that are good for the retinal cells and also the mitochondria.

 

super greens, spinachThe National Eye Institute has recommended that people who are high-risk for developing AMD eat diets rich in green leafy vegetables, whole fruits, any type of nuts and omega 3 fatty acids. Many of these foods have anti-oxidant properties that help to “turn off” genes involved with inflammation, an important factor of retinal diseases. Salmon, mackerel and sardines have the highest levels of omega-3 fatty acids. An analysis that combined the data from 9 different studies showed that fish intake at least twice a week was associated with reduced risk of early and late AMD. Other studies show that Omega-3 fatty acids improve mitochondrial function, decreases production of reactive oxygen species (free radicals that damage cells) and leads to less fat accumulation in the body. The green leafy vegetables contain important protective macular pigments (carotenoids) called lutein and zeaxanthin that reduce the risk of AMD by 43%. High levels of lipid or fat deposits in the body (obesity) can “soak-up” the lutein and zeaxanthin so that they are not available to protect the retina.

The goal is to increase the omega-3 fatty acid and carotenoid levels to protect the eye. Below is a list of foods that are eye healthy:

Foods that have lutein or zeaxanthin:

– 6mg/d of lutein and zeaxanthin – decreased

– Lutein/zeaxanthin content – ug/100g wet weight

– Kale, cooked – 15,798

– Spinach, raw – 11,935

– Spinach, cooked – 7,053

– Lettuce, raw – 2,635

– Broccoli, cooked – 2,226

– Green peas, cooked – 1350

Source: Johnson, et al 2005 Nutr Rev 63:9

 

To help kickstart an eye healthy diet, here is a list of “eye-healthy recipes” that provide nutritional support for the mitochondria and retinal cells.

Asparagus Soup
Kale Chips
Quinoa Collard Green Wraps with Summer Vegetables
Smoked Salmon Rillettes

Sources:
Geoffrey K. Broadhead, John R. Grigg, Andrew A. Chang, and Peter McCluskey Nutrition Reviews. Dietary modification and supplementation for the treatment of age-related macular degeneration VR Vol. 73(7):448–462

Chong et al., Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol 2008;126:826–33.

5/19/16

courtesy of the
SFCulinaryAcademyLogoWEB

 

 

Mitochondria and Age-Related Macular Degeneration

Research on mitochondrial DNA shows promise for treating AMD

For the past few years, DEF Research Director Dr. M. Cristina Kenney has been researching the relationship of mitochondria and age-related macular degeneration (AMD). She found that damaged mitochondria from people with AMD send signals that can cause retinal cells to die at an increased rate, compared with people who had healthy mitochondria and no AMD. That research led to the exploration of stimulating mitochondria to support retinal cell health in an effort to retain or restore vision for people with AMD.

Mitochondria in Cells
Cells are the basic building blocks of all living things. The human body is composed of trillions of cells. They provide structure for the body, take in nutrients from food, convert those nutrients into energy and carry out specialized functions. Cells also contain the body’s hereditary material (DNA) and so they can make copies of themselves.

Mitochondria are tiny structures inside cells whose function is to produce energy, like a battery in a flashlight, to keep cells alive. Each cell contains hundreds to thousands of mitochondria, which are located in the fluid that surrounds the nucleus. Although most DNA is packaged in chromosomes within the nucleus of a cell (nuclear DNA), mitochondria also have a small amount of their own DNA, known as mitochondrial DNA or mtDNA.

Because only egg cells contribute mitochondria to a developing embryo, only females can pass on the mitochondrial DNA to their children.

Mitochondrial Haplogroups
The mtDNA can be classified into categories called haplogroups, which represent different ancient, geographically separated groups of people. For example, African-Americans and people of ancient African lineage have inherited L haplogroup mitochondria from their mothers no matter where they currently live.
mitochondria and age-related macular degeneration
Similarly, most Ashkenazi Jewish populations (primarily those Jews whose families originated in Eastern or Central Europe) possess mitochondria of the K haplogroup. People with this haplogroup of mtDNA seem to be susceptible to a variety of age-related diseases, including age-related macular degeneration (AMD).

The incidence of AMD varies a lot among different ethnic/racial populations. For example, in the United States, the likelihood of losing vision from AMD is very low for a person with an African maternal background but it is much higher in people of European descent. Similarly, in an Israeli eye clinic, of the people who had AMD, 96% were Jewish while only 4% were of Arab descent. This suggests that European mtDNA in retinal cells of Caucasians may be the reason they are more susceptible to AMD.

Mitochondria and Age-Related Macular Degeneration
Figure 1

It has been recognized that AMD is a very complex disease with many factors involved (Figure 1). There are more than 30 genes associated with AMD, representing many different biological pathways. In addition, mitochondrial damage and specific mtDNA haplogroups have been associated with AMD. Finally, it is recognized that environmental factors, such as smoking and obesity, increase the risk to develop AMD.

Although millions of dollars and thousands of man-hours have been invested in finding the causes and treatments for AMD, we still do not understand how to prevent the most common form of AMD. One major difficulty has been that when we study a diverse group of individuals, each with hundreds of different nuclear and mitochondrial genes, it is very difficult to identify the causes and pathways involved with developing AMD and determining effective treatments. One drug may not help everyone and different people develop different types and severities of AMD.

Mitochondria and Age-Related Macular Degeneration
Figure 2

Kenney’s approach to this dilemma has been to SIMPLIFY THE TESTING SYSTEM (Figure 2). In her research with different ethnic/racial groups, Kenney has found that the Ashkenazi Jewish population (K haplogroup) is an excellent group in which to study age-related diseases. This group has very well characterized nuclear and mitochondrial genes, the population tends to relatively homogenous and to marry within their community. Finally, the Ashkenazi Jewish population has longevity, which increases the likelihood that they will develop aging diseases, such as AMD.

Kenney’s laboratory has created a “cybrid” test system, which are cell lines with identical nuclei and nuclear DNA, but different mitochondrial DNA so that the differences in the cell behavior can be attributed to the different mitochondrial DNA (see the following cybrid story on 11/17/15). Using the cybrid system, Kenney has compared cell behavior of mitochondria from subjects with the K (Ashkenazi Jewish) haplogroups and the mitochondria from people of the H haplogroup (Figure 3), the most common European haplogroup.

Mitochondria and Age-Related Macular Degeneration
Figure 3

There are:

  • Major differences in production of cholesterol and lipid molecules
  • Altered levels of inflammation
  • Differences in their responses to toxic effects of amyloid-? (a toxic protein associated with AMD and Alzheimer’s disease)

These differences are important contributors to AMD and other age-related diseases.

Significance of the Findings
Maternally inherited mitochondrial DNA can influence how a person’s cells respond to stress and this can contribute to age-related diseases. This is a completely new way of thinking about common aging diseases and offers new approaches to treatment and prevention of those diseases.

Future Studies
Kenney’s laboratory will continue to use the K haplogroup cybrid model to study the mitochondrial DNA, with the goal of blocking the harmful events that cause early retinal cell death, such as that seen in AMD. An additional advantage of cybrids is that they are unique to the donor whose blood was used to make them. Therefore with these “personalized cybrids,” Kenney can test the responses of the personalized cybrids to drugs that are currently being used for AMD (Lucentis™, Avastin™ and Eylea™). They can also be used to identify novel, new drugs that can protect the cells from early cellular death, a major event in the dry form of AMD. This research shows great promise in developing personalized treatments for AMD and other age-related diseases.

11/12/15


Anthony B. Nesburn, MD  FACSAnthony B. Nesburn, MD FACS
President/Medical Director
Discovery Eye Foundation