Abstract

BackgroundPeripheral blood mononuclear cells (PBMCs) are implicated in the pathogenesis of age-related macular degeneration (AMD). We here mapped the global gene transcriptome of PBMCs from patients with different clinical subtypes of late AMD.ResultsWe sampled fresh venous blood from patients with geographic atrophy (GA) secondary to AMD without choroidal neovascularizations (n = 19), patients with neovascular AMD without GA (n = 38), patients with polypoidal choroidal vasculopathy (PCV) (n = 19), and aged control individuals with healthy retinae (n = 20). We isolated PBMCs, extracted RNA, and used microarray to investigate gene expression. Volcano plots identified statistically significant differentially expressed genes (P < 0.05) at a high magnitude (≥30% higher/lower) for GA (62 genes), neovascular AMD (41 genes), and PCV (41 genes). These clinical subtypes differed substantially across gene expression and the following pathways identified in enrichment analyses. In a subgroup analysis, we investigated presence vs. absence of subretinal fibrosis and found 826 differentially expressed genes (≥30% higher/lower, P < 0.05) with relation to mRNA splicing, endothelial migration, and interleukin-1 signaling.ConclusionsWe here map the global gene transcriptome of PBMCs related to clinical subtypes of late AMD and find evidence of subtype-specific immunological involvement. Our findings provide a transcriptomic insight into the systemic immunity associated with AMD.

Highlights

  • Peripheral blood mononuclear cells (PBMCs) are implicated in the pathogenesis of age-related macular degeneration (AMD)

  • We find that the PBMC in patients with late AMD differ from healthy controls, but that specific clinical subtypes associate with specific immunological changes

  • We included a total of 96 participants: 19 patients with geographic atrophy (GA) with no choroidal neovascularizations (CNV), 38 patients with neovascular AMD with no GA, patients with polypoidal choroidal vasculopathy (PCV), and healthy controls

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Summary

Introduction

Peripheral blood mononuclear cells (PBMCs) are implicated in the pathogenesis of age-related macular degeneration (AMD). Age-related macular degeneration (AMD) is the most frequent cause of visual impairment in the developed countries and the demographic developments towards an aging population are expected to continually and significantly increase the disease burden in the years to come [1,2,3]. In geographic atrophy (GA), fundus examination reveals the demarcated areas of atrophy of the neuroretina and the RPE, which gradually progress over time. This subtype of late AMD, GA without any choroidal neovascularizations (CNV), accounts for ~ 40% of all late AMD cases in Caucasian populations [3, 4, 6].

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