Rescue of cone and rod photoreceptor function in a CDHR1-model of age-related retinal degeneration.

Yusuf IH., Burgoyne T., Salman A., McClements ME., MacLaren RE., Charbel Issa P.

Age-related macular degeneration (AMD) is the most common cause of untreatable blindness in the developed world. Recently, CDHR1 has been identified as the cause of a subset of AMD that has the appearance of the "dry" form, or geographic atrophy. Biallelic variants in CDHR1-a specialized protocadherin highly expressed in cone and rod photoreceptors-result in blindness from shortened photoreceptor outer segments and progressive photoreceptor cell death. Here we demonstrate long-term morphological, ultrastructural, functional, and behavioral rescue following CDHR1 gene therapy in a relevant murine model, sustained to 23-months after injection. This represents the first demonstration of rescue of a monogenic cadherinopathy in vivo. Moreover, the durability of CDHR1 gene therapy seems to be near complete-with morphological findings of the rescued retina not obviously different from wildtype throughout the lifespan of the mouse model. A follow-on clinical trial in patients with CDHR1-associated retinal degeneration is warranted. Hypomorphic CDHR1 variants may mimic advanced dry AMD. Accurate clinical classification is now critical, as their pathogenesis and treatment are distinct.

DOI

10.1016/j.ymthe.2024.03.026

Type

Journal article

Publication Date

2024-05-01T00:00:00+00:00

Volume

32

Pages

1445 - 1460

Total pages

15

Keywords

CDHR1, cadherin-related family member 1, cone-rod dystrophy, gene supplementation, gene therapy, macular degeneration, macular dystrophy, optical coherence tomography, protocadherin, retinitis pigmentosa, Animals, Mice, Disease Models, Animal, Retinal Rod Photoreceptor Cells, Cadherin Related Proteins, Retinal Cone Photoreceptor Cells, Cadherins, Retinal Degeneration, Humans, Genetic Therapy, Macular Degeneration, Nerve Tissue Proteins

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