New Research Links Obesity to Blinding Eye Disease

Human Eye Close Up

Macular degeneration is a progressive eye disease that affects the central part of the retina, called the macula. It leads to a loss of central vision, making it difficult to read, drive, and recognize faces.

A new study from Canada, published in the renowned journal Science, has shed light on a potential molecular cause of age-related macular degeneration (AMD).

Research conducted at Hôpital Maisonneuve-Rosemont in Montreal has revealed how stressors of daily life, such as obesity, can alter the immune system and cause harm to the eye as it ages.

“We wanted to know why some people with a genetic predisposition develop AMD while others are spared,” said University of Montreal ophthalmology professor Przemyslaw (Mike) Sapieha, who led the study with his postdoctoral fellow Dr. Masayuki Hata.

“Although considerable effort has been invested in understanding the genes responsible for AMD, variations, and mutations in susceptibility genes only increase the risk of developing the disease, but do not cause it,” Sapieha explained.

“This observation suggests that we must gain a better understanding of how other factors such as environment and lifestyle contribute to disease development.”

AMD is a major cause of irreversible blindness worldwide and affected approximately 196 million people in 2020. It comes in two forms:

  • dry AMD, characterized by the accumulation of fatty deposits at the back of the eye and the death of nerve cells in the eye,
  • and wet AMD, which is characterized by diseased blood vessels that develop in the most sensitive part of the sight-generating tissue, called the macula.

Contact with pathogens

It is already known that the immune system in the eye of a person with AMD becomes dysregulated and aggressive. Normally, immune cells keep the eye healthy, but contact with pathogens such as bacteria and viruses can make them go awry.

At the same time, immune cells are also activated when the body is exposed to stressors such as excess fat in obesity, making being overweight the number one non-genetic risk factor for developing AMD, after smoking.

In their study, Sapieha and Hata used obesity as a model to accelerate and exaggerate the stressors experienced by the body throughout life.

They found that transient obesity or a history of obesity leads to persistent changes in the DNA architecture within immune cells, making them more susceptible to producing inflammatory molecules.

“Our findings provide important information about the biology of the immune cells that cause AMD and will allow for the development of more tailored treatments in the future,” said Hata, now an ophthalmology professor at Kyoto University, in Japan.

The researchers hope their discovery will lead other scientists to broaden their interest beyond obesity-related diseases to other diseases characterized by increased neuroinflammation, including Alzheimer’s disease and multiple sclerosis.

Reference: “Past history of obesity triggers persistent epigenetic changes in innate immunity and exacerbates neuroinflammation” by Masayuki Hata, Elisabeth M. M. A. Andriessen, Maki Hata, Roberto Diaz-Marin, Frédérik Fournier, Sergio Crespo-Garcia, Guillaume Blot, Rachel Juneau, Frédérique Pilon, Agnieszka Dejda, Vera Guber, Emilie Heckel, Caroline Daneault, Virginie Calderon, Christine Des Rosiers, Heather J. Melichar, Thomas Langmann, Jean-Sebastien Joyal, Ariel M. Wilson and Przemyslaw Sapieha, 5 January 2023, Science.
DOI: 10.1126/science.abj8894

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