Hereditary retinal degeneration (RD) is characterized by progressive photoreceptor cell death and is caused by mutations in a wide variety of pathogenic genes1. The end result of RD is vision loss and in the vast majority of cases the disease remains untreatable to this day. Therefore, it is important to study the cellular mechanisms leading to photoreceptor death using models that faithfully represent the human disease condition. Here, primate-based models are of particular interest due to their closeness to humans. Notably, such models may advance the development of appropriate therapeutic interventions that can halt or delay photoreceptor cell death.
Previous research on the mechanisms of cell death in RD has demonstrated that the decrease or loss of phosphodiesterase 6 (PDE6) activity caused by RD-triggering gene mutations leads to reduced hydrolysis of cyclic guanosine monophosphate (cGMP)2,3. cGMP is a specific agonist of the cyclic nucleotide-gated ion channels (CNGCs) in the rod outer segments (ROSs) and is also a key molecule responsible for the conversion of light signals into electrical signals in vertebrate photoreceptor cells4. Reduced cGMP hydrolysis causes the accumulation of cGMP in ROSs, leading to the opening of CNGCs 5. Consequently, the phototransduction pathways are activated, resulting in an increase in cation concentrations in photoreceptor cells. This process imposes a metabolic burden on photoreceptors, which when overactivated, for instance, by mutations in PDE6, may cause cell death.
Many studies have shown that a significant overaccumulation of cGMP in photoreceptors of mouse models with different RD gene mutations may cause the activation of cGMP-dependent protein kinase (PKG)3,6. This leads to a substantial increase in dying, TUNEL-positive cells and a gradual thinning of the photoreceptor cell layer. Previous studies suggest that PKG overactivation caused by elevated cGMP levels is a necessary and sufficient condition for the induction of photoreceptor cell death2,5. Studies on different mouse models of RD have also shown that PKG activation induced by elevated cGMP levels in photoreceptors, leads to overactivation of downstream effectors such as poly-ADP-ribose polymerase 1 (PARP1), histone deacetylase (HDAC), and calpain2,7,8,9. This implies causal associations between these different target proteins and photoreceptor cell death.
However, previous research on the pathology, toxicopharmacology, and therapy of RD was mainly based on mouse models for RD10,11,12. Nevertheless, immense difficulties remain in the clinical translation of these results. This is owing to the considerable genetic and physiological differences between mice and humans, especially with respect to the retinal structure. In contrast, non-human primates (NHPs) also share a high degree of similarity with humans with respect to genetic characteristics, physiological patterns, and environmental factor regulation. For example, optogenetic therapy was investigated as a means to restore retinal activity in an NHP model13. Lingam and colleagues demonstrated that good manufacturing practice-grade human-induced pluripotent stem cell-derived retinal photoreceptor precursor cells may rescue cone photoreceptor damage in NHP14. Therefore, NHP models are important for the exploration of RD pathogenesis and the development of effective treatment methods. In particular, NHP models of RD, exhibiting pathogenic mechanisms similar to those in humans, could play a critical role in studies on the development and in vivo toxicopharmacology analysis of new drugs.
In view of the long life-cycle, high level of technical difficulties, and high cost involved in establishing in vivo primate models, we established an in vitro non-human primate (NHP) model using cultures of explanted macaque retina. First, wild-type macaques aged 1-3 years were selected for in vitro culture of retinal explants, which included the retina-RPE-choroid complex. Explants were then treated with different concentrations of the PDE6 inhibitor zaprinast (100 µM, 200 µM, and 400 µM) to induce the cGMP-PKG signaling pathway. Photoreceptor cell death was quantified and analyzed using the TUNEL assay, and cGMP accumulation in explants was verified via immunofluorescence. Given the high degree of similarity with respect to cell distribution and morphology, retinal layer thickness, and other physiological characteristics of the retina between monkeys and humans, the establishment of the cGMP-PKG signaling pathway in the in vitro retinal model may facilitate future research on the pathogenesis of RD as well as studies into the development and toxicopharmacology of new drugs for RD treatment.