PROJECT SUMMARY
Retinal pigment epithelial (RPE) cell dysfunction and damage are hallmarks of age-related macular
degeneration (AMD), the leading cause of blindness in the elderly. While anti-VEGF has revolutionized the
management of wet or exudative AMD, there is currently no treatment available for non-exudative AMD. Aging
is the major risk factor for RPE degeneration and the development of AMD. During aging, epigenetic changes
disrupt "youthful" DNA methylation patterns, leading to cellular dysfunction and senescence. Partial epigenetic
reprogramming via ectopic induction of three Yamanaka factors, Oct4, Sox2, Klf4 (OSK), in retinal ganglion
cells was recently reported to reprogram and reverse epigenetic age, leading to vision improvement in aged
mice as well as in a mouse glaucoma model. I propose to test the hypothesis that partial epigenetic
reprogramming can rescue age-related RPE cell degeneration and function in vivo, prevent RPE cell injury
induced by a range of insults in vitro, and inhibit the formation of AMD-like pathologies in a mouse model with
the following aims. (i) To determine whether OSK-mediated epigenetic reprogramming can restore RPE
morphology and function in aged mice, I will examine the visual function and RPE morphology in aged mice
with and without OSK induction by optomotor, ERG, RPE flatmount, and transmission electron microscopy. In
addition, I will compare the transcriptomes and epigenomes of RPE from aged mice with and without OSK
induction to assess the effect of OSK expression. (ii) To test the ability of OSK-induction in rescuing primary
human RPE cells from morphologic and functional changes, as well as cell death following various AMD-
associated insults in vitro, including oxidative stress, ox-LDL, and cigarette smoking extract. I will also examine
the effect of OSK-induction in iPSC-RPE cells derived from high-risk and low-risk donors with AMD. (iii)
Examine the role of OSK induction in NaIO3-treated mice, a short-term injury model that induces regional RPE
atrophy, and in RPE specific aged Cfh heterozygous (Cfh+/-) mice fed with a high fat, high cholesterol diet,
which have pathological changes mimicking early dry AMD. The results of these investigations will reveal the
efficacy and viability of epigenetic reprogramming as a therapeutic strategy for RPE regeneration in vivo. My
mentoring panel and the proposed training plan will equip me with new knowledge and skills to study age-
related retinal diseases and will catalyze my transition to a career as an independent investigator.