PROJECT SUMMARY / ABSTRACT
Chronic autoimmune uveitis is often a treatment-resistant disease, leading to irreversible vision loss in a
significant number of patients, particularly in the working-age population, and thus adds a substantial socio-
economic burden due to consequent healthcare costs and productivity loss. The preponderance of previous
studies investigating autoimmune uveitis have focused on the acute stage of the disease using the popular
murine models of acute uveitis, which in fact uncommonly leads to severe vision loss in humans in contrast
to chronic uveitis. Thus, there is a major deficiency in our current understanding of the precise pathogenic
mechanisms in chronic uveitis. Our laboratory has recently developed and validated a mouse model of
chronic autoimmune uveitis (CAU) in wild-type animals, which replicates the clinical features of chronic
sight-threatening uveitis observed in humans. Using this unique CAU model, we have demonstrated distinct
long-lived memory CD4+ T cells in chronic disease, in contrast to the short-lived effector CD4+ T cells in
acute disease. These memory T cells are antigen-specific, autoreactive effectors (`effector-memory' T cells)
responsible for the chronic persistence of intraocular inflammation in CAU. Furthermore, our preliminary
work reveals a local hypoxic microenvironment within the inflamed retina in CAU, which is associated with
prominent up-regulation of hypoxia-inducible factor-1α (HIF-1α), glycolytic metabolism, and Wnt/β-catenin
transcriptional activity selectively in the retinal infiltrating memory T cells but not in other retinal cells. We
thus hypothesize that HIF-1α promotes chronic autoimmune uveitis via maintaining the pathogenic memory
CD4+ T cell pool through regulating metabolic and transcriptional reprogramming of T cells that facilitates
their function and long-term survival. The principal objectives of this project are to (i) determine individual
contribution of HIF-1α, glycolysis, and Wnt/β-catenin activation to uveitogenicity of memory CD4+ T cells;
and further (ii) determine whether HIF-1α modulates memory CD4+ T cells and chronic uveitis through
activating glycolytic metabolism and Wnt/β-catenin transcriptional pathway. To achieve these objectives,
three specific aims have been developed: Aim 1: Is HIF-1α expression by memory T cells required for their
function and long-term survival and maintaining disease chronicity? Aim 2: Is enhanced glycolysis in
memory T cells required for their pathogenic function and driven by HIF-1α? And Aim 3: Is activated Wnt/β-
catenin transcriptional pathway in memory T cells required for their longevity and driven by HIF-1α?
Successful completion of this project will substantially advance our knowledge of molecular mechanisms in
modulating pathobiology of uveitogenic memory T cells and provide potentially novel therapeutic
approaches precisely targeting the underlying cause of chronic autoimmune uveitis.