Anti-Aging Molecule Sirt6 in Neuroprotection in Diabetic Retina
SUMMARY
Diabetic retinopathy (DR) is the most frequent cause of blindness in working age adults in the US today. It was
traditionally characterized as microvascular complications due to its clinical manifestation of a period of vascular
leakage and degeneration followed by neovascularization. However, recent studies in animal models and
patients have shown that retinal neuron injury, in particular retinal ganglion cell (RGC) dysfunction and loss,
occurs at early stage of DR and contributes to vision loss. Moreover, though less studies, dysfunction and
degeneration of axons of RGC is also evident in diabetes. Current therapies for DR targets clinically significant
vascular leakage or neovascularization, which happens much later, and do not protect retinal neurons. This
project is to delineate the mechanisms of RGC injury and axonal degeneration during DR in order to identify
novel strategies to limit injury and preserve vision. Increasing evidence indicates that stress-induced premature
senescence (SIPS) plays a key role in many diseases. There are a few studies reporting SIPS in DR but they
are exclusively focused on endothelial cells and have not linked SIPS to DR pathology. There is a significant
knowledge gap on how Db induce SIPS in the retina and how to regulate such mechanisms for DR treatment.
Sirt6 is a key anti-aging molecule belonging to the sirtuin family that is evolutionarily conserved nicotinamide
adenine dinucleotide (NAD)-dependent histone deacetylases and shares homolog with yeast Sir2 protein, a
critical regulator of the lifespan of yeast. We now propose to test a hypothesis that Sirt6 suppresses chronic
activation of the DNA damage response (DDR)-ATM (ataxia-telangiectasia mutated) pathway to prevent
dysfunction/degeneration of RGCs and their axons in DR, partly by inhibiting RGC senescence and
mitochondrial dysfunction. We will use our newly developed Sirt6 global and conditional knockout
(KO)/overexpression mice, AAV2-mediated gene knockdown, clinic-relevant non-invasive imaging and
functional tests, immunohistochemistry, biochemistry and morphometric analyses to test this hypothesis. This
study will identify novel roles of Sirt6 and DDR-ATM pathway in RGC and axonal degeneration in DR and
establish a link between these them. It will also provide proof-of-concept that boosting anti-aging mechanisms
may be utilized to treat DR.