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Journal of Lipid Research, Vol. 51, 451-467, March 2010
Copyright © 2010 by American Society for Biochemistry and Molecular Biology

Thematic Review

Apolipoprotein B-containing lipoproteins in retinal aging and age-related macular degeneration

Christine A. Curcio^1,*, Mark Johnson, Jiahn-Dar Huang and Martin Rudolf^**

^* Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL
Biomedical Engineering Department, Northwestern University, Evanston, IL
National Eye Institute, the National Institutes of Health, Bethesda, MD
^** University Eye Hospital, Lübeck Universitätsklinikum Schleswig-Holstein, Lübeck, Germany

¹ To whom correspondence should be addressed. e-mail: curcio{at}uab.edu

The largest risk factor for age-related macular degeneration (ARMD) is advanced age. With aging, there is a striking accumulation of neutral lipids in Bruch's membrane (BrM) of normal eye that continues through adulthood. This accumulation has the potential to significantly impact the physiology of the retinal pigment epithelium (RPE). It also ultimately leads to the creation of a lipid wall at the same locations where drusen and basal linear deposit, the pathognomonic extracellular, lipid-containing lesions of ARMD, subsequently form. Here, we summarize evidence obtained from light microscopy, ultrastructural studies, lipid histochemistry, assay of isolated lipoproteins, and gene expression analysis. These studies suggest that lipid deposition in BrM is at least partially due to accumulation of esterified cholesterol-rich, apolipoprotein B-containing lipoprotein particles produced by the RPE. Furthermore, we suggest that the formation of ARMD lesions and their aftermath may be a pathological response to the retention of a sub-endothelial apolipoprotein B lipoprotein, similar to a widely accepted model of atherosclerotic coronary artery disease (Tabas, I., K. J. Williams, and J. Borén. 2007. Subendothelial lipoprotein retention as the initiating process in atherosclerosis: update and therapeutic implications. Circulation. 116:1832–1844). This view provides a conceptual basis for the development of novel treatments that may benefit ARMD patients in the future.

Supplementary key words retinal pigment epithelium • Bruch's membrane • drusen • basal deposits • cholesterol • retinyl ester

Abbreviations: apo, apolipoprotein; ARMD, age-related macular degeneration; BlamD, basal laminar deposit; BlinD, basal linear deposit; BrM, Bruch's membrane; CAD, coronary artery disease; CM, chylomicron; EC, esterified cholesterol; HBL, hypobetalipoproteinemia; MTP, microsomal triglyceride transfer protein; OTAP, osmium-tannic acid-paraphenylenediamine; QFDE, quick-freeze/deep-etch; RPE, retinal pigment epithelium; TG, triglyceride; UC, unesterified cholesterol

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