Cellular Inflammation Links to Macular Degeneration

Inflammation is a major cause of human disease. It isn’t your usual idea of inflammation either, when something is swollen, red and hot with a great sensitivity to touch. That kind of inflammation is usually acute (currently active) and is often associated with a topical trauma that is easily remedied with a course of ice and analgesics (pain killers).

The inflammation many do not consider is cellular inflammation. It can go undetected until the body is in such distress strong medication is needed to attempt to alleviate it. When it comes to vision, inflammation has been known for over a decade to be one of the major causes of sight weakness or even loss. When it comes to dry age-related macular degeneration (AMD), tracking down inflammation and its cause has proven to be a real uphill battle.

In a report by AARP, Dr. Jayakrishna Ambati, director of the University of Virginia Center for Advanced Vision Science comments on how inflammation has eluded scientists as “the driving force in the vision-robbing disease (dry AMD) that affects 196 million people worldwide.”

Also, in response to the constant search for inflammation, Dr. Ambati remarked,

“what triggered the cellular overactivity in the eye and why it grew into a retina-destroying “inflammatory cascade” was unknown.”

Now, a new study published in Nature Medicine by researchers at the University of Virginia School of Medicine gives another dose of hope to the future of eradicating macular degeneration.  Scientists have identified an inflammatory enzyme once thought of as doing one job but may actually be an important cellular inflammation link to the cause of dry AMD.

An Amateur Immune Cell

The newly researcher inflammatory enzyme is called cGAS and has been known to scientist for several years now but seems to have been operating under the radar when it comes to inflammation.

cGAS is responsible for detecting foreign DNA, an important role in the immune system. However, although cGAS is found in the retina macular degeneration is not caused by viral or bacterial intruders. In fact, the inner structure of the eye is rarely susceptible to pathogens cGAS would need to detect. So scientists wondered why cGas was there in the first place and now, new research suggests another important role for this unassuming enzyme.

Optometry Today reports Dr. Ambati’s reaction,

“It’s really surprising that in macular degeneration, which, as far as we know, has nothing to do with viruses or bacteria, that cGAS is activated, and that this alarm system is turned on,”

Once cGas sounds the alarm which is “heard” as a viral sensor, an inflammatory response is triggered and the body begins killing retinal cells which ultimately leads to dry AMD and inevitably vision loss.

Dr. Ambati continues,

“Almost 200 million people in the world have macular degeneration. If macular degeneration were a country, it would be the eighth most populated nation in the world. That’s how large a problem this is,…For the first time, we know in macular degeneration what is one of the very first events that triggers the system to get alarmed and start, to use an anthropomorphic term, hyperventilating. This overdrive of inflammation is what ultimately damages cells, and so, potentially, we have a way of interfering very early in the process.”

Controlling cGAS Inflammation

Now that researchers have found one of the cellular inflammation links to macular degeneration (primarily dry AMD), the hard part going forward is to find a way to inhibit the cGAS response.

Nagaraj Kerur, PhD, assistant professor in the Department of Ophthalmology at the University of Virginia and co-author of the study comments on some ways scientists can hone in on controlling cGAS,

“Because the target we’re talking about is an enzyme, we could develop small molecules that could block it,…There are many drugs already on the market that target specific enzymes, such as the statins [which are used to lower cholesterol levels.]”

Studies are continuing to investigate this enzymatic inflammatory reaction with a variety of options being considered to apply for treatment.

These might include:

• Redirecting the enzyme
• Developing an enzyme detection protocol
• Nano medicines to stop the enzyme from reacting
• “Tricking” the enzyme into “believing” everything is okay

There is even talk of reformulating and redirecting the highly successful enzyme controlling HIV cocktail prescriptions to “shut off” the cGAS reaction.

According to Dr. Ambati,

“I think it is eminently reasonable to expect very good treatments available for dry macular degeneration within a decade,”

Keep Stress at Bay

More and more research is showing the obvious adverse health fallout of dealing with stress such as weight gain, hair loss, erectile dysfunction and mood swings to name a few. Now, several studies have recently investigated the effects of stress on visual cellular inflammation, one of many “hidden” casualties.

Information resource organization Wolters Kluwer Health published a study on visual stress in Science Daily titled, ‘Assessing the impact of stress in age-related macular degeneration’. It was found that by using a Perceived Stress Scale (PSS) on over 100 patients afflicted by AMD a significant stress pattern emerged. The study recommended for healthy and even AMD patients to instill stress reducing techniques to reduce visual cellular inflammation.

Some stress reducing applications for preventing or alieving macular degeneration include:

• Meditation
• Exercise
• Creativity
• Yoga
• Clean diet
• Humor
• Mindfullness
• Listening to calming music
• Reducing or eliminating vices such as alcohol and drugs

All it takes is paying attention to how stress may be affecting your life and then doing something about it. It just may be the best thing you’ve done for not only your sight but possibly your overall health.

The cGas reaction is another example of how easily the body can slip into an autoimmune response aka your system attacking itself. Researchers believe that the discovery of the cGas response may open doors for not only treating dry-AMD but also for other diseases beyond macular degeneration such as diabetes, obesity, and lupus. This proves once again how important it is to look beyond “fixing” and instead to search for the root cause. If inflammation can be controlled for dry-AMD there is no telling how many other treatments it could be applied to as well.