京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20810号 / 医博第4310号 / 新制||医||1025(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 清水 章, 教授 萩原 正敏, 教授 松原 和夫 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20996号 / 医博第4342号 / 新制||医||1027(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 鈴木 茂彦, 教授 富樫 かおり, 教授 開 祐司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21002号 / 医博第4348号 / 新制||医||1027(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 大森 孝一, 教授 山田 亮, 教授 Shohab YOUSSEFIAN / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

No description available.

The retinal pigment epithelium (RPE) is a monolayer of cells located directly behind the photoreceptor cells in the retina. These cells are involved in a variety of functions that support the visual process in the eye, namely 1) they form a blood-retina barrier which separates the neural retina from the choroid's blood supply, 2) the apical processes of RPE cells diurnally phagocytose the outer segments of photoreceptor cells, and 3) they participate in the renewal of the photopigment 11-cis retinal. Age-related macular degneration (AMD) is the leading cause of blindness in people over the age of 50 years in North America and other developed countries. AMD involves the death of retinal pigment epithelial (RPE) cells in the macula early in the progress of the disease. Like some other postmitotic cells, the RPE accumulates autofluorescent lysosomal storage bodies (lipofuscin) during senescence. Lipofuscin is reported to begin accumulating in the human RPE around age 20 and continues to accumulate throughout an individual's life. This progressive accumulation of lipofuscin can eventually occupy a substantial fraction of the RPE cytoplasmic volume and may lead to impairment of normal RPE functions, resulting in retinal degeneration and loss of visual function as in AMD. Another autofluorescent granule that accumulates in RPE cells and may contribute to the etiology of AMD is a complex granule exhibiting properties of both melanosomes and lipofuscin granules called melanolipofuscin (MLF). In contrast with the accumulation of LF in the RPE, MLF accumulation has been reported by Feeney-Burns to more closely reflect the onset of AMD. Although there have been significant advances in our understanding of AMD, knowledge of the mechanisms responsible for its progression remain unclear. This dissertation details experiments that were designed to better understand the factors that may play a causal role in AMD as well as the development of methods to assist in AMD research. Specifically, the protein composition of retinal LF was assessed to elucidate its origin. These findings are reported in chapter 2. The accumulation, composition and phototoxicity of MLF were analyzed to assess MLF's origin and possible contribution to AMD. These results are reported in chapter 3. Because protein oxidation is possibly a common posttranslational modification to proteins which accumulate in lipofuscin and melanolipofuscin granules, a method for the detection and analysis of oxidized proteins was developed and is reported in chapter 4. Chapter 5 details the proteomic differences between ARPE-19 cells - the only human RPE cell line available for research - in their differentiated and undifferentiated states and compares these to the proteome of human RPE cells. These results are also compared to the phenotypic difference of these cells as observed by transmission electron microscopy.

Age-related macular degeneration (AMD) is the leading cause of blindness in the United States of America. The pyridinium bis-retinoid A2-ethanolamine (A2E) has been implicated to play a role in AMD. We have observed novel pyridinium bis-retinoids through melanolipofuscin and human RPE extractions that may also play a role in the pathology of AMD. We have begun the construction of an amino-retinoid library in order to identify these ocular compounds. The compounds from the amino-retinoid library are also used in a targeted and triggered drug delivery system for treating cancer. Folic acid is coupled with the amino-retinoids to specifically target cancer cells. The first two amino-retinoids to be synthesized and characterized were A2-dopamine (A2D) and A2-cadaverine (A2C). Both pyridinium bis-retinoids were shown to generate cytotoxic oxidation products similar to A2E. Successful coupling of folic acid to A2C was achieved to form the folic acid-A2-cadaverine (FA-A2C) product. Preliminary irradiation results suggest that the FA-A2C product may be more photoreactive than initially anticipated. This could mean less drug and light exposure required to induce apoptosis and could eventually lead to a less invasive and toxic cancer treatment.

No description available.

Paediatric glaucoma leads to a decreased thickness of the peripapillary retinal nerve fibre layer (pRNFL) and of the macula. These changes can be precisely quantified using spectral domain-optical coherence tomography (SD-OCT). Despite abundant reports in adults, studies on the diagnostic capacity of macular SD-OCT in paediatric glaucoma are rare. The aim of this study was to compare the glaucoma discriminative ability of pRNFL and macular segment thickness in paediatric glaucoma patients and healthy children. Data of 72 children aged 5–17 years (glaucoma: 19 (26.4%), healthy: 53 (73.6%)) examined with SD-OCT (SPECTRALIS®, Heidelberg Engineering) were analysed retrospectively. The thickness of pRNFL sectors and of macular segment subfields were compared between diseased and healthy participants. Areas under the receiver-operating characteristic curves (AUC), sensitivity, and specificity from logistic regression were used to evaluate the glaucoma discriminative capacity of single and combined pRNFL and macular segments’ thickness. The results revealed a reduced thickness of the pRNFL and of the three inner macular layers in glaucoma patients, which correlates highly with the presence of glaucoma. The highest glaucoma discriminative ability was observed for the combination of pRNFL sectors or inner macular segments (AUC: 0.83 and 0.85, respectively), although sensitivity remained moderate (both 63% at 95% specificity). In conclusion, while confirmation from investigations in larger cohorts is required, SD-OCT-derived pRNFL and macular thickness measurements seem highly valuable for the diagnosis of paediatric glaucoma.

No description available.

No description available.