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      Emerging therapies for inherited retinal degeneration.

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          Abstract

          Inherited retinal degenerative diseases, a genetically and phenotypically heterogeneous group of disorders, affect the function of photoreceptor cells and are among the leading causes of blindness. Recent advances in molecular genetics and cell biology are elucidating the pathophysiological mechanisms underlying these disorders and are helping to identify new therapeutic approaches, such as gene therapy, stem cell therapy, and optogenetics. Several of these approaches have entered the clinical phase of development. Artificial replacement of dying photoreceptor cells using retinal prostheses has received regulatory approval. Precise retinal imaging and testing of visual function are facilitating more efficient clinical trial design. In individual patients, disease stage will determine whether the therapeutic strategy should comprise photoreceptor cell rescue to delay or arrest vision loss or retinal replacement for vision restoration.

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          Most cited references107

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          Independent Optical Excitation of Distinct Neural Populations

          Optogenetic tools enable the causal examination of how specific cell types contribute to brain circuit functions. A long-standing question is whether it is possible to independently activate two distinct neural populations in mammalian brain tissue. Such a capability would enable the examination of how different synapses or pathways interact to support computation. Here we report two new channelrhodopsins, Chronos and Chrimson, obtained through the de novo sequencing and physiological characterization of opsins from over 100 species of algae. Chrimson is 45 nm red-shifted relative to any previous channelrhodopsin, important for scenarios where red light would be preferred; we show minimal visual system mediated behavioral artifact in optogenetically stimulated Drosophila. Chronos has faster kinetics than any previous channelrhodopsin, yet is effectively more light-sensitive. Together, these two reagents enable crosstalk-free two-color activation of neural spiking and downstream synaptic transmission in independent neural populations in mouse brain slice.
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            Human embryonic stem cell-derived retinal pigment epithelium in patients with age-related macular degeneration and Stargardt's macular dystrophy: follow-up of two open-label phase 1/2 studies

            The Lancet, 385(9967), 509-516
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              Retinitis pigmentosa.

              Hereditary degenerations of the human retina are genetically heterogeneous, with well over 100 genes implicated so far. This Seminar focuses on the subset of diseases called retinitis pigmentosa, in which patients typically lose night vision in adolescence, side vision in young adulthood, and central vision in later life because of progressive loss of rod and cone photoreceptor cells. Measures of retinal function, such as the electroretinogram, show that photoreceptor function is diminished generally many years before symptomic night blindness, visual-field scotomas, or decreased visual acuity arise. More than 45 genes for retinitis pigmentosa have been identified. These genes account for only about 60% of all patients; the remainder have defects in as yet unidentified genes. Findings of controlled trials indicate that nutritional interventions, including vitamin A palmitate and omega-3-rich fish, slow progression of disease in many patients. Imminent treatments for retinitis pigmentosa are greatly anticipated, especially for genetically defined subsets of patients, because of newly identified genes, growing knowledge of affected biochemical pathways, and development of animal models.
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                Author and article information

                Journal
                Sci Transl Med
                Science translational medicine
                American Association for the Advancement of Science (AAAS)
                1946-6242
                1946-6234
                Dec 07 2016
                : 8
                : 368
                Affiliations
                [1 ] Department of Ophthalmology, University of Basel, 4056 Basel, Switzerland. hendrik.scholl@usb.ch.
                [2 ] Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, USA.
                [3 ] Moorfields Eye Hospital, London EC1V 2PD, U.K.
                [4 ] UCL Institute of Ophthalmology, University College London, London EC1V 9EL, U.K.
                [5 ] Department of Ophthalmology, Medical University Graz, Graz, Austria.
                [6 ] Department of Ophthalmology, Johannes Kepler University Linz, 4021 Linz, Austria.
                [7 ] INSERM, UMR S 968, 75012 Paris, France.
                [8 ] Sorbonne Universités, UPMC Univ Paris 06, Institut de la Vision, Paris, France.
                [9 ] CNRS, UMR 7210, 75012 Paris, France.
                [10 ] Department of Ophthalmology, University of Basel, 4056 Basel, Switzerland.
                [11 ] Neural Circuit Laboratories, Friedrich Miescher Institute for Biomedical Research, 4058 Basel, Switzerland.
                [12 ] Fondation Ophtalmologique Adolphe de Rothschild, 75019 Paris, France.
                [13 ] Centre d'Investigation Clinique 1423, INSERM-Center Hospitalier National d'Ophtalmologie des Quinze-Vingts, 75012 Paris, France.
                [14 ] Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
                Article
                8/368/368rv6
                10.1126/scitranslmed.aaf2838
                27928030
                84941fdb-d7b9-423c-8b3d-5690a98f29fb
                History

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