Biomarkers reveal how patients with glaucoma may respond to treatment
Key Takeaways
- Researchers have identified markers in the blood that predict whether glaucoma patients are at higher risk of continued loss of vision following conventional treatment.
- The research may lead to new treatments that do not rely on lowering eye pressure.
Currently, all approved treatments for glaucoma are designed to lower pressure in the eye — also known as intraocular pressure (IOP). However, some patients continue to lose their sight following treatment.
To help doctors better understand who will lose their vision faster, a new study, published in Nature Medicine, asked whether mitochondrial function, measured in white blood cells, is lower in people with glaucoma than those without glaucoma and if mitochondrial function is associated with the rate at which glaucoma patients lose vision. Mitochondria are the ‘batteries’ inside cells that produce energy for the cells to function. White blood cells are a part of the body’s immune system that help fight infection and other diseases.
The researchers assessed 139 participants who were already receiving treatment to lower IOP and 50 healthy people acting as a control (comparison) group. They measured how well cells in the blood use oxygen, how much vision was lost over time and nicotinamide adenine dinucleotide (NAD) levels. NAD, which plays a key role in mitochondrial function, is a molecule in the body that helps cells produce energy and is made from vitamin B3 that is obtained through the diet.
The researchers discovered that certain cells in the blood, known as peripheral blood mononuclear cells, use oxygen differently in people with glaucoma. Additionally, people with glaucoma were found to have lower levels of NAD in their blood cells compared to people without glaucoma. These lower NAD levels were linked to the lower oxygen use in the blood cells.
Senior author Professor David (Ted) Garway-Heath said, “White blood cell mitochondrial function and NAD levels, if introduced as a clinical test, would enable clinicians to predict which patients are at higher risk of continued vision loss, allowing them to be prioritised for more intensive monitoring and treatment. If further research shows that low mitochondrial function or low NAD levels are a cause for glaucoma, then this opens the way for new treatments.”
He added, “UCL and Moorfields Eye Hospital are currently leading a major clinical trial…to establish whether high-dose vitamin B3 can boost mitochondrial function and reduce vision loss in glaucoma. We hope that this will open a new avenue for treatment of glaucoma patients which does not depend on lowering the eye pressure.”
Edited by Miriam Kaplan, PhD
Source: University College London, ScienceDaily, July 12, 2024; see source article