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Glaucoma Research

Glaucoma Research. Boosting optic nerve energy to slow glaucoma Ian Trounce Principal Investigator CERA Wagstaff Fellow RVEEH. The burden of glaucoma. 67 million world-wide 6 million estimated blind 7 million out-patient visits in the USA 150,000 people in Australia

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Glaucoma Research

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  1. Glaucoma Research Boosting optic nerve energy to slow glaucoma Ian Trounce Principal Investigator CERAWagstaff Fellow RVEEH

  2. The burden of glaucoma • 67 million world-wide • 6 million estimated blind • 7 million out-patient visits in the USA • 150,000 people in Australia • $145 million in direct health costs to Australia • Significant number of Australians with glaucoma are undiagnosed.

  3. Problems with current treatments • Eye pressure lowering is the only treatment proven to be effective in glaucoma • Lowering eye pressure does not always prevent progression • Cannot restore optic nerve tissue once lost

  4. Glaucoma Research Unit • Professor Jonathan Crowston, Principal Investigator • Translational research • Molecular and cellular research • Experimental models • Rodents, rabbits • Clinical research

  5. The cell’s powerhouse: The mitochondrion • ‘Burns’ fuels (food) • Produces energy (ATP) • Produces byproduct‘free radicals’ • Wears out with age

  6. Mitochondria: Power generators of our cells • IN: • Fuel • Carbohydrates • Fats • Proteins • O2 OUT: Energy (ATP) Free radicals CO2 H20 Heat

  7. Mitochondrial DNA - Maternal inheritance

  8. Douglas C. Wallace – University of Pennsylvania

  9. Complex I defect in glaucoma • Link to Parkinson’s disease? • Is it mitochondrial DNA-linked? • New collaboration with • Doug Wallace, Univ. Pennsylvania

  10. Highly energetic nerve cells with long axonsare prone to age-related decline The optic nerve - Glaucoma Dopamine neurons - Parkinson’s disease

  11. Exercise (and fasting) allow old optic nerves to recover from a pressure injury

  12. PhNR change at 1 month P=0016 P=0.0014 3.0 cd.s/m2 2.25 cd.s/m2 IOVS 2013

  13. Summary Mitochondrial energy generation is impaired in some glaucoma patients Diet moderation and exercise improve optic nerve resilience Is this due to increased mitochondrial ‘health’? Genetic analysis of mitochondrial DNA in glaucoma subjects underway Can we identify subjects with genetic markers who may respond to ‘mitochondrial boosting’ therapies?

  14. Can we drive increased Mitochondrial turnover to “recharge the batteries” Dietary restriction Exercise Resveratrol Other drugs e.g. Fibrates Metformin Rapamycin

  15. Thank you Funding Wagstaff Bequest (RVEEH) DHB Foundation Brockhoff Foundation (ANZ Trustees) – Leber Optic Atrophy stem cell study Mason Foundation (ANZ Trustees) – The ‘good’ Alzheimer protein & the ageing eye Michael J. Fox Foundation for Parkinson’s disease – A mitochondrial PD model National Health and Medical Research Council

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