Bruch’s membrane heparan sulfate retains lipoproteins in the early stages of age-related macular degeneration

C Christopher B. Toomey (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) S Savanna Pflugmacher (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) K Kamalu Park (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) J Jessica Pihl (Glycobiology Research and Training Center, University of California San Diego) S Sammy Weiser Novak (Waitt Advanced Biophotonic Core, Salk Institute) J Jessica Rodriguez (Glycobiology Research and Training Center, University of California San Diego) M Maryam Jalali (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) J Jaesoo Jung (Glycobiology Research and Training Center, University of California San Diego) M Madeline Mozafari (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) S Sima P. Omran (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) C Cameron K. Pormir (Department of Cellular and Molecular Medicine, University of California San Diego) J Jill Hauer (Glycobiology Research and Training Center, University of California San Diego) C Chelsea Painter (Glycobiology Research and Training Center, University of California San Diego) E Evan Walker (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) A Alex S. Huang (Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego) D Daniela Boassa (Waitt Advanced Biophotonic Core, Salk Institute) J James T. Handa (Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medical Institute) T Teodor Aastrup (Attana AB, Stockholm) P Philip L. S. M. Gordts (Glycobiology Research and Training Center, University of California San Diego) J Jeffrey D. Esko

Abstract

Lipoprotein retention in Bruch’s membrane is a key event in the pathobiology of early and intermediate age-related macular degeneration (AMD). However, the mechanism of lipoprotein retention in BrM is unknown. Given the established role of glycosaminoglycans (GAG) in binding lipoproteins, our laboratory sought to determine the role of GAGs in AMD BrM. In this study, BrM GAG content in AMD pathobiology was analyzed in human postmortem tissue. Strikingly, increased levels of highly sulfated heparan sulfate were present in AMD Bruch’s membrane as compared to non-AMD samples. In addition, using scanning electron microscopy of postmortem AMD tissue, we show aggregates of lipoprotein-like particles on the retinal pigmented epithelium side of Bruch’s membrane adjacent to heparan sulfate. We also show that heparin displaces lipoproteins rich in apolipoprotein A1 from human BrM, suggesting their identity as high-density lipoproteins. Using human BrM immobilized to quartz crystal microbalance biosensor (QCM) chips, we show that heparan sulfate is required for lipoprotein binding to BrM and soluble heparan sulfate can remove lipoproteins bound to BrM. Thus, our data establish that heparan sulfate regulates lipoprotein deposition in AMD BrM. These findings provide a foundation for targeted therapies capable of either preventing lipoprotein accumulation or removing drusen in the early and intermediate stages of AMD prior to vision loss.

Article Details

Volume / Issue Vol. 122, Issue 24
Published June 17, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (20)

C

Christopher B. Toomey

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

S

Savanna Pflugmacher

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

K

Kamalu Park

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

J

Jessica Pihl

Glycobiology Research and Training Center, University of California San Diego

S

Sammy Weiser Novak

Waitt Advanced Biophotonic Core, Salk Institute

J

Jessica Rodriguez

Glycobiology Research and Training Center, University of California San Diego

M

Maryam Jalali

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

J

Jaesoo Jung

Glycobiology Research and Training Center, University of California San Diego

M

Madeline Mozafari

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

S

Sima P. Omran

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

C

Cameron K. Pormir

Department of Cellular and Molecular Medicine, University of California San Diego

J

Jill Hauer

Glycobiology Research and Training Center, University of California San Diego

C

Chelsea Painter

Glycobiology Research and Training Center, University of California San Diego

E

Evan Walker

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

A

Alex S. Huang

Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego

D

Daniela Boassa

Waitt Advanced Biophotonic Core, Salk Institute

J

James T. Handa

Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medical Institute

T

Teodor Aastrup

Attana AB, Stockholm

P

Philip L. S. M. Gordts

Glycobiology Research and Training Center, University of California San Diego

J

Jeffrey D. Esko