Hopx(+) optic nerve head-astrocytes counter neuronal stress and glaucoma damage

S Steven L. Bernstein (Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine) Z Zara Mehrabian (Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine) Y Yan Guo J Jean Jouffroy (Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine) B Ben Mead (Exosome and Retinal Research Group, School of Optometry and Vision Sciences, University of Wales) S Stanislav Tomarev (Retinal Ganglion Cell Biology Lab, National Eye Institute, National Institutes of Health) E Esmahan Durmaz (Exosome and Retinal Research Group, School of Optometry and Vision Sciences, University of Wales) J Jonathan A. Epstein (Department of Medicine, Perelman School of Medicine, University of Pennsylvania) A Adam Kronk (Office of Research and Development, University of Maryland Ventures) S Seth Blackshaw T Thanh Hoang (Department of Ophthalmology, Michigan Neuroscience Institute, University of Michigan)

Abstract

Retinal ganglion cell (RGC) axons form the optic nerve (ON). Numerous age-related ON diseases, including glaucoma, the second most common cause of worldwide blindness, result from multiple RGC stressors. Nearly all ON astrocytes in the optic nerve head (ONH): the junctional region between the ON and the retina in young-adult rodents expresses the homeodomain only (Hopx) protein. Hopx(+) ONH astrocytes are depleted during aging. ONH primary cultures which include Hopx(+) astrocytes secrete extracellular vesicles (ONH-EVs) which selectively enhance RGC survival and neurite extension in culture, while extracellular vesicles (EVs) secreted from distal ON cultures lacking Hopx(+) astrocytes do not. ONH-EVs also enhance RGC survival in vivo in a rodent model of glaucoma. Combining rat ONH single-cell (scRNA-seq) sequencing with EV proteomic analysis, we identified ONH-Hopx(+) astrocyte secreted factors. We interrogated the online Broad institute scRNA-seq database for rat RGC gene expression in control animals and following rodent ON crush, an RGC stress model, to correlate ONH-astrocyte secreted factors with RGC gene expression changes. Following stress, RGCs upregulate the complementary pathways involving Hopx(+) astrocytic-associated factors, suggesting reciprocal communication. Using a highly selective transgenic Hopx-cre ONH knockdown strategy, we demonstrate that eliminating Hopx(+) astrocytes also results in upregulation of RGC stress responses. Our results implicate age-related loss of young ONH-astrocytes as a crucial factor in the development of age-related optic nerve diseases, and discuss replacing ONH associated factors as a paradigm shift for ON disease treatment.

Article Details

Volume / Issue Vol. 123, Issue 18
Published May 05, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (11)

S

Steven L. Bernstein

Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine

Z

Zara Mehrabian

Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine

Y

Yan Guo

J

Jean Jouffroy

Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine

B

Ben Mead

Exosome and Retinal Research Group, School of Optometry and Vision Sciences, University of Wales

S

Stanislav Tomarev

Retinal Ganglion Cell Biology Lab, National Eye Institute, National Institutes of Health

E

Esmahan Durmaz

Exosome and Retinal Research Group, School of Optometry and Vision Sciences, University of Wales

J

Jonathan A. Epstein

Department of Medicine, Perelman School of Medicine, University of Pennsylvania

A

Adam Kronk

Office of Research and Development, University of Maryland Ventures

S

Seth Blackshaw

T

Thanh Hoang

Department of Ophthalmology, Michigan Neuroscience Institute, University of Michigan