1. Unravelling genotype-phenotype correlations in Stargardt disease using patient-derived retinal organoids.
- Author
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Watson A, Queen R, Ferrández-Peral L, Dorgau B, Collin J, Nelson A, Hussain R, Coxhead J, McCorkindale M, Atkinson R, Zerti D, Chichagova V, Conesa A, Armstrong L, Cremers FPM, and Lako M
- Subjects
- Humans, Genetic Association Studies, ATP-Binding Cassette Transporters genetics, ATP-Binding Cassette Transporters metabolism, Male, Female, Stargardt Disease genetics, Stargardt Disease pathology, Organoids metabolism, Organoids pathology, Retina metabolism, Retina pathology, Induced Pluripotent Stem Cells metabolism
- Abstract
Stargardt disease is an inherited retinopathy affecting approximately 1:8000 individuals. It is characterised by biallelic variants in ABCA4 which encodes a vital protein for the recycling of retinaldehydes in the retina. Despite its prevalence and impact, there are currently no treatments available for this condition. Furthermore, 35% of STGD1 cases remain genetically unsolved. To investigate the cellular and molecular characteristics associated with STGD1, we generated iPSCs from two monoallelic unresolved (PT1 & PT2), late-onset STGD1 cases with the heterozygous complex allele - c.[5461-10 T > C;5603 A > T]. Both patient iPSCs and those from a biallelic affected control (AC) carrying -c.4892 T > C and c.4539+2001G > A, were differentiated to retinal organoids, which developed all key retinal neurons and photoreceptors with outer segments positive for ABCA4 expression. We observed patient-specific disruption to lamination with OPN1MW/LW
+ cone photoreceptor retention in the retinal organoid centre during differentiation. Photoreceptor retention was more severe in the AC case affecting both cones and rods, suggesting a genotype/phenotype correlation. scRNA-Seq suggests retention may be due to the induction of stress-related pathways in photoreceptors. Whole genome sequencing successfully identified the missing alleles in both cases; PT1 reported c.-5603A > T in homozygous state and PT2 uncovered a rare hypomorph - c.-4685T > C. Furthermore, retinal organoids were able to recapitulate the retina-specific splicing defect in PT1 as shown by long-read RNA-seq data. Collectively, these results highlight the suitability of retinal organoids in STGD1 modelling. Their ability to display genotype-phenotype correlations enhances their utility as a platform for therapeutic development., Competing Interests: Competing interests: The authors declare no competing interests Ethics approval and consent to participate: All participants in this research study were identified and enlisted with informed consent by collaborators in the Marie-Skłodowska Curie Innovative Training Network – StarT (Grant no: 813490). All samples were collected in accordance with the tenets of the Declaration of Helsinki and written informed consent was obtained for all patients participating in the study., (© 2025. The Author(s).)- Published
- 2025
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