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The Light Peak of the Electroretinogram Is ARTICLE The Light Peak of the Electroretinogram Is Dependent on Voltage-gated Calcium Channels and Antagonized by Bestrophin (Best-1) Lihua Y. Marmorstein,1 Jiang Wu,3 Precious McLaughlin,1 John Yocom,1 Mike O. Karl,4 Rudgar Neussert,4 Soenke Wimmers,4 J. Brett Stanton,1 Ronald G. Gregg,5 Olaf Strauss,4 Neal S. Peachey,3,6 and Alan D. Marmorstein1,2 1Department of Ophthalmology and Vision Science and 2Optical Sciences Center, University of Arizona, Tucson, AZ 85711 3Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH 44195 4Experimentelle Ophthalmologie Universitaetsklinkum Hamburg-Eppendorf, Hamburg, Germany 5Biochemistry and Molecular Biology, Ophthalmology and Visual Science, University of Louisville, KY 40202 6Research Service, Cleveland VA Medical Center, Cleveland, OH 44106 Mutations in VMD2, encoding bestrophin (best-1), cause Best vitelliform macular dystrophy (BMD), adult-onset vitelliform macular dystrophy (AVMD), and autosomal dominant vitreoretinochoroidopathy (ADVIRC). BMD is distinguished from AVMD by a diminished electrooculogram light peak (LP) in the absence of changes in the fl ash electroretinogram. Although the LP is thought to be generated by best-1, we fi nd enhanced LP luminance responsiveness with normal amplitude in Vmd2−/− mice and no differences in cellular Cl− currents in comparison to Vmd2+/+ littermates. The putative Ca2+ sensitivity of best-1, and our recent observation that best-1 alters the kinetics of voltage-dependent Ca2+ channels (VDCC), led us to examine the role of VDCCs in the LP. Nimodipine diminished the LP, leading us to survey VDCC β-subunit mutant mice. Lethargic mice, which harbor a loss of func- β tion mutation in the 4 subunit of VDCCs, exhibited a signifi cant shift in LP luminance response, establishing a 2+ ++ role for Ca in LP generation. When stimulated with ATP, which increases [Ca ]I, retinal pigment epithelial cells derived from Vmd2−/− mice exhibited a fi vefold greater response than Vmd2+/+ littermates, indicating that 2+ β best-1 can suppress the rise in [Ca ]I associated with the LP. We conclude that VDCCs regulated by a 4 subunit are required to generate the LP and that best-1 antagonizes the LP luminance response potentially via its ability to modulate VDCC function. Furthermore, we suggest that the loss of vision associated with BMD is not caused by the same pathologic process as the diminished LP, but rather is caused by as yet unidentifi ed effects of best-1 on other cellular processes. INTRODUCTION In response to a light stimulus, the fi rst components of 1983; Steinberg et al., 1985; Gallemore and Steinberg, the electroretinogram (ERG) that can be recorded are 1989). In contrast to the c-wave and FO, the LP arises generated by neuronal elements of the retina (Robson independent of the change in subretinal [K+] that ac- and Frishman, 1995; Kofuji et al., 2000; Robson et al., companies phototransduction. Instead, the LP is sig- The Journal of General Physiology 2003). These initial components are then followed by a naled by an as yet unidentifi ed light peak substance series of slow changes in potential that are generated by (LPS) that is presumed to be secreted by photorecep- nonneuronal retinal cells (Steinberg et al., 1985). The tors (Gallemore et al., 1998). One candidate for the positive polarity c-wave represents the sum of two com- LPS is ATP, which, when applied to RPE cells in vitro, ponents of opposite polarity that are generated in re- causes a Ca2+-dependent increase in the Cl− conduc- sponse to the decline in subretinal [K+] associated with tance across the RPE basal membrane that is highly the retinal response to light, and is followed by the fast reminiscent of the LP (Peterson et al., 1997). oscillation (FO), which is generated in part by the re- Clinically, the LP is measured by electrooculography covery of the c-wave and a Cl−-induced hyperpolariza- (EOG), a test that is used to monitor drug toxicity ef- tion of the basal membrane of the retinal pigment fects on the RPE and is also considered the defi ning epithelium (RPE) (Griff and Steinberg, 1984; Linsen- diagnostic test for Best vitelliform macular dystrophy meier and Steinberg, 1984; Steinberg et al., 1985). The (BMD). BMD is caused by mutations in the VMD2 gene. light peak (LP) follows the FO and refl ects a depolariza- tion of the basal membrane of the RPE due to an Abbreviations used in this paper: ADVIRC, autosomal dominant vit- − increased Cl conductance (Linsenmeier and Steinberg, reoretinal choroidopathy; AVMD, adult onset vitelliform dystrophy; BMD, Best vitelliform macular dystrophy; DC, direct current; EOG, electrooculogram; ERG, electroretinogram; FO, fast oscillation; LP, Correspondence to Alan D. Marmorstein: light peak; LPS, LP substance; VDCC, voltage-dependent calcium [email protected] channel; wt, wild-type. J. Gen. Physiol. © The Rockefeller University Press $8.00 577 Volume 127 Number 5 May 2006 577–589 http://www.jgp.org/cgi/doi/10.1085/jgp.200509473 It is an autosomal dominant inherited disease charac- Ca2+-sensitive Cl− currents that were not observed or terized by early onset degeneration of the macula were signifi cantly smaller when BMD-associated mu- (Godel et al., 1986), a specialized central region of the tants were introduced. Subsequent patch-clamp stud- retina necessary for high acuity vision. The pathogene- ies in transfected cells (Qu et al., 2003; Tsunenari sis of BMD is characterized clinically by an egg yolk–like et al., 2003) have found that different bestrophin fam- vitelliform lesion in the ocular fundus (Marmor, 1979; ily members have unique I/V relationships (Qu et al., Gass, 1997) which typically presents in childhood. Even- 2003; Tsunenari et al., 2003; Qu et al., 2004), and have tually the vitelliform lesion will become disrupted and identifi ed amino acid residues that appear to confer ion atrophic. Postmortem studies of donor eyes typically in- selectivity in transfected cells (Qu et al., 2004; Qu and dicate substantial abnormal accumulation of lipofuscin Hartzell, 2004). A consistent fi nding has been that the in the RPE (Frangieh et al., 1982; Weingeist et al., 1982; introduction of mutations that cause BMD at conserved O’Gorman et al., 1988), though exceptions have been positions in the amino acid sequence results in a loss reported (Mullins et al., 2005). Not all carriers of BMD- of diminished level of channel activity. These data have associated mutations develop vitelliform lesions and resulted in a model of BMD pathogenesis that explains vision loss. The only fully penetrant symptom of the dis- the diminished LP and histopathologic consequences ease is the fi nding of a diminished LP without aberra- as the result of reduced or absent best-1 Cl− channel tions in the a- or b-waves of the fl ash ERG (Deutman, activity (Sun et al., 2002). We have recently shown that 1969; Cross and Bard, 1974). Historically the EOG has rats overexpressing BMD-associated best-1 mutants been the diagnostic determinant that distinguishes exhibit a diminished LP and an altered luminance re- BMD from adult onset vitellifrom dystrophy (AVMD) sponse function (Marmorstein et al., 2004). However, (Marmor, 1979), though mutations in VMD2 have been overexpression of wild-type (wt) best-1 did not increase reported in AVMD patients (Allikmets et al., 1999; LP amplitude, as might be predicted based on other White et al., 2000; Seddon et al., 2001). studies of Cl− channel overexpression (Zhou et al., Mutations in VMD2 have also been found in auto- 1994; Wersto et al., 1996), but did appear to reduce the somal dominant vitreoretinochoroidopathy (ADVIRC) sensitivity of the LP generator to light (Marmorstein (Yardley et al., 2004). ADVIRC is characterized by spe- et al., 2004). cifi c defects in pigmentation accompanied by choroidal In the present study, we sought to test the hypothesis atrophy and the presence of yellow-white retinal opac- that best-1 is the generator of the LP response by dis- ities (Blair et al., 1984). Abnormalities in the LP have rupting the Vmd2 gene in mice. Surprisingly, in com- also been observed (Han and Lewandowski, 1992) in parison to wt littermates, Vmd2−/− mice have a normal ADVIRC patients. These abnormalities however are ac- maximum LP but exhibit larger LPs in response to companied by a subnormal fl ash ERG response (Han lower intensity stimuli. We also noted that the LP can and Lewandowski, 1992). be diminished by nimodipine, a blocker of L-type volt- The VMD2 gene encodes bestrophin (best-1), a age-dependent calcium channels (VDCCs), and that 68-kD member of the bestrophin or RFP-TM family of lethargic mice harboring a loss of function mutation in β proteins. Although mRNA for best-1 is in RPE, testis, the VDCC 4 subunit (Burgess et al., 1997) exhibit sig- placenta, and brain, (Petrukhin et al., 1998; Marquardt nifi cant shifts in LP responses across a broad range of et al., 1998), the protein has only been detected in RPE stimulus luminance, but have otherwise normal retinal cells (Stanton et al., 2006), where it is localized to function. Finally we demonstrate that Vmd2−/− mice the basolateral plasma membrane (Marmorstein et al., exhibit normal Ca2+-activated Cl− conductances, but 2+ −/− 2000; Bakall et al., 2003). Understanding best-1 func- that the change in [Ca ]I in Vmd2 mice elicited by tion should be a key toward identifying candidate ther- extracellular ATP is substantially elevated in compari- apies for BMD. The EOG LP abnormality has served for son to wt littermates. Based on these fi ndings, we con- β many in the fi eld as the basis to hypothesize a function clude that VDCCs containing a 4 subunit are required for best-1. Studies performed in the Steinberg labora- to generate a normal LP, and that best-1 is not required tory have shown that the LP is generated by a depolar- to generate the LP, but in fact functions to antagonize 2+ ization of the basal plasma membrane due to activation the LP luminance response by regulating [Ca ]I per- of a Cl− conductance (Gallemore and Steinberg, 1989).
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