On 20 October, during the American Academy of Ophthalmology (AAO) conference in Chicago, US, Hani El Helwe, MD, research fellow in Ophthalmology, Institution Massachusetts Eye and Ear, Infirmary presented findings showing that levels of apolipoprotein E (ApoE) are elevated in the aqueous humour (AH) and serum samples of patients with glaucoma.
ApoE and glaetin-3 (Gal-3) are markers of activated microglia in neurodegenerative diseases of the central nervous system (CNS), and their targeting has shown neuroprotective effects in mouse models of glaucoma.
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Dr Hekwe presented findings at the AAO conference, highlighting the growing need for improved biomarkers as neuroprotective strategies evolve in glaucoma treatment. The team hypothesised that serum Gal-3 and ApoE could serve as potential biomarkers for identifying patients who may benefit from microglia-based neuroprotective therapies, including Gal-3 inhibition. Their results showed that ApoE and Gal-3 levels are positively correlated in the AH of all glaucoma patients, particularly in those with primary open-angle glaucoma and normal-tension glaucoma. Additionally, glaucoma patients with prior pars plana vitrectomy exhibited a trend toward higher ApoE and Gal-3 levels. However, no correlation was found between serum ApoE and AH ApoE in either glaucoma or control patients, and the ApoE4 gene status did not significantly influence serum ApoE levels in either group.
Dr Hekwe concluded that the elevated levels of ApoE and Gal-3 in the AH of glaucoma patients, along with their positive correlation, indicate they may serve as valuable markers of microglial activity within the eye. The lack of correlation between serum and AH ApoE levels suggests that systemic measurements may not adequately capture ocular inflammation. The link between lipid metabolism and glaucoma pathophysiology could guide future research and treatment strategies, especially in addressing lipid dysregulation in these patients. Overall, these findings underscore the importance of AH analysis, rather than serum, for identifying specific glaucoma biomarkers, which could improve diagnosis and therapeutic approaches.
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