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Toxicity Screens in Human Retinal Organoids for Pharmaceutical Discovery

Published: March 4th, 2021



1Lowy Medical Research Institute, 2The Scripps Research Institute

Here we present a step-by-step protocol to generate mature human retinal organoids and utilize them in a photoreceptor toxicity assay to identify pharmaceutical candidates for the age-related retinal degenerative disease macular telangiectasia type 2 (MacTel).

Organoids provide a promising platform to study disease mechanism and treatments, directly in the context of human tissue with the versatility and throughput of cell culture. Mature human retinal organoids are utilized to screen potential pharmaceutical treatments for the age-related retinal degenerative disease macular telangiectasia type 2 (MacTel).

We have recently shown that MacTel can be caused by elevated levels of an atypical lipid species, deoxysphingolipids (deoxySLs). These lipids are toxic to the retina and may drive the photoreceptor loss that occurs in MacTel patients. To screen drugs for their ability to prevent deoxySL photoreceptor toxicity, we generated human retinal organoids from a non-MacTel induced pluripotent stem cell (iPSC) line and matured them to a post-mitotic age where they develop all of the neuronal lineage-derived cells of the retina, including functionally mature photoreceptors. The retinal organoids were treated with a deoxySL metabolite and apoptosis was measured within the photoreceptor layer using immunohistochemistry. Using this toxicity model, pharmacological compounds that prevent deoxySL-induced photoreceptor death were screened. Using a targeted candidate approach, we determined that fenofibrate, a drug commonly prescribed for the treatment of high cholesterol and triglycerides, can also prevent deoxySL toxicity in the cells of the retina.

The toxicity screen successfully identified an FDA-approved drug that can prevent photoreceptor death. This is a directly actionable finding owing to the highly disease-relevant model tested. This platform can be easily modified to test any number of metabolic stressors and potential pharmacological interventions for future treatment discovery in retinal diseases.

Modeling human disease in cell culture and animal models has provided invaluable tools for the discovery, modification, and validation of pharmacologic therapeutics, allowing them to advance from candidate drug to approved therapy. Although a combination of in vitro and non-human in vivo models has long been a critical component of the drug development pipeline they frequently fail to predict the clinical performance of novel drug candidates1. There is a clear need for the development of technologies that bridge the gap between simplistic human cellular monocultures and clinical trials. Recent technological advances in self-organized three-dime....

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1. Thawing, passaging, and expanding iPSCs/ESCs

NOTE: For all cell culturing steps, use best practices to maintain a sterile cell culture.

  1. Coat a 6-well cell culture plate with basement membrane matrix medium.
    1. To prepare 1x of this medium, follow product specifications or dilute 75 µL cold matrix medium with 9 mL of DMEM/F12. Add 1.5 mL of freshly prepared 1x medium per well in a 6-well plate. Incubate at 37 °C for 30 min.
    2. Aspirate off the basement .......

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Retinal organoids were generated from a non-MacTel control iPSC line. After organoids reached 26 weeks in culture they were selected and split into experimental groups. Organoids were treated with varying concentrations of deoxySA to determine if deoxySA is toxic to photoreceptors. Four concentrations of deoxySA were tested, from 0 to 1 µM (Figure 2) and organoids were treated for 8 days, with media changes every other day. Cell death in response to deoxySA is concentration-dependent an.......

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Differentiation protocol variations
Since the invention of self-forming optic cups by Yoshiki Sasai's group20, many labs have developed protocols to generate retinal organoids that can vary at almost every step5,18,19,21. An exhaustive list of protocols can be found in Capowski et al.22. The differentiation protocol we p.......

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Supported by the Lowy Medical Research Institute. We would like to thank the Lowy family for their support of the MacTel project. We would like to thank Mari Gantner, Mike Dorrell, and Lea Scheppke for their intellectual input and assistance preparing the manuscript.


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Name Company Catalog Number Comments
0.5M EDTA Invitrogen 15575020
125mL Erlenmeyer Flasks VWR 89095-258
1-deoxysphinganine Avanti 860493
B27 Supplement, minus vitamin A Gibco 12587010
Beaver 6900 Mini-Blade Beaver-Visitec BEAVER6900
D-(+)-Sucrose VWR 97061-432
DAPI Thermo-fisher D1306
Dispase II, powder Gibco 17105041
DMEM, high glucose, pyruvate Gibco 11995073
DMEM/F12 Gibco 11330
Donkey anti-rabbit Ig-G, Alexa Fluor plus 555 Thermo-fisher A32794
donkey serum Sigma D9663-10ML
FBS, Heat Inactivated Corning 45001-108
Fenofibrate Sigma F6020
Glutamax Gibco 35050061
Heparin Stemcell Technologies 7980
In Situ Cell Death Detection Kit, Fluorescin Sigma 11684795910
Matrigel, growth factor reduced Corning 356230
MEM Non-Essential Amino Acids Solution Gibco 11140050
mTeSR 1 Stemcell Technologies 85850
N2 Supplement Gibco 17502048
Penicillin-Streptomycin Gibco 15140122
Pierce 16% Formaldehyde Thermo-fisher 28906
Rabbit anti-Recoverin antibody Millipore AB5585
Sodium Citrate Sigma W302600
Steriflip Sterile Disposable Vacuum Filter Units MilliporeSigma SE1M179M6
Taurine Sigma T0625
Tissue Plus- O.C.T. compound Fisher Scientific 23-730-571
Tissue-Tek Cryomold EMS 62534-10
Triton X-100 Sigma X100
Tween-20 Sigma P1379
Ultra-Low Attachment 6 well Plates Corning 29443-030
Ultra-Low Attachment 75cm2 U-Flask Corning 3814
Vacuum Filtration System VWR 10040-436
Vectashield-mounting medium vector Labs H-1000
wax pen-ImmEdge vector Labs H-4000
Y-27632 Dihydrochloride (Rock inhibitor) Sigma Y0503

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