Targeting BAX as a Therapeutic for Protection of Retinal Ganglion Cells

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BAX is a proapoptotic protein, which is critical for the execution of intrinsic apoptosis in retinal ganglion cells (RGCs) after optic nerve damage, suggesting that targeting BAX may be an effective therapeutic strategy for neuroprotection. It has been reported, however, that reducing BAX levels only provides a transient protection to axons in a mouse model of glaucoma. Whether or not this transient protection is sufficient to allow axons to recover after elimination of the original stressor, has not been tested. Aim 1 will test the protective effect of BAX reduction on the ability of axons to survive and/or recover in models that mimic the IOP-lowering therapy experienced by patients with ocular hypertension (OHT). Two models of inducible OHT in mice, microbead injection and steroid induced OHT, will be employed on both wild type and Bax+/- mice (where reduced BAX more likely mimics a human treatment). In both models IOP levels can be returned to normal after a desired interval. We will test if reducing BAX protein levels both reduces soma and axon pathology, and either protects axon function, or allows functional recovery. We will also examine the effects of controlled experimental IOP (CEI). The advantage of CEI is that it normalizes the IOP insult, which eliminates the confounding factors of variable IOP associated with other models of OHT. Dorsal Root Ganglion cells contain a BAX-dependent degenerative pathway that is activated early and before other more well-characterized catabolic reactions involving calcium influx. This pathway is activated by a BH3- only protein produced in the cell soma and then transported to the axon. A similar mechanism in RGC axons may explain the partial protective effect of BAX reduction. Aim 2 will evaluate the presence of this pathway in RGC axons where degeneration will be induced in optic nerves ex vivo. We will also interrogate axons for the presence and localization of key molecules that activate BAX, and molecules that act down-stream of BAX activation. Preliminary studies suggest that the BH3-only protein NOXA may be an important regulator of BAX activation in axons. We will explore this in detail using Noxa-deficient mice subjected to induced OHT. Protected RGCs silence transcription of genes required for function. New studies show that the committed process of dying in Bax-deficient cells, is shut down after 8 weeks. Thus cells can be classified into two categories, those actively dying (AD-mode) and those that have gone quiescent (Q-mode). Aim 3 will investigate if cells in Q-mode respond differently to 3 attempts to reactivate them, including using HDAC inhibitors to attenuate the transcriptional silencing of RGC-specific gene expression, the addition of Zymosan and CPT-cAMP to induce regeneration, or the up-regulation of transcription factors that can specify retinal precursor cells as RGCs. These experiments will be conducted on RGCs after acute damage to the optic nerve, which serves as a model where regeneration has a high priority for a therapeutic outcome.