Vitamins are essential compounds obtained through diet that are necessary for normal development and function in an organism. One of the most important vitamins for human physiology is vitamin A, a group of retinoid compounds and carotenoids, which generally function as a mediator for cell growth, differentiation, immunity, and embryonic development, as well as serving as a key component in the phototransduction cycle in the vertebrate retina. For humans, vitamin A is obtained through the diet, where provitamin A carotenoids such as β-carotene from plants or preformed vitamin A such as retinyl esters from animal sources are absorbed into the body via the small intestine and converted into all-trans retinol within the intestinal enterocytes. Specifically, once absorbed, carotenoids are cleaved by carotenoid cleavage oxygenases (CCOs), such as Beta-carotene 15,15’-monooxygenase (BCO1), to produce all-trans retinal that subsequently gets converted into all-trans retinol. CRBP2 bound retinol is then converted into retinyl esters (REs) by the enzyme lecithin retinol acyltransferase (LRAT) in the endoplasmic reticulum, which is then packaged into chylomicrons and sent into the bloodstream for storage in hepatic stellate cells in the liver or for functional use in peripheral tissues such as the retina. All-trans retinol also travels through the bloodstream bound to retinol binding protein 4 (RBP4), where it enters cells with the assistance of the transmembrane transporters, stimulated by retinoic acid 6 (STRA6) in peripheral tissues or retinol binding protein 4 receptor 2 (RBPR2) in systemic tissues (e.g., in the retina and the liver, respectively). Much is known about the intake, metabolism, storage, and function of vitamin A compounds, especially with regard to its impact on eye development and visual function in the retinoid cycle. However, there is much to learn about the role of vitamin A as a transcription factor in development and cell growth, as well as how peripheral cells signal hepatocytes to secrete all-trans retinol into the blood for peripheral cell use. This article aims to review literature regarding the major known pathways of vitamin A intake from dietary sources into hepatocytes, vitamin A excretion by hepatocytes, as well as vitamin A usage within the retinoid cycle in the RPE and retina to provide insight on future directions of novel membrane transporters for vitamin A in retinal cell physiology and visual function.

The systemic transport of dietary vitamin A/all-trans retinol bound to RBP4 into peripheral tissues for storage is an essential physiological process that continuously provides visual chromophore precursors to the retina under fasting conditions. This mechanism is critical for phototransduction, photoreceptor cell maintenance and survival, and in the support of visual function. While the membrane receptor STRA6 facilitates the blood transport of lipophilic vitamin A into the eye, it is not expressed in most peripheral organs, which are proposed to express a second membrane receptor for the uptake of vitamin A from circulating RBP4. The discovery of a novel vitamin A receptor, RBPR2, which is expressed in the liver and intestine, but not in the eye, alluded to this long-sort non-ocular membrane receptor for systemic RBP4-ROL uptake and transport. We have previously shown in zebrafish that the retinol-binding protein receptor 2 (Rbpr2) plays an important role in the transport of yolk vitamin A to the eye. Mutant rbpr2 zebrafish lines manifested in decreased ocular retinoid concentrations and retinal phenotypes. To investigate a physiological role for the second vitamin A receptor, RBPR2, in mammals and to analyze the metabolic basis of systemic vitamin A transport for retinoid homeostasis, we established a whole-body Rbpr2 knockout mouse (Rbpr2^−/−) model. These mice were viable on both vitamin A-sufficient and -deficient diets. Rbpr2^−/− mice that were fed a vitamin A-sufficient diet displayed lower ocular retinoid levels, decreased opsins, and manifested in decrease visual function, as measured by electroretinography. Interestingly, when Rbpr2^−/− mice were fed a vitamin A-deficient diet, they additionally showed shorter photoreceptor outer segment phenotypes, altogether manifesting in a significant loss of visual function. Thus, under conditions replicating vitamin A sufficiency and deficiency, our analyses revealed that RBPR2-mediated systemic vitamin A transport is a regulated process that is important for vitamin A delivery to the eye when RBP4-bound ROL is the only transport pathway in the fasting condition or under vitamin A deficiency conditions.

In this review, we outline our current understanding of the mechanisms involved in the absorption, storage, and transport of dietary vitamin A to the eye, and the trafficking of rhodopsin protein to the photoreceptor outer segments, which encompasses the logistical backbone required for photoreceptor cell function. Two key mechanisms of this process are emphasized in this manuscript: ocular and systemic vitamin A membrane transporters, and rhodopsin transporters. Understanding the complementary mechanisms responsible for the generation and proper transport of the retinylidene protein to the photoreceptor outer segment will eventually shed light on the importance of genes encoded by these proteins, and their relationship on normal visual function and in the pathophysiology of retinal degenerative diseases.

The distribution of stored dietary vitamin A/all‐ trans ‐retinol (ROL) from the liver throughout the body is critical for maintaining retinoid function in peripheral tissues and for generating visual pigments for photoreceptor cell function. ROL circulates in the blood bound to the retinol binding protein 4 (RBP4) as RBP4‐ROL. Two membrane receptors, RBPR2 in the liver and other non‐ocular tissues, and STRA6 in the eye are proposed to bind circulatory RBP4 and this mechanism facilitates the internalization of ROL. Herein, we conducted a longitudinal study to investigate the importance of RBPR2 and influence of vitamin A content in the diet on whole‐body retinoid homeostasis and its effects on chromophore production in the support of visual function. Rbpr2 ‐knockout ( Rbpr2 ^−/− ) and wild‐type mice were fed a vitamin A sufficient (VAS) or a vitamin A deficient (VAD) diet. After 3‐months of dietary intervention and compared with WT mice, Rbpr2 ^−/− mice showed significantly lower hepatic ROL and retinyl ester content, and decreased chromophore concentrations, manifesting in dysfunctional scotopic and photopic electroretinogram (ERG) responses. These phenotypes were more severe in VAD Rbpr2 ^−/− mice, when compared with VAS Rbpr2 ^−/− mice. After 6 months of dietary intervention, while WT mice were able to maintain retinoid homeostasis in peripheral tissues, Rbpr2 ^−/− mice showed elevated serum apo‐RBP4 protein, decreased retinoid content in peripheral tissues including the liver and the eye causing an accumulation of apoprotein opsin in photoreceptors, which resulted in delayed rod and cone opsin regeneration. Together, our analyses characterize the molecular events underlying nutritional blindness in a novel mouse model and indicate that the vitamin A receptor, RBPR2, is required for whole‐body retinoid homeostasis, which supports chromophore production and visual function under variable conditions of dietary vitamin A intake throughout the lifespan of the animal.

G protein-coupled receptors (GPCRs) are a superfamily of transmembrane proteins that initiate signaling cascades through activation of its G protein upon association with its ligand. In all mammalian vision, rhodopsin is the GPCR responsible for the initiation of the phototransduction cascade. Within photoreceptors, rhodopsin is bound to its chromophore 11-cis-retinal and is activated through the light-sensitive isomerization of 11-cis-retinal to all-trans-retinal, which activates the transducin G protein, resulting in the phototransduction cascade. While phototransduction is well understood, the processes that are involved in the supply of dietary vitamin A precursors for 11-cis-retinal generation in the eye, as well as diseases resulting in disruption of this supply, are not yet fully understood. Once vitamin A precursors are absorbed into the intestine, they are stored in the liver as retinyl esters and released into the bloodstream as all-trans-retinol bound to retinol-binding protein 4 (RBP4). This circulatory RBP4-retinol will be absorbed by systemic organs, such as the liver, lungs, kidney, and eye. Hence, a method for the quantification of the various metabolites of dietary vitamin A in the eye and systemic organs is critical to the study of proper rhodopsin GPCR function. In this method, we present a comprehensive extraction and analytical method for vitamin A analysis in murine tissue. Through normal-phase, high-performance liquid chromatography analysis, all relevant isomers of retinaldehydes, retinols, and retinyl esters can be detected simultaneously through a single run, which allows for the efficient use of experimental samples and increases internal reliability across different vitamin A metabolites within the same sample. With this comprehensive method, investigators will be able to better assess systemic vitamin A supply in rhodopsin GPCR function.

In this review, we outline our current understanding of the mechanisms involved in the absorption, storage, and transport of dietary vitamin A to the eye, the trafficking of rod opsin protein to the photoreceptor outer segments, which encompasses the logistical backbone required for visual function. Two key mechanisms of this process are emphasized in this manuscript: Ocular and systemic vitamin A membrane transporters, and rhodopsin transporters. Understanding the complementary mechanisms responsible for the generation and proper transport of the retinylidene opsin to the photoreceptor outer segment will eventually shed light on the importance of genes encoded by these proteins, and their relationship on normal visual function and in the pathophysiology of retinal degenerative diseases.