The vertebrate lens has a distinct polarity and structure that are regulated by growth factors resident in the ocular media. Fibroblast growth factors, in concert with other growth factors, are key regulators of lens fiber cell differentiation. While members of the transforming growth factor (TGFβ) superfamily have also been implicated to play a role in lens fiber differentiation, inappropriate TGFβ signaling in the anterior lens epithelial cells results in an epithelial-mesenchymal transition (EMT) that bears morphological and molecular resemblance to forms of human cataract, including anterior subcapsular (ASC) and posterior capsule opacification (PCO; also known as secondary cataract or after-cataract), which occurs after cataract surgery. Numerous in vitro and in vivo studies indicate that this TGFβ-induced EMT is part of a wound healing response in lens epithelial cells and is characterized by induced expression of numerous extracellular matrix proteins (laminin, collagens I, III, tenascin, fibronectin, proteoglycans), intermediate filaments (desmin, α-smooth muscle actin) and various integrins (α2, α5, α7B), as well as the loss of epithelial genes [Pax6, Cx43, CP49, α-crystallin, E-cadherin, zonula occludens-1 protein (ZO-1)]. The signaling pathways involved in initiating the EMT seem to primarily involve the Smad-dependent pathway, whereby TGFβ binding to specific high affinity cell surface receptors activates the receptor-Smad/Smad4 complex. Recent studies implicate other factors [such as fibroblast growth factor (FGFs), hepatocyte growth factor, integrins], present in the lens and ocular environment, in the pathogenesis of ASC and PCO. For example, FGF signaling can augment many of the effects of TGFβ, and integrin signaling, possibly via ILK, appears to mediate some of the morphological features of EMT initiated by TGFβ. Increasing attention is now being directed at the network of signaling pathways that effect the EMT in lens epithelial cells, with the aim of identifying potential therapeutic targets to inhibit cataract, particularly PCO, which remains a significant clinical problem in ophthalmology.

Rationale: Primary ciliary dyskinesia (PCD) is a rare, usually autosomal recessive, genetic disorder characterized by ciliary dysfunction, sino-pulmonary disease, and situs inversus. Disease-causing mutations have been reported in DNAI1 and DNAH5 encoding outer dynein arm (ODA) proteins of cilia. Objectives: We analyzed DNAI1 to identify disease-causing mutations in PCD and to determine if the previously reported IVS1+2_3insT (219+3insT) mutation represents a “founder” or “hot spot” mutation. Methods: Patients with PCD from 179 unrelated families were studied. Exclusion mapping showed no linkage to DNAI1 for 13 families; the entire coding region was sequenced in a patient from the remaining 166 families. Reverse transcriptase–polymerase chain reaction (RT-PCR) was performed on nasal epithelial RNA in 14 families. Results: Mutations in DNAI1 including 12 novel mutations were identified in 16 of 179 (9%) families; 14 harbored biallelic mutations. Deep intronic splice mutations were not identified by reverse transcriptase–polymerase chain reaction. The prevalence of mutations in families with defined ODA defect was 13%; no mutations were found in patients without a defined ODA defect. The previously reported IVS1+2_3insT mutation accounted for 57% (17/30) of mutant alleles, and marker analysis indicates a common founder for this mutation. Seven mutations occurred in three exons (13, 16, and 17); taken together with previous reports, these three exons are emerging as mutation clusters harboring 29% (12/42) of mutant alleles. Conclusions: A total of 10% of patients with PCD are estimated to harbor mutations in DNAI1; most occur as a common founder IVS1+2_3insT or in exons 13, 16, and 17. This information is useful for establishing a clinical molecular genetic test for PCD.

To develop criteria to aid in the diagnosis of primary ciliary dyskinesia (PCD) we analyzed quantitatively the incidence and the range of ciliary ultrastructural abnormalities in healthy subjects and in patients with respiratory tract disease. The beat frequency and ultrastructure of nasal respiratory tract cilia, including ciliary orientation, were measured in 62 healthy subjects (31 nonsmokers, 20 exsmokers, and 11 smokers), ranging in age from 1 to 76 yr, and in 51 patients with respiratory tract disease. In healthy subjects, ciliary beat frequency (CBF) ranged between 9.6 and 15.3 Hz, the incidence of microtubule defects varied between 0 to 9%, the mean number of inner dynein arms per cilium ranged from 3.0 to 7.1, and the mean number of outer dynein arms per cilium ranged from 7.4 to 9.0. The deviation of cilia in healthy subjects varied between 8 and 29 degrees. By comparing the data for ciliary defects in healthy subjects with the data obtained from patients with respiratory disease, we identified two patient groups: patients with PCD (n = 31) and patients with respiratory tract disease not due to PCD. For comparison with the PCD patients, a group of 20 patients with bronchiectasis was selected and analyzed. Patients with PCD had significantly lower CBF (p < 0.001), significantly higher incidences of peripheral and central tubule defects (p < 0.01), and greater ciliary disorientation (p < 0.005). There was a strong correlation between CBF and the number of outer dynein arm numbers, but not with inner dynein arm numbers, suggesting that inner and outer dynein arms may play different functional roles in producing ciliary motility.(ABSTRACT TRUNCATED AT 250 WORDS)

Over the recent years, there have been tremendous advances in our understanding of the genetic and environmental factors associated with the development of age‐related macular degeneration (AMD). Examination of retinal changes in various animals has aided our understanding of the pathogenesis of the disease. Notably, mouse strains, carrying genetic anomalies similar to those affecting humans, have provided a foundation for understanding how various genetic risk factors affect retinal integrity. However, to date, no single mouse strain that develops all the features of AMD in a progressive age‐related manner has been identified. In addition, a mutation present in some background strains has clouded the interpretation of retinal phenotypes in many mouse strains. The aim of this perspective was to describe how animals can be used to understand the significance of each sign of AMD, as well as key genetic risk factors.

As part of an investigation into the role FGF in lens development, we have studied the distribution of both aFGF and bFGF during eye morphogenesis from embryonic days 10 to 18 (E10–E18) in the rat. For aFGF, reactivity was found only in ectoderm at E10, prior to contact between the optic vesicle and presumptive lens ectoderm. During lens placode formation (E11) there was a transient, diffuse reactivity for aFGF in anterior optic vesicle cells directly apposed to the labelled ectoderm of the lens placode. At E12 the diffuse reactivity of the lens placode had changed to a discrete localisation along the basolateral surfaces of differentiating cells in the lens pit. Similar reactivity was associated with neuroblasts along the inner margin of the optic cup. At the early lens vesicle stage (E13) the baso‐lateral aFGF‐like reactivity associated with elongating lens cells was more intense and extensive. From the late lens vesicle stage (E14) to E18, reactivity in the lens was increasingly restricted to the equatorial regions which incorporate the germinative and transitional zones. From E16 to E18, aFGF‐like reactivity in the retina was predominantly localised in the peripheral regions corresponding to the developing ciliary body and iris and in the central retina associated with ganglion cell axons. For bFGF, weak reactivity was detectable as early as E13 in the developing lens capsule and increased in intensity during lens development with the posterior capsule reacting more intensely than the anterior capsule. Retinal bFGF‐like reactivity was first detected at E14, associated with differentiating ganglion cells in the central retina. From E16 to E18 the retinal ganglion cells showed increasing reactivity and the pattern of reactivity followed the centro‐peripheral pattern of retinal development. Thus reactivity for aFGF is first detected in presumptive lens ectoderm and subsequently in optic vesicle cells which are closely associated with lens ectoderm. This raises the possibility that aFGF may be involved in inductive interactions between presumptive lens ectoderm and optic vesicle. Furthermore the localisation patterns established for both aFGF and bFGF during lens and retina morphogenesis suggest an important role for FGF in regulating their morphogenesis and growth.