# Mechanisms of RPE dysfunction in macular degenerations: role of intracellular complement activation

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $579,201

## Abstract

The complement system controls the balance between homeostatic and inflammatory processes. Although
abnormal complement activity is strongly associated with macular degenerations, inhibiting this pathway has
been unsuccessful in halting vision loss. To date, therapeutic approaches have focused on complete inhibition
of extracellular complement activity, with limited insight into how complement proteins modulate retinal health
and disease. This is particularly evident in approaches targeting the complement protein C3, the core effector
molecule of the complement system, which plays context-dependent roles in the retina. Countering the
conventional view of C3 acting solely in the extracellular space, recent studies from our group have identified
intracellular C3 activation as a novel mechanism that modulates health of the retinal pigment epithelium (RPE),
a primary site of injury in macular degenerations. In stressed or diseased RPE, increased uptake and proteolysis
of C3 generates biologically active C3a (“intracellular C3 activation”). C3a in turn activates mTOR, a master
regulator of cell health. Chronic mTOR activation is detrimental to cell health because it can reprogram cellular
metabolism and cell fate decisions. Based on these exciting studies, we hypothesize that abnormal intracellular
complement activation could drive disease pathology by compromising RPE homeostasis. We propose to
molecularly dissect the machinery, mechanisms, and consequences of dysregulated intracellular C3a activity in
the RPE, and identify potential points of therapeutic intervention to halt this cascade. We will identify the cellular
machinery responsible for increased intracellular C3a generation in diseased RPE (Aim 1); investigate the
dynamics of C3a signaling via its cognate receptor C3aR (Aim 2); and determine how persistent C3a-C3aR
signaling disrupts RPE homeostasis and retinal function (Aim 3). We will use our expertise in innovative high-
speed and super-resolution live-cell imaging and mouse models of disease to gain unprecedented spatial and
temporal information about intracellular C3 activation and its consequences for retinal health. These studies will
aid the development of a unified model that links multiple features of AMD, including cholesterol accumulation,
complement activation, metabolic deficits and RPE dedifferentiation. Identifying molecular mechanisms that
underlie increased intracellular C3 activation will aid the design of precision therapeutics to safeguard RPE health
and retinal function over a lifetime.

## Key facts

- **NIH application ID:** 10150856
- **Project number:** 5R01EY030668-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Aparna Lakkaraju
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $579,201
- **Award type:** 5
- **Project period:** 2020-05-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10150856

## Citation

> US National Institutes of Health, RePORTER application 10150856, Mechanisms of RPE dysfunction in macular degenerations: role of intracellular complement activation (5R01EY030668-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10150856. Licensed CC0.

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