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RESEARCH PAPER / 2026-04-27

Hopx(+) optic nerve head-astrocytes counter neuronal stress and glaucoma damage.

Steven L Bernstein, Zara Mehrabian, Yan Guo, Jean Jouffroy, Ben Mead, Stanislav Tomarev, Esmahan Durmaz, Jonathan A Epstein, Adam Kronk, Seth Blackshaw, Thanh Hoang

Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine, Baltimore, MD 21201.Department of Ophthalmology and Visual Sciences, Lab of Molecular Research, University of Maryland at Baltimore School of Medicine, Baltimore, MD 21201. · pubmed

Abstract

Retinal ganglion cell (RGC) axons form the optic nerve (ON). Numerous age-related ON diseases, including glaucoma, the second most common cause of worldwide blindness, result from multiple RGC stressors. Nearly all ON astrocytes in the optic nerve head (ONH): the junctional region between the ON and the retina in young-adult rodents expresses the homeodomain only (Hopx) protein. Hopx(+) ONH astrocytes are depleted during aging. ONH primary cultures which include Hopx(+) astrocytes secrete extracellular vesicles (ONH-EVs) which selectively enhance RGC survival and neurite extension in culture, while extracellular vesicles (EVs) secreted from distal ON cultures lacking Hopx(+) astrocytes do not. ONH-EVs also enhance RGC survival in vivo in a rodent model of glaucoma. Combining rat ONH single-cell (scRNA-seq) sequencing with EV proteomic analysis, we identified ONH-Hopx(+) astrocyte secreted factors. We interrogated the online Broad institute scRNA-seq database for rat RGC gene expression in control animals and following rodent ON crush, an RGC stress model, to correlate ONH-astrocyte secreted factors with RGC gene expression changes. Following stress, RGCs upregulate the complementary pathways involving Hopx(+) astrocytic-associated factors, suggesting reciprocal communication. Using a highly selective transgenic Hopx-cre ONH knockdown strategy, we demonstrate that eliminating Hopx(+) astrocytes also results in upregulation of RGC stress responses. Our results implicate age-related loss of young ONH-astrocytes as a crucial factor in the development of age-related optic nerve diseases, and discuss replacing ONH associated factors as a paradigm shift for ON disease treatment.

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Research summary

The paper claims that the age-related depletion of Hopx(+) astrocytes in the optic nerve head contributes to the development of glaucoma by affecting retinal ganglion cell survival. This research is relevant as it addresses the underlying mechanisms of age-related optic nerve diseases, potentially offering insights into therapeutic strategies that target aging processes rather than merely treating symptoms.

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