Rod-cone dystrophy (RCD), also known as retinitis pigmentosa, is a group of inherited disorders characterized by rod degeneration followed by degeneration of peripheral cones, leaving patients with tunnel vision in mid stages and blindness in the latest stages. Previous studies expressed microbial chloride pumps, in degenerating cone photoreceptors to restore these cells’ activity and prolong vision. Microbial opsins lack intracellular signal amplification, requiring high light intensities. To develop a more sensitive strategy; we examined the phototransduction cascade in degenerating cones, in two RCD mouse models. We found that opsin and arrestin expression is maintained in the soma during outer segment degeneration. We thus hypothesized that cone reactivation based on cone opsin signaling may be feasible by expressing a target channel activated by G proteins recruited by cone opsin. Adeno-associated viral (AAV) mediated expression of G protein coupled inwardly rectifying K (GIRK) channel provided improvements in visual function in two RCD mouse models with mutations in two distinct genes. Importantly, we confirmed cone opsin and cone arrestin expression in cones of late-stage RCD patients, validating the rationale of GIRK-mediated gene therapy in humans. We propose GIRK channel expression in cones as a new approach to maintain high acuity, high sensitivity, color vision in RCD independently of the underlying mutation.
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