Cited by 422Retinal Development and DisordersRetinal Diseases and TreatmentsRetinal Imaging and Analysis

The DOI matches its Crossref record; 379 of the 379 references it cites were found in a registry or an index; none of the 439 sources its claims cite is checked for support yet.

The cell biology of the retinal pigment epithelium

Open access
Lakkaraju, Aparna, Umapathy, Ankita, Tan, Li Xuan, Daniele, Lauren, Philp, Nancy J., Boesze-Battaglia, Kathleen, Williams, David S.·2020·Progress in Retinal and Eye Research

Abstract

The retinal pigment epithelium (RPE), a monolayer of post-mitotic polarized epithelial cells, strategically situated between the photoreceptors and the choroid, is the primary caretaker of photoreceptor health and function. Dysfunction of the RPE underlies many inherited and acquired diseases that cause permanent blindness. Decades of research have yielded valuable insight into the cell biology of the RPE. In recent years, new technologies such as live-cell imaging have resulted in major advancement in our understanding of areas such as the daily phagocytosis and clearance of photoreceptor outer segment tips, autophagy, endolysosome function, and the metabolic interplay between the RPE and photoreceptors. In this review, we aim to integrate these studies with an emphasis on appropriate models and techniques to investigate RPE cell biology and metabolism, and discuss how RPE cell biology informs our understanding of retinal disease.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesizes RPE cell biology, emphasizing outer segment phagocytosis, LC3-associated phagocytosis, classical autophagy, organelle function, and metabolic coupling with photoreceptors. It argues that appropriate, well-polarized RPE models and live-cell imaging are essential for understanding RPE health and retinal disease.

Key findings

  • The RPE is a post-mitotic, polarized monolayer that supports photoreceptors; in the central human retina, ~33 photoreceptors are associated with each RPE cell, while the mouse central retina has >200 per RPE cell and peripheral ratios are ~12 in human and 100–120 in mouse.
  • OS phagocytosis follows a daily rhythm: rod OS phagosomes peak after light onset, cone OS phagosomes vary by species, and mouse/zebrafish RPE can show two peaks after light onset and lights-off. Phagosome degradation involves apical-to-basal migration, acidification, and proteases including cathepsin D and cysteine proteases; LAP recruits LC3B to ~30–45% of ingested phagosomes in vitro/in vivo, though GFP-LC3B overexpression yields 80–90%.
  • Autophagy and endolysosomal defects are linked to AMD and inherited retinal degenerations; RPE-specific loss of RB1CC1 causes RPE atrophy by 4 months, and RPE-specific Atg5 or Atg7 deletions produce retinal degeneration in 35–45% of mice between 8 and 24 months.
  • RPE metabolism is oxidative and coupled to photoreceptors: OSs are ~50% protein and 50% lipid by weight, and in human fetal RPE, ~50% of palmitate-derived acetyl-CoA is diverted to ketogenesis to produce β-hydroxybutyrate; Hmgcs2 transcripts are 30% higher and PGC-1 is 50% higher at 1.5 versus 9 h after light onset.

Methods

  • Narrative review integrating decades of published RPE cell biology, with no primary experimental data reported.
  • Discusses experimental preparations including RPE/choroid/sclera flatmounts, primary RPE cultures from rodent/pig/human sources, stem cell-derived RPE, and cell lines such as RPE-J, hTERT-RPE1, and ARPE-19, often on Transwell filters for polarization and live-cell imaging.
  • Main analysis is a synthesis of mechanisms across OS phagocytosis, LAP, classical autophagy, organelle biology, and RPE-photoreceptor metabolism, with emphasis on model selection and appropriate techniques.

Limitations

  • The paper states model limitations: flatmounts remain useful for only hours; primary human RPE has limited tissue availability and dedifferentiates with passaging; stem cell-derived RPE has inefficient transfection and limited passaging before failing to re-differentiate; ARPE-19 has genetic abnormalities and diminished differentiation with passage; in vitro metabolism does not recapitulate the in vivo RPE environment.
  • The paper identifies many open questions, including what distinguishes LC3-associated OS phagosomes, how autophagy is scaled to diurnal phagocytosis, how the organelle interactome changes with age/disease, and the need for in vivo RPE metabolic studies.
  • Evident from the text: as a narrative review, it does not conduct a systematic search or meta-analysis and reports no new experimental data; conclusions depend on cited studies and model-dependent findings.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.preteyeres.2020.100846

Cites

379 of 379 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

337 Not checked yet · 107 No basis given · 65 Own interpretation · 2 Own result · 1 Sources not found · 1 Own method

Verify all 437 references — free account

Show all 261 claims

  • Probably not a substantial claim. 71
  • It may state two separate claims as one. 202
252 of 252
  • The paper relies on this without support.

    Dysfunction of the RPE underlies many inherited and acquired diseases that cause permanent blindness.

    “Dysfunction of the RPE underlies many inherited and acquired diseases that cause permanent blindness.”
  • The paper relies on this without support.

    The RPE is the primary caretaker of photoreceptor health and function.

    “The retinal pigment epithelium (RPE), a monolayer of post-mitotic polarized epithelial cells, strategically situated between the photoreceptors and the choroid, is the primary caretaker of photoreceptor health and function.”
  • The paper relies on this without support.

    The RPE forms a critical barrier between the retina and the systemic circulation and performs many essential functions to support the neural retina.

    “The retinal pigment epithelium (RPE) forms a critical barrier between the retina and the systemic circulation, and performs many essential functions to support the neural retina.”
  • The paper relies on this without support.

    New technologies such as live-cell imaging have resulted in major advancement in our understanding of areas such as the daily phagocytosis and clearance of photoreceptor outer segment tips, autophagy, endolysosome function, and the metabolic interplay between the RPE and photoreceptors.

    “In recent years, new technologies such as live-cell imaging have resulted in major advancement in our understanding of areas such as the daily phagocytosis and clearance of photoreceptor outer segment tips, autophagy, endolysosome function, and the metabolic interplay between the RPE and photoreceptors.”
  • The paper relies on this without support.

    OS phagocytosis is an important function of RPE cells.

    “Given that OS phagocytosis is an important function of RPE cells, measuring phagocytic capacity of these cells is a commonly-used metric.”
  • The paper relies on this without support.

    RPE cell cultures are disconnected from in vivo rhythms.

    “RPE cell cultures appear to be disconnected from in vivo rhythms, but are nevertheless amenable to experimentally-induced pulses of OS phagocytosis.”
  • The paper relies on this without support.

    Cysteine proteases are considerably more abundant than aspartyl proteases.

    “Cysteine proteases are considerably more abundant than aspartyl proteases.”
  • The paper relies on this without support.

    OS phagosomes have a high lipid content.

    “Given the high lipid content of OS phagosomes, it is not surprising that the RPE has the highest acid lipase activity of all ocular tissues (Hayasaka et al., 1977).”
  • The paper relies on this without support.

    Classical autophagy occurs at a basal, constitutive level in all eukaryotic cells.

    “Classical autophagy occurs at a basal, constitutive level in all eukaryotic cells, and is modulated by intrinsic and extrinsic stimuli.”
  • The paper relies on this without support.

    The specific mechanisms responsible for elevated peroxisomes in ageing and in AMD have not been elucidated in the RPE.

    “However, the specific mechanisms responsible for elevated peroxisomes in ageing and in AMD have not been elucidated in the RPE.”
  • The paper relies on this without support.

    Little is known of the role of PPARs in the regulation of RPE peroxisome homeostasis or proliferation.

    “However, little is known of the role of PPARs in the regulation of RPE peroxisome homeostasis or proliferation.”
  • The paper relies on this without support.

    No studies have demonstrated elevated peroxisome numbers or function as a result of PPAR regulation in RPE cells.

    “However, we are otherwise unaware of studies demonstrating elevated peroxisome numbers or function as a result of PPAR regulation in RPE cells.”
12 of 12

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

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Metadata

Authors
Lakkaraju, A., Umapathy, A., Tan, L. X., Daniele, L., Philp, N. J., Boesze-Battaglia, K., & Williams, D. S.
Affiliations
  • University of California, San Francisco (US)
  • University of California, Los Angeles (US)
  • University of Pennsylvania (US)
  • Thomas Jefferson University (US)
Corresponding author
Williams, David S.
Venue
Progress in Retinal and Eye Research
Publisher
Elsevier BV
Published
2020-09
Volume
78
Pages
100846
ISSN
1350-9462 (ISSN-L)
OpenAlex
W3007934773
Cited by
422
References
379
Citations by year
2026: 59 · 2025: 79 · 2024: 94 · 2023: 70 · 2022: 53 · 2021: 52 · 2020: 14
FWCI
4.52
Type
journal article
Language
en
Open access
Locations
  • Progress in Retinal and Eye Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • Scholarly Commons (University of Pennsylvania) (submittedVersion)
Funders
  • OS
  • NIH NEI (R01 EY023299, R01 EY026525, R01 EY012042, R21 EY029826, R01EY027442, R01EY013408)
  • Foundation Fighting Blindness grant
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Development and Disorders
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Keywords
retinal pigment epithelium, photoreceptor outer segment phagocytosis, autophagy, retinal disease, live-cell imaging

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