Summary
The optic nerve is a special sensory nerve that transmits visual impulses from the retina to the brain. Primary Open Angle Glaucoma (POAG) is a chronic, progressive optic neuropathy of multifactorial origin that affects 1 in 10 elderly individuals. The condition is characterised by an elevated intraocular pressure in the eye that causes irreversible damage to the retinal ganglion cells and optic nerve and can remain undiagnosed for many years, only affecting vision when the damage is quite advanced. An early diagnosis before significant vision loss is essential for treating this preventable condition. Glaucoma shows familial aggregation with its prevalence varying among different ethnic groups indicating that genetic factors play a major role in pathogenesis. Mendelian mutations in myocilin, optineurin and WD-repeat-36 of large effect, and at least 20 genetic loci in different genes contributing small effects, only account for at most 5% of cases suggesting that the underlying genetic cause for the majority of cases remains to be discovered.
Full descriptionThe primary aim of this project will be to identify POAG patients with defined genetic subtypes enriching for patients with a strong family history. Whole genome sequencing (WGS) and whole exome sequencing (WES) of the familial cases will identify coding and non-coding variants both in the known POAG genes, myocilin, optineurin and WD-repeat-36, and in novel genes. These variants will be further studied on neurological tissue or cells to provide functional validation of the genetic findings but specific experiments will be determined by the initial findings. In each case the better understanding of the disease mechanisms in light of the molecular diagnosis will initiate re-examination of the patients, histories compared and best treatment practise for each subgroup inferred. If successful, this approach may also support the development of new therapies for this complex condition.
The techniques used in this PhD will include PCR, Sanger sequencing, bioinformatics, analyzing WES and WGS data, functional validation of variants may include expression profiling, spicing mini- and midi-gene assays, protein structural modelling, RNA sequencing, creating knock-out cell models of putative pathogenic variants by CRISPR-Cas9 genome editing and the study of animal models where available.
In line with the bespoke nature of our International PhD Academy a modified PhD project can be proposed dependent on students interests and background.
