Rescue of mutant rhodopsin traffic by metformin-induced AMPK activation accelerates photoreceptor degeneration

Dimitra Athanasiou, Monica Aguila, Chikwado A. Opefi, Kieron South, James Bellingham, Dalila Bevilacqua, Peter M. Munro, Naheed Kanuga, Francesca E. Mackenzie, Adam M. Dubis, Anastasios Georgiadis, Anna B. Graca, Rachael A. Pearson, Robin R. Ali, Sanae Sakami, Krzysztof Palczewski, Michael Y. Sherman, Philip J. Reeves, Michael E. Cheetham

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Protein misfolding caused by inherited mutations leads to loss of protein function and potentially toxic 'gain of function', such as the dominant P23H rhodopsin mutation that causes retinitis pigmentosa (RP). Here, we tested whether the AMPK activator metformin could affect the P23H rhodopsin synthesis and folding. In cell models, metformin treatment improved P23H rhodopsin folding and traffic. In animal models of P23H RP, metformin treatment successfully enhanced P23H traffic to the rod outer segment, but this led to reduced photoreceptor function and increased photoreceptor cell death. The metformin-rescued P23H rhodopsin was still intrinsically unstable and led to increased structural instability of the rod outer segments. These data suggest that improving the traffic of misfolding rhodopsin mutants is unlikely to be a practical therapy, because of their intrinsic instability and long half-life in the outer segment, but also highlights the potential of altering translation through AMPK to improve protein function in other protein misfolding diseases.

Original languageEnglish
Pages (from-to)305-319
Number of pages15
JournalHuman Molecular Genetics
Issue number2
StatePublished - 2017
Externally publishedYes


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