Retinopathy of prematurity (ROP) is the leading cause of blindness in the U.S. and other developed countries in the pediatric population. A pivotal aspect of early ROP is the development of retinal avascularity, which leads to advanced stages of ROP and retinal NV. Visual impairment in ROP results from retina avascularity: the ischemic/hypoxic retina produces pro-angiogenic growth factors including VEGF which stimulates retinal neovascularization. Important pathophysiologic processes underlie retinal avascularity in ROP, including oxidative stress and pro-inflammatory processes. The ability to modulate oxidative stress and inflammation in ROP, thereby facilitating physiologic retinal vascularization, would therefore be of great benefit in the treatment of ROP. Indeed, promotion of revascularization is highly desirable in a variety of retinal diseases, particularly the ischemi retinopathies. The transcription factor Nrf2 has an important cytoprotective role against oxidative stress and inflammation in multiple disease processes. Nrf2 is quite amenable to pharmacologic modulation, so its protective effects can be augmented. Our lab has been studying the role of Nrf2 in the retina. We have found that Nrf2 plays a vital protective role in the retinal response t ischemia-reperfusion injury, and have similar evidence in the context of oxygen-induced retinopathy. We hypothesize that Nrf2 is an important mechanism promoting retinal vascularization of ischemic retina, regulating oxidative stress and pro- inflammatory changes in the retina via modulation of NADPH oxidase. We propose the following 3 aims:
Specific Aim 1. Investigate the role of Nrf2 in retinal revascularization and pathologic retinal neovascularization Specific Aim 2. Investigate the hypothesis that Nrf2 regulates oxidative stress and pro- inflammatory processes in OIR via modulation of NADPH oxidase.
Specific Aim 3. Determine if pharmacologic activation of Nrf2 protects against pathophysiologic and functional changes in oxygen-induced retinopathy. We expect that these aims will allow us to identify Nrf2 as an important protective mechanism in oxygen-induced retinopathy, thereby providing a new therapeutic strategy for ROP.

Public Health Relevance

Retinopathy of prematurity (ROP) is the leading cause of blindness in the U.S. and other developed countries in the pediatric population. This research will allow us to investigate the beneficial role of the protective molecule Nrf2 using a mouse model for this condition. This could allow us to develop a new therapy for retinopathy of prematurity, aimed at enhancing the beneficial effects of Nrf2.

National Institute of Health (NIH)
National Eye Institute (NEI)
Research Project (R01)
Project #
Application #
Study Section
Program Officer
Shen, Grace L
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Johns Hopkins University
Schools of Medicine
United States
Zip Code
Chen, Wan-Ju; Wu, Caiying; Xu, Zhenhua et al. (2017) Nrf2 protects photoreceptor cells from photo-oxidative stress induced by blue light. Exp Eye Res 154:151-158
Duh, Elia J; Sun, Jennifer K; Stitt, Alan W (2017) Diabetic retinopathy: current understanding, mechanisms, and treatment strategies. JCI Insight 2:
Wei, Yanhong; Gong, Junsong; Xu, Zhenhua et al. (2016) Nrf2 promotes reparative angiogenesis through regulation of NADPH oxidase-2 in oxygen-induced retinopathy. Free Radic Biol Med 99:234-243
Shen, Yu-I; Cho, Hongkwan; Papa, Arianne E et al. (2016) Engineered human vascularized constructs accelerate diabetic wound healing. Biomaterials 102:107-19
Hartsock, Matthew J; Cho, Hongkwan; Wu, Lijuan et al. (2016) A Mouse Model of Retinal Ischemia-Reperfusion Injury Through Elevation of Intraocular Pressure. J Vis Exp :
Wei, Yanhong; Gong, Junsong; Xu, Zhenhua et al. (2015) Nrf2 in ischemic neurons promotes retinal vascular regeneration through regulation of semaphorin 6A. Proc Natl Acad Sci U S A 112:E6927-36
Cho, Hongkwan; Hartsock, Matthew J; Xu, Zhenhua et al. (2015) Monomethyl fumarate promotes Nrf2-dependent neuroprotection in retinal ischemia-reperfusion. J Neuroinflammation 12:239
Xu, Zhenhua; Yoshida, Takeshi; Wu, Lijuan et al. (2015) Transcription factor MEF2C suppresses endothelial cell inflammation via regulation of NF-?B and KLF2. J Cell Physiol 230:1310-20
Xu, Zhenhua; Cho, Hongkwan; Hartsock, Matthew J et al. (2015) Neuroprotective role of Nrf2 for retinal ganglion cells in ischemia-reperfusion. J Neurochem 133:233-41
Xu, Zhenhua; Wei, Yanhong; Gong, Junsong et al. (2014) NRF2 plays a protective role in diabetic retinopathy in mice. Diabetologia 57:204-13

Showing the most recent 10 out of 11 publications