Steven J. Fliesler, PhD

Steven J. Fliesler, PhD, is lead author of a study that found adding antioxidant therapy to current standard of care prevents retinal degeneration in a rare genetic disease.

Antioxidant Therapy Prevents Vision Loss in Rare Birth Defect

Published February 20, 2018

Vision researchers at the Jacobs School of Medicine and Biomedical Sciences and VA Western New York Healthcare System led a study demonstrating that adding antioxidant therapy to current standard of care prevents vision loss in an animal model of a rare genetic disease.

“Using our combination therapy approach, we were able to prevent otherwise progressive and irreversible retinal degeneration from occurring in a rodent model of this hereditary human metabolic disease ...”
UB Distinguished Professor and Meyer H. Riwchun Endowed Chair Professor of ophthalmology

Therapy Effective in Preventing Retinal Degeneration

The paper — published Jan. 19 in Scientific Reports — describes the combination therapy that resulted in preventing the retinal degeneration that occurs in an animal model of Smith-Lemli-Opitz syndrome (SLOS).

Caused by the body’s inability to make cholesterol, SLOS is a birth defect that results in multiple neurosensory and cognitive abnormalities, physical deformities and disabilities, including impaired vision. In severe cases, it can be fatal.

“Using our combination therapy approach, we were able to prevent otherwise progressive and irreversible retinal degeneration from occurring in a rodent model of this hereditary human metabolic disease that we had previously developed,” says Steven J. Fliesler, PhD, the paper’s lead author and UB Distinguished Professor and Meyer H. Riwchun Endowed Chair Professor of ophthalmology.

Blocking Oxidation of Specific Molecule Key Component

To treat the condition, dietary supplementation with cholesterol is prescribed in addition to treating the individual conditions seen in babies with SLOS, ranging from those affecting the central nervous system (including the eyes) to the heart, lungs, gastrointestinal tract and genitourinary systems, as well as the musculoskeletal system.

However, Fliesler notes that outcomes from the supplementation vary widely.

“We hypothesized — based upon findings in the literature, including seminal work from my lab — that oxidation of a specific molecule (which happens to be the immediate precursor of cholesterol) was key to the disease mechanism,” he explains.

“We reasoned that blocking such oxidation with antioxidants should prevent or significantly reduce the severity of the retinal degeneration observed in the rodent model. That evidence-based therapeutic approach worked.”

Added Preclinical Studies Needed to Refine Dosages

Fliesler cautions that more studies are needed before scientists may be able to suggest a similar type of combination therapy might also be effective with humans.

“It is advisable to conduct additional preclinical studies using appropriate animal models of the disease — such as those we used in this study — in order to refine dosages and specific antioxidant combinations,” he says. “Some emerging, highly potent antioxidants not yet approved for human use might in the future be appropriate to investigate as a potential treatment for human SLOS patients.”

Fliesler is vice-chair and director of research for the Department of Ophthalmology and director of research for the Ira G. Ross Eye Institute Vision Research Center. Additionally, he is a Research Career Scientist at the VA Western NY Healthcare System, where he directs the Ross Eye Institute Vision Research Center.

Jacobs School Graduate Students Among Co-Authors

Co-authors on the study from the Jacobs School are:

Additional co-authors are from the following institutions:

  • Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
  • Cleveland Clinic Cole Eye Institute 
  • Louis Stokes Cleveland VA Medical Center
  • University of Washington School of Pharmacy

Clinical and Translational Science Award Supports Work

The research was supported by: