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terça-feira, 12 de abril de 2011

Reciis Vol. 5, Nº 1 - Revista Eletrônica de Ciências e Inovação em Saúde


Vol. 5, No 1

Editorial - DOI:10.3395/reciis.v5i1.454pt
Maria Cristina Soares Guimarães, Josué Laguardia
Carlos Alberto Alves, Maria Tereza Serrano Barbosa, Asterio Kiyoshi Tanaka, Regina Maria Papais Alvarenga

Patricia Henning, Paula Xavier dos Santos, Érica de Castro Loureiro, Marcus Vinícius Pereira da Silva

Nilton Bahlis dos Santos, José Alberto de Francisco Rodríguez

Karla Travi, Karina Gulbis Zimmermann, Maria Teresa Soratto, Neiva Junkes Hoepers, Luciana Rosa, Maria Salete Salvaro, Maria Tereza Zanini, Luciane Bisognin Ceretta, Mágada Tessmann Schwalm

Luana Rosado Emil, Fernando Seffner, Carlos Alberto Steil

Julio Cezar Reis Danielski, Daniela Martí Barros, Fernanda Antoniolo Hammes de Carvalho

Jorge Lima de Magalhães, Adelaide Maria de Souza Antunes, Núbia Boechat
Márcia de Oliveira Teixeira, Ana Tereza Filipecki
Paulo Augusto Loncarovich Gomes, Karina da Paz Loncarovich
Antes que os Vaga-Lumes Desapareçam ou Influência da Iluminação Artificial sobre o Ambiente; Alessandro Barghini - DOI:10.3395/reciis.v5i1.442pt
Valdenize Tiziani
Filmografia de Humberto Mauro em ciência inovação e saúde; Humberto Mauro- DOI:10.3395/reciis.v5i1.451pt
Alice Ferry de Moraes

Sem Noção: zoação tem limite?; Labcities- DOI:10.3395/reciis.v5i1.453pt
Rosinalva Alves de Souza

2º Ciclo de Debates do Sistema Gestec - NIT -

Jardins suspensos da biologia cultivam células em 3D

Jardins suspensos da biologia cultivam células em 3D
Esta imagem mostra a célula na estrutura 3-D. O citoesqueleto da célula aparece em verde, a estrutura do jardim suspenso aparece em cinza e os suportes celulares aparecem em vermelho.
Células em 3D
Pesquisadores do Instituto de Tecnologia de Karlsruhe, na Alemanha, usaram a nanotecnologia para construir estruturas tridimensionais para cultivar células.
Tradicionalmente, as células são cultivadas em laboratórios sobre lâminas ou discos de Petri. As superfícies planas as forçam a crescer em duas dimensões, enquanto, nos órgãos reais, dentro do organismo, elas se organizam em 3-D.
O mais fascinante nesse desenvolvimento é que essas estruturas nanotecnológicas possuem suportes onde as células podem aderir e se interligar umas com as outras.
A adesão só é possível nesses pontos especialmente projetados para isso, e não com o resto da estrutura, o que transforma o aparato em uma espécie de jardim suspenso da era da nanotecnologia.
Controle do crescimento celular
O crescimento em 3-D simula o ambiente real das células, o que permite que elas funcionem de forma mais parecida com seu padrão normal, gerando experimentos mais realísticos.
Várias abordagens têm sido utilizadas para a cultura de células em ambientes tridimensionais, geralmente produzidas a partir de agarose, fibras de colágeno ou matrigel.
Mas todas essas abordagens têm uma deficiência em comum: elas são em sua maioria heterogêneas, com tamanhos aleatórios de poros.
A equipe do Dr. Martin Bastmeyer resolveu o problema criando os suportes, colocados com precisão na estrutura, eliminando o aspecto aleatório do desenvolvimento das células.
Desta forma, parâmetros tais como a forma da célula, o volume celular, desenvolvimento de força intercelular ou a diferenciação celular, podem ser determinados de forma sistemática em função da geometria externa da estrutura.
Adesão de proteínas
A nova estrutura é importante para a futura produção em larga escala de ambientes de crescimento tridimensional para culturas de tecidos necessários na medicina regenerativa, por exemplo.
O jardim suspenso da biologia é feito com um polímero flexível e que repele proteínas. No polímero, são construídos os suportes em formato de caixa, feitos com um material ao qual as proteínas aderem.

Composto de soja aumenta eficácia da radioterapia

Radioterapia com soja
Um componente presente na soja aumenta os efeitos da radiação para matar células do câncer de pulmão.
O composto natural pode assim, ser um complemento ao tratamento capaz de reforçar os efeitos da radioterapia, além de proteger os pacientes de seus efeitos colaterais.
A pesquisa, realizada por cientistas Universidade do Estado de Wayne, nos Estados Unidos, foi publicada na última edição do Journal of Thoracic Oncology.
Isoflavonas
"Para melhorar a radioterapia para o câncer de pulmão, estamos estudando o potencial de componentes naturais e não-tóxicos da soja, as isoflavonas, para ampliar o efeito da radiação contra as células do tumor e ao mesmo tempo proteger as células normais do pulmão contra danos causados pela radiação," explica Gilda Hillman, que liderou a equipe de pesquisadores.
"Essas isoflavonas naturais da soja podem aumentar a sensibilidade das células cancerosas aos efeitos da radioterapia, inibindo os mecanismos de sobrevivência que as células cancerosas ativam para se proteger.
"Ao mesmo tempo, as isoflavonas da soja também podem atuar como antioxidantes, que protegem os tecidos normais contra danos não intencionais da radioterapia," disse Hillman.
Reparo do DNA
Hillman e sua equipe demonstraram que as isoflavonas de soja aumentam a morte das células cancerosas por radiação bloqueando os mecanismos de reparo do DNA, que são ativados pelas células cancerosas para sobreviver aos danos causados pela radiação.
As células do câncer de pulmão humano, chamadas A549, que foram tratadas com isoflavonas de soja antes da radiação, apresentaram mais danos ao DNA e menor atividade de reparação do que as células que receberam somente a radioterapia.
Isoflavonas da soja
Os pesquisadores utilizaram uma formulação com as três principais isoflavonas encontradas na soja - genisteínadaidzeína e gliciteína.
Pesquisas anteriores já haviam demonstrado que a genisteína pura tem atividade antitumoral em linhagens de células do câncer de pulmão, além de otimizar os efeitos do receptor do fator de crescimento epidérmico - os inibidores da tirosina quinase.
O estudo de Hillman mostrou que a mistura de soja teve um efeito antitumoral ainda maior do que a genisteína pura.
A mistura de soja também é consistente com os comprimidos de isoflavonas de soja utilizados em estudos clínicos, que já se provaram seguros para uso humano.

Antibiotic Resistance Spreads Rapidly Between Bacteria

ScienceDaily (Apr. 11, 2011) — The part of bacterial DNA that often carries antibiotic resistance is a master at moving between different types of bacteria and adapting to widely differing bacterial species, shows a study made by a research team at the University of Gothenburg in cooperation with Chalmers University of Technology.


Antibiotic resistance-carrying plasmids from different bacteria can meet and exchange genetic material. The result is plasmids consisting of genes that have each been adapted to different bacterial species. This facilitates further adaptation and mobility, and consequently also the spread of antibiotic resistance between different bacterial species.

The results are published in an article in the scientific journal Nature Communications.

More and more bacteria are becoming resistant to our common antibiotics, and to make matters worse, more and more are becoming resistant to all known antibiotics. The problem is known as multi-resistance, and is generally described as one of the most significant future threats to public health Antibiotic resistance can arise in bacteria in our environment and in our bodies. Antibiotic resistance can then be transferred to the bacteria that cause human diseases, even if the bacteria are not related to each other.

A large proportion of gene transfer between bacteria takes place with the aid of what are known as conjugative plasmids, a part of the bacterial DNA. A plasmid can only exist and multiply inside a cell, where it uses the cell's machinery, but can then be transferred to another cell and in that way spread between bacteria.

The research team has studied a group of the known carriers of antibiotic resistance genes: IncP-1 plasmids. Using advanced DNA analysis, the researchers have succeeded in mapping the origin of different IncP-1 plasmids and their mobility between different bacterial species. "Our results show that plasmids from the IncP-1 group have existed in, and adapted to, widely differing bacteria. They have also recombined, which means that a single plasmid can be regarded as a composite jigsaw puzzle of genes, each of which has adapted to different bacterial species," says Peter Norberg, a researcher in the Institute of Biomedicine at the University of Gothenburg. This indicates very good adaptability and suggests that these plasmids can move relatively freely between, and thrive in, widely differing bacterial species.

"IncP-1 plasmids are very potent 'vehicles' for transporting antibiotic resistance genes between bacterial species. Therefore, it does not matter much in what environment, in what part of the world, or in what bacterial species antibiotic resistance arises. Resistance genes could relatively easily be transported from the original environment to bacteria that infect humans, through IncP-1 plasmids, or other plasmids with similar properties, as 'vehicles'," says Professor Malte Hermansson of the Department of Cell and Molecular Biology at the University of Gothenburg.

It has been known for some time that plasmids are important in the spread of antibiotic resistance. The research team's findings show that IncP-1 plasmids can move, and have moved, between widely differing bacterial species and in addition have interacted directly with one another, which can increase the potential for gene spreading.

Scientists Develop 'Universal' Virus-Free Method to Turn Blood Cells Into 'Beating' Heart Cells

ScienceDaily (Apr. 11, 2011) — Johns Hopkins scientists have developed a simplified, cheaper, all-purpose method they say can be used by scientists around the globe to more safely turn blood cells into heart cells. The method is virus-free and produces heart cells that beat with nearly 100 percent efficiency, they claim.
"Beating" cardiomyocyte.
"We took the recipe for this process from a complex minestrone to a simple miso soup," says Elias Zambidis, M.D., Ph.D., assistant professor of oncology and pediatrics at the Johns Hopkins Institute for Cell Engineering and the Kimmel Cancer Center.

Zambidis says, "many scientists previously thought that a nonviral method of inducing blood cells to turn into highly functioning cardiac cells was not within reach, but "we've found a way to do it very efficiently and we want other scientists to test the method in their own labs." However, he cautions that the cells are not yet ready for human testing.

To get stem cells taken from one source (such as blood) and develop them into a cell of another type (such as heart), scientists generally use viruses to deliver a package of genes into cells to, first, get them to turn into stem cells. However, viruses can mutate genes and initiate cancers in newly transformed cells. To insert the genes without using a virus, Zambidis' team turned to plasmids, rings of DNA that replicate briefly inside cells and eventually degrade.

Adding to the complexity of coaxing stem cells into other cell types is the expensive and varied recipe of growth factors, nutrients and conditions that bathe stem cells during their transformation. The recipe of this "broth" differs from lab to lab and cell line to cell line.

Reporting in the April 8 issue of Public Library of Science ONE (PLoS ONE), Zambidis' team described what he called a "painstaking, two-year process" to simplify the recipe and environmental conditions that house cells undergoing transformation into heart cells. They found that their recipe worked consistently for at least 11 different stem cell lines tested and worked equally well for the more controversial embryonic stem cells, as well as stem cell lines generated from adult blood stem cells, their main focus.

The process began with Johns Hopkins postdoctoral scientist Paul Burridge, Ph.D., who studied some 30 papers on techniques to create cardiac cells. He drew charts of 48 different variables used to create heart cells, including buffers, enzymes, growth factors, timing, and the size of compartments in cell culture plates. After testing hundreds of combinations of these variables, Burridge narrowed the choices down to between four to nine essential ingredients at each of three stages of cardiac development.

Beyond simplification, an added benefit is reduced cost. Burridge used a cheaper growth media that is one-tenth the price of standard media for these cells at $250 per bottle lasting about one week.

Zambidis says that he wants other scientists to test the method on their stem cell lines, but also notes that the growth "soup" is still a work in progress. "We have recently optimized the conditions for complete removal of the fetal bovine serum from one brief step of the procedure -- it's made from an animal product and could introduce unwanted viruses," he says.

In their experiments with the new growth medium, the Hopkins team began with cord blood stem cells and a plasmid to transfer seven genes into the stem cells. They delivered an electric pulse to the cells, making tiny holes in the surface through which plasmids can slip inside. Once inside, the plasmids trigger the cells to revert to a more primitive cell state that can be coaxed into various cell types. At this stage, the cells are called induced pluripotent stem cells (iPSC).

Burridge then bathed the newly formed iPSCs in the now simplified recipe of growth media, which they named "universal cardiac differentiation system." The growth media recipe is specific to creating cardiac cells from any iPSC line.

Finally, they incubated the cells in containers that removed oxygen down to a quarter of ordinary atmospheric levels. "The idea is to recreate conditions experienced by an embryo when these primitive cells are developing into different cell types," says Burridge. They also added a chemical called PVA, which works like glue to make cells stick together.

Nine days later, the nonviral iPSCs turned into functional, beating cardiac cells, each the size of a needlepoint.

Burridge manually counted how often iPSCs formed into cardiac cells in petri dishes by peering into a microscope and identifying each beating cluster of cells. In each of 11 cell lines tested, each plate of cells had an average of 94.5 percent beating heart cells. "Most scientists get 10 percent efficiency for IPSC lines if they're lucky," says Zambidis.

Zambidis and Burridge also worked with Johns Hopkins University bioengineering experts to apply a miniversion of an electrocardiograph to the cells, which tests how cardiac cells use calcium and transmit a voltage. The resulting rhythm showed characteristic pulses seen in a normal human heart.

Virus-free, iPSC-derived cardiac cells could be used in laboratories to test drugs that treat arrhythmia and other conditions. Eventually, bioengineers could develop grafts of the cells that are implanted into patients who suffered heart attacks.

Zambidis' team has recently developed similar techniques for turning these blood-derived iPSC lines into retinal, neural and vascular cells.

The research was funded by the Maryland Stem Cell Research Fund and the National Institutes of Health.

Research participants include Susan Thompson, Michal Millrod, Seth Weinberg, Xuan Yuan, Ann Peters, Vasiliki Mahairaki, Vassilis E. Koliatsos, and Leslie Tung at Johns.

What Sea Squirts Can Teach Us About the Heart

ScienceDaily (Apr. 11, 2011) — Each year in the U.S., approximately 40,000 babies are born with a heart defect. Without the proper diagnosis and treatment, many of these babies would die before their first birthday, according to Dr. Scott Klewer, a cardiologist at the UA's College of Medicine.
Ciona allows scientists to study in detail how cells interact to build complex organs. In this microscopic image, two of the cells that will form the heart were stained with a green fluorescent marker and can be seen in the lower portion of the tadpole-like Ciona embryo.
"We still don't know much about the causes of many of these defects. Some have been linked to certain genes but the picture is still sketchy," he says. "At this point, we can't predict how children will respond to current methods, but if we had genetic indicators we could use them to personalize treatments."

Dr. Ricardo Samson, who heads the pediatric cardiology section at the College of Medicine, adds that "some heart defects can be difficult to diagnose because they don't present the typical signs such as a heart murmur or blueness of the skin."

"Fortunately, prenatal ultrasound allows obstetricians to identify many babies with specific forms of severe heart defects before they are born," he says. "But because of the way the heart develops in a fetus, some severe defects go undetected and don't cause problems until the baby has gone home from the nursery."

Samson and Klewer both are members of the UA's Steele Children's Research Center and the UA's Sarver Heart Center's heart development research group, which is internationally recognized for its discoveries expanding the understanding of molecular elements that cause congenital heart defects.

In studying heart-specifying genes, less is more

Studying the genetic underpinnings of heart defects is complicated by the fact that humans, like all other vertebrates, have multiple and slightly different copies of each gene. This redundancy makes it difficult if not impossible to tease apart the functions associated with a particular gene, because disrupting its function in model organisms such as mice to figure out its role does not always result in an obvious effect.

In their quest to better understand and help clinicians develop better diagnostics and treatments for congenital heart defects, scientists at the UA's department of molecular and cell biology have turned to a creature most people -- with the possible exception of scuba divers -- would not consider a familiar sight: a sea squirt in the genus Ciona.

Lacking a head, appendages and eyes, sea squirts resemble strange-looking, leathery sacks more than animals. Up to 6 inches long, with two conspicuous openings, Ciona spends its life attached to submerged rocks or piers, pumping sea water through its body and straining out food particles, much like clams do. Its simple body structure, however, belies the sea squirts' biological kinship, which places them closer to the vertebrate lineage than any other invertebrate. Most importantly, Ciona's genetic blueprint is almost the same as that of vertebrates.

"We want to understand the basic processes by which embryonic cells make the decision to become heart cells," says Brad Davidson, an assistant professor in the UA's department of molecular and cellular biology and a member of the Sarver Heart Center. "Early steps of heart formation are very similar in Ciona, mice and humans."

Except -- and for a scientist studying heart development, this is huge -- each of Ciona's genes is represented only once because the genome has not been duplicated as in vertebrates. Therefore, Ciona has only one copy of the major genes involved in heart development.

One of the genes vital for heart development is GATA, a so-called transcription factor or master gene that controls other heart-specific genes and plays a key role in heart development. Human babies with GATA mutations have congenital heart defects. If the gene's function is disrupted, both the heart and the gut are deformed.

"But it's not clear where the problem is," Davidson says. "Is it because the heart doesn't form properly or because the gut doesn't form properly? Ciona allows us to break it apart."

IMAGE: This is Katerina Ragkousi, the first author of the research report, with principal investigator Brad Davidson.

Click here for more information.

A heart needs a gut

"We tend to think of cells building an organ as an isolated process but that is never true in an embryo," he says. "Anything that is being built has to be made alongside all the other organs, and there are a lot of complications in terms of the instructions."

Katerina Ragkousi, a postdoctoral fellow in Davidson's lab, just published the results of a study shedding light on this process in the journal Developmental Biology. The editors deemed her work important enough to feature it on the cover of the magazine.

"We know that in vertebrates, GATA has to be activated not only in the future heart cells, but in the neighboring gut cells, too," Ragkousi says. "In this study, we show that this is the same in Ciona, justifying even more the value of this model organism in studying heart development."

"Vertebrates have three GATA factors that are both in the developing gut and in the heart, so it has been really difficult to tease apart what's going on with these factors in each tissue."

When Ragkousi and her team experimentally disrupted GATA in heart precursor cells, the cells lost their identity.

"They don't express the right genes and stay in a state of limbo instead of moving on with their development," Davidson said.

"When we disturb GATA function independently in the developing gut, we see that heart cell identity is not perturbed, at least not at this stage," Ragkousi says. "However, we find that GATA in the gut plays an indirect role in heart formation in that it is necessary for heart precursors to be properly positioned in the developing embryo."

In addition to its genetic similarity to vertebrates, Ciona comes with several other benefits. It is easy to keep in the lab, and, unlike vertebrate embryos, a Ciona embryo consists of a mere few hundred cells. The embryos develop in only 24 hours and are translucent, allowing scientists to literally watch as the heart forms from only four cells.

"It is this simplicity that we are hoping to be able to exploit," Davidson says. "That we can not only see vaguely and in general how the cells build a heart, but very specifically how each cell is acting as they come together to make the heart."

In their natural habitat, Ciona embryos drift along with the ocean currents until they hatch as tiny, tadpole-like larvae.

"They need to develop rapidly because until they hatch, they're floating around as food," Davidson says. "Sometimes it can take days for them to settle. They can stay alive for five or six days. In the right kind of current, they can go pretty far."

Once the larvae come to rest on the seafloor, a rock or a pier, they undergo one of the most dramatic metamorphoses found in the natural world. Giving their body a total makeover, they morph from a free-swimming larva with a brain, primitive eyes and a tail into the sponge-like sack that spends remainder of its life attached to the very place it settled down.

"With Ciona, we can introduce genes into the early embryo and as it develops, we can study where the genes are expressed," Ragkousi says. "We also can locate the cells relative to each other. We are looking at the cellular interactions that happen during the early stages heart formation. It has been almost impossible to address this at such a high resolution and study the behavior of individual cells in more complex organisms."

Bench-to-bedside medicine, or from the water tank to the hospital

"Basic research with model organisms like Ciona allows us to identify the genes involved in heart development and recognize who the players are," says Klewer. "We can then look at these factors in patients to determine the best approach for treatment that would benefit that particular patient. It also gives us an opportunity to refine our approaches based on the genetic background. I am hopeful that we can soon integrate that knowledge in our clinical practice."

Researchers studying heart development put high hopes in Ciona not only to improve diagnostic tests through a better understanding of the genetic mechanisms underlying heart development, but also to develop better therapeutics for failing hearts.

"Many people are going to have a heart attack at some point in their lives," says Davidson. "And since the heart can't regenerate damaged tissue, what do you do to manage that? There is a big push to see if we can reprogram cells to build heart tissue. Progress is being made, but there are a lot of stumbling blocks to figuring out how to do that right. One of the keys is to make sure the cells that doctors put into a damaged heart behave like heart cells and not like cancer cells and don't do the wrong things."

Klewer adds: "In the future, clinicians will have more options for successfully performing surgery on a fetus. But they can't do that unless they know there is a problem. This approach holds the promise of correcting a heart problem early, and allow for more normal heart growth and function during development, which might save an affected child from a lot of complicated procedures that otherwise would be needed after birth."

Vision Loss in Eye Disease Slowed Using Novel Encapsulated Cell Therapy

ScienceDaily (Apr. 11, 2011) — A phase 2 clinical trial for the treatment of a severe form of age-related macular degeneration called geographic atrophy (GA) has become the first study to show the benefit of a therapy to slow the progression of vision loss for this disease. The results highlight the benefit of the use of a neurotrophic factor to treat GA and provide hope to nearly one million Americans suffering from GA.
Image showing geographic atrophy (GA).
The multi-center research team, including Kang Zhang, MD, PhD, of the University of California, San Diego, Shiley Eye Center, the lead author of the paper and one of the leading investigators in the study, found that long-term delivery of ciliary neurotrophic factor (CNTF) served to re-nourish the retina and stop or slow the loss of visual acuity caused by the disorder. The results were recently published online in theProceedings of National Academy of Sciences (PNAS).

According to Zhang -- professor of ophthalmology and human genetics at the UCSD School of Medicine and director of UCSD's Institute of Genomic Medicine -- there is currently no effective treatment for dry AMD or GA, though there is a very big need. "This could open the door to long-term treatment of dry AMD, using a simple surgical procedure."

Age-related macular degeneration, or AMD, is a leading cause of vision loss in Americans age 60 and older. It is a disease that causes cells in the macula -- the part of the eye that allows us to see in fine detail -- to die. There are two forms of the disorder, wet and dry AMD. GA is considered the end stage of dry AMD, where central vision is lost.

According to the National Eye Institute, wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye, resulting in rapid loss of central version. There is currently a very effective therapy for wet AMD. Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye.

In the trial, high-dose CNTF was delivered to 27 GA patients using encapsulated cell therapy (ECT). Another 24 patients received either a sham surgery (12) or a low-dose of CNTF (12). CNTF affects survival and differentiation of cells in the nervous system, including retinal cells. CNTF has been shown to retard the loss of photoreceptor cells in many animal models of retinal degeneration.

The ECT utilized a capsule that contains genetically engineered cells to continuously produce CNTF over a 12-month period. The CNTF-secreting capsule was implanted in the back of the study subject's eye. The implant allows the CNTF molecules to diffuse into the eye tissue, while keeping out antibodies and immune cells that would attack and destroy the CNTF-producing cells.

There was a statistically significant difference in the change of the total macular volume in the eyes of study participants at the 12-month point, versus baseline in the high-dose group, according to Zhang. "In addition, all but one of the patients in the high dose group, or 96.3 percent, maintained stabilized vision, compared to only 75% of the patients in the sham-treatment group."

The patients treated with a high dose of CNTF also showed an increase in retinal thickness as early as four months after implant, an increase that correlated to the stabilization of vision.

Additional contributors to the study included Jill J. Hopkins, Retina-Vitreous Associates Medical Group, Los Angeles; Jeffrey S. Heier, Ophthalmic Consultants of Boston; David G. Birch, Retina Foundation of the Southwest, Dallas; Lawrence S. Halperin, Retina Group of Florida, Ft. Lauderdale; Thomas A. Albini, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine; David M. Brown, Retina Consultants of Houston, Houston; Glenn J. Jaffe, Duke University Eye Center; Weng Tao, Neurotech USA, Lincoln, RI; and George A. Williams, Beaumont Eye Institute, Royale Oak, MI.

Zhang's research is supported by the National Eye Institute, National Institutes of Health; the Macula Vision Research Foundation; Burroughs Wellcome Fund; Research to Prevent Blindness, Lew Wasserman Merit Award and Senior Investigator Award; and the Chinese National 985 Project to Sichuan University and West China Hospital.