Most of the proteins identified by our mass spectrometric analysis are secreted and have the potential to influence retinal development, homeostasis, and/or disease. PEDF is an inhibitor of retinal angiogenesis
59 60 with neuroprotective and neurotrophic properties
60 that is secreted by RPE before and after birth.
61 62 Galectin-3 binding protein is apically secreted and promotes integrin-mediated cell adhesion and binds numerous extracellular proteins, including fibronectin.
63 64 Prostaglandin D2 synthase, an enzyme postulated to function as a retinoid transporter,
65 is released into the interphotoreceptor matrix where it is taken up by photoreceptors. The roles of complement proteins C1s and C1r are less clear, although other complement proteins have been implicated in the pathogenesis of age-related macular degeneration (AMD).
66 67 Cystatin C is a secreted cysteine protease inhibitor thought to be involved in neurodegeneration, neuroprotection, and central nervous system (CNS) repair.
68 69 It is highly expressed in fetal and adult RPE and is postulated to regulate photoreceptor degradation during development and after trauma or ischemia.
68 70 71 72 Cystatin C may indirectly regulate the activity of cathepsin D, a major lysosomal protease responsible for the degradation of phagocytosed photoreceptor outer segments.
68 73 Although the proenzyme form of cathepsin D (52 kDa) is secreted by RPE,
74 its precise role after release into the extracellular environment is not known. Transthyretin is a homotetrameric serum transport protein for thyroxine and triiodothyronine that also interacts with retinol binding protein.
75 In the eye, it is known to be secreted in abundance by RPE,
75 predominantly from the apical surface,
76 77 but it is also found in AMD drusen deposits.
78 Ceruloplasmin serves as an antioxidant, converting ferrous iron to the less dangerous ferric form.
79 80 It has a secreted form that is present within the retina and vitreous,
79 80 81 and the absence of ceruloplasmin has been linked to free radical injury and degenerative diseases within the brain and retina.
79 82 Alcadeins indirectly associate with amyloid β-protein precursor (APP)
83 84 and are thought to function physiologically in concert with APP, a molecule implicated in the pathogenesis of Alzheimer disease and AMD.
85 Like APP, alcadein α-1 is a transmembrane protein whose extracellular domain is subject to cleavage and release into the extracellular space. However, the present analysis discovered only the unprocessed form of alcadein α-1 in RPE CM.