Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma

A glaucoma polygenic risk score (PRS) can effectively identify disease risk, but some individuals with high PRS do not develop glaucoma. Factors contributing to this resilience remain unclear. Using 4,658 glaucoma cases and 113,040 controls in a cross-sectional study of the UK Biobank, we investigat...

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Main Authors: Keva Li, Nicholas Tolman, Ayellet V Segrè, Kelsey V Stuart, Oana A Zeleznik, Neeru A Vallabh, Kuang Hu, Nazlee Zebardast, Akiko Hanyuda, Yoshihiko Raita, Christa Montgomery, Chi Zhang, Pirro G Hysi, Ron Do, Anthony P Khawaja, Janey L Wiggs, Jae H Kang, Simon WM John, Louis R Pasquale, UK Biobank Eye and Vision Consortium
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Language:English
Published: eLife Sciences Publications Ltd 2025-04-01
Series:eLife
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Online Access:https://elifesciences.org/articles/105576
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author Keva Li
Nicholas Tolman
Ayellet V Segrè
Kelsey V Stuart
Oana A Zeleznik
Neeru A Vallabh
Kuang Hu
Nazlee Zebardast
Akiko Hanyuda
Yoshihiko Raita
Christa Montgomery
Chi Zhang
Pirro G Hysi
Ron Do
Anthony P Khawaja
Janey L Wiggs
Jae H Kang
Simon WM John
Louis R Pasquale
UK Biobank Eye and Vision Consortium
author_facet Keva Li
Nicholas Tolman
Ayellet V Segrè
Kelsey V Stuart
Oana A Zeleznik
Neeru A Vallabh
Kuang Hu
Nazlee Zebardast
Akiko Hanyuda
Yoshihiko Raita
Christa Montgomery
Chi Zhang
Pirro G Hysi
Ron Do
Anthony P Khawaja
Janey L Wiggs
Jae H Kang
Simon WM John
Louis R Pasquale
UK Biobank Eye and Vision Consortium
author_sort Keva Li
collection DOAJ
description A glaucoma polygenic risk score (PRS) can effectively identify disease risk, but some individuals with high PRS do not develop glaucoma. Factors contributing to this resilience remain unclear. Using 4,658 glaucoma cases and 113,040 controls in a cross-sectional study of the UK Biobank, we investigated whether plasma metabolites enhanced glaucoma prediction and if a metabolomic signature of resilience in high-genetic-risk individuals existed. Logistic regression models incorporating 168 NMR-based metabolites into PRS-based glaucoma assessments were developed, with multiple comparison corrections applied. While metabolites weakly predicted glaucoma (Area Under the Curve = 0.579), they offered marginal prediction improvement in PRS-only-based models (p=0.004). We identified a metabolomic signature associated with resilience in the top glaucoma PRS decile, with elevated glycolysis-related metabolites—lactate (p=8.8E-12), pyruvate (p=1.9E-10), and citrate (p=0.02)—linked to reduced glaucoma prevalence. These metabolites combined significantly modified the PRS-glaucoma relationship (Pinteraction = 0.011). Higher total resilience metabolite levels within the highest PRS quartile corresponded to lower glaucoma prevalence (Odds Ratiohighest vs. lowest total resilience metabolite quartile=0.71, 95% Confidence Interval = 0.64–0.80). As pyruvate is a foundational metabolite linking glycolysis to tricarboxylic acid cycle metabolism and ATP generation, we pursued experimental validation for this putative resilience biomarker in a human-relevant Mus musculus glaucoma model. Dietary pyruvate mitigated elevated intraocular pressure (p=0.002) and optic nerve damage (p<0.0003) in Lmx1bV265D mice. These findings highlight the protective role of pyruvate-related metabolism against glaucoma and suggest potential avenues for therapeutic intervention.
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spelling doaj-art-c51fc0e6bc6e4d12b5a301a9a373eac12025-08-20T02:18:35ZengeLife Sciences Publications LtdeLife2050-084X2025-04-011410.7554/eLife.105576Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucomaKeva Li0https://orcid.org/0000-0001-5922-4955Nicholas Tolman1Ayellet V Segrè2Kelsey V Stuart3Oana A Zeleznik4Neeru A Vallabh5Kuang Hu6Nazlee Zebardast7Akiko Hanyuda8Yoshihiko Raita9Christa Montgomery10https://orcid.org/0009-0004-2430-2772Chi Zhang11Pirro G Hysi12Ron Do13https://orcid.org/0000-0002-3144-3627Anthony P Khawaja14Janey L Wiggs15Jae H Kang16https://orcid.org/0000-0003-4812-0557Simon WM John17Louis R Pasquale18https://orcid.org/0000-0002-5835-3496UK Biobank Eye and Vision ConsortiumDepartment of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, United StatesDepartment of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, United StatesDepartment of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States; Broad Institute of MIT and Harvard, Cambridge, United StatesNIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, and University College London Institute of Ophthalmology, London, United KingdomChanning Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, United StatesDepartment of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom; St. Paul’s Eye Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, United KingdomNIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, and University College London Institute of Ophthalmology, London, United KingdomDepartment of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United StatesDepartment of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, JapanOkinawa Kenritsu, Chubu Byoin, Uruma, Okinawa, JapanDepartment of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, United StatesDepartment of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, United StatesDepartment of Ophthalmology, St Thomas' Hospital, King's College London, London, United Kingdom; Department of Twin Research & Genetic Epidemiology, St Thomas' Hospital, King's College London, London, United KingdomDepartment of Genetics and Genomics Science, Icahn School of Medicine at Mount Sinai, New York, United StatesNIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, and University College London Institute of Ophthalmology, London, United KingdomDepartment of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, United States; Broad Institute of MIT and Harvard, Cambridge, United StatesChanning Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, United StatesDepartment of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, United States; Zuckerman Mind Brain Behavior Institute, Columbia University, New York, United StatesDepartment of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, United StatesA glaucoma polygenic risk score (PRS) can effectively identify disease risk, but some individuals with high PRS do not develop glaucoma. Factors contributing to this resilience remain unclear. Using 4,658 glaucoma cases and 113,040 controls in a cross-sectional study of the UK Biobank, we investigated whether plasma metabolites enhanced glaucoma prediction and if a metabolomic signature of resilience in high-genetic-risk individuals existed. Logistic regression models incorporating 168 NMR-based metabolites into PRS-based glaucoma assessments were developed, with multiple comparison corrections applied. While metabolites weakly predicted glaucoma (Area Under the Curve = 0.579), they offered marginal prediction improvement in PRS-only-based models (p=0.004). We identified a metabolomic signature associated with resilience in the top glaucoma PRS decile, with elevated glycolysis-related metabolites—lactate (p=8.8E-12), pyruvate (p=1.9E-10), and citrate (p=0.02)—linked to reduced glaucoma prevalence. These metabolites combined significantly modified the PRS-glaucoma relationship (Pinteraction = 0.011). Higher total resilience metabolite levels within the highest PRS quartile corresponded to lower glaucoma prevalence (Odds Ratiohighest vs. lowest total resilience metabolite quartile=0.71, 95% Confidence Interval = 0.64–0.80). As pyruvate is a foundational metabolite linking glycolysis to tricarboxylic acid cycle metabolism and ATP generation, we pursued experimental validation for this putative resilience biomarker in a human-relevant Mus musculus glaucoma model. Dietary pyruvate mitigated elevated intraocular pressure (p=0.002) and optic nerve damage (p<0.0003) in Lmx1bV265D mice. These findings highlight the protective role of pyruvate-related metabolism against glaucoma and suggest potential avenues for therapeutic intervention.https://elifesciences.org/articles/105576metabolomicsgeneticsglaucomapyruvateglaucoma resiliencetricarboxylic acid cycle
spellingShingle Keva Li
Nicholas Tolman
Ayellet V Segrè
Kelsey V Stuart
Oana A Zeleznik
Neeru A Vallabh
Kuang Hu
Nazlee Zebardast
Akiko Hanyuda
Yoshihiko Raita
Christa Montgomery
Chi Zhang
Pirro G Hysi
Ron Do
Anthony P Khawaja
Janey L Wiggs
Jae H Kang
Simon WM John
Louis R Pasquale
UK Biobank Eye and Vision Consortium
Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma
eLife
metabolomics
genetics
glaucoma
pyruvate
glaucoma resilience
tricarboxylic acid cycle
title Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma
title_full Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma
title_fullStr Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma
title_full_unstemmed Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma
title_short Pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma
title_sort pyruvate and related energetic metabolites modulate resilience against high genetic risk for glaucoma
topic metabolomics
genetics
glaucoma
pyruvate
glaucoma resilience
tricarboxylic acid cycle
url https://elifesciences.org/articles/105576
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