Department of Genetics, Washington University School of Medicine, St. Louis, United States
Hiroki Kakita
Department of Genetics, Washington University School of Medicine, St. Louis, United States; Department of Perinatal and Neonatal Medicine, Aichi Medical University, Aichi, Japan
Shunsuke Kubota
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, United States
Abdoulaye Sene
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, United States
Department of Developmental Biology, Washington University School of Medicine, St. Louis, United States; Needleman Center for Neurometabolism and Axonal Therapeutics, St. Louis, United States
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, United States; Department of Developmental Biology, Washington University School of Medicine, St. Louis, United States; Department of Medicine, Washington University School of Medicine, St. Louis, United States
Jeffrey Milbrandt
Department of Genetics, Washington University School of Medicine, St. Louis, United States; Needleman Center for Neurometabolism and Axonal Therapeutics, St. Louis, United States
Leber congenital amaurosis type nine is an autosomal recessive retinopathy caused by mutations of the NAD+ synthesis enzyme NMNAT1. Despite the ubiquitous expression of NMNAT1, patients do not manifest pathologies other than retinal degeneration. Here we demonstrate that widespread NMNAT1 depletion in adult mice mirrors the human pathology, with selective loss of photoreceptors highlighting the exquisite vulnerability of these cells to NMNAT1 loss. Conditional deletion demonstrates that NMNAT1 is required within the photoreceptor. Mechanistically, loss of NMNAT1 activates the NADase SARM1, the central executioner of axon degeneration, to trigger photoreceptor death and vision loss. Hence, the essential function of NMNAT1 in photoreceptors is to inhibit SARM1, highlighting an unexpected shared mechanism between axonal degeneration and photoreceptor neurodegeneration. These results define a novel SARM1-dependent photoreceptor cell death pathway and identifies SARM1 as a therapeutic candidate for retinopathies.