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Dryad

Plasma metabolomes of aged rhesus macaques with and without maculopathies

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May 28, 2026 version files 659.87 KB

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Abstract

Mitochondrial dysfunction is associated with aging and age-related macular degeneration (AMD), but human studies have limited access to ocular tissues, and mouse models do not recapitulate AMD features such as drusen. Nonhuman primates (NHPs) exhibit long lifespans, a true macula, and AMD-related phenotypes, including punctate dots composed of intracellular lipid droplets and soft drusen composed of extracellular deposits beneath the retinal pigment epithelium (RPE). In this study, we perform a comprehensive quantitative analysis of mitochondrial ultrastructure, complemented by functional imaging, plasma metabolomics, and genetic data implicating mitochondrial dysfunction in the RPE of aged rhesus macaques with AMD phenotypes. Retinal flavoprotein fluorescence imaging of NHP drusen showed increased heterogeneity similar to AMD patients. Quantitative morphometric profiling of RPE mitochondria revealed (1) concentric cristae and type I paracrystalline inclusions indicating early stress in normal aging, (2) hyperbranching, fusion, and megamitochondria formation indicating adaptive remodeling with punctate lesions, and (3) reduced fusion, sparse branching, and compromised ultrastructure reflecting mitochondrial degeneration in eyes with soft drusen. Plasma metabolomics showed elevated glycolytic and tricarboxylic acid cycle ratios, higher sphinganine-1-phosphate levels, and reduced thiol redox buffering that reflect metabolic strain in animals with punctate dots, and decreased methionine sulfone/methionine, 2-hydroxybutanoic acid, and increased 3-hydroxybutyrate/glucose ratios, indicating chronic mitochondrial decline in animals with drusen. Whole exome sequencing of mitochondrial genes identified a single nucleotide variant MT:9582G>A in the cytochrome-c oxidase subunit III (COX3) gene associated with NHP drusen. Our data suggest that in macaques, punctate dots may reflect an adaptive mitochondrial trajectory, while soft drusen are characterized by failed RPE remodeling and degeneration, providing insights into mitochondrial dysfunction in NHP models of AMD.