“The detection of apoptosis and cell stress is a promising strategy for detecting neurodegenerative disease before irreversible damage occurs and for monitoring treatment response ahead of existing endpoints. This article reviews a novel retinal biomarker—the Detection of Apoptosing Retinal Cells (DARC)—and the potential for this to function as a surrogate endpoint in glaucoma and other conditions.”(…) DARC technology allows the opportunity to not only monitor disease activity (DARC count) but also treatment efficacy (reduction of DARC count)(…)
With these validations, we then went a step further to assess whether DARC was predictive of changes in the brain. We found that, in a rotenone-induced animal model of Parkinson disease, DARC could detect the loss of dopaminergic cells in the eye 90 days before it could be detected in the brain.22 Additionally, in a triple-transgenic model of Alzheimer disease, DARC was predictive of a therapeutic effect of a novel curcumin nanoparticle formulation before the effect could be observed in the brain.”(..) This investigation further validated DARC as a biomarker of angiogenesis-related retinal diseases such as wet AMD and diabetic eye diseases.(…) We found that a DARC spot at baseline was predictive of a new area of exudation about 36 months later. Further, patients with a DARC count greater than five ultimately developed new lesions. Although larger validation studies are required, this finding shows the potential of DARC as a biomarker of wet AMD.(…)
A significantly higher DARC count was seen in the glaucomatous eyes that were progressing versus those with stable disease. The positive predictive value of DARC was 100% for predicting glaucomatous progression. All patients who had a DARC count greater than 30 had experienced glaucomatous progression by 18 months. (…) We will soon be conducting a study to explore the use of DARC as a predictor of macular atrophy and to assess wet AMD treatment. We are also working with pharmaceutical companies to explore the use of DARC in AMD and diabetic retinopathy studies as an exploratory endpoint and as a measure of treatment efficacy.”
The detection of apoptosis and cell stress is a promising strategy for detecting neurodegenerative disease before irreversible damage occurs and for monitoring treatment response ahead of existing endpoints. This article reviews a novel retinal biomarker—the Detection of Apoptosing Retinal Cells (DARC)—and the potential for this to function as a surrogate endpoint in glaucoma and other conditions. Read more on this editorial by Francesca M. Cordeiro, MD, PhD, MRCP, FRCOphth here: https://bit.ly/448VO6S
