Characterizing the effect of supplements on the phenotype of cultured macrophages from patients with age-related macular degeneration

Mol Vis. 2017 Dec 6:23:889-899. eCollection 2017.


Purpose: Oral vitamin and mineral supplements reduce the risk of visual loss in age-related macular degeneration (AMD). However, the pathways that mediate this beneficial effect are poorly understood. Macrophages may exert oxidative, inflammatory, and angiogenic effects in the context of AMD. We aim to assess if oral supplements can modulate the macrophage phenotype in this disease.

Methods: Monocytes were isolated from patients with neovascular AMD (nvAMD), cultured, matured to macrophages, and polarized to classical [M1 (stimulated by IFNγ and lipopolysaccharide (LPS))] and alternative [M2 (stimulated with IL-4 and IL-13)] phenotypes. Combinations of antioxidants including lutein+zeaxanthin (1 μM; 0.2 μM), zinc (10 µM), carnosic acid (2 µM), beta-carotene (2 µM), and standardized tomato extract containing lycopene and other tomato phytonutrients were added to the culture media. Levels of anti-inflammatory, antioxidant, and pro-angiogenic gene and protein expression were then evaluated.

Results: Combinations of lutein and carnosic acid with zinc and standardized tomato extract or with beta-carotene yielded an antioxidative, anti-inflammatory, and antiangiogenic effect in M1 and M2 macrophages. These effects manifested in the upregulation of antioxidative genes (HMOX1, SOD1) and the downregulation of pro-angiogenic genes and pro-inflammatory genes (SDF-1, TNF-alpha, IL-6, MCP-1). Lutein monotherapy or a combination of lutein and zinc had less effect on the expression of these genes.

Conclusions: Combinations of supplements can modify the expression of genes and proteins that may be relevant for the involvement of macrophages in the pathogenesis of AMD. Further studies are required to evaluate if the modulation of the macrophage phenotype partially accounts for the beneficial effect of oral supplements in AMD and if modification of the AREDS formula can improve its effect on macrophages.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Antioxidants / administration & dosage*
  • Cells, Cultured
  • Chemokine CCL2 / genetics
  • Chemokine CCL2 / metabolism
  • Chemokine CXCL12 / genetics
  • Chemokine CXCL12 / metabolism
  • Cytokines / genetics*
  • Cytokines / metabolism
  • Dietary Supplements*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gene Expression Regulation / physiology*
  • Heme Oxygenase-1 / genetics
  • Heme Oxygenase-1 / metabolism
  • Humans
  • Interleukin-6 / genetics
  • Interleukin-6 / metabolism
  • Macrophage Activation
  • Macrophages / metabolism*
  • Male
  • Oxidoreductases / genetics*
  • Oxidoreductases / metabolism
  • Phenotype
  • Real-Time Polymerase Chain Reaction
  • Superoxide Dismutase-1 / genetics
  • Superoxide Dismutase-1 / metabolism
  • Tumor Necrosis Factor-alpha / genetics
  • Tumor Necrosis Factor-alpha / metabolism
  • Wet Macular Degeneration / genetics*
  • Wet Macular Degeneration / metabolism


  • Antioxidants
  • CCL2 protein, human
  • CXCL12 protein, human
  • Chemokine CCL2
  • Chemokine CXCL12
  • Cytokines
  • IL6 protein, human
  • Interleukin-6
  • SOD1 protein, human
  • Tumor Necrosis Factor-alpha
  • Oxidoreductases
  • HMOX1 protein, human
  • Heme Oxygenase-1
  • Superoxide Dismutase-1