Working Together to Find Biomarkers for Glaucoma Means Lower Risk of Vision Loss

Biomarkers could save lives by finding signs of impending disease or susceptibility to disease before illness actually appears. They also lead the way in personalized medicine by helping researchers develop unique and individualized treatments, based on differences in susceptibility and response to existing treatments. And there’s no doubt that one day they’ll do the same for people with glaucoma.

As researchers unite under the Catalyst for a Cure Biomarker Initiative (CFC2), they have one important goal: to discover glaucoma biomarkers as quickly as possible. With exciting new biomarkers on the horizon, this is a good time to learn more about what they are and how they’ll ultimately help find a cure for glaucoma.

What Are Biomarkers and How Do They Work?

Even if you’re not familiar with the word “biomarker,” chances are some of your biomarkers have been measured. When you go in for a routine exam and the nurse checks your pulse and blood pressure, two biomarkers have been taken. Blood tests that show levels of cholesterol and inflammatory proteins predict the risk for developing cardiovascular disease. Other common biomarkers are hormones that reveal an underactive thyroid or enzymes indicating early stages of cancer.

Think about biomarkers as road signs. Just as road signs alert you to potential hazards or changes ahead, biomarkers are medical signs indicating that health problems could be in the future if you don’t take action. A biomarker may be anything that can be accurately measured and that consistently indicates a predictable process in the body, including whether a certain treatment is likely to work. Some biomarkers foreshadow future disease, while others can be used to diagnose disease at the earliest possible stage. Biomarkers also lead the way to more effective treatments. They show where disease begins, which means researchers can create new medications or ways to deliver medications that zero in on a precise target.

Biomarker Advances in Glaucoma

When experts start to search for biomarkers, they first have to figure out where to look. This is a complex task and can be difficult when dealing with degenerative diseases like glaucoma. That’s where collaborating with a group of glaucoma experts in the Catalyst for a Cure Biomarker Initiative makes a significant difference. Each researcher on the team contributes a different area of expertise, so they can put their heads together to determine the best and quickest way to find new biomarkers.

The team began by exploring ganglion cells, which gather visual information and send it to the brain. Ganglion cells are damaged and die from high eye pressure, but there are about 20 different types. This meant the first step was to figure out which ones would act as the best potential biomarkers. After developing genetic tools that let them observe how the cells responded to light, they learned that ganglion cells located in a specific layer of the retina began to change long before other glaucoma symptoms appeared. Now they’re working to develop a visual test that will enable doctors to see this new biomarker—the earliest identifiable changes in ganglion cells—which means vision can be protected with timely treatment to prevent ongoing damage.

The group at the Catalyst for a Cure Biomarker Initiative have other research in the works and they’re not alone. Studies published between October and December 2016 show progress being made by researchers around the world. Some are looking at levels of antioxidant enzymes that can be found in blood tests, which indicate the amount of antioxidants in the eye and predict the presence of glaucoma. Others are using imaging techniques to see if the number of retinal ganglion cells can be used as a reliable biomarker. Meanwhile, a group from China reported that elevated levels of a protein called endothelin-1 may predict a higher risk for developing normal tension and primary open-angle glaucoma.

Biomarker Research Must Continue to Prevent Vision Loss

Until new treatments are developed or a cure is found, the only way to prevent vision loss in glaucoma is to catch it as early as possible and begin treatment to lower eye pressure. This sounds fairly straightforward, but glaucoma presents a unique challenge, as the disease develops and causes nerve damage long before symptoms arise. Biomarkers are the answer to this problem, providing the tools to facilitate early diagnosis and develop more effective treatment. As researchers discover the most reliable glaucoma biomarkers, they bring us ever closer to finding a cure.

Pictured above: The four principal investigators in the Catalyst for a Cure Biomarker Initiative: (Left to right) Alfredo Dubra, PhD, Andrew Huberman, PhD, Jeffrey Goldberg, MD, PhD, and Vivek Srinivasan, PhD.

First posted on January 20, 2017; Last reviewed on May 11, 2022.