Retinal pigment epithelium-specific 65 kDa protein (also known as RPE65) is a
retinoid
The retinoids are a class of chemical compounds that are natural derivatives of vitamin A or are chemically related to it. Synthetic retinoids are utilized in cosmetic formulations, clinical dermatology, and the treatment of some forms of cancer ...
isomerohydrolase enzyme of the vertebrate
visual cycle.
RPE65 is expressed in the
retinal pigment epithelium
The pigmented layer of retina or retinal pigment epithelium (RPE) is the pigment
A pigment is a powder used to add or alter color or change visual appearance. Pigments are completely or nearly solubility, insoluble and reactivity (chemistry), ...
(RPE, a layer of epithelial cells that nourish the
photoreceptor cell
A photoreceptor cell is a specialized type of neuroepithelial cell found in the retina that is capable of visual phototransduction. The great biological importance of photoreceptors is that they convert light (visible electromagnetic radiation ...
s) and is responsible for the conversion of all-trans-
retinyl esters to 11-cis-
retinol
Retinol, also called vitamin A1, is a fat-soluble vitamin in the vitamin A family that is found in food and used as a dietary supplement. Retinol or other forms of vitamin A are needed for vision, cellular development, maintenance of skin and ...
during
phototransduction
Visual phototransduction is the sensory transduction process of the visual system by which light is detected by photoreceptor cells ( rods and cones) in the vertebrate retina. A photon is absorbed by a retinal chromophore (each bound to an opsin), ...
. 11-cis-retinol is then used in visual pigment regeneration in
photoreceptor cells
A photoreceptor cell is a specialized type of neuroepithelial cell found in the retina that is capable of visual phototransduction. The great biological importance of photoreceptors is that they convert light (visible electromagnetic radiatio ...
.
RPE65 belongs to the
carotenoid oxygenase family of enzymes.
Function
RPE65 is a critical enzyme in the vertebrate
visual cycle found in the retinal pigmented epithelium. It is also found in
rods and cones. The photoisomerization of 11-cis-retinal to all-trans-retinal initiates the
phototransduction
Visual phototransduction is the sensory transduction process of the visual system by which light is detected by photoreceptor cells ( rods and cones) in the vertebrate retina. A photon is absorbed by a retinal chromophore (each bound to an opsin), ...
pathway through which the brain detects light. All-trans-retinol is not
photoactive and therefore must be reconverted to 11-cis-retinal before it can recombine with
opsin
Animal opsins are G-protein-coupled receptors and a group of proteins made light-sensitive via a chromophore, typically retinal. When bound to retinal, opsins become retinylidene proteins, but are usually still called opsins regardless. Most pro ...
to form an active visual pigment.
RPE65 reverses the photoisomerization by converting an all-trans-retinyl ester to 11-cis-retinol. Most commonly, the ester substrate is
retinyl palmitate
Retinyl palmitate, or vitamin A palmitate, is the ester of retinol (vitamin A) and palmitic acid, with formula C36H60O2. It is the most abundant form of vitamin A storage in animals.
An alternate spelling, retinol palmitate, which violates the - ...
. The other enzymes of the visual cycle complete the reactions necessary to oxidize and esterify all-trans-retinol to a retinyl ester (RPE65's substrate) and to oxidize 11-cis-retinol to 11-cis-retinal (the required photoactive visual pigment component).

RPE65 is also referred to as
retinol isomerase or retinoid isomerase, owing to past debates about the enzyme's substrate and whether it was involved in
ester hydrolysis.
Structure
RPE65 is a
dimer of two symmetrical, enzymatically independent subunits. The active site of each subunit has a seven-bladed
beta-propeller
In structural biology, a beta-propeller (β-propeller) is a type of all-β protein architecture characterized by 4 to 8 highly symmetrical blade-shaped beta sheets arranged toroidally around a central axis. Together the beta-sheets form a funnel- ...
structure with four
histidine
Histidine (symbol His or H) is an essential amino acid that is used in the biosynthesis of proteins. It contains an Amine, α-amino group (which is in the protonated –NH3+ form under Physiological condition, biological conditions), a carboxylic ...
s that hold an iron(II)
cofactor.
This structural motif is common across the studied members of the
carotenoid oxygenase family of enzymes. RPE65 is strongly associated with the membrane of the
smooth endoplasmic reticulum in RPE cells.
Active site structure
The active site of each RPE65 active site contains an Fe(II) cofactor bound by four histidines (His
180, His
241, His
313, and His
527), each contributed by a separate blade on the beta-propeller structure. Three of the four
histidine
Histidine (symbol His or H) is an essential amino acid that is used in the biosynthesis of proteins. It contains an Amine, α-amino group (which is in the protonated –NH3+ form under Physiological condition, biological conditions), a carboxylic ...
s are coordinated to nearby
glutamic acid
Glutamic acid (symbol Glu or E; known as glutamate in its anionic form) is an α- amino acid that is used by almost all living beings in the biosynthesis of proteins. It is a non-essential nutrient for humans, meaning that the human body can ...
residues (Glu
148, Glu
417, and Glu
469), which are thought to help position the histidines to bind the iron cofactor in an
octahedral geometry
In chemistry, octahedral molecular geometry, also called square bipyramidal, describes the shape of compounds with six atoms or groups of atoms or ligands symmetrically arranged around a central atom, defining the vertices of an octahedron. The oc ...
.
Phe
103, Thr
147, and Glu
148 surround the active site where they help stabilize the carbocation intermediate and increase the stereoselectivity of RPE65 for 11-cis-retinol over 13-cis-retinol.

Reactants and products likely enter and leave the active site through a hydrophobic tunnel which is thought to open into the lipid membrane for direct lipid substrate absorption. A second, smaller tunnel also reaches the active site and may serve as a pathway for water, but is too narrow to transport the retinoid reactants and products.
Membrane interactions
RPE65 is strongly associated with the membrane of the sER. sER is abnormally abundant in RPE cells due to their role in processing lipidic
retinoid
The retinoids are a class of chemical compounds that are natural derivatives of vitamin A or are chemically related to it. Synthetic retinoids are utilized in cosmetic formulations, clinical dermatology, and the treatment of some forms of cancer ...
s. Structural studies indicate that RPE65 is partially imbedded in the sER membrane via interactions between its hydrophobic face and the interior of the
lipid membrane
The lipid bilayer (or phospholipid bilayer) is a thin polar membrane made of two layers of lipid molecules. These membranes form a continuous barrier around all cells. The cell membranes of almost all organisms and many viruses are made of a l ...
. This is supported by the need for detergent to solubilize RPE65. A major portion of RPE65's hydrophobic face, residues 109–126, forms an
amphipathic
In chemistry, an amphiphile (), or amphipath, is a chemical compound possessing both hydrophilic (''water-loving'', polar) and lipophilic (''fat-loving'', nonpolar) properties. Such a compound is called amphiphilic or amphipathic. Amphiphilic c ...
alpha helix
An alpha helix (or α-helix) is a sequence of amino acids in a protein that are twisted into a coil (a helix).
The alpha helix is the most common structural arrangement in the Protein secondary structure, secondary structure of proteins. It is al ...
that likely contributes to the protein's membrane affinity. Additionally, Cys
112 is
palmitoylated in native RPE65, further supporting the theory that the hydrophobic face of RPE65 is imbedded in the membrane.
The hydrophobic face contains the entrance to the large tunnel that leads to the enzyme's
active site
In biology and biochemistry, the active site is the region of an enzyme where substrate molecules bind and undergo a chemical reaction. The active site consists of amino acid residues that form temporary bonds with the substrate, the ''binding s ...
. The presence of this channel on the hydrophobic face combined with RPE65's demonstrated ability to absorb substrate direction from the lipid bilayer is consistent with RPE65 being partially embedded in the membrane.
Conservation
RPE65 has been isolated from a wide range of vertebrates including zebra fish, chicken, mice, frogs, and humans.
Its structure is highly conserved between species, particularly in the beta-propeller and likely membrane bound regions. The amino acid sequences of human and bovine RPE65 differ by less than 1%.
The histidine residues of the beta-propeller structure and the bound iron(II) cofactor are 100% conserved across studied RPE65
orthologs
Sequence homology is the biological homology between DNA, RNA, or protein sequences, defined in terms of shared ancestry in the evolutionary history of life. Two segments of DNA can have shared ancestry because of three phenomena: either a spec ...
and other members of the
carotenoid oxygenase family.
Soluble RPE65 (sRPE65)
Previously, it was proposed that RPE65 exists in two, interconverted forms: membrane bound mRPE65 and soluble sRPE65. This theory suggested that the reversible conversion of sRPE65 to mRPE65 by
palmitoylation
In molecular biology, palmitoylation is the covalent attachment of fatty acids, such as palmitic acid, to cysteine (''S''-palmitoylation) and less frequently to serine and threonine (''O''-palmitoylation) residues of proteins, which are typic ...
at Cys
231, Cys
329, and Cys
330 played a role in regulating the retinoid cycle and endowing mRPE65 with its membrane affinity. However, crystallographic studies of RPE65 have demonstrated that these residues are neither palmitoylated nor surface facing. New studies have also failed to confirm the presence of abundant soluble RPE65. Thus, this theory has been largely abandoned.
Mechanism

RPE65 catalyzes the conversion of all-trans-retinyl ester to 11-cis-retinol through a proposed
SN1 O-alkyl bond cleavage. RPE65's combination of an O-alkyl ester cleavage, geometric isomerization, and water addition is currently thought to be unique in biology. However, O-alkyl ester cleavage reactions with similarly stabilized carbocation intermediates are used by organic chemists.
O-Alkyl cleavage
The O-alkyl cleavage of the ester bond, assisted by an Fe(II) cofactor, creates a carbocation intermediate that is stabilized by the conjugated polyene chain. The delocalization of the carbocation reduces the bond order of the polyene chain, thereby reducing the activation energy of the trans-to-cis isomerization. Phe
103 and Thr
178 additionally stabilize the isomerized carbocation and are thought to be responsible for the
stereoselectivity
In chemistry, stereoselectivity is the property of a chemical reaction in which a single reactant forms an unequal mixture of stereoisomers during a non- stereospecific creation of a new stereocenter or during a non-stereospecific transformation ...
of the enzyme. After isomerization, a
nucleophilic attack
In chemistry, a nucleophile is a chemical species that forms bonds by donating an electron pair. All molecules and ions with a free pair of electrons or at least one pi bond can act as nucleophiles. Because nucleophiles donate electrons, they a ...
by water at C15 restores the
conjugation
Conjugation or conjugate may refer to:
Linguistics
*Grammatical conjugation, the modification of a verb from its basic form
*Emotive conjugation or Russell's conjugation, the use of loaded language
Mathematics
*Complex conjugation, the change o ...
of the polyene chain and completes the ester bond cleavage.
Alternate SN2 mechanism
Nearly all other biochemical ester hydrolysis reactions occur through an
addition-elimination reaction at the
acyl carbon. However, isotope labeling studies have demonstrated that the oxygen on the final 11-cis-retinol product of RPE65 originates from the solvent rather than the reacting ester, supporting the O-alkyl cleavage mechanism.
Another possible mechanism would begin with a nucleophilic attack at C11, but such an attack would rely on some
nucleophile
In chemistry, a nucleophile is a chemical species that forms bonds by donating an electron pair. All molecules and ions with a free pair of electrons or at least one pi bond can act as nucleophiles. Because nucleophiles donate electrons, they are ...
- most likely a
cystine
Cystine is the oxidized derivative of the amino acid cysteine and has the formula (SCH2CH(NH2)CO2H)2. It is a white solid that is poorly soluble in water. As a residue in proteins, cystine serves two functions: a site of redox reactions and a mec ...
residue - to complete the isomerization portion of the reaction. Not only is the polyenyl ester probably not electron-poor enough to allow this reaction, but the active site region is lacking cystine residues to act as the nucleophile.
Clinical significance
Mutations in this gene have been associated with
Leber's congenital amaurosis
Leber congenital amaurosis (LCA) is a rare inherited eye disease that appears at birth or in the first few months of life.
It affects about 1 in 40,000 newborns. LCA was first described by Theodor Leber in the 19th century. It should not be ...
type 2 (LCA2) and
retinitis pigmentosa
Retinitis pigmentosa (RP) is a member of a group of genetic disorders called inherited retinal dystrophy (IRD) that cause loss of vision. Symptoms include trouble seeing at night and decreasing peripheral vision (side and upper or lower visua ...
(RP).
RPE65 mutations are the most commonly detected mutations in LCA patients in Denmark. The vast majority of RPE65 mutations in patients with LCA2 and RP occur in the beta-propeller regime and are believed to inhibit proper protein folding and iron cofactor binding. Particularly common propeller mutation sites are Tyr
368 and His
182. Substitution at Arg
91 is also common and have been shown to impact RPE65 membrane interactions and substrate uptake.
Though complete loss of function is associated with diseases such as LCA and RP, partial inhibition of RPE65 has been proposed as a treatment for age-related
macular degeneration
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred vision, blurred or vision loss, no vision in the center of the visual field. Early on there are often no sym ...
(AMD). All-trans-retinylamine (Ret-NH2) and
emixustat have both been shown to
competitively inhibit RPE65.
Emixustat is currently undergoing
FDA
The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
phase 3 clinical trials as a therapy for AMD.
Jean Bennett
Jean Bennett is the F. M. Kirby Professor of Ophthalmology in the Perelman School of Medicine at the University of Pennsylvania. Her research focuses on gene therapy for retinal diseases. Her laboratory developed the first FDA approved gene the ...
and
Katherine A. High's work with the RPE65 mutation has reversed an inherited form of blindness. They received the first FDA approval of a gene therapy for a genetic disease, which is called
Voretigene neparvovec.
See also
* The
Visual Cycle
References
Further reading
; Protein Structure and Function:
*
*
*
; Clinical and Genetic Studies:
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
{{Refend
External links
GeneReviews/NIH/NCBI/UW entry on Retinitis Pigmentosa Overview