LAUSR

The underlying mechanisms of complement activation in Stargardt disease type 1 (STGD1) and age‐related macular degeneration (AMD) are not fully understood. Overaccumulation of all‐trans‐retinal (atRAL) has been proposed as the pathogenic factor in both diseases. By incubating retinal pigment epithelium (RPE) cells with atRAL, we showed that C5b‐9 membrane attack complexes (MACs) were generated mainly through complement alternative pathway. An increase in complement factor B (CFB) expression as well as downregulation of complement regulatory proteins CD46, CD55, CD59, and CFH were observed in RPE cells after atRAL treatment. Furthermore, interleukin‐1β production was provoked in both atRAL‐treated RPE cells and microglia/macrophages. Coincubation of RPE cells with interleukin‐1 receptor antagonist (IL1Ra) and atRAL ameliorated complement activation and downregulated CFB expression by attenuating both p38 and c‐Jun N‐terminal kinase (JNK) signaling pathways. Our findings demonstrate that atRAL induces an autocrine/paracrine IL‐1/IL‐1R signaling to promote complement alternative pathway activation in RPE cells and provide a novel perspective on the pathomechanism of macular degeneration.