The emerging roles of the macular pigment carotenoids throughout the lifespan and in prenatal supplementation

Abstract

Since the publication of the Age-Related Eye Disease Study (AREDS2) in 2013, the macular pigment carotenoids lutein and zeaxanthin have become well known to both the eye care community and the public. It is a fascinating aspect of evolution that primates have repurposed photoprotective pigments and binding proteins from plants and insects to protect and enhance visual acuity. Moreover, utilization of these plant-derived nutrients has been widely embraced for preventing vision loss from age-related macular degeneration (AMD). More recently, there has been growing awareness that these nutrients can also play a role in improving visual performance in adults. On the other hand, the potential benefits of lutein and zeaxanthin supplementation at very young ages have been underappreciated. In this review, we examine the biochemical mechanisms and supportive data for lutein and zeaxanthin supplementation throughout the lifespan, with particular emphasis on prenatal supplementation. We propose that prenatal nutritional recommendations may aim at improving maternal and infant carotenoid status. Prenatal supplementation with lutein and zeaxanthin might enhance infant visual development and performance and may even prevent retinopathy of prematurity, possibilities that should be examined in future clinical studies.

Early Pediatric Benefit of Lutein for Maturing Eyes and Brain—An Overview

“…The conjugated polyene chromophore is the most characteristic feature of carotenoids and, together with the end groups, determines the shape, chemical reactivity and consequent role as antioxidants, light-absorbing properties and related color [ 31 , 32 ]. The specific end groups type in the lutein molecular structure (one β ring conjugated with the polyene chain and one non-conjugated ε ring) result in the presence of 10 conjugated double bonds and characterize the molecule ability to absorb light in the blue-band of the visible spectrum (maximum absorption at 445 nm in methanol and 452 nm in olive oil) defining its yellow color [ 33 , 34 ].…”

“…Lutein isomer zeaxanthin presents two β rings in the molecule. The presence of these end groups increase the number of conjugated double bonds to eleven and results in a shift of maximum light absorption to a slightly higher wavelength within the blue light band (maximum absorption at 450 nm in methanol and 463 nm in olive oil) and a more intense yellow-orange color [ 33 , 34 ]. Because of the C=C isomerism, multiple cis/trans configurations are theoretical possible for lutein and zeaxanthin.…”

“…The concentration of macular carotenoids can be measured in the macula of donor eyes with high performance liquid chromatography (HPLC) while in living eyes MPOD can be assessed non-invasively using subjective psychophysical techniques, such as heterochromatic flicker photometry, and objective optical methods, such as fundus autofluorescence and reflectometry [ 33 ]. In children up to the age of 7 years, due to the difficulties in performing psychophysical task reliably, objective measurements are preferred, and blue light reflectometry offers the opportunity to image the MP of infants and children [ 34 ].…”

Factors Differentiating the Antioxidant Activity of Macular Xanthophylls in the Human Eye Retina

“…Li et al reported a higher meso-zeaxanthin and zeaxanthin-to-lutein ratio (4:1) [ 17 ] at the fovea than reported previously (2:1) with HPLC-based studies [ 15 ]. Both the HPLC and resonance Raman spectroscopy methods have their advantages and disadvantages in the identification of macular xanthophylls in human retina sections [ 20 , 21 , 22 ], but both showed the selective accumulation of zeaxanthin and meso-zeaxanthin in the center of the fovea. Not only did the resonance Raman spectroscopy imaging method separately map the spatial distributions for zeaxanthin and lutein, but it also measured the retinal layer distribution for both of these macular xanthophylls.…”

Introduction to the Thematic Review Series: Seeing 2020: lipids and lipid-soluble molecules in the eye

“…They are plant-derived dietary constituents that become concentrated in the central zone of the retina known as the fovea in humans and nonhuman primates; there, they comprise the macular pigment that gives the fovea its characteristic yellow-orange color. Bernstein and Arunkumar ( 3 ) review the chemistry, metabolism, and physiological function of this class of molecules in the retina. Of importance, they provide an overview of the role of lutein and zeaxanthin across the lifespan in humans, from early pre- and postnatal ocular development throughout the aging process.…”