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In order to stimulate the phototransduction pathway, 11-''cis''-retinal must be absorbed into the body. 11-''cis''-retinal often referred as Vitamin A, is an important dietary vitamin that starts the cascade of phototransduction. Once absorbed into the body and brought to the photoreceptor outer segment (POS), 11-''cis''-retinal is conjugated to opsin to form the rhodopsin complex. Upon light incidence, 11-''cis''-retinal is converted though a photo-isomerization reaction into all-''trans''-retinal. The conversion of 11-''cis''-retinal to all-''trans''-retinal causes a conformation change in the rhodopsin complex. This conformation change activates a G-protein coupled protein transducing which triggers the subsequent phototransduction cascade. The generated all-''trans''-retinal then dissociates from the rhodopsin complex which frees the opsin protein to bind another 11-''cis''-retinal molecule and restart the phototransduction cascade. All-''trans''-retinal must be converted back into 11-''cis''-retinal to serve as the chromophore for the phototransduction cascade. To regenerate 11-''cis''-retinal a series of enzyme catalyzed chemical reactions must take place. These reactions take place within the photoreceptor outer segment (POS) as well as the retinal pigment epithelium (hRPE).  
In order to stimulate the phototransduction pathway, 11-''cis''-retinal must be absorbed into the body. 11-''cis''-retinal often referred as Vitamin A, is an important dietary vitamin that starts the cascade of phototransduction. Once absorbed into the body and brought to the photoreceptor outer segment (POS), 11-''cis''-retinal is conjugated to opsin to form the rhodopsin complex. Upon light incidence, 11-''cis''-retinal is converted though a photo-isomerization reaction into all-''trans''-retinal. The conversion of 11-''cis''-retinal to all-''trans''-retinal causes a conformation change in the rhodopsin complex. This conformation change activates a G-protein coupled protein transducing which triggers the subsequent phototransduction cascade. The generated all-''trans''-retinal then dissociates from the rhodopsin complex which frees the opsin protein to bind another 11-''cis''-retinal molecule and restart the phototransduction cascade. All-''trans''-retinal must be converted back into 11-''cis''-retinal to serve as the chromophore for the phototransduction cascade. To regenerate 11-''cis''-retinal a series of enzyme catalyzed chemical reactions must take place. These reactions take place within the photoreceptor outer segment (POS) as well as the retinal pigment epithelium (hRPE).  


Following dissociation from opsin, all-''trans''-retinal is transported from the lumen of the photoreceptor disk though an ATP-cassette transporter 4 (''ABCA4''). The enzyme all-''trans''-retinol dehydrogenase (atRDH) reduces all-''trans''-retinal into all-''trans''-retinol. Another transporter enzyme, interphotoreceptor retinoid-binding protein (IRBP) facilitates the transporter of all-''trans''-retinol back into the hRPE. Within the hRPE, all-''trans''-retinol is esterified by the enzyme lecithin retinol acyltransferase (LRAT) to form all-''trans''-retinyl ester. RPE65 also known as retinoid isomerohydrolase (IMH) then converts all-''trans''-retinyl ester into 11-''cis''-retinol and palmityl acid. Following the RPE65 catalyzed reaction, 11-''cis''-retinol dehydrogenase (11-''cis''-RDH) oxidizes 11-''cis''-retinol into 11-''cis''-retinal. 11-''cis''-retinal is finally transported back into the photoreceptors to be conjugated to opsin to form the rhodopsin complex. This process is shown in Figure 2. <ref>DOI 10.1016/j.bbadis.2018.04.014</ref>
Following dissociation from opsin, all-''trans''-retinal is transported from the lumen of the photoreceptor disk though an ATP-cassette transporter 4 (''ABCA4''). The enzyme all-''trans''-retinol dehydrogenase (atRDH) reduces all-''trans''-retinal into all-''trans''-retinol. Another transporter enzyme, interphotoreceptor retinoid-binding protein (IRBP) facilitates the transport of all-''trans''-retinol back into the hRPE. Within the hRPE, all-''trans''-retinol is esterified by the enzyme lecithin retinol acyltransferase (LRAT) to form all-''trans''-retinyl ester. RPE65 also known as retinoid isomerohydrolase (IMH) then converts all-''trans''-retinyl ester into 11-''cis''-retinol and palmityl acid. Following the RPE65 catalyzed reaction, 11-''cis''-retinol dehydrogenase (11-''cis''-RDH) oxidizes 11-''cis''-retinol into 11-''cis''-retinal. 11-''cis''-retinal is finally transported back into the photoreceptors to be conjugated to opsin to form the rhodopsin complex. This process is shown in Figure 2. <ref>DOI 10.1016/j.bbadis.2018.04.014</ref>


[[Image:Visual_Cycle_RPE65.jpg|thumb|center|512 px|alt=Figure 2: Human Visual Cycle| '''Figure 2:''' A schematic representation of the Retinoid (Visual) Cycle in Humans. (Abbreviations: all-''trans''-ROL, all-''trans''-retinol; LRAT, lecithin retinol acyltransferase; RPE65, retinal pigment epithelium 65; 11-''cis''-ROL, 11-''cis''-retinol; 11-''cis''-RDH, 11-''cis''-retinol dehydrogenase; 11-''ci''s-RAL, 11-''cis''-retinal; ''hV'', light energy; all-''trans''-RAL, all-''trans''-retinal; atRDH, all-''trans''-retinol dehydrogenase) <ref> DOI 10.1016/j.bbadis.2018.04.014 </ref>]]
[[Image:Visual_Cycle_RPE65.jpg|thumb|center|512 px|alt=Figure 2: Human Visual Cycle| '''Figure 2:''' A schematic representation of the Retinoid (Visual) Cycle in Humans. (Abbreviations: all-''trans''-ROL, all-''trans''-retinol; LRAT, lecithin retinol acyltransferase; RPE65, retinal pigment epithelium 65; 11-''cis''-ROL, 11-''cis''-retinol; 11-''cis''-RDH, 11-''cis''-retinol dehydrogenase; 11-''ci''s-RAL, 11-''cis''-retinal; ''hV'', light energy; all-''trans''-RAL, all-''trans''-retinal; atRDH, all-''trans''-retinol dehydrogenase) <ref> DOI 10.1016/j.bbadis.2018.04.014 </ref>]]