Advancements and turning point of artificial intelligence in ophthalmology: A comprehensive analysis of research trends and collaborative networks.

Artificial intelligence (AI) has emerged as a transformative force with great potential in various fields, including healthcare. In recent years, AI has garnered significant attention due to its potential to revolutionise ophthalmology, leading to advancements in patient care such as disease detection, diagnosis, treatment and monitoring of disease progression. This study presents a comprehensive analysis of the research trends and collaborative networks at the intersection of AI and ophthalmology. In this study, we conducted an extensive search of the Web of Science Core Collection to identify articles related to 'artificial intelligence' in ophthalmology published from 1968 to 2023. We performed co-occurrence keywords and co-authorship network analyses using VOSviewer software to explore the relationships between keywords and country collaboration. We found a remarkable surge in articles applying AI in ophthalmology after 2017, marking a turning point in the integration of AI within the medical field. The primary application of AI shifted towards the diagnosis of ocular disease, which was particularly evident through keywords such as glaucoma, diabetic retinopathy and age-related macular degeneration. Analysis of the collaboration networks of countries revealed a global expansion of ophthalmology-related AI research. This study provides valuable insights into the evolving landscape of AI integration in ophthalmology, indicating its growing potential for enhancing disease detection, diagnosis, treatment planning and monitoring of disease progression. In order to translate AI technologies into clinical practice effectively, it is imperative to comprehend the evolving research trends and advancements at the intersection of AI and ophthalmology.

Persistent Organic Pollutants released from decomposed adipose tissue affect mitochondrial enzyme function in the brain and eyes other than the liver.

Persistent organic pollutants (POPs) are toxic chemicals that can accumulate in the human body, and particularly in adipose tissue. POPs can induce metabolic diseases via mitochondrial dysfunction and can also cause cancer, obesity, and cardiovascular and neurodegenerative diseases. Although the effects of POPs were studied by evaluating mitochondrial function, which is fundamental in investigating the etiologies of various metabolic diseases, the physiological impact of POPs released by the decomposition of fat in adipose tissue is barely understood. Therefore, to investigate the mitochondrial dysfunction caused by POPs released from adipose tissue to other organs, zebrafish were exposed to POPs and placed into four groups: control (C), obesity control (OC), obesity control with POPs (OP), and POP exposure with obesity and caloric restriction (OPR). Next, the activities of the mitochondrial respiratory complexes and the levels of ATP production, reactive oxygen species/reactive nitrogen species (ROS/RNS), and antioxidants, such as glutathione and superoxide dismutase, were measured in the brain, eyes, and liver, as these are the major organs most susceptible to metabolic diseases. POPs released from adipose tissue showed a stronger effect than the direct effects of obesity and POPs on mitochondrial enzyme activity in the brain and eye. Released POPs increased mitochondrial complex I activity and decreased mitochondrial complex II activity compared with normal, obesity, and POP-treated conditions in the brain and eyes. However, the mitochondrial complexes' activities in the liver were affected more by obesity and POPs. In the liver, the mitochondrial enzyme activities of the OPR group seemed to recover to the control level, but it was slightly lowered in the OC and OP groups. Independently, the ROS/RNS and antioxidant levels were not affected by obesity, POPs, or the released POPs in the brain, eye, and liver. The results indicate that POPs stored in adipose tissue and released during fat decomposition did not affect oxidative stress but could affect mitochondrial respiratory enzymes in organ dependent manner. This study is meaningful in that it provides experimental evidence that stored POPs affect specific organs for prolonged periods and can be linked to various diseases in advance.

A Bibliometric Analysis of Myopia Research in East Asia in the 21st Century: The Socio-Economic Status and Quantitative Analysis.

The purpose of this study is to assess the quantity and quality of myopia related articles from 2001 to 2021 using bibliometric methods. The number of published articles and citations, the correlation analysis between gross domestic product (GDP) and annual publication number and citations was investigated. The proportion of myopia articles from East Asia accounted for 55.28% in 2021. The researchers from China published the most articles on myopia during 2001 to 2021, followed by Japan and South Korea. The annual number of articles and citations from China and South Korea showed an exponential increase with strong positive correlation with GDP. All 3 countries in East Asia are mainly researching refractive surgery, prevalence, and glaucoma, and research on children's myopia is particularly active in China, and in Japan. The researchers from East Asia published more than half of articles on myopia since 2019, in order of China, Japan, and South Korea. The annual number of articles and citations from China and South Korea showed an exponential increase with strong positive correlation with GDP whereas those from Japan did not. All 3 countries are mainly researching refractive surgery, and glaucoma, and research on children's myopia is particularly active in China, and in Japan.

The Ionization of Polymeric Materials Accelerates Protein Deposition on Hydrogel Contact Lens Material.

Contact lens materials include polymers that are ionized in the ocular pH condition and are susceptible to protein deposition due to their surface characteristics. Herein, we investigated the effect of the electrostatic state of the contact lens material and protein on protein deposition level using hen egg white lysozyme (HEWL) and bovine serum albumin (BSA) as model proteins and etafilcon A and hilafilcon B as model contact lens materials. Only HEWL deposition on etafilcon A showed a statistically significant pH-dependency (p < 0.05); protein deposition increased with pH. HEWL showed a positive zeta potential at acidic pH, while BSA showed a negative zeta potential at basic pH. Only etafilcon A showed a statistically significant pH-dependent point of zero charge (PZC) (p < 0.05), implying that its surface charge became more negative under basic conditions. This pH-dependency of etafilcon A is attributed to the pH-responsive degree of ionization of its constituent methacrylic acid (MAA). The presence of MAA and its degree of ionization could accelerate protein deposition; more HEWL deposited as pH increased despite the weak positive surface charge of HEWL. The highly negatively charged etafilcon A surface attracted HEWL, even overwhelming weak positive charge of HEWL, increasing the deposition with pH.

The pH-induced physical properties of ionic contact lens material.

The degree of protonation of contact lens materials is affected by the surrounding pH environment, due to the different pKa values. The swelling of ionic contact lenses is generally controlled by these factors which determines physical properties of contact lenses. The purpose of this study was to evaluate the pH dependence of the physical properties of contact lenses. The ionic etafilcon A and non-ionic hilafilcon B contact lenses were used in this study. The diameter, refractive power, equilibrium water content (EWC), and the amounts of freezable-free water (Wff), freezable-bound water (Wfb) and non-freezable water (Wnf) in the contact lens at each pH condition were measured. The diameter, refractive power and EWC of etafilcon A decreased with decreasing pH below 7.0 or 7.4, whereas hilafilcon B showed relatively constant values. The quantity of Wfb tended to increase with increasing pH, showing a relatively constant value above 7.0, whereas Wnf decreased. Hilafilcon B did not show changes in EWC and specific trends in Wfb and Wnf. The significant change of etafilcon A at more acidic condition is derived from the presence of methacrylic acid (MA) which makes it vulnerable to pH. Additionally, though the EWC is composed of various states of water, (i) various states of water could response to surrounding environment in different way with EWC and (ii) Wfb could be the crucial factor that determines physical properties of contact lens.

Synergetic effects of concurrent chronic exposure to a mixture of OCPs and high-fat diets on type 2 diabetes and beneficial effects of caloric restriction in female zebrafish.

This study aimed to investigate the relationship among chronic exposure to a low concentration of organochlorine pesticides (OCPs), high-fat diet (HFD)-induced obesity, and caloric restriction in type 2 diabetes (T2D). Thus, female zebrafish were divided into four groups and treated for 12 weeks as follows: (i) negative control, (ii) HFD (obesity) control, (iii) obesity + a mixture of OCPs (OP), and (iv) obesity + a mixture of OCPs + caloric restriction (OPR). We then assessed T2D-related effects via hematological analysis, histopathology, mitochondrial evaluation, and multiomics analyses. The OP group showed a significant increase in glucose levels, whereas the OPR group maintained glucose at nonsignificant levels. Multiomics analyses revealed that the exacerbated metabolic effects in the OP group were associated with molecular alterations in oxidative stress, inflammation, nucleotide metabolism, and glucose/lipid homeostasis. These alterations were histologically verified by the increased numbers of hypertrophic adipocytes and inflammatory cells observed. Caloric restriction activated pathways related to antioxidant response, mitochondrial fatty acid oxidation, and energy metabolism in zebrafish, leading to preserved glucose homeostasis. In conclusion, this study identified molecular mechanisms underlying the synergistic effect of concurrent exposure to a mixture of OCPs and HFD as well as shed light on the beneficial effect of regular caloric restriction in T2D development.

Nonmonotonic response of type 2 diabetes by low concentration organochlorine pesticide mixture: Findings from multi-omics in zebrafish.

Exposure to a single organochlorine pesticide (OCP) at high concentration and over a short period of exposure constrain our understanding of the contribution of chemical exposure to type 2 diabetes (T2D). A total of 450 male and female zebrafish was exposed to mixtures of five OCPs at 0, 0.05, 0.25, 2.5, and 25 µg/L for 12 weeks. T2D-related hematological parameters (i.e., glucose, insulin, free fatty acid, and triglycerides) and mitochondrial complex I to IV activities were assessed. Metabolomics, proteomics, and transcriptomics were analyzed in female livers, and their data-driven integration was performed. High fasting glucose and low insulin levels were observed only at 0.05 µg/L of the OCP mixture in females, indicating a nonlinear and sexually dependent response. We found that exposure to the OCP mixture inhibited the activities of mitochondrial complexes, especially III and IV. Combining individual and integrated omics analysis, T2D-linked metabolic pathways that regulate mitochondrial function, insulin signaling, and energy homeostasis were altered by the OCP mixture, which explains the observed phenotypic hematological effects. We demonstrated the cause-and-effect relationship between exposures to OCP mixture and T2D using zebrafish model. This study gives an insight into mechanistic research of metabolic diseases caused by chemical exposure using zebrafish.

Mixed Exposure of Persistent Organic Pollutants Alters Oxidative Stress Markers and Mitochondrial Function in the Tail of Zebrafish Depending on Sex.

Persistent organic pollutants (POPs) are lipid-soluble toxins that are not easily degraded; therefore, they accumulate in the environment and the human body. Several studies have indicated a correlation between POPs and metabolic diseases; however, their effects on mitochondria as a central organelle in cellular metabolism and the usage of mitochondria as functional markers for metabolic disease are barely understood. In this study, a zebrafish model system was exposed to two subclasses of POPs, organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs), under two different conditions (solitary OCPs or OCPs with PCBs (Aroclor 1254)), and changes in the oxidative stress marker levels and mitochondrial enzyme activities in the electron transport chain of the tail were measured to observe the correlation between POPs and representative biomarkers for metabolic disease. The results indicated different responses upon exposure to OCPs and OCPs with Aroclor 1254, and accelerated toxicity was observed following exposure to mixed POPs (OCPs with Aroclor 1254). Males were more sensitive to changes in the levels of oxidative stress markers induced by POP exposure, whereas females were more susceptible to the toxic effects of POPs on the levels of mitochondrial activity markers. These results demonstrate that the study reflects real environmental conditions, with low-dose and multiple-toxin exposure for a long period, and that POPs alter major mitochondrial enzymes' functions with an imbalance of redox homeostasis in a sex-dependent manner.

Mori Ramulus Inhibits Pancreatic ß-Cell Apoptosis and Prevents Insulin Resistance by Restoring Hepatic Mitochondrial Function.

Type 2 diabetes mellitus is characterized by insulin resistance and pancreatic beta (ß)-cell dysfunction. Accumulating evidence suggests that mitochondrial dysfunction may cause insulin resistance in peripheral tissues. As commercial hypoglycemic drugs have side effects, it is necessary to develop safe and effective natural compound-based hypoglycemic treatments. This study aimed to investigate the hypoglycemic effects of Mori Ramulus ethanol extract (ME) in a high-fat diet (HFD)-induced diabetes mouse model to decipher the underlying mechanisms focusing on apoptosis and mitochondrial function. ME significantly decreased tunicamycin-induced apoptotic cell death and increased insulin secretion following glucose stimulation in NIT-1 pancreatic ß-cells. Tunicamycin-exposed NIT-1 pancreatic ß-cells showed elevated reactive oxygen species levels and reduced mitochondrial membrane potential, which were reversed by ME treatment. ME inhibited the tunicamycin-induced apoptosis cascade in tunicamycin-exposed NIT-1 pancreatic ß-cells. In HFD diabetic mice, the serum-free fatty acid and insulin levels decreased following a 15-week ME administration. Glucose and insulin tolerance tests showed that ME improved insulin sensitivity. Moreover, ME ameliorated pancreatic ß-cell mass loss in diabetic mice. Finally, ME-treated HFD-fed mice showed improved hepatic mitochondrial function resulting in insulin sensitivity in target tissues. Thus, ME provides protection against pancreatic ß-cell apoptosis and prevents insulin resistance by improving mitochondrial function.

Binding affinity of benzalkonium chloride on contact lens surfaces and the effects on their physical properties.

Benzalkonium chloride (BKC) is a cationic surfactant used as a component in ophthalmic eye drops. The effects of BKC on the eye and the simple binding of BKC on the contact lens surface have been reported in other studies. However, the exact value of the BKC binding affinity on the contact lens surfaces and its effects on the physical properties of contact lenses have not been studied. Here, the binding affinity of BKC toward two types of contact lenses, those with the wetting agent polyvinylpyrrolidone (PVP) and those without, was calculated. In addition, the refractive power, UV-vis transmittance, contact angle, water content, base curve, and diameter of the contact lenses after treatment with BKC were examined to evaluate the effects of its adsorption on the contact lens. We found that the maximum amount of adsorbed BKC was 2.88 mM for the contact lens without PVP whereas it was 2.32 mM for that with PVP. In contrast, the BKC binding affinities were similar. Crucially, the physical properties of the contact lens changed significantly because of the adsorption of BKC. Although BKC is a widely used preservative, our results suggest that use of PVP-containing contact lenses reduces BKC adsorption and discomfort.

Differential mitochondrial dysregulation by exposure to individual organochlorine pesticides (OCPs) and their mixture in zebrafish embryos.

Organochlorine pesticides (OCPs) have been reported to cause mitochondrial dysfunction. However, most studies reported its mitochondrial toxicity with respect to a single form, which is far from the environmentally relevant conditions. In this study, we exposed zebrafish embryos to five OCPs: chlordane, heptachlor, p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT), ß-hexachlorocyclohexane (ß-HCH), and hexachlorobenzene (HCB), as well as an equal ratio mixture of these OCPs. We evaluated mitochondrial function, including oxygen consumption, the activity of mitochondrial complexes, antioxidant reactions, and expression of genes involved in mitochondrial metabolism. Oxygen consumption rate was reduced by exposure to chlordane, and ß-HCH, linking to the increased activity of specific mitochondrial complex I and III, and decreased GSH level. We found that these mitochondrial dysfunctions were more significant in the exposure to the OCP mixture than the individual OCPs. On the mRNA transcription level, the individual OCPs mainly dysregulated the metabolic cycle (i.e., cs and acadm), whereas the OCP mixture disrupted the genes related to mitochondrial oxidative phosphorylation (i.e., sdha). Consequently, we demonstrate that the OCP mixture disrupts mitochondrial metabolism by a different molecular mechanism than the individual OCPs, which warrants further study to evaluate mitochondrial dysregulation by chronic exposure to the OCP mixture.

Cassia tora Seed Improves Pancreatic Mitochondrial Function Leading to Recovery of Glucose Metabolism.

Mitochondrial metabolism plays a crucial role in insulin resistance and insulin secretion in type 2 diabetes mellitus (T2D). Some studies have focused on how Cassia tora extracts affect insulin resistance and hyperglycemia. However, the effects of Cassia tora extracts on mitochondrial dysfunction associated with insulin secretion have not been well explained. In this study, well-known effective compounds extracted from Cassia tora using 70% ethanol were administered to a high-fat diet (HFD) fed mouse to examine the effects of Cassia tora ethanolic extracts (CSEE) on mitochondrial dysfunction in the pancreas. Furthermore, we examined how CSEE regulates the basal mechanism of insulin secretion through mitochondrial functions. Our experimental data suggest that pancreatic mitochondrial metabolism in HFD mice is enhanced to compensate for constrained glucose consumption. HFD-fed mice treated with CSEE showed improved pancreatic mitochondrial functions resulting in alleviation of insulin resistance at target tissue as well as basal hyperinsulinemia.

Tobacco etch virus (TEV) protease with multiple mutations to improve solubility and reduce self-cleavage exhibits enhanced enzymatic activity.

Tobacco etch virus (TEV) protease is a 27-kDa catalytic domain of the polyprotein nuclear inclusion a (NIa) in TEV, which recognizes the specific amino acid sequence ENLYFQG/S and cleaves between Q and G/S. Despite its substrate specificity, its use is limited by its autoinactivation through self-cleavage and poor solubility during purification. It was previously reported that T17S/N68D/I77V mutations improve the solubility and yield of TEV protease and S219 mutations provide protection against self-cleavage. In this study, we isolated TEV proteases with S219N and S219V mutations in the background of T17S, N68D, and I77V without the inclusion body, and measured their enzyme kinetics. The kcat of two isolated S219N and S219V mutants in the background of T17S, N68D, and I77V mutations was highly increased compared to that of the control, and S219N was twofold faster than S219V without Km change. This result indicates that combination of these mutations can further enhance TEV activity.

Bottom-line mechanism of organochlorine pesticides on mitochondria dysfunction linked with type 2 diabetes.

Environmental pollution by anthropogenic chemicals has become a considerable problem. Organochlorine pesticides (OCPs), a subclass of persistent organic pollutants, are used as insecticides and industrial chemicals. They are lipophilic and minimally degradable, and they easily accumulate in the environment and human body. Epidemiological studies have demonstrated that exposure to OCPs strongly correlates with the development of type 2 diabetes, which involves mitochondrial dysfunction. To clarify their effects, OCP mixtures (ß-hexachlorocyclohexane, heptachlor, hexachlorobenzene, 4,4'-DDT, and chlordane) were used to treat mitochondria from zebrafish livers. Results showed that as OCP concentrations increased, Ca2+ intake into the mitochondria rose, which increased the activity of mitochondrial complexes I, II, IV, and citrate synthase. Complex III yielded the opposite result because the OCP mixture mimicked decylubiquinol, a natural substrate of complex III. Our results reflect the actual state of toxins, non-monotonic, in the environment, which is important for determining the consequences of OCPs on mitochondrial dysfunction.

The action of low doses of persistent organic pollutants (POPs) on mitochondrial function in zebrafish eyes and comparison with hyperglycemia to identify a link between POPs and diabetes.

Type 2 diabetes (T2D) is characterized by defects in insulin action to target tissues, resulting in hyperglycemia, insulin resistance, and mitochondrial dysfunction. The eye is one of the organs susceptible to T2D, but knowledge regarding mitochondrial dysfunction in the eyes after hyperglycemia and T2D is based mainly on epidemiological evidence, with little experimental data. Persistent organic pollutants (POPs) are known as endocrine-disrupting chemicals and are associated with uncontrolled glucose and lipid metabolism, leading to the onset of diabetes. To determine the relationship between POPs and T2D, two model systems were developed: glucose-immersed zebrafish to induce hyperglycemia, and zebrafish exposed to low-dose POPs in a water circulating system for three months. To examine the role of mitochondrial function, the activity of mitochondrial complexes I, II, III, and IV from the eyes of the two zebrafish models was measured spectrophotometrically. Enhanced enzymatic activities of mitochondrial complexes III and IV were observed in the eyes of both hyperglycemia and low-dose POPs exposed models, especially in male zebrafish. These results demonstrate that POPs alleviate mitochondrial oxidative phosphorylation (OXPHOS) in a sex-dependent manner through a compensatory mechanism, which is also observed in acute hyperglycemia.

Copper-binding energetics of amicyanin in different folding states.

Amicyanin is a type I copper protein that mediates electron transfer between methylamine dehydrogenase and cytochrome c-551i for energy production in Paracoccus denitrificans. Although the Met98 axial ligand of amicyanin has been shown to dictate metal selectivity and specificity during protein folding, the mechanism involved in copper-mediated amicyanin folding is unknown. Here, we kinetically and spectroscopically described reaction steps for incorporating copper into fully and less folded apo-amicyanin and established thermodynamic parameters for two amicyanin folding states. The rate constant for the incorporation of copper into fully folded apo-amicyanin at 25 °C was almost 1.5-fold lower than that for the initial phase of copper addition to the less folded apo-amicyanin. However, the rate constant was 10-fold higher than that of the second phase of copper addition to less folded apo-amicyanin at 25 °C. When overall binding energetic parameters (ΔH° and ΔS°) for the incorporation of copper into fully folded apo-amicyanin were measured by the van't Hoff method and isothermal titration calorimetry, the values were more positive than those determined for less folded apo-amicyanin. This indicates that during amicyanin biogenesis, copper rapidly binds to an unfolded apo-amicyanin active site, inducing protein folding and favorably influencing subsequent organization of copper ligands.

A T67A mutation in the proximal pocket of the high-spin heme of MauG stabilizes formation of a mixed-valent FeII/FeIII state and enhances charge resonance stabilization of the bis-FeIV state.

The diheme enzyme MauG catalyzes a six-electron oxidation required for posttranslational modification of a precursor of methylamine dehydrogenase (preMADH) to complete the biosynthesis of its protein-derived tryptophan tryptophylquinone (TTQ) cofactor. One heme is low-spin with ligands provided by His205 and Tyr294, and the other is high-spin with a ligand provided by His35. The side chain methyl groups of Thr67 and Leu70 are positioned at a distance of 3.4Å on either side of His35, maintaining a hydrophobic environment in the proximal pocket of the high-spin heme and restricting the movement of this ligand. Mutation of Thr67 to Ala in the proximal pocket of the high-spin heme prevented reduction of the low-spin heme by dithionite, yielding a mixed-valent state. The mutation also enhanced the stabilization of the charge-resonance-transition of the high-valent bis-FeIV state that is generated by addition of H2O2. The rates of electron transfer from TTQ biosynthetic intermediates to the high-valent form of T67A MauG were similar to that of wild-type MauG. These results are compared to those previously reported for mutation of residues in the distal pocket of the high-spin heme that also affected the redox properties and charge resonance transition stabilization of the high-valent state of the hemes. However, given the position of residue 67, the structure of the variant protein and the physical nature of the T67A mutation, the basis for the effects of the T67A mutation must be different from those of the mutations of the residues in the distal heme pocket.

A simple method to engineer a protein-derived redox cofactor for catalysis.

The 6×-Histidine tag which is commonly used for purification of recombinant proteins was converted to a catalytic redox-active center by incorporation of Co(2+). Two examples of the biological activity of this engineered protein-derived cofactor are presented. After inactivation of the natural diheme cofactor of MauG, it was shown that the Co(2+)-loaded 6×His-tag could substitute for the hemes in the H2O2-driven catalysis of tryptophan tryptophylquinone biosynthesis. To further demonstrate that the Co(2+)-loaded 6×His-tag could mediate long range electron transfer, it was shown that addition of H2O2 to the Co(2+)-loaded 6×His-tagged Cu(1+) amicyanin oxidizes the copper site which is 20Å away. These results provide proof of principle for this simple method by which to introduce a catalytic redox-active site into proteins for potential applications in research and biotechnology.

The sole tryptophan of amicyanin enhances its thermal stability but does not influence the electronic properties of the type 1 copper site.

The cupredoxin amicyanin possesses a single tryptophan residue, Trp45. Its fluorescence is quenched when copper is bound even though it is separated by 10.1Å. Mutation of Trp45 to Ala, Phe, Leu and Lys resulted in undetectable protein expression. A W45Y amicyanin variant was isolated. The W45Y mutation did not alter the spectroscopic properties or intrinsic redox potential of amicyanin, but increased the pKa value for the pH-dependent redox potential by 0.5 units. This is due to a hydrogen-bond involving the His95 copper ligand which is present in reduced W45Y amicyanin but not in native amicyanin. The W45Y mutation significantly decreased the thermal stability of amicyanin, as determined by changes in the visible absorbance of oxidized amicyanin and in the circular dichroism spectra for oxidized, reduced and apo forms of amicyanin. Comparison of the crystal structures suggests that the decreased stability of W45Y amicyanin may be attributed to the loss of a strong interior hydrogen bond between Trp45 and Tyr90 in native amicyanin which links two of the ß-sheets that comprise the overall structure of amicyanin. Thus, Trp45 is critical for stabilizing the structure of amicyanin but it does not influence the electronic properties of the copper which quenches its fluorescence.

Characterization of electron tunneling and hole hopping reactions between different forms of MauG and methylamine dehydrogenase within a natural protein complex.

Respiration, photosynthesis, and metabolism require the transfer of electrons through and between proteins over relatively long distances. It is critical that this electron transfer (ET) occur with specificity to avoid cellular damage, and at a rate that is sufficient to support the biological activity. A multistep hole hopping mechanism could, in principle, enhance the efficiency of long-range ET through proteins as it does in organic semiconductors. To explore this possibility, two different ET reactions that occur over the same distance within the protein complex of the diheme enzyme MauG and different forms of methylamine dehydrogenase (MADH) were subjected to kinetic and thermodynamic analysis. An ET mechanism of single-step direct electron tunneling from diferrous MauG to the quinone form of MADH is consistent with the data. In contrast, the biosynthetic ET from preMADH, which contains incompletely synthesized tryptophan tryptophylquinone, to the bis-Fe(IV) form of MauG is best described by a two-step hole hopping mechanism. Experimentally determined ET distances matched the distances determined from the crystal structure that would be expected for single-step tunneling and multistep hopping. Experimentally determined relative values of electronic coupling (H(AB)) for the two reactions correlated well with the relative H(AB) values predicted from computational analysis of the structure. The rate of the hopping-mediated ET reaction is also 10-fold greater than that of the single-step tunneling reaction despite a smaller overall driving force for the hopping-mediated ET reaction. These data provide insight into how the intervening protein matrix and redox potentials of the electron donor and acceptor determine whether the ET reaction proceeds via single-step tunneling or multistep hopping.