Hyperactive microtubule binding of RP1L1 R45W underlies retinal degeneration and is suppressed by glycerol.

Photoreceptors rely on microtubule (MT)-based transport within the connecting cilium to maintain cellular homeostasis. Mutations in RP1L1, a retina-specific doublecortin (DC) domain protein, cause inherited retinal disorders including occult macular dystrophy (OMD), yet the underlying mechanisms remain poorly defined. Here, we show that the RP1L1 R45W variant, prevalent in East Asian individuals with OMD, confers a toxic gain-of-function phenotype characterized by abnormally strong MT binding. Live-cell imaging revealed an approximately twofold increase in MT association relative to wild-type RP1L1. Molecular dynamics simulations indicated that R45W stabilizes RP1L1-α-tubulin interactions via cation-π contacts and reduced electrostatic repulsion. Remarkably, low concentrations of glycerol selectively disrupted these aberrant interactions, restoring MT binding to wild-type levels in both cellular and biochemical contexts. Our study elucidates a structural and mechanistic basis for RP1L1 R45W hyper-binding and demonstrates that small-molecule modulation of DC-domain interactions might provide a variant-specific therapeutic strategy for RP1L1-related retinopathies.