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AMD is currently incurable; the best solution is to prevent its occurrence. To develop drugs for AMD, it is crucial to have a model system that mimics the symptoms and mechanisms in patients. It is most important to develop safer and more effective anti-AMD drug. In this study, the dose of A2E and the intensity of blue light were evaluated to establish an appropriate atrophic in vitro model of AMD and anti-AMD effect and therapeutic mechanism of <jats:italic>Codonopsis lanceolata<\/jats:italic>. The experimental groups included a control group an AMD group treated with A2E and blue light, a lutein group treated with 25\u00a0\u03bcM lutein after AMD induction, and three groups treated with different doses of <jats:italic>C. lanceolata<\/jats:italic> (10, 20, and 50\u00a0\u03bcg\/mL) after AMD induction. Intrinsic apoptotic pathway (Bcl-2 family), anti-oxidative system (Keap1\/Nrf2\/HO-1 antioxidant response element), and anti-carbonyl effect (4-hydroxynonenal [4-HNE]) were evaluated using immunofluorescence, MTT, TUNEL, FACS, and western blotting analyses. A2E accumulation in the cytoplasm of ARPE-19 cells depending on the dose of A2E. Cell viability of ARPE-19 cells according to the dose of A2E and\/or blue light intensity. The population of apoptotic or necrotic cells increased based on the A2E dose and blue light intensity. <jats:italic>Codonopsis lanceolata<\/jats:italic> dose-dependently prevented cell death which was induced by A2E and blue light. The antiapoptotic effect of that was caused by activating Keap1\/Nrf2\/HO-1 pathway, suppressing 4-HNE, and modulating Bcl-2 family proteins like increase of antiapoptotic proteins such as Bcl-2 and Bcl-XL and decrease of proapoptotic protein such as Bim. Based on these findings, 30\u00a0\u03bcM A2E and 20 mW\/cm<jats:sup>2<\/jats:sup> blue light on adult retinal pigment epithelium-19 cells was an appropriate condition for AMD model and <jats:italic>C. lanceolata<\/jats:italic> shows promise as an anti-AMD agent.<\/jats:p>","DOI":"10.1038\/s41598-024-67044-3","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T18:04:45Z","timestamp":1721066685000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Oxidative and carbonyl stress induced AMD and Codonopsis lanceolata ameliorates AMD via controlling oxidative and carbonyl stress"],"prefix":"10.1038","volume":"14","author":[{"given":"Soon-Young","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon-Kyoung","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Sik","family":"Bae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyeyeop","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Jae","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Sik","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Chul","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae-Hun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"67044_CR1","first-page":"493","volume":"6","author":"JB Jonas","year":"2017","unstructured":"Jonas, J. 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