University of California, Jules Stein Eye Institute, Retina Division, 200 Stein Plaza, Los Angeles, CA 90095, USA.
Expert Opin Biol Ther. 2013 Aug;13(8):1125-33. doi: 10.1517/14712598.2013.793304. Epub 2013 May 25.
Retinal degenerations are typically characterized by loss of highly differentiated cell types within the neurosensory retina, such as photoreceptors, or retinal pigment epithelium (RPE). RPE loss is the final common pathway in a number of degenerations including the leading cause of new blindness in the developed world: age-related macular degeneration (AMD).
This paper presents the pathophysiologic case for RPE transplantation with stem cell (SC)-derived tissue, a review of the preclinical data substantiating the hypothesis and the initial clinical trials safety data from early human trials.
Targeting the RPE for transplantation with SC-derived tissue presents a reasonable therapeutic opportunity in a variety of important, otherwise untreatable, blinding conditions. Success of cellular replacement strategies is contingent on finding a viable source of replacement cells, establishing a safe technique for delivery and survival of transplanted cells within the host, restoration of normal retinal architecture and stabilization or improvement of vision.
视网膜变性通常表现为神经感觉视网膜中高度分化的细胞类型丧失,如光感受器或视网膜色素上皮(RPE)。RPE 的丧失是许多变性疾病的最终共同途径,包括发达国家新失明的主要原因:年龄相关性黄斑变性(AMD)。
本文提出了用干细胞(SC)衍生组织进行 RPE 移植的病理生理学案例,回顾了支持该假说的临床前数据以及早期人体试验的初步临床试验安全性数据。
用 SC 衍生组织对 RPE 进行移植的靶向治疗为多种重要的、否则无法治疗的致盲疾病提供了合理的治疗机会。细胞替代策略的成功取决于能否找到可行的替代细胞来源,能否建立一种安全的技术,将移植细胞递送至宿主内并使其存活,以及能否重建正常的视网膜结构并稳定或改善视力。