Manthey Abby Leigh, Liu Wei, Jiang Zhi Xin, Lee Marcus Hiu Kong, Ji Jian, So Kwok-Fai, Lai Jimmy Shiu Ming, Lee Vincent Wing Hong, Chiu Kin
Cell Transplant. 2017 Jun 9;26(6):949-965. doi: 10.3727/096368917X694877. Epub 2017 Feb 3.
Disease or trauma-induced loss or dysfunction of neurons in any central nervous system (CNS) tissue will have a significant impact on the health of the affected patient. The retina is a multilayered tissue that originates from the neuroectoderm, much like the brain and spinal cord. While sight is not required for life, neurodegeneration-related loss of vision not only affects the quality of life for the patient but also has societal implications in terms of health care expenditure. Thus, it is essential to develop effective strategies to repair the retina and prevent disease symptoms. To address this need, multiple techniques have been investigated for their efficacy in treating retinal degeneration. Recent advances in cell transplantation (CT) techniques in preclinical, animal, and in vitro culture studies, including further evaluation of endogenous retinal stem cells and the differentiation of exogenous adult stem cells into various retinal cell types, suggest that this may be the most appropriate option to replace lost retinal neurons. Unfortunately, the various limitations of CT, such as immune rejection or aberrant cell behavior, have largely prevented this technique from becoming a widely used clinical treatment option. In parallel with the advances in CT methodology, the use of electrical stimulation (ES) to treat retinal degeneration has also been recently evaluated with promising results. In this review, we propose that ES could be used to enhance CT therapy, whereby electrical impulses can be applied to the retina to control both native and transplanted stem cell behavior/survival in order to circumvent the limitations associated with retinal CT. To highlight the benefits of this dual treatment, we have briefly outlined the recent developments and limitations of CT with regard to its use in the ocular environment, followed by a brief description of retinal ES, as well as described their combined use in other CNS tissues.
任何中枢神经系统（CNS）组织中因疾病或创伤导致的神经元丢失或功能障碍都会对受影响患者的健康产生重大影响。视网膜是一种多层组织，起源于神经外胚层，与大脑和脊髓非常相似。虽然视力并非生命所必需，但与神经退行性变相关的视力丧失不仅会影响患者的生活质量，还会在医疗保健支出方面产生社会影响。因此，制定有效的策略来修复视网膜并预防疾病症状至关重要。为满足这一需求，人们对多种技术在治疗视网膜变性方面的疗效进行了研究。临床前、动物和体外培养研究中细胞移植（CT）技术的最新进展，包括对内源性视网膜干细胞的进一步评估以及外源性成体干细胞向各种视网膜细胞类型的分化，表明这可能是替代丢失的视网膜神经元的最合适选择。不幸的是，CT的各种局限性，如免疫排斥或异常细胞行为，在很大程度上阻碍了该技术成为广泛应用的临床治疗选择。与CT方法的进展并行，最近也对使用电刺激（ES）治疗视网膜变性进行了评估，结果很有前景。在这篇综述中，我们提出ES可用于增强CT治疗，即可以将电脉冲应用于视网膜，以控制天然和移植干细胞的行为/存活，从而规避与视网膜CT相关的局限性。为突出这种双重治疗的益处，我们简要概述了CT在眼部环境中的最新进展和局限性，随后简要描述了视网膜ES，并介绍了它们在其他CNS组织中的联合应用。
