Lin Tai-Chi, Seiler Magdalene J, Zhu Danhong, Falabella Paulo, Hinton David R, Clegg Dennis O, Humayun Mark S, Thomas Biju B
Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, CA, USA.
USC Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA, USA.
Stem Cells Int. 2017;2017:9428176. doi: 10.1155/2017/9428176. Epub 2017 Aug 27.
Dysfunction and death of retinal pigment epithelium (RPE) and or photoreceptors can lead to irreversible vision loss. The eye represents an ideal microenvironment for stem cell-based therapy. It is considered an "immune privileged" site, and the number of cells needed for therapy is relatively low for the area of focused vision (macula). Further, surgical placement of stem cell-derived grafts (RPE, retinal progenitors, and photoreceptor precursors) into the vitreous cavity or subretinal space has been well established. For preclinical tests, assessments of stem cell-derived graft survival and functionality are conducted in animal models by various noninvasive approaches and imaging modalities. experiments conducted in animal models based on replacing photoreceptors and/or RPE cells have shown survival and functionality of the transplanted cells, rescue of the host retina, and improvement of visual function. Based on the positive results obtained from these animal experiments, human clinical trials are being initiated. Despite such progress in stem cell research, ethical, regulatory, safety, and technical difficulties still remain a challenge for the transformation of this technique into a standard clinical approach. In this review, the current status of preclinical safety and efficacy studies for retinal cell replacement therapies conducted in animal models will be discussed.
视网膜色素上皮(RPE)和/或光感受器的功能障碍及死亡可导致不可逆的视力丧失。眼睛是基于干细胞治疗的理想微环境。它被认为是一个“免疫赦免”部位,并且对于聚焦视力区域(黄斑)而言,治疗所需的细胞数量相对较少。此外,将干细胞衍生的移植物(RPE、视网膜祖细胞和光感受器前体细胞)手术植入玻璃体腔或视网膜下间隙已得到充分证实。对于临床前测试,通过各种非侵入性方法和成像方式在动物模型中评估干细胞衍生移植物的存活和功能。基于动物模型中替换光感受器和/或RPE细胞所进行的实验表明,移植细胞具有存活和功能,挽救了宿主视网膜,并改善了视觉功能。基于这些动物实验获得的阳性结果,正在开展人体临床试验。尽管干细胞研究取得了这样的进展,但伦理、监管、安全和技术难题仍然是将该技术转化为标准临床方法的挑战。在本综述中将讨论在动物模型中进行的视网膜细胞替代疗法临床前安全性和有效性研究的现状。