Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA; Center for Neural Science, College of Arts and Science, New York University, New York, NY, USA; Departments of Biomedical Engineering and Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA; Department of Physiology and Neuroscience, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
Prog Retin Eye Res. 2022 Sep;90:101063. doi: 10.1016/j.preteyeres.2022.101063. Epub 2022 Apr 6.
Glaucoma is the leading cause of global irreversible blindness, necessitating research for new, more efficacious treatment options than currently exist. Trabecular meshwork (TM) cells play an important role in the maintenance and function of the aqueous outflow pathway, and studies have found that there is decreased cellularity of the TM in glaucoma. Regeneration of the TM with stem cells has been proposed as a novel therapeutic option by several reports over the last few decades. Stem cells have the capacity for self-renewal and the potential to differentiate into adult functional cells. Several types of stem cells have been investigated in ocular regenerative medicine: tissue specific stem cells, embryonic stem cells, induced pluripotent stem cells, and adult mesenchymal stem cells. These cells have been used in various glaucoma animal models and ex vivo models and have shown success in IOP homeostasis and TM cellularity restoration. They have also demonstrated stability without serious side effects for a significant period of time. Based on current knowledge of TM pathology in glaucoma and existing literature regarding stem cell regeneration of this tissue, we propose a human clinical study as the next step in understanding this potentially revolutionary treatment paradigm. The ability to protect and replace TM cells in glaucomatous eyes could change the field forever.
青光眼是全球致盲的主要原因，因此需要研究新的、更有效的治疗方法。小梁网（TM）细胞在维持和功能的房水流出途径中发挥重要作用，研究发现青光眼患者 TM 细胞的细胞减少。几十年来，有几项研究报告提出了用干细胞再生 TM 作为一种新的治疗选择。干细胞具有自我更新的能力，并有可能分化为成体功能细胞。在眼部再生医学中已经研究了几种类型的干细胞：组织特异性干细胞、胚胎干细胞、诱导多能干细胞和成人间充质干细胞。这些细胞已在各种青光眼动物模型和体外模型中得到应用，并在眼压稳态和 TM 细胞数量恢复方面取得了成功。它们还表现出相当长时间的稳定性，没有严重的副作用。基于目前对青光眼 TM 病理学的认识和关于该组织干细胞再生的现有文献，我们提出进行一项人类临床研究，作为进一步理解这一潜在革命性治疗方法的下一步。保护和替代青光眼眼中 TM 细胞的能力可能会永远改变这一领域。
