Flaum Eye Institute, University of Rochester, Rochester, NY, US.
Iinstitute of Ophthalmology and visual Science, Rutgers-New Jersey Medical School, Rutgers University, Newark, NJ, US.
Asia Pac J Ophthalmol (Phila). 2022;11(4):302-313. doi: 10.1097/APO.0000000000000521. Epub 2022 Aug 30.
Retinal pigment epithelium (RPE) transplants rescue photoreceptors in selected animal models of retinal degenerative disease. Early clinical studies of RPE transplants as treatment for age-related macular degeneration (AMD) included autologous and allogeneic transplants of RPE suspensions and RPE sheets for atrophic and neovascular complications of AMD. Subsequent studies explored autologous RPE-Bruch membrane-choroid transplants in patients with neovascular AMD with occasional marked visual benefit, which establishes a rationale for RPE transplants in late-stage AMD. More recent work has involved transplantation of autologous and allogeneic stem cell-derived RPE for patients with AMD and those with Stargardt disease. These early-stage clinical trials have employed RPE suspensions and RPE monolayers on biocompatible scaffolds. Safety has been well documented, but evidence of efficacy is variable. Current research involves development of better scaffolds, improved modulation of immune surveillance, and modification of the extracellular milieu to improve RPE survival and integration with host retina.
视网膜色素上皮 (RPE) 移植可挽救某些视网膜退行性疾病动物模型中的光感受器。早期 RPE 移植治疗年龄相关性黄斑变性 (AMD) 的临床研究包括自体和同种异体 RPE 悬浮液和 RPE 片的移植，用于治疗 AMD 的萎缩性和新生血管性并发症。随后的研究探索了自体 RPE-布鲁赫膜-脉络膜移植治疗新生血管性 AMD 患者，偶尔会有明显的视力改善，为晚期 AMD 的 RPE 移植提供了依据。最近的工作涉及自体和同种异体干细胞衍生的 RPE 移植治疗 AMD 患者和 Stargardt 病患者。这些早期临床试验采用了 RPE 悬浮液和 RPE 单层贴壁在生物相容性支架上。安全性已得到充分证实，但疗效证据不一。目前的研究涉及开发更好的支架、改善免疫监视的调节以及改变细胞外环境，以提高 RPE 的存活率并与宿主视网膜整合。
