Sorrentino Francesco Saverio, Di Terlizzi Patrick, De Rosa Francesco, Salati Carlo, Spadea Leopoldo, Gagliano Caterina, Musa Mutali, Zeppieri Marco
Department of Surgical Sciences, Unit of Ophthalmology, Ospedale Maggiore, Bologna 40100, Italy.
Department of Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola 47014, Italy.
World J Transplant. 2024 Dec 18;14(4):97690. doi: 10.5500/wjt.v14.i4.97690.
New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells. Deficiency or alterations of synaptic input and neurotrophic factors result in trans-neuronal degeneration of the inner retinal cells. Thus, the disruption of photoreceptors takes place. However, even in advanced forms of retinal degeneration, a good percentage of the ganglion cells and the inner nuclear layer neurons remain intact. This phenomenon provides evidence for obtaining retinal circuitry through the transplantation of photoreceptors into the subretinal region. The eye is regarded as an optimal organ for cell transplantation because of its immunological privilege and the relatively small number of cells collaborating to carry out visual activities. The eyeball's immunological privilege, characterized by the suppression of delayed-type hypersensitivity responses in ocular tissues, is responsible for the low rate of graft rejection in transplant patients. The main discoveries highlight the capacity of embryonic stem cells (ESCs) and induced pluripotent stem cells to regenerate damaged retinal regions. Recent progress has shown significant enhancements in transplant procedures and results. The research also explores the ethical ramifications linked to the utilization of stem cells, emphasizing the ongoing issue surrounding ESCs. The analysis centers on recent breakthroughs, including the fabrication of three-dimensional retinal organoids and the innovation of scaffolding for cell transportation. Moreover, researchers are currently assessing the possibility of CRISPR and other advanced gene editing technologies to enhance the outcomes of retinal transplantation. The widespread use of universally recognized safe surgical and imaging methods enables retinal transplantation and monitoring of transplanted cell growth toward the correct location. Currently, most therapy approaches are in the first phases of development and necessitate further research, including both pre-clinical and clinical trials, to attain favorable visual results for individuals suffering from retinal degenerative illnesses.
视网膜退行性疾病的视网膜细胞移植新前沿始于这样一种理念，即作用于干细胞有助于视网膜各层再生，并在视网膜细胞之间建立新的突触。突触输入和神经营养因子的缺乏或改变会导致视网膜内层细胞的跨神经元变性。因此，光感受器会发生破坏。然而，即使在视网膜变性的晚期形式中，相当一部分神经节细胞和内核层神经元仍保持完整。这一现象为通过将光感受器移植到视网膜下区域来获得视网膜神经回路提供了证据。由于眼睛具有免疫赦免特性，且参与视觉活动的细胞数量相对较少，因此被视为细胞移植的理想器官。眼球的免疫赦免特性表现为眼部组织中迟发型超敏反应受到抑制，这导致移植患者的移植物排斥率较低。主要发现突出了胚胎干细胞（ESC）和诱导多能干细胞再生受损视网膜区域的能力。最近的进展表明，移植程序和结果有了显著改善。该研究还探讨了与干细胞利用相关的伦理问题，强调了围绕胚胎干细胞的持续问题。分析集中在最近的突破上，包括三维视网膜类器官的制造和细胞运输支架的创新。此外，研究人员目前正在评估CRISPR和其他先进基因编辑技术提高视网膜移植效果的可能性。普遍认可的安全手术和成像方法的广泛应用使得视网膜移植以及对移植细胞向正确位置生长的监测成为可能。目前，大多数治疗方法正处于开发的第一阶段，需要进一步研究，包括临床前和临床试验，以便为患有视网膜退行性疾病的个体取得良好的视觉效果。
