Mathivanan Isai, Volker Enzmann, Thyagarajan Keerthana, Sivasubramanian Anitha Thirugnanasambantham, Raju Kamaraj, Thangaraj Annadurai
Department of Zoology, Seethalakshmi Ramaswami College (Autonomous), Affiliated to Bharathidasan University, Tiruchirappalli, Tamilnadu, India.
Department of Ophthalmology, Bern University Hospital, University of Bern, Bern, Switzerland.
Stem Cell Rev Rep. 2025 Jun 24. doi: 10.1007/s12015-025-10917-5.
Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the elderly in developed countries, manifesting in two primary forms: neovascular (wet) AMD and non-neovascular (dry) AMD. Current treatments, such as anti-VEGF therapy, offer limited efficacy, particularly for dry AMD, highlighting the urgent need for alternative strategies. Advancements in contemporary treatment strategies for these eye conditions are a pressing medical concern. Stem cell-based therapies have emerged as a promising approach for retinal regeneration due to their capacity for self-renewal and differentiation into retinal cell types, including retinal pigment epithelial (RPE) cells and photoreceptors, two key cell populations damaged in AMD. Among the various sources, pluripotent stem cells such as human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) show significant potential in generating functional RPE cells and restoring retinal architecture and function. Preclinical and early clinical studies have demonstrated promising outcomes, including improved visual acuity and anatomical integration. However, challenges such as immune rejection, tumorigenicity, limited long-term integration, and ethical concerns continue to impede clinical translation. This review critically evaluates current stem cell-based therapeutic strategies for AMD, including advances in mesenchymal stem cells, retinal organoids, and combinatorial approaches with gene and nanotherapy. Furthermore, this review outlines the translational bottlenecks and future directions required to advance these therapies toward clinical application.
年龄相关性黄斑变性(AMD)是发达国家老年人不可逆视力丧失的主要原因,主要表现为两种形式:新生血管性(湿性)AMD和非新生血管性(干性)AMD。目前的治疗方法,如抗VEGF治疗,疗效有限,尤其是对干性AMD,这凸显了对替代策略的迫切需求。这些眼部疾病当代治疗策略的进展是一个紧迫的医学问题。基于干细胞的疗法因其自我更新能力以及分化为视网膜细胞类型(包括视网膜色素上皮(RPE)细胞和光感受器,这是AMD中受损的两个关键细胞群体)的能力,已成为视网膜再生的一种有前景的方法。在各种来源中,多能干细胞,如人类胚胎干细胞(hESCs)和诱导多能干细胞(iPSCs),在生成功能性RPE细胞以及恢复视网膜结构和功能方面显示出巨大潜力。临床前和早期临床研究已证明了有前景的结果,包括视力提高和解剖学整合。然而,免疫排斥、致瘤性、有限的长期整合以及伦理问题等挑战继续阻碍临床转化。本综述批判性地评估了目前基于干细胞的AMD治疗策略,包括间充质干细胞、视网膜类器官以及基因和纳米治疗联合方法的进展。此外,本综述概述了将这些疗法推进到临床应用所需克服的转化瓶颈和未来方向。