4.6 Review

Sources of retinal pigment epithelium (RPE) for replacement therapy

Journal

BRITISH JOURNAL OF OPHTHALMOLOGY
Volume 95, Issue 4, Pages 445-449

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bjo.2009.171918

Keywords

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Categories

Funding

  1. Medical Research Council
  2. Royal College of Surgeons of Edinburgh
  3. Fight for Sight
  4. Oxford University Press
  5. Special Trustees of Moorfields Eye Hospital
  6. NIHR Ophthalmology Biomedical Research Centre
  7. Wellcome Trust
  8. MRC
  9. Health Foundation
  10. NIHR
  11. Medical Research Council [G0601588] Funding Source: researchfish
  12. MRC [G0601588] Funding Source: UKRI

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Stem cells, with their capacity to regenerate and replace diseased tissues, have recently been proposed as having great potential in the treatment of age-related macular degeneration (AMD). A stem cell therapeutic approach could operate to replace either the retinal pigment epithelium (RPE), the neurosensory retina or a combination of both. From the scientific perspective, RPE replacement alone is likely to be far more straightforward than rebuilding the complex circuitry of the neurosensory retina. Furthermore, recent advances with induced pluripotent stem cells have raised the real possibility of transplanting healthy 'young' autologous RPE into patients with early signs of AMD. At this stage, however, it is useful to reconsider some of the earlier clinical studies that used suspensions of autologous RPE cells harvested from the peripheral retina. These showed that isolated RPE cell suspensions had little capacity to recreate a monolayer on the diseased Bruch's membrane of AMD. To counter this problem, researchers from Southampton in the UK report the use of a synthetic polymer alternative to Bruch's membrane, which could provide a scaffold for future RPE derived from stem cells or possibly reopen opportunities for autologous RPE cells harvested from the peripheral retina.

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