Eye doctors use a variety of tests to catch signs of glaucoma. Early detection and prompt treatment can prevent vision loss, but the condition is chronic and must be monitored for life. Credit: Steven E. Smith
Treatment would use cells from patient’s skin. An infusion of stem cells could help restore proper drainage for fluid-clogged eyes at risk for glaucoma. That’s the upshot of a study led by a Veterans Affairs and University of Iowa team. Researchers led by Dr. Markus Kuehn injected stem cells into the eyes of mice with glaucoma. The influx of cells regenerated the tiny, delicate trabecular meshwork, which serves as a drain for the eyes to avoid fluid buildup. When fluid accumulates in the eye, the increase in pressure could lead to glaucoma. The disease damages the optic nerve and can result in blindness.
Induced pluripotent stem cells can be created from cells harvested from a patient’s own skin. That gets around the ethical quandary of using fetal stem cells, and it also lessens the chance of the patient’s body rejecting the transplanted cells. Kuehn’s team was able to get the stem cells to grow into cells like those of the trabecular meshwork by culturing them in a solution that had previously been “conditioned” by actual human trabecular meshwork cells.
The stem cell injection led to a proliferation of new endogenous cells within the trabecular meshwork, ie stem cells not only survived on their own, but coaxed the body into making more of its own cells within the eye, thus multiplying the therapeutic effect. The team measured the effects in the mice 9 weeks after the transplant. Lab mice generally live only 2 of 3 years, and 9 weeks is roughly equal to about 5 or 6 years for humans.
Some 120,000 Americans are blind from glaucoma, according to the Gluacoma Research Foundation. African Americans are at especially high risk, as are >60yo, those with diabetes or family history of the disease. The disease is not curable, but it can be managed so as to prevent the eventual loss of vision. Among the current treatments are eye drops and laser or traditional surgery.
The findings hold promise for the most common form of glaucoma, primary open angle glaucoma. They aren’t sure yet if their mouse model is as relevant for other forms of the disease.
Another possible limitation of the research: It could be that new trabecular meshwork cells generated from the stem cell infusion eventually succumb to the same disease process that caused the breakdown in the first place. This would require retreatment. It’s unclear, though, whether an approach requiring multiple treatments over time would be viable. The researchers plan to continue studying the approach. http://www.research.va.gov/currents/0716-5.cfm
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