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Editors Selection IGR 15-4

Basic Research: Stem cell transplantation

Comment by Keith Martin on:

23905 Effects of bone-marrow mesenchymal stem cells transplanted into vitreous cavity of rat injured by ischemia/reperfusion, Li N; Li XR; Yuan JQ, Graefe's Archive for Clinical and Experimental Ophthalmology, 2009; 247: 503-514

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Neurotrophic factor depletion due to impaired retrograde transport from the brain to the retina has been proposed as a mechanism contributing to retinal ganglion cell death in glaucoma. Thus, sustained delivery of neurotrophic factors to the retina has been explored in several previous studies as a potential neuroprotective treatment for the disease. Neurotrophic factor gene therapy delivered by intravitreal injection has been successful in animal models, but recent research suggests that autologous intraocular stem cell transplantation might also be feasible.

Li et al. (571) investigated the neuroprotective value of bone marrow-derived mesenchymal stromal cell (MSC) transplantation in rat retinal ischemia/reperfusion ‐ a model which shares some similarities to glaucoma, including selective loss of RGCs. In agreement with a growing body of literature, the authors demonstrate that MSCs produce a variety of neurotrophic factors including brainderived neurotrophic factor and ciliary neurotrophic factor. Following intravitreal injection, MSCs survived for at least several weeks and, most importantly, resulted in approximately 33% greater RGC survival one month after the ischemic insult. While certain aspects of this paper, including assessment of MSC integration and differentiation post-transplantation, would benefit from greater rigor and elaboration, the results add to the growing body of evidence which suggests that stem cell transplantation could confer neuroprotection in patients suffering from neurodegenerative diseases including glaucoma. The cell type investigated is particularly attractive as it could be isolated from patients' own bone marrow, transplanted autologously, and continuously deliver protective factors locally.

While much work remains to elucidate the molecular mechanisms, long-term efficacy, effect on retinal function and safety profile of stem cell-mediated neuroprotection, a role for this approach in glaucoma is certainly worth further investigation.

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