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Neuroprotection is a big problem in glaucoma practice. Recently, many so-call neuroprotective agents have been introduced into glaucoma patients, such as calcium blocker, ginkgo biloba, memantine, and neurotrophic factors, but there is not even one agent mentioned has strong supporting evidence from a randomized clinical trial. Johnson et al. (867) focused on cell replacement therapy by autologous intravitreal transplantation of mesenchymal stem cell (MSCs). The preliminary experimental results relates to a special deliver way by cells and/or drugs. However, there still are fundamental problems in both the quantity of harvested stem cells and the restoration of neuron function.
Reprogramming is a new strategy to obtain enough BMSC. Somatic cells can be reprogrammed into the induced pluripotent stem cells (iPS) by gene or protein transferring, and then inducing iPS cells into BMSC. The iPS cells have infinite proliferation capacity in vitro. Thus, enough BMSC could be harvested through the targeting differentiation of iPS into BMSC. Besides, the iPS cells are derived from autologous cells, so no immunogenicity exists in the BMSC differentiated from iPS cells. Immunologic rejection would not happen after transplantation. It is very important for the survival of BMSC in vivo and the persistent release of cytokines.
IPS could offer another new insight into neuroprotection in glaucoma patients, owing to the relative ease of picking up tissue somatic cells, transferring some special gene into tissue somatic cell, and then translate them into iPS. It may be possible to combine the results with iPS and Genome Wide Association Study (GWAS) for better results. Large progress has.been made in these two research fields that may achieve lower time consumption and much lower cost.