Sources of RPE for replacement therapy

Edward Lee (1) , Robert E Maclaren (2)

1 UCL Institute of Ophthalmology
2 Nuffield Laboratory of Ophthalmology University of Oxford

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 either to replace the retinal pigment epithelium (RPE), or 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 (iPS) 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 use of a synthetic polymer alternative to Bruch's membrane,1 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.

Mots clés: Retina; Macula; Genetics; Degeneration; Experimental &#8211 laboratory

Edward Lee, Robert E Maclaren. Sources of RPE for replacement therapy. British Journal of Ophthalmology, 2010, 95 (4), pp.445. ⟨10.1136/bjo.2009.171918⟩. ⟨hal-00577961⟩