Cornea from a donor
Researchers from the University of Edinburgh and the Scottish National Blood Transfusion Service conducted a unique multicenter randomized clinical trial in which they used donor stem cells to grow corneal tissue, which was subsequently transplanted to patients with a blindness-causing condition.
This condition, known as limbal stem cell insufficiency, develops as a result of loss or dysfunction of epithelial stem cells, usually after chemical or thermal damage to the eye, as well as with aniridia – the absence of the iris, most often caused by genetic pathology. It leads to the formation of scar tissue and severe visual impairment, as well as causes chronic pain and redness of the eyes. Limbal stem cell insufficiency is an important cause of blindness, especially in poor countries with limited access to medical services, and usually does not respond well to traditional therapies.
An effective method of treatment for unilateral and even partially bilateral forms of the disease is the transplantation of one's own limbal stem cells, but it is not applicable in the full bilateral form.
The authors proposed to solve this problem with the help of donor stem cells. To do this, they isolated epithelial stem cells from the cornea of postmortem donors. Subsequently, they were cultured on the amniotic membrane until a tissue fragment suitable for transplantation was obtained.
As part of a clinical study, 16 patients with severe bilateral limbal stem cell insufficiency were randomly divided into 2 groups. Patients of the experimental group were transplanted with a graft grown on an amniotic membrane, and patients of the control group – only an amniotic membrane. Patients of both groups received traditional therapy, as well as immunosuppressive drugs to prevent rejection of donor material.
After 18 months, only 13 out of 16 patients underwent all the necessary examinations, the results of which confirmed the safety of the procedure and the absence of serious side effects. At the same time. Moreover, an improvement in visual acuity was registered in 9 out of 13 patients. There were no significant differences in this indicator between the groups, but all patients in the experimental group had a significant improvement in the condition of the eye surface (ocular surface score, OSS), which was not observed in the control group. The authors believe that this observation indicates the need for additional study of the mechanisms involved in this.
Experts recognized the work carried out as a significant achievement in the field of cell therapy, demonstrating the possibility of using donor stem cells to repair damage to the surface of the eye. They believe that the results obtained should be taken as a basis for planning future larger clinical trials.
Article by John D.M. Campbell et al. Allogeneic Ex Vivo Expanded Corneal Epithelial Stem Cell Transplantation: A Randomized Controlled Clinical Trial published in the journal STEM CELLS Translational Medicine.
Evgenia Ryabtseva, portal "Eternal Youth" http://vechnayamolodost.ru based on the materials of the University of Edinburgh: Trial using donated eye tissue offers stem cell surgery hope.