Scientists from Osaka University in Japan have used corneal tissue transformed from human induced pluripotent stem cells (iPS) for the first time to repair the corneas of four patients with corneal limbal stem cell deficiency (LSCD). The results showed that three patients had significant improvement in vision, lasting for up to one year. The research team plans to conduct larger clinical trials to further explore the exact efficacy of this therapy. The relevant paper was published in the latest issue of The Lancet. The outermost layer (epithelium) of the cornea is maintained by a reservoir of stem cells within the corneal limbic ring. These stem cells proliferate and continuously provide epithelial cells to the cornea, maintaining its healthy state. When corneal limbal stem cells are depleted, people will develop LSCD. As the condition worsens, scar tissue will cover the cornea, ultimately leading to blindness. LSCD may be caused by eye trauma, low autoimmune capacity, or genetic diseases. Currently, treatment methods are limited, and the efficacy is often difficult to predict. To tackle this medical challenge, the team led by Yukio Nishida at Osaka University took a different approach by using iPS cells for corneal transplantation. They collect blood cells from healthy donors, reprogram them into embryonic like states, and then convert these embryonic like cells into corneal epithelial cells. Between June 2019 and November 2020, the research team recruited two females and two males, aged between 39 and 72 years old, with LSCD in both eyes. During the surgery, the research team first removed the scar tissue layer covering the cornea of one eye of the patient, then sutured human iPS corneal epithelial cells on it, and provided the patient with flexible protective contact lenses. After surgery, the research team conducted a one-year follow-up and an additional year of safety monitoring. The results showed that during the 1-year follow-up period, the visual acuity of 3 patients continued to steadily improve, while 1 patient experienced a slight decline in visual acuity. Two years after the transplantation surgery, all patients did not experience any serious side effects. The transplant did not form a tumor - some iPS cells may have this risk, and the transplanted cells did not show signs of being attacked by the recipient's immune system. Although it is currently unclear what exactly causes the improvement in patients' vision, the research team has proposed several possibilities: transplanted cells proliferate in the recipient's cornea; Removing scar tissue before transplantation surgery promotes corneal recovery; Alternatively, transplantation can trigger the migration of the recipient's own cells from other areas of the eye, thereby revitalizing the cornea. The research team plans to launch a larger clinical trial in March next year to evaluate the effectiveness of the therapy. (New Society)
Edit：Chen Jie Responsible editor：Li Ling
Source：Science and Technology Daily
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