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Adult Stem Cells and Glaucoma

University of California, San Francisco, UCSF Medical Center
Stem Cells and Glauomca

This article will focus on several areas of investigation in the use of adult stem cells to treat glaucoma, as well as some important points to consider if you are interested in an adult stem cell treatment for glaucoma.

The field of adult stem cell research is indeed very exciting, and particularly so for the eye. After all, the world’s first transplantation of cells that were derived from induced pluripotent stem cells (iPSCs) took place in the eye!

What are Induced Pluripotent Stem Cells?

There are many different types of adult stem cells, including pluripotent stem cells. These stem cells are special because they can mature and change into many different types of cells in the body, as well as replace themselves.

There are also several types of pluripotent stem cells, including human induced pluripotent stem cells. These stem cells are created from skin or blood cells in adults that have been reprogrammed back into a primitive state, which allows them to develop into any type of human cell needed for therapeutic purposes.

Steady Progress

Although progress may seem slow to patients with vision loss who are awaiting a cure, this first transplantation actually took place only ten years after iPSCs were first discovered and made.

All this being said, although there is rigorous and scientifically sound work being done in adult stem cell laboratories all over the world, some stem cell “treatments” are not yet ready to treat glaucoma.

Current Research

There are many areas of active investigation surrounding adult stem cells and glaucoma. One important feature about stem cells to consider is that the term “stem cells to treat glaucoma” is broad and covers a wide variety of approaches that could be used potentially.

Fixing the Eye’s Drainage System

For example, in primary open-angle glaucoma, the drainage system does not properly drain the fluid inside the eye, and eye pressure can increase. One idea is to take pluripotent stem cells and use them to make the cells that drain fluid out of the eye (trabecular meshwork cells) in an effort to restore the eye’s drainage system. This approach has the potential to lower eye pressure, although we already have many therapies that do the same.

Retinal Ganglion Cells: A Challenging Problem

The method described above to fix the eye’s drainage system would not help a glaucoma patient who has already lost vision, since the vision loss is due to the death of the retinal ganglion cells that comprise the optic nerve.

Retinal ganglion cells are the cells that connect the visual information processed by the retina, the “film” that lines the back of the eye, and the brain, where visual information is further processed. The retinal ganglion cells die in glaucoma, an irreversible process, which is why at present there is no cure for glaucoma.

Currently, the only treatment we have is to lower eye pressure, a major risk factor for glaucoma. Thus, there is excitement around the possibility of using adult stem cells to make retinal ganglion cells, and then to transplant these into the eye. This is an extremely challenging problem, however, since any transplanted stem cell-derived retinal ganglion cells, for example, would need to connect with their appropriate partners both in the retina and in the brain.

Scientists around the world are working to tackle this challenge, and we should continue to devote resources to it. In short, this particular area of adult stem cell research is important, but not ready for patient care.

Finding Clinical Trials

So, if you are a glaucoma patient with vision loss, where might you turn to find stem cell treatments?

Talk with Your Ophthalmologist

You should talk to your ophthalmologist, which is a very important step. Your ophthalmologist should be up to date in the field, and may be aware of recent advances that even this article will not address, since the field is constantly changing and advancing.

Buyer Beware

Other patients might Google “stem cells” and “glaucoma.” Some patients may go to a clinical trial website thinking that any study listed on the website has a rubber stamp of approval from the federal government and is based on solid science. Unfortunately, this is not always the case.

Recent news stories have detailed how unsuspecting patients suffered severe vision damage after treatment at certain illegitimate “trials.”  If you are considering a stem cell treatment for glaucoma, please think about the following very important factors:

  • In a typical clinical trial, patients are not asked to pay for the treatment. Indeed, for some clinical trials patients are reimbursed for costs associated with study visits, such as parking or travel. Thus, be wary of treatments in which you are asked to pay for the procedure or the stem cells.
  • A clinical trial or study in which the same stem cell “treatment” is used for many different diseases of the eye and/or that uses many different ways of delivering the stem cells is also concerning.  It suggests that there is not good understanding of how stem cell treatment works.
  • Treatments that involve both eyes being treated at the same time are also a red flag.
  • Finally, certain stem cell “clinics” have cropped up that offer unproven treatments, with websites prominently featuring patient testimonials. These clinics often use “autologous” stem cells, where the stem cells are harvested from the patient’s own fat (such as from liposuction) or bone marrow. The Food and Drug Administration (FDA) does not have as strict control over these types of stem cells, so it is important to understand that these treatments have no regulatory protection. These clinics offer treatments that have not had any proper vetting for use in humans.

For more information on clinical trials, view or download Clinical Trials: Your Questions Answered.

Summary

It is an exciting time for the adult stem cell field, as the pace of new discoveries and understanding about how stem cells can be used for potential therapies is moving quickly. However, there are currently no FDA-approved stem cell treatments for glaucoma.

Some glaucoma patients may feel, especially if they have very little vision left, that they have little to lose by paying for an unproven stem cell treatment. However, it is possible to lose all vision or even have worse outcomes such as loss of the eye or tumor growth.

Despite these cautions, we should continue investing our resources into legitimate research with adult stem cells, developing potential uses in the treatment of eye disease. We just have to be patient and focus on treatments that have been carefully studied and tested.

Resources:

This content was first posted on: May 23, 2017

The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for personalized advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product, therapy, or resources mentioned or listed in this article. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

These articles do not imply an endorsement of BrightFocus by the author or their institution, nor do they imply an endorsement of the institution or author by BrightFocus.

Some of the content may be adapted from other sources, which will be clearly identified within the article.

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