Progress has been slow in stem cell therapy for retinal diseases
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BOSTON — Stem cell therapies for retinal diseases come with advantages and disadvantages, according to a speaker at the American Society of Cataract and Refractive Surgery meeting.
Rajesh C. Rao, MD, ABO, said stem cells therapy has gotten a lot of attention, but so far, progress has been slow.
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“There are many trials that have happened essentially over the last 10 years,” he said. “We’re really limited by the size of these trials. Many of them have not made it past phase 2.”
Researchers have been able to identify some of the strengths and weaknesses of the currently available stem cell options.
Rao said autologous stem cell therapy has the advantage of a reduced chance for an autoimmune response, but it is expensive and can introduce mutations or copy number alterations during the reprogramming process.
Meanwhile, allogenic stem cell therapy requires immune suppression, but it can be used “off the shelf” and is less expensive.
Different methods of stem cell therapy administration also have pros and cons, Rao said.
Injecting cells in a suspension can be a simpler method and requires a smaller incision than a retinal pigment epithelium (RPE) scaffold patch. However, a suspension may not settle in an atrophic area and carries the risk of not forming a monolayer. An RPE scaffold patch, which requires a larger-scale surgery, distributes the cells in a more uniform layer.
Rao said the future of stem cell therapy in retinal diseases could bring new sources of cells and ways to deliver them, but progress could be made by shifting which patients receive treatment.
“Inclusion of patients with moderate vision loss rather than severe is a hope in the biotechnology field,” he said. “Maybe if you’re approaching them at a very late stage, there may not be much to save, and perhaps starting earlier may be helpful.”
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Rao RC. Stem cell therapy for retinal disease: Where we stand. Presented at: American Society of Cataract and Refractive Surgery meeting; April 5-8, 2024; Boston.
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