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Trabecular meshwork regeneration by stem cells for glaucoma treatment: rationale, feasibility, and mechanisms

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Abstract:

Glaucoma damages the retinal ganglion cells and causes irreversible blindness. The trabecular meshwork (TM) is the primary site of dysfunction in high-pressure open-angle glaucoma. Reduced cellularity of the TM is associated with increased aqueous humor outflow resistance and increased intraocular pressure (IOP). Various strategies such as surgery, laser, different medications, and eye drops are being used to delay vision loss in glaucoma, but none of these strategies impart a long-term therapeutic effect. Stem cell therapy has been proposed as an effective treatment option in regenerative medicine. Trabecular meshwork stem cells (TMSCs) offer an attractive potential for glaucoma treatment. In this chapter, we discuss the rationale and feasibility of using stem cells for TM regeneration to treat glaucoma. We review the mechanisms of TMSC homing, integration, regeneration, and IOP reduction. We present evidence that adipose-derived stem cells and corneal stromal stem cells are potential candidates for TM regeneration. We also discuss other stem cell types, such as mesenchymal stem cells and induced pluripotent stem cells for the same purpose. Finally, we prospect stem cell secretome as a new player for TM regeneration. In conclusion, stem cell therapy for TM regeneration sheds light on long-term glaucoma treatment to prevent elevated IOP.

Glaucoma Research 2020-2022, pp. 95-104 #9
Edited by: Paul A. Knepper and John R. Samples
© Kugler Publications, Amsterdam, The Netherlands

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