¿Habrá un tratamiento seguro con células madre para glaucoma en 2023?

El médico doctorado Jeffrey Goldberg repasa los avances recientes de la investigación y explica los riesgos potenciales.

This is one of the most pressing and frequently asked questions by patients, especially those who have lost significant vision due to glaucoma. Vision loss from glaucoma is associated with the degeneration of retinal ganglion cells (known as “RCGs”), and the premise, and promise, of replacing RGCs with stem cells to restore vision is compelling.

Are we moving towards stem cell treatments?

We have made a lot of progress in the laboratory towards glaucoma cell therapy. Our lab and those of others have figured out how to convert human stem cells and human RGCs in a lab dish, and we can characterize their function and anatomy in ultra-fine molecular detail. Furthermore, transplants of human RGCs into preclinical animal models of glaucoma or human-like eye diseases are increasingly progressing and showing more promise, although much remains to be resolved: how to transplant enough cells into the retina to improve vision significantly? How to maximize the integration of donor cells into retinal circuits? How much immunosuppression is needed in the short or long term?

Another aspect worth highlighting is the advances in the conversion of retinal cells into replacement RGCs through gene therapy. The science on harnessing our so-called “endogenous stem cells” is advancing rapidly.

Are there already safe stem cell treatments for glaucoma?

Here I must continue to advise patients, we are not yet ready to carry out safe tests on patients. Some interim clinical trials have been initiated in the US for eye diseases other than glaucoma. Because the FDA is unable to monitor and prevent the operation of dishonest stem cell clinics, patients are at significant risk of being tricked into trying unsafe products by dubious professionals.

What are the risks of unapproved stem cell treatment?

The risks are significant, and in the worst cases include blindness (we published a series of such cases in a Florida clinic) or cancer (we just treated a patient with tumors caused by stem cell injections abroad) . Fraudulent clinics often charge patients exorbitant fees, running into thousands of dollars, putting them at risk of losing their money and their eyesight.

What questions should I ask if I am considering stem cell treatment?

I would confirm in writing that what is being offered to a patient (1) has been published in peer-reviewed articles in prestigious journals; (2) is part of a clinical trial found at clinicaltrials.gov; (3) is a trial registered with the FDA (and has been assigned an “IND” number); and (4) it doesn’t cost you money.

Article by PhD physician Jeffrey L. Goldberg.

Jeffrey L. Goldberg, MD, PhD

Jeffrey L. Goldberg, MD, PhD

Jeffrey L. Goldberg, MD, PhD is Professor and Chair of Ophthalmology at the Byers Eye Institute at Stanford University School of Medicine. Dr. Goldberg is a scientific advisor for the Catalyst for a Cure Vision Restoration Initiative (CFC3).