A novel glaucoma approach: Stem cell regeneration of the trabecular meshwork

Glaucoma is the leading cause of global irreversible blindness, necessitating research for new, more efficacious treatment options than currently exist. Trabecular meshwork (TM) cells play an important role in the mainte-nance and function of the aqueous outflow pathway, and studies have found that there is decreased cellularity of the TM in glaucoma. Regeneration of the TM with stem cells has been proposed as a novel therapeutic option by several reports over the last few decades. Stem cells have the capacity for self-renewal and the potential to differentiate into adult functional cells. Several types of stem cells have been investigated in ocular regenerative medicine: tissue specific stem cells, embryonic stem cells, induced pluripotent stem cells, and adult mesenchymal stem cells. These cells have been used in various glaucoma animal models and ex vivo models and have shown success in IOP homeostasis and TM cellularity restoration. They have also demonstrated stability without serious side effects for a significant period of time. Based on current knowledge of TM pathology in glaucoma and existing literature regarding stem cell regen-eration of this tissue, we propose a human clinical study as the next step in understanding this potentially revolutionary treatment paradigm. The ability to protect and replace TM cells in glaucomatous eyes could change the field forever.

Automated summary

Glaucoma, a leading cause of irreversible blindness worldwide, is characterized by decreased cellularity of trabecular meshwork (TM). The regeneration of TM using stem cells has shown success in various animal and ex vivo models, with stability and no serious side effects. A human clinical study is proposed as the next step to understand the potential revolutionary treatment paradigm of protecting and replacing TM cells in glaucomatous eyes.