New frontiers in retinal transplantation.

Francesco Saverio Sorrentino, Patrick Di Terlizzi, Francesco De Rosa, Carlo Salati, Leopoldo Spadea, Caterina Gagliano, Mutali Musa, Marco Zeppieri
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Abstract

New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells. Deficiency or alterations of synaptic input and neurotrophic factors result in trans-neuronal degeneration of the inner retinal cells. Thus, the disruption of photoreceptors takes place. However, even in advanced forms of retinal degeneration, a good percentage of the ganglion cells and the inner nuclear layer neurons remain intact. This phenomenon provides evidence for obtaining retinal circuitry through the transplantation of photoreceptors into the subretinal region. The eye is regarded as an optimal organ for cell transplantation because of its immunological privilege and the relatively small number of cells collaborating to carry out visual activities. The eyeball's immunological privilege, characterized by the suppression of delayed-type hypersensitivity responses in ocular tissues, is responsible for the low rate of graft rejection in transplant patients. The main discoveries highlight the capacity of embryonic stem cells (ESCs) and induced pluripotent stem cells to regenerate damaged retinal regions. Recent progress has shown significant enhancements in transplant procedures and results. The research also explores the ethical ramifications linked to the utilization of stem cells, emphasizing the ongoing issue surrounding ESCs. The analysis centers on recent breakthroughs, including the fabrication of three-dimensional retinal organoids and the innovation of scaffolding for cell transportation. Moreover, researchers are currently assessing the possibility of CRISPR and other advanced gene editing technologies to enhance the outcomes of retinal transplantation. The widespread use of universally recognized safe surgical and imaging methods enables retinal transplantation and monitoring of transplanted cell growth toward the correct location. Currently, most therapy approaches are in the first phases of development and necessitate further research, including both pre-clinical and clinical trials, to attain favorable visual results for individuals suffering from retinal degenerative illnesses.

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视网膜移植的新领域。
视网膜细胞移植治疗视网膜退行性疾病的新前沿是从作用于干细胞可以帮助视网膜层再生和在视网膜细胞之间建立新的突触的想法开始的。突触输入和神经营养因子的缺乏或改变导致视网膜内细胞的跨神经元变性。因此,发生了光感受器的破坏。然而,即使在视网膜退化的晚期,神经节细胞和内核层神经元的很大比例保持完整。这一现象为通过将光感受器移植到视网膜下区域获得视网膜回路提供了证据。眼睛被认为是细胞移植的最佳器官,因为它的免疫特权和相对较少的细胞协同进行视觉活动。眼球的免疫特权,其特点是抑制眼部组织的延迟型超敏反应,是移植患者移植排斥率低的原因。主要发现强调了胚胎干细胞(ESCs)和诱导多能干细胞再生受损视网膜区域的能力。最近的进展表明移植程序和结果有了显著的改善。该研究还探讨了与干细胞利用相关的伦理后果,强调了围绕ESCs的持续问题。分析集中在最近的突破,包括三维视网膜类器官的制造和用于细胞运输的支架的创新。此外,研究人员目前正在评估CRISPR和其他先进基因编辑技术提高视网膜移植结果的可能性。普遍认可的安全手术和成像方法的广泛使用使视网膜移植和监测移植细胞向正确位置生长成为可能。目前,大多数治疗方法都处于开发的第一阶段,需要进一步的研究,包括临床前和临床试验,以获得对患有视网膜退行性疾病的个体有利的视觉效果。
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