4 ms·

Cell therapy repairs cornea damage with patient's stem cells gives trial results

177 points by wglb 3y ago

westurner 3y ago
Which brand of CL (Contact Lens) did they use for the limbal stem cell delivery? From "Sight for sore eyes" (2009) https://newsroom.unsw.edu.au/news/health/sight-sore-eyes https://newsroom.unsw.edu.au/news/health/sight-sore-eyes : "A contact lens-based technique for expansion and transplantation of autologous epithelial progenitors for ocular surface reconstruction" (2009) http://dx.doi.org/10.1097/TP.0b013e3181a4bbf2 http://dx.doi.org/10.1097/TP.0b013e3181a4bbf2 In this study, they found that only one brand (Bausch and Lomb IIRC) of contact lens worked well as a scaffold for the SC "Contact lens delivery of stem cells for restoring the ocular surface." (2016) https://scholar.google.com/scholar?hl=en&as_sdt=0%2C33&q=Contact+lens+delivery+of+stem+cells+for+restoring+the+ocular+surface.&btnG= https://scholar.google.com/scholar?hl=en&as_sdt=0%2C33&q=Con... List of soft contact lens materials: https://en.wikipedia.org/wiki/List_of_soft_contact_lens_materials https://en.wikipedia.org/wiki/List_of_soft_contact_lens_mate... ; Hydrogels
arijun 3y ago
From a cursory view this seems not at all novel. I can’t tell what is improved over the paper from over 20 years ago ([1], although there was a similar paper released that same year). I’m asking one of the primary authors on that paper for their opinion on this now. [1] https://pubmed.ncbi.nlm.nih.gov/10928750/ https://pubmed.ncbi.nlm.nih.gov/10928750/
- est31 3y ago
  Maybe the two last paragraphs of the introduction section of the study help? Apparently, yes, a stem cell based therapy was a thing already but it wasn't allowed in the USA, so they made a manufacturing process that didn't involve murine (mice) cell lines. https://www.science.org/doi/10.1126/sciadv.adg6470 https://www.science.org/doi/10.1126/sciadv.adg6470 > CLET is not available in the United States, as the manufacturing procedure uses xenogeneic murine feeder cells and fetal bovine serum (FBS) and is not compatible with current good manufacturing practices (cGMPs). The use of murine fibroblasts carry a risk of viral contaminants and inflammatory response against murine antigens > We developed a manufacturing technique to address these shortcomings: cultivated autologous limbal epithelial cells (CALECs). We removed antibiotics and murine feeder cells, used highly reproducible methods for LSC isolation and expansion onto human amniotic membrane, and developed rigorous quality criteria for the manufactured tissue graft.
  - haldujai 3y ago
    Interesting, it makes sense but I didn't know that using FBS isn't good manufacturing practice. The article below is by the same author GP linked to and talks about the risks (summary is very low but potentially very serious). The other thing they point out is that the predecessor (CLET) is only available for investigational use whereas CALECs introduced by this paper seem capable of making the leap to commercial use/manufacturing. Going back to GP's question this does appear to be novel and significantly improved. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/418824 https://jamanetwork.com/journals/jamaophthalmology/fullartic...
car 3y ago
Another medicalxpress.com posting with many points (71) but initially hardly any comments (3 right now)? Saw one before today, https://news.ycombinator.com/item?id=37194394 https://news.ycombinator.com/item?id=37194394
- haldujai 3y ago
  I had the same thought but seems like this site is submitted a lot and by a variety of users, some of whom I recognize so I don't think it's a bot. These are also both fairly good and accessible summaries of very interesting and well-done studies. I've never browsed medicalxpress.com before but it's 2/2 today, maybe it's just a good aggregator/newsletter we've never head of.
- konschubert 3y ago
  I often upvote these posts because they interest me. But since I am not a medical expert, I don't comment and wait for the experts to chime in.
Eduard 3y ago
> Cell therapy repairs cornea damage with patient's stem cells gives trial results This modified title needs some fixing
sholladay 3y ago
What are the chances that a similar procedure could repair the optic nerve from damage caused by glaucoma? Seems within reach but maybe the complexity of the optic nerve makes it a whole different ballgame.
- robbiep 3y ago
  The optic nerve is actually the central nervous system. We don’t have the faintest clue about how to repair nerves of the central nervous system
apienx 3y ago
Incremental progress at best. The editors at Science Magazine referred the paper to Science Advances (which generally has a pay-to-publish model).
culopatin 3y ago
I wonder if this would apply to keratoconus. My cornea is thin and can’t hold its shape well, so I see double with each eye, i constantly see ghosting, like when the old analog tvs we’re not getting the signal quite right. I wonder rid this would regrow my cornea and allow me to play tennis or read a screen at night.
- layer8 3y ago
  Very unlikely. This is specifically about treating limbal stem cell deficiency, to which keratoconus seems to be unrelated. Furthermore, it is specifically about treating unilateral LSCD in one eye by transplanting stem cells from the other, healthy eye. Meaning, it doesn't apply when both eyes are afflicted. Thirdly, the treatment helped patients to meet the preconditions for a corneal transplant, which means it's no substitute for a corneal transplant. This isn't a magical "regrow my cornea" treatment.
  - mahkeiro 3y ago
    The vision of half (2/4) of the patient has improved enough to no longer require a transplantation
- secondcoming 3y ago
  Is C3R surgery not an option? My keratoconus slightly improved after that, but the goal of the treatment is to stop things getting worse; not to fix it.
  - layer8 3y ago
    This is anecdotal of course, but C3R didn't help in my case, the KC still continued to worsen. I kinda regret it, because it also reduced CL tolerance for one eye.
    - nness 3y ago
      I've had a graft arising from KC — you shouldn't regret the C3R, its the right move to try whatever you can to treat the disease and it is the best option available.

177 points by wglb 3y ago

Which brand of CL (Contact Lens) did they use for the limbal stem cell delivery? From "Sight for sore eyes" (2009) https://newsroom.unsw.edu.au/news/health/sight-sore-eyes https://newsroom.unsw.edu.au/news/health/sight-sore-eyes : "A contact lens-based technique for expansion and transplantation of autologous epithelial progenitors for ocular surface reconstruction" (2009) http://dx.doi.org/10.1097/TP.0b013e3181a4bbf2 http://dx.doi.org/10.1097/TP.0b013e3181a4bbf2 In this study, they found that only one brand (Bausch and Lomb IIRC) of contact lens worked well as a scaffold for the SC "Contact lens delivery of stem cells for restoring the ocular surface." (2016) https://scholar.google.com/scholar?hl=en&as_sdt=0%2C33&q=Contact+lens+delivery+of+stem+cells+for+restoring+the+ocular+surface.&btnG= https://scholar.google.com/scholar?hl=en&as_sdt=0%2C33&q=Con... List of soft contact lens materials: https://en.wikipedia.org/wiki/List_of_soft_contact_lens_materials https://en.wikipedia.org/wiki/List_of_soft_contact_lens_mate... ; Hydrogels

arijun 3y ago

From a cursory view this seems not at all novel. I can’t tell what is improved over the paper from over 20 years ago ([1], although there was a similar paper released that same year). I’m asking one of the primary authors on that paper for their opinion on this now. [1] https://pubmed.ncbi.nlm.nih.gov/10928750/ https://pubmed.ncbi.nlm.nih.gov/10928750/

est31 3y ago
Maybe the two last paragraphs of the introduction section of the study help? Apparently, yes, a stem cell based therapy was a thing already but it wasn't allowed in the USA, so they made a manufacturing process that didn't involve murine (mice) cell lines. https://www.science.org/doi/10.1126/sciadv.adg6470 https://www.science.org/doi/10.1126/sciadv.adg6470 > CLET is not available in the United States, as the manufacturing procedure uses xenogeneic murine feeder cells and fetal bovine serum (FBS) and is not compatible with current good manufacturing practices (cGMPs). The use of murine fibroblasts carry a risk of viral contaminants and inflammatory response against murine antigens > We developed a manufacturing technique to address these shortcomings: cultivated autologous limbal epithelial cells (CALECs). We removed antibiotics and murine feeder cells, used highly reproducible methods for LSC isolation and expansion onto human amniotic membrane, and developed rigorous quality criteria for the manufactured tissue graft.
- haldujai 3y ago
  Interesting, it makes sense but I didn't know that using FBS isn't good manufacturing practice. The article below is by the same author GP linked to and talks about the risks (summary is very low but potentially very serious). The other thing they point out is that the predecessor (CLET) is only available for investigational use whereas CALECs introduced by this paper seem capable of making the leap to commercial use/manufacturing. Going back to GP's question this does appear to be novel and significantly improved. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/418824 https://jamanetwork.com/journals/jamaophthalmology/fullartic...

car 3y ago

Another medicalxpress.com posting with many points (71) but initially hardly any comments (3 right now)? Saw one before today, https://news.ycombinator.com/item?id=37194394 https://news.ycombinator.com/item?id=37194394

haldujai 3y ago
I had the same thought but seems like this site is submitted a lot and by a variety of users, some of whom I recognize so I don't think it's a bot. These are also both fairly good and accessible summaries of very interesting and well-done studies. I've never browsed medicalxpress.com before but it's 2/2 today, maybe it's just a good aggregator/newsletter we've never head of.
konschubert 3y ago
I often upvote these posts because they interest me. But since I am not a medical expert, I don't comment and wait for the experts to chime in.

Eduard 3y ago

> Cell therapy repairs cornea damage with patient's stem cells gives trial results This modified title needs some fixing

sholladay 3y ago

What are the chances that a similar procedure could repair the optic nerve from damage caused by glaucoma? Seems within reach but maybe the complexity of the optic nerve makes it a whole different ballgame.

robbiep 3y ago
The optic nerve is actually the central nervous system. We don’t have the faintest clue about how to repair nerves of the central nervous system

apienx 3y ago

Incremental progress at best. The editors at Science Magazine referred the paper to Science Advances (which generally has a pay-to-publish model).

culopatin 3y ago

I wonder if this would apply to keratoconus. My cornea is thin and can’t hold its shape well, so I see double with each eye, i constantly see ghosting, like when the old analog tvs we’re not getting the signal quite right. I wonder rid this would regrow my cornea and allow me to play tennis or read a screen at night.

layer8 3y ago
Very unlikely. This is specifically about treating limbal stem cell deficiency, to which keratoconus seems to be unrelated. Furthermore, it is specifically about treating unilateral LSCD in one eye by transplanting stem cells from the other, healthy eye. Meaning, it doesn't apply when both eyes are afflicted. Thirdly, the treatment helped patients to meet the preconditions for a corneal transplant, which means it's no substitute for a corneal transplant. This isn't a magical "regrow my cornea" treatment.
- mahkeiro 3y ago
  The vision of half (2/4) of the patient has improved enough to no longer require a transplantation
secondcoming 3y ago
Is C3R surgery not an option? My keratoconus slightly improved after that, but the goal of the treatment is to stop things getting worse; not to fix it.
- layer8 3y ago
  This is anecdotal of course, but C3R didn't help in my case, the KC still continued to worsen. I kinda regret it, because it also reduced CL tolerance for one eye.
  - nness 3y ago
    I've had a graft arising from KC — you shouldn't regret the C3R, its the right move to try whatever you can to treat the disease and it is the best option available.