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Have you ever fathomed that a cornea can be manufactured outside the body to help treat blindness? Not only is it now a possibility, it is better than the previous techniques. With a new age biotechnology, Professor Sheila MacNeil, Professor of Tissue Engineering, at the University of Sheffield (UK) has collaborated with LV Prasad eye institute to pioneer a new type of biotechnology that can grow a scaffold out side the body – just like in-vitro fertilization – and transplant it along with stem cells into the human eye to reverse blindness.
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How does it work?
‘We have developed a new technique for delivering a stem cell therapy to the eye which will repair the damaged in the eye. What commonly happens in the case of diseases or an accident of the eye, is that the specialized cells (called limbal epithelial stem cells) at the front of the eye get damaged. Their main function is to keep the cornea clear and scar-free, helping a person see clearly. This leads to the build up of scar tissue over the eye resulting in lowered visual acuity or sometimes blindness.’ says Dr Macneil.
‘There
are two steps in the development of this technique – regenerating a new
corneal epithelium from a very small piece of the unaffected eye and
producing a synthetic membrane as an alternative to the human amniotic
membrane which can be stored and ready for use by surgeons anywhere.’
‘Since,
there are very few specialist centres around the world which are
equipped to culture limbal epithelial cells from the unaffected eye,
thus, we at the University of Sheffield are working in collaboration
with the LV Prasad Eye Institute in Hyderabad to simplify this
technique.’ ‘Dr Virender Sangwan, Clinical Director of LV Prasad Eye
Institute, has already tested out the first concept and now together, we
have completed the development of a synthetic sterilized biodegradable
membrane which can be stored at -20°C for at least a year before use.’
Why is it something noteworthy?
Proffessor McNeil says, ‘Corneal disease is the fourth most important cause of blindness worldwide according to the WHO(Word Health Organisation)
and this statistic is even higher in India. The dark side to this is
that access to treatment is limited and there are relatively few centres
that have surgeons who are in a position to treat these patients. Thus,
this therapy will make the treatment not only more accessible but also
more affordable for patients in India. Moreover, since we are producing
the base or the scaffolding for the stem cells to grow on and for
corneal cells, it is a procedure that can benefit many. All we need is
some stem cells. These scaffoldings can be pre-manufactured and stored
for up to a year, making the job of the surgeon that much easier.
Additionally, these stem cells can be taken from the uninjured eye of
the patient or the inner lining of the mouth, so it even benefits those
people who have suffered damage to both the eyes.
How is this different from other methods of treating blindness?
Standard treatments for corneal blindness are corneal transplants or grafting stem cells on to the eye using the amniotic membrane (membrane that is present around a baby before it is born) from human donors as a temporary carrier to deliver these cells to the eye. But we have developed a simple biodegradable membrane as an alternative to the human amniotic membrane. This membrane can be sterilised and stored in a vacuum pack until needed and then combined with a small part of the patient’s tissue from their healthy eye for immediate use in surgery.
What is the durability of this treatment? Is it possible for the treatment to somehow reverse?
The experience of Dr Sangwan is that for most patients who have received cultured cell therapy the initial results are excellent, but some patients may need further treatment after 3-5 years if the cells that have been transplanted do not survive long term. Dr Sangwan’s team is now looking into approaches to improve the long term survival of these cells.
Who can benefit from this new technology, and who cannot?
This approach is only appropriate for patients who have damage to the front of the eye (the cornea) which is often due to some accident or rarely due to a disease. This therapy is not applicable to any other eye problems that causes a loss of vision like problems of the retina etc.
Source : Health India , 30th October 2013
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