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@#Retinitis pigmentosa is an inherited eye disease. The inheritance methods include autosomal dominant inheritance, autosomal recessive inheritance, and sex-linked recessive inheritance. Currently, there are more than 3,000 mutation sites, which makes clinical treatment of this disease difficult. Ophthalmologists are committed to exploring the treatment of retinitis pigmentosa, and have conducted a large number of experimental studies, mainly including drug treatment, cell transplantation, gene therapy, <i>etc</i>. Drug therapy includes traditional Chinese medicine, antioxidants, anti-apoptotic agents, neurotrophic factors, <i>etc</i>. Compared with other treatment methods, it is non-invasive and convenient and cheap, but its mechanism of action needs further research. Cell transplantation is considered an effective method for the treatment of retinitis pigmentosa, but it may cause preretinal membrane and macular folds. Although gene therapy has certain limitations, with the development of gene editing technology and new gene delivery vectors, it will become one of the most promising treatments for retinitis pigmentosa in the future. This article reviews and prospects the recent experimental research on retinitis pigmentosa.
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@#Retinitis pigmentosa is an inherited eye disease. The inheritance methods include autosomal dominant inheritance, autosomal recessive inheritance, and sex-linked recessive inheritance. Currently, there are more than 3,000 mutation sites, which makes clinical treatment of this disease difficult. Ophthalmologists are committed to exploring the treatment of retinitis pigmentosa, and have conducted a large number of experimental studies, mainly including drug treatment, cell transplantation, gene therapy, <i>etc</i>. Drug therapy includes traditional Chinese medicine, antioxidants, anti-apoptotic agents, neurotrophic factors, <i>etc</i>. Compared with other treatment methods, it is non-invasive and convenient and cheap, but its mechanism of action needs further research. Cell transplantation is considered an effective method for the treatment of retinitis pigmentosa, but it may cause preretinal membrane and macular folds. Although gene therapy has certain limitations, with the development of gene editing technology and new gene delivery vectors, it will become one of the most promising treatments for retinitis pigmentosa in the future. This article reviews and prospects the recent experimental research on retinitis pigmentosa.
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La retinopatía diabética, la degeneración macular relacionada con la edad y la retinitis pigmentosason las enfermedades retinianas más frecuentes en todo el mundo. A pesar de no contar consuficientes estudios que demuestren resultados funcionales positivos en cuanto a recuperar lafunción visual, el uso de células madre y células progenitoras retinianas y el trasplante de retinafetal parecen bastante promisorios. Hasta el momento no se han podido obtener resultadospositivos sobre la funcionalidad de las células trasplantadas, pero sí se ha demostrado que elprocedimiento para transferir el tejido retiniano es seguro y confiable. Aún no se ha intentadoen seres humanos el trasplante de células progenitoras retinianas, pero dicho trasplante ha dadoresultados satisfactorios en modelos múridos. Los estudios con células progenitoras retinianashan logrado demostrar en modelos múridos que se activan y expresan los fotorreceptores. Existenalgunas barreras de disponibilidad para el uso de células progenitoras retinianas, que se debensuperar con el fin de adelantar estudios que permitan aumentar las posibilidades de integracióny diferenciación de dichas células hacia fotorreceptores.
Retinal tissue transplantation and retinal progenitor cells: A therapeutic promise for patients with retinal diseaseWorldwide, diabetic retinopathy, age-related macular degeneration, and retinitis pigmentosahave the highest incidence rate among retinal diseases. Despite the lack of enough trialsdemonstrating positive functional results on eyesight recovery, the use of stem cells, retinalprogenitor cells, and fetal retinal tissue transplantation seem very promising. So far positiveresults on the functionality of the transplanted cells have not been obtained. However, the safetyand reliability of the procedure to transfer retinal tissue have been demonstrated. Transplantationof retinal progenitor cells has not been tried on human beings, but there have been satisfactory results with it in murine models. Trials with retinalprogenitor cells have demonstrated activation andexpression of photoreceptors in murine models. Somebarriers of availability exist for the use of retinalprogenitor cells that must be overcome in order tocarry out studies to increase the possibility of theirintegration and differentiation towards photoreceptors.
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Humanos , Enfermedades de la Retina/cirugía , Enfermedades de la Retina/patología , Retina , Retina/trasplante , Trasplante de Células Madre/tendenciasRESUMEN
Objective To investigate the possibility that transplanting the full-thickness neonatal piggy retinas that are completely differentiated but immature improves the retinal function after light-induced retinal degeneration in pigs.Methods Retinas from normal Guangxi Bama pigs aged 1-6 days were used as donor tissues.Neuroretina-RPE cografts were obtained from newborn pigs by using excimer laser for microablation of choroidal tissue and transplanted into the subretinal cavity of adult Bama pigs after light-induced retinal degeneration through vitrectomy and retinotomy.On days 5-7 and in 1st to 5th month after retinal transplantation,the survival of the cografts in the recipients and whether the host retinas have rejection were observed by ophthalmoscope,colour fundus photography and fundus fluorescein angiography,and the amplitude and lantency of N1,P1 waves between different periods were measured by mfERG.Results The retinal transplantation was performed in 15 eyes of 8 Bama pigs after light-induced retinal degeneration.The subretinal transplantation of the cografts was performed successfully in 11 eyes,with the operation success rate of 84.6%(11/15).In host retina,the gray-black graft inside transplantation bed could be seen clearly in 1st to 2nd month after transplantation and the leaked fluorescence in transplants was checked with FFA.The vertical comparison between different periods showed the amplitude of N1,P1 waves of retinal transplants rose with the extension of the survival time,and the areas where active response was observed were ring 2 and ring 3;but the latency of N1,P1 waves was shortened significantly in each ring as compared with that before operation,especially in late survival period.Conclusion The function measurement and the observation of living body together confirm the transplantation of completely differentiated retina from newborn pigs improves the retinal function of pigs after light-induced retinal degeneration.
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Retinal pigment epithelial cells(RPE) from a monolayer on the outer portion of sensory retina and have important physiologic functions that include solute transport, phagocytiosis and digestion of membrances shed from photoreceptor outer segments, and drug detoxication. Recently, transplantation of normal RPE has been proposed as a potential therapeutic modality in the surgical management of subretinal neovascularization in age related macular degeneration(ARMD). The viability of RPE at the time of transplantation is important for a good result after transplantation. This viability can be influenced by the period and environmental conditions of storage after harvest.In this study, the influence of these two factors on the viability was evaluated under controlling other remaining factors in vitro. And limitation of masimal time and optimal environmental conditions of storage were investigated.From November 1997 to February 1998, RPE cell sheets from six donor eyeballs for corneal transplantation in the department of ophthalmology of Severance Hospital were harvested and stored in -70degrees C, 4degrees C, or room temperature condotion. The viability of RPE cells at 0, 24 and 48 hours after havest was assessed and compared statistically.The viability was highest at 4degrees C condition. During storage, the viability was about 95% at 24 hours for and decreased abruptly to below 90% at 48 hours. Therefore, RPE cells for transplantation are to be stored at 4degrees C condition and transplantation should be performed within 24 hours after harvest.