Cell therapy repairs cornea damage with patient's stem cells gives trial results | Hacker News Reader

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

medicalxpress.com

177 pointswglb20 comments

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 :

"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

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=Con...

List of soft contact lens materials: https://en.wikipedia.org/wiki/List_of_soft_contact_lens_mate... ; Hydrogels

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.

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.

The vision of half (2/4) of the patient has improved enough to no longer require a transplantation

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.

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.

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.

According to my doctor it normally stops progressing at around 40 so I got the surgery as a kind of insurance policy if it didn't. But even then there aren't any guarantees. My vision tests did indicate some improvement, albeit barely perceptible.

Fair enough. I (42) also recently opted for Refractive Lens Exchange (cataract) surgery even though I didn't medically need it. I got sick of wearing lenses and glasses. It might be worth checking out if it's appropriate for you since contact lenses help with Keratoconus more than glasses.

People who experience chemical burns and other eye injuries may develop limbal stem cell deficiency, an irreversible loss of cells on the tissue surrounding the cornea. These patients experience permanent vision loss, pain and discomfort in the affected eye. Without limbal cells and a healthy eye surface, patients are unable to undergo artificial cornea transplants, the current standard of vision rehabilitation.

So my understanding is that the cornea isn't exactly "alive" anymore. As a guess, you would be better off wondering if there are chemicals getting into the vitreous that cause keratoconus and if those chemicals can in some way be mitigated.

/random internet stranger making conversation. Definitely Not A Doctor.

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

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.

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.

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/

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

> 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.

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/fullartic...

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

This modified title needs some fixing

Incremental progress at best.

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

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.

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

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