Age-related macular degeneration (AMD) causes irreversible blindness. It is estimated to globally affect more than 250 million people by 2040. It occurs due to degeneration or thinning of the macula. The retina in the eye is responsible for receiving the light signals and converting them into nerve impulses. Macula is a region of the retina that is located centrally in the eye. It provides sharp visuals with fine details which is beneficial in activities like reading, writing, driving, etc.
AMD typically begins with the accumulation of deposits (drusen) in the eye and is termed dry AMD. As the deposits grow in size, they restrict the blood flow to the macula. The progressing condition impairs blood vessels and induces abnormal vessel formation. During the process, blood leaks into the eye, compromising the retinal epithelium layer. The lacunae of current treatment modalities and the damaging nature of AMD have propelled scientists towards regenerative medicine.
Regenerative Medicine for Age-Related Macular Degeneration (AMD)
Stem cells are the core components of regenerative medicine. They can create their multiple copies and transform into diverse cell types. Therefore, scientists have been exploring their potential to treat Age-related Macular Degeneration (AMD). They have primarily focused on mesenchymal stem cells (MSCs) for their easy availability, manufacture of clinical-grade cells, and extensive therapeutic potential. The early studies on animal models have revealed the following impact of MSCs on AMD:
- MSCs have the ability to migrate to the damaged sites and shield the cells in the retina from oxidative stress, thereby preventing further deterioration of the retina.
- They also modulate the levels of anti-inflammatory and pro-inflammatory cytokines to reduce inflammation.
- By releasing vascular endothelial growth factor (VEGF), MSCs induce repair and regeneration of blood vessels, ensuring adequate blood supply to the retina.
- MSCs secrete neurotropic growth factors, including brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and glial-derived neurotrophic factor (GDNF). These factors protect nerve cells from injury, which enhances their survival and maintains effective nerve signal transmission.
Scientific Studies
The studies on animals have yielded promising results of Stem Cell Therapy for Macular Degeneration (MD) including improvement in vision and reduction of damage in retina. It led to the approval of the therapy for clinical trials. A clinical trial measured both the adverse effects of the treatment and its effectiveness in dry AMD patients. The administration of MSCs resulted in a statistically significant improvement in vision. The study also reported that no side effects occurred due to the treatment, underscoring that the therapy is safe for use.
Challenges in Stem Cell Therapy for Macular Degeneration
Despite the favorable results of the Stem Cell for Macular Degeneration, the therapy is not considered as the mainstream treatment modality. It suffers a few bottlenecks that are delaying the clinical approval of this regenerative treatment.
- Treatment Specifics: The protocol of treatment includes dosage of stem cells, the number of infusions, and the time interval between infusions. Although clinical studies have proven the potential of stem cell therapy, the variation in the treatment process has made the optimization of the procedural details challenging for application in clinical use.
- Source of Stem Cells: For approval in mainstream treatment, stem cells should be consistent in quality and quantity. Many studies have not addressed this aspect. Most stem cell treatments in research studies do not factor in the variation in donor characteristics.
- Route of Administration: Cells are infused into the eyes via two routes. Studies have shown that the administration route can impact the efficacy of the stem cell treatment. Therefore, standardization of a suitable route is necessary before regulatory approval.
In brief, the stem cells for macular degeneration are effective but require only the optimization of the treatment-related details through additional large-scale clinical studies for translation into hospital settings.
Latest Research in Regenerative Medicine
Stem cell treatment or AMD seems a promising avenue. Therefore, while research continues to streamline the treatment protocol, scientists are also tweaking the therapy to tap into the full potential of regenerative medicine. The following are a few efforts in this direction:
- Instead of directly infusing stem cells, efforts are underway to transform them into retinal cells. It will enhance the integration of laboratory-created retinal cells in the eyes, thus improving their functional capacity. Stem cell patch for macular degeneration takes this approach one step further. Instead of only creating retinal cells, this approach forms a layer of retinal cells by using 3D polymeric structures called scaffolds. These patches have been transplanted in patients with either type of AMD. As a result, the reading ability increased, AMD progression halted, and visual acuity enhanced.
- Gene Therapy has also been incorporated into regenerative medicine for macular degeneration to maximize the treatment potential. For example, through gene editing, the expression of proteins, including Bcl-2, neuroprotective factors, and VEGF, in MSCs has been increased. It enhances the therapeutic potential of MSCs to improve the outcomes of the treatment.
- Exosomes have been a popular frontier nowadays. Its applications have extended to diverse disorders for diagnostic and treatment purposes. These are cell-derived vesicles that contain biomolecules and carry the therapeutic properties of the cells they originated from. Therefore, stem cell-based exosomes also have regenerative properties. The key advantage of these exosomes is that they confer their benefits in a cell-free manner. It substantially reduces the risk associated with cell-based therapies.
Macular Degeneration Treatment in India
The progress of India in the field of regenerative medicine has been noteworthy. The efforts from both the private and government sectors have contributed to the field. The development of prestigious stem cell research institutions, integration of advanced infrastructure, and establishment of a regulatory framework have led to applications of stem cells in research and therapy. The production of quality stem cells, clinical expertise, and sophisticated technology has facilitated Macular Degeneration Treatment in India.
Conclusion
AMD is a prevalent cause of blindness. The present therapies fail to repair the damage in retina propelling the search for alternatives in regenerative medicine, especially stem cell therapy. Mesenchymal stem cells (MSCs), in particular, have therapeutic properties such as angiogenesis, anti-inflammation, neuroprotection, and anti-oxidation that can target the root pathways of AMD and induce repair in retina.
The application of stem cells in macular degeneration in animal models and in AMD patients has shown considerable improvement in visual capacity without causing any serious complications. Further standardization of the treatment process and large-scale clinical trials might soon make the treatment available in healthcare facilities.
Meanwhile, scientists are investigating different ways to maximize the potential of the therapy. Exosomes, gene therapy, and a stem cell patch for macular degeneration are a few potential avenues. Advancells prioritizes patient’s health at its core. It has been progressing macular degeneration treatment in India by delivering premium-quality stem cells for therapy.
FAQ’s
Q- What is age-related macular degeneration (AMD), and how does it affect vision?
AMD is a progressive disorder that damages the macula—the central part of the retina responsible for sharp, detailed vision. It leads to irreversible blindness and can severely impact daily activities like reading, driving, and recognizing faces.
Q- How can stem cells help treat AMD?
Stem cells, especially mesenchymal stem cells (MSCs), offer regenerative potential by migrating to damaged retinal areas, reducing inflammation and oxidative stress, promoting blood vessel repair via VEGF, and protecting nerve cells with neurotrophic factors like BDNF and NGF.
Q- Is stem cell therapy for AMD safe and effective?
Early animal studies and clinical trials have shown promising results, including improved vision and no significant side effects. However, standardization of treatment protocols is still needed before widespread clinical adoption.
Q- What is the latest research in regenerative medicine for AMD?
Innovations include stem cell patches, gene-edited MSCs, and exosome therapy to minimize risk and maximize stem cell potential.
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