title: Enhancing RPE Cell-Based Therapy Outcomes for AMD: The Role of Bruch's Membrane.
abstract: Age-related macular degeneration (AMD) is the leading cause of legal blindness in older people in the developed world. The disease involves damage to the part of the retina responsible for central vision. Degeneration of retinal pigment epithelial (RPE) cells, photoreceptors, and choriocapillaris may contribute to visual loss. Over the past decades, scientists and clinicians have tried to replace lost RPE cells in patients with AMD using cells from different sources. In recent years, advances in generating RPE cells from stem cells have been made and clinical trials are currently evaluating the safety and efficiency of replacing the degenerated RPE cell layer with stem cell-derived RPE cells. However, the therapeutic success of transplantation of stem cell-derived RPE cells may be limited unless the transplanted cells can adhere and survive in the long term in the diseased eye. One hallmark of AMD is the altered extracellular environment of Bruch's membrane to which the grafted cells have to adhere. Here, we discuss recent approaches to overcome the inhibitory environment of the diseased eye and to enhance the survival rate of transplanted RPE cells. Our aim is to highlight novel approaches that may have the potential to improve the efficacy of RPE transplantation for AMD in the future.
authors: John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, United Kingdom ; Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, United Kingdom.
authors: Janosch P
authors: JP
authors: Heller
authors: John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, United Kingdom ; Department of Ophthalmology, NIHR Biomedical Research Centre and Wellcome Trust-MRC Cambridge Stem Cell Institute, University of Cambridge, United Kingdom.
authors: Keith R
authors: KR
authors: Martin
keywords: age-related macular degeneration; integrin; retinal pigment epithelium