Optic nerve atrophy treatment using umbilical cord stem cells

Optic nerve atrophy is one of the most common causes of poor vision and blindness worldwide [1,2]. Certain pathologies causing damage to the optic nerve are atherosclerosis of the major vessels, tumors on the optic nerve, ischemia, glaucoma, improper formation of the optic nerve, vasculitis diseases of the optic nerve, and retina, hereditary and toxic diseases of various etiologies. It can occur as progressive degeneration following the destruction of ganglion cells in the retina or progressive atrophy following nerve fiber destruction following an optic nerve lesion [2,3]. Optic atrophy can also cause irreversible damage to the optic ganglion cells or involve the posterior optic tract and can lead to a life-threatening condition [2]. Early diagnosis of the pathogenesis is crucial for disease control and treatment planning.

Besides traditional methods, stem cell therapies are being widely explored as eye disease treatments by replacing lost nerve cells and restoring neurogenesis blood vessels. Based on recent evidence, treatment using stem cell-derived trophic factors can protect damaged endogenous retinal neurons and induce the development of new neural pathways.

Treatment of optic nerve atrophy.

It’s essential to detect the cause of optic atrophy to prevent vision loss. The factors needed to be clear are whether the patient’s optic atrophy is unilateral or bilateral, stable or not, and whether there is any ongoing ganglion cell destruction. Depending on the severity of the disease, we can use methods, such as using acupuncture or stem cell therapy [4].

Methods of acupuncture treatment.

They evaluated skillful needle insertion techniques and operations as an effective method in terms of safety acupuncture, as well as acupuncture point selection. Acupuncture also significantly improves patients’ vision, visual field, and visual function [1]. Acupuncture alone has shown certain effectiveness compared to other traditional optic nerve atrophy treatments. It took clinical trials to show stronger evidence for acupuncture treatment for optic nerve atrophy.

Stem cell treatments

Tissue engineering is a growing field of science that combines cells, biomaterials, and biochemical factors to restore, maintain, and replace various types of tissues. Stem cells play an important role in various fields of medicine, including ophthalmology, specifically in cases of optic nerve atrophy [5,6]. Stem cells play an important role in treating optic nerve atrophy by restoring the structure and function of the optic nerve through blood vessel and tissue induction. Irreversible apoptosis of nerve cells causes optic nerve atrophy. Current treatments are based on the disease pathogenesis or late complications. Therefore, there is a lack of specific treatment for optic nerve atrophy. Given the availability of advanced therapies, stem cell therapy offers a novel approach.

It has carried clinical trials using mesenchymal stem cells for optic nerve atrophy treatment out with many advantages. Mesenchymal stem cells are easy to harvest and culture. It is also the most commonly used in regenerative medicine because they can induce it to differentiate into cartilage, tendons, adipose tissue, and other cell lines. Mesenchymal stem cells produce growth factors with endocrine effects that are thought to activate endogenous repair mechanisms. Therefore, researchers have used it in several clinical studies on optic nerve disorders [7]. Sources of stem cells used in clinical trials to treat eye diseases are bone marrow, adipose tissue, and milk tooth pulp [8,9,10]. Stem cells primarily provide trophic support for neuroprotection and axonal regeneration of damaged retinal cells either directly through the secretion of neurotrophic factors or indirectly, followed by stimulation of endogenous retinal cells. There are currently many clinical trials testing the safety and effectiveness of stem cell transplantation in the eye [5,6,8].

Treatment using stem cells from the umbilical cord.

We used umbilical cord stem cells in regenerative medicine because they can differentiate into various cell types, including corneal and retinal cells. Umbilical cord tissue is a major source of stem cells, which can effectively treat several eye disorders [11]. Stem cell-based therapeutic studies depend not only on the synthesis of nutritional and growth factors but also on the application of both mesenchymal and epithelial stem cells with anti-inflammatory properties, as they can replace damaged tissues by differentiating into the retina and corneal epithelial, stromal, and endothelial cells. Further, we need clinical studies to evaluate this therapy’s long-term efficacy and safety for human ophthalmic disorders, clarify the pharmacokinetic aspects, and provide a standardized treatment for the clinical use of umbilical cord stem cells. There needs to be more clear evidence on the use of umbilical cord stem cells to treat eye diseases, especially optic nerve atrophy.

Potential application of umbilical cord stem cells in the treatment of optic nerve atrophy

Current promising findings from research and clinical trials lighten up the hope of using stem cells and umbilical cord stem cells in particular on people with optic nerve atrophy. Currently, researchers and clinical trials mention few effective methods to treat and eliminate optic nerve atrophy. However, with the current advancement of stem cell treatments for optic nerve atrophy, stem cells may be the way to go for support and treatment in improving patients’ vision in the future. Ultimately, researchers hope to optimize and apply the use of stem cells in many parts of the world.

References:

1. Zhou, Ping-ping, Peng Sun, Hong-wei Liu, and Yan Meng. “Acupuncture treatment for optic atrophy: A protocol for systematic review.” Medicine98, no. 33 (2019).
2. Drakon, A. K., J. V. Kosova, V. M. Sheludchenko, and N. B. Korchazhkina. “Modern treatment of different forms of optic nerve atrophy.” Vestnik Oftalmologii137, no. 5. Vyp. 2 (2021): 340-345.
3. Shrestha, Pranav, Sanjeeta Sitaula, Ananda Kumar Sharma, and Purushottam Joshi. “Clinical Assessment and Etiological Evaluation of Optic Nerve Atrophy.” Nepalese Journal of Ophthalmology: a Biannual Peer-reviewed Academic Journal of the Nepal Ophthalmic Society: NEPJOPH13, no. 25 (2021): 73-81.
4. Chwalisz, Bart, Dean M. Cestari, and François-Xavier Borruat. “Workup for Optic Atrophy.” In Neuro-Ophthalmology, pp. 167-199. Springer, Cham, 2019.
5. Weiss, Jeffrey N., and Steven Levy. “Stem cell ophthalmology treatment study (SCOTS): Bone marrow derived stem cells in the treatment of dominant optic atrophy.” Stem Cell Investigation6 (2019).
6. Cheng, Jie, Melissa Liu, Aniruddha M. Kaushik, Xiaoli Chang, Yukan Duan, Liben Chen, Cynthia Berlinicke, and Donald J. Zack. “Single-Cell Transcriptome Profiling of Human Stem Cell-Derived Retinal Ganglion Cells in a Dominant Optic Atrophy Model.” Investigative Ophthalmology & Visual Science59, no. 9 (2018): 1988-1988.
7. Taralunga, Tatiana, Ala Paduca, and Viorel Nacu. “The treatment of the optic nerve atrophy using stem cells.” In MedEspera, vol. 9, pp. 450-450. 2022.
8. Mead, Ben, Ann Logan, Martin Berry, Wendy Leadbeater, and Ben A. Scheven. “Intravitreally transplanted dental pulp stem cells promote neuroprotection and axon regeneration of retinal ganglion cells after optic nerve injury.” Investigative ophthalmology & visual science54, no. 12 (2013): 7544-7556.
9. Dahlmann-Noor, Annegret, Sauparnika Vijay, Hari Jayaram, Astrid Limb, and Peng Tee Khaw. “Current approaches and future prospects for stem cell rescue and regeneration of the retina and optic nerve.” Canadian Journal of Ophthalmology45, no. 4 (2010): 333-341.
10. Mesentier-Louro, Louise Alessandra, Camila Zaverucha-do-Valle, Almir Jordao da Silva-Junior, Gabriel Nascimento-dos-Santos, Fernanda Gubert, Ana Beatriz Padilha de Figueirêdo, Ana Luiza Torres et al. “Distribution of mesenchymal stem cells and effects on neuronal survival and axon regeneration after optic nerve crush and cell therapy.” PLoS One9, no. 10 (2014): e110722.
11. Giannaccare, Giuseppe, Adriano Carnevali, Carlotta Senni, Laura Logozzo, and Vincenzo Scorcia. “Umbilical cord blood and serum for the treatment of ocular diseases: a comprehensive review.” Ophthalmology and Therapy 9, no. 2 (2020): 235-248.