Stem cell breakthrough in Japan: lab-created cornea implant success

by Antonia Alalitei


When you think nothing could surprise you anymore, your news feed just pops up with another wonder of the 21st century medical technologies, bringing us one more step closer to humanity’s ideal of a disease-free world. We keep saying there’s still a long way to go, but is this path still seemingly never ending, or can we see a wary beam of light peaking at the end of the tunnel? Take a sip of your preferred beverage and let’s take a look at the breakthrough of the day!


Experiment motivation: corneal disease stats

The cornea, as any part of our complex body, has a crucial and clearly defined role to perform in order to maintain our crystal clear vision. Illness or injury of the cornea can damage the cells that repair and preserve the corneal tissue, causing inevitable damage in sight quality or even vision loss.

What are the options of a patient suffering from corneal disease? The typical treatment consists of replacing the damaged cornea with a new donor one. But in Japan, as in any other country, waiting for a transplant can turn into a lengthy process, with 1600 patients being registered on waiting lists for a healthy donor cornea. On top of this, conventional corneal transplant surgeries are prone to rejection due to immune cells being implanted along with the rest of the cornea. And with the scarce availability of transplants, there is the urgent need for an innovative approach.


Induced pluripotent stem cells

Let us explore these particular types of cells in order to better appreciate their contribution. Stem cells are an undifferentiated(not yet specialized) type of cells, whose popularity arises from the fact that they possess a “master” property, allowing them to give rise to infinitely more cells of the same type and eventually grow into any specific type of adult cell(pluripotent). But now, the word “induced” comes into place.

Until not too long ago, stem cells were cultured from embryonic cells, since that was the developmental stage providing non-mature cells with potential of artificially programmed specialization. Luckily, quite recent Japanese discoveries presented the induced pluripotent stem cells, which can be derived by forcing adult epithelial cells back into their embryonic state, followed by a reprogramming into the desired specialized cells. This technique has the great advantage of bypassing the risks of donated embryonic cells to be rejected by the new host.


Can you make a cornea out of iPSCs?

Of course you can! The team of researchers from Osaka University in Japan, led by ophthalmologist Dr Kohji Nishida, have cultured skin cells and reprogrammed them into iPSCs. These cells, laid out in layers of 0.03-0.05 mm thickness, have been transferred directly on top of the left eye cornea, with the aim of restoring the corneal ability to heal and regenerate. The first procedure of its kind took place earlier this year in July, with the approval from the ministry of health, while the pioneering 40-year-old woman will be held under attentive supervision by the team of doctors during a year’s time.


Results and future aims

During a press conference held at the end of August, the doctors reported remarkable recovery of the patient, with concrete restoration of vision quality. Their future hopes reach high, having all the reasons to believe that the transplant would be sufficient to provide for a lifetime. Meanwhile, 3 other patients are awaiting their turn as part of this clinical trial, with the next intervention being scheduled for later this year.

Even though stem cell procedures are slower to advance to the clinic, Nishida is projecting the procedure to be clinically available in 5 years’ time, with great potential of improving the substantial donor cornea demand.




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