2023, Vol. 27 ›› Issue (10): 1593-1602

Protective effect of stem cells on retinal ganglion cell regeneration

Zhang Chunli1, Liu Jingchen2, Zhou Wenjie1, Yu Yongzhen1, Tang Cuicui1, Zou Xiulan1, Zou Yuping1   

Abstract: BACKGROUND: Damage to retinal ganglion cells is an important cause of irreversible vision loss, and stem cells have shown a great potential in therapeutic research for the treatment of such diseases, but there are fewer comprehensive descriptions of the relationship between stem cells and ocular tissues and the mechanisms of optic nerve protection.  
OBJECTIVE: To describe the progress of stem cell research in retinal ganglion cell protection and regeneration from the source of stem cells and their role in the maintaining of retinal ganglion cell function.
METHODS: “Stem cells, retinal precursor cells, retinal progenitor cells, transdifferentiation” and “retinal ganglion cells, retinal degeneration” were used as Chinese keywords to search in the Wanfang database and CNKI database. “Stem cell, retinal precursor cell, retinal progenitor cell, trans differentiation” and “retinal ganglion cell, RGC, retinal degeneration” were used as English keywords to search in the PubMed database. Finally, 102 articles were included for analysis according to the inclusion criteria.  
RESULTS AND CONCLUSION: (1) Retinal stem cells and retinal progenitor cells are present in the mammalian eye, but their scarcity and restricted differentiation potential result in a low regenerative capacity of retinal ganglion cells in the eye. (2) In vitro cultures have shown that many cells in intraocular tissues can differentiate directly into retinal ganglion cells and some have the potential to reprogram into retinal stem cells. Finding conditions that promote the proliferation, differentiation, and reprogramming of these cells could greatly facilitate the intraocular regeneration of retinal ganglion cells. (3) Due to the limitations of current technology, the regeneration of retinal ganglion cells from extraocular stem cells requires multiple processes such as ex vivo culture, induction of differentiation, and surgical reimplantation into the eye. Although the steps are tedious, extraocular stem cells are still the focus of research on retinal ganglion cell regeneration due to their wide source and a large number of cells. (4) Stem cells increase the survival rate of damaged retinal ganglion cells and maintain cell function. Mechanisms such as expression of neurotrophic factors, reduction of the inflammatory response, improvement of ischemia, and promotion of reprogramming of other cells into retinal stem cells are the basis for the optic neuroprotective role of stem cells. (5) In stem cell-based research on retinal ganglion cell regeneration, there are shortcomings such as the risk of tumor formation, the lack of attachment of transplanted cells and the difficulty of integrating them into the host retina, immune rejection, death of transplanted cells, and ethics-related issues that need to be addressed to find an appropriate solution.
Key words: stem cell, retinal progenitor cell, optic nerve, retinal ganglion cell, differentiation, intravitreal injection, optic nerve regeneration, optic nerve protection