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Medicine Biotech

Embryonic Stem Cell Retinal Implants Seem Safe, So Far 91

An anonymous reader writes "A biotechnology company said Monday that results from the world's first human trial using embryonic stem cells to treat eye diseases suggested that the new procedure appears to be safe four months after the cells were injected into the eyes of two blind patients. The study also describes visual improvements in patients, and experts said the findings hold promise for treating blindness in patients with currently incurable conditions like age-related macular degeneration in older patients and Stargardt's Disease, a main cause of blindness in young people."
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Embryonic Stem Cell Retinal Implants Seem Safe, So Far

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  • by Anonymous Coward

    We're still way behind in visual prosthesis, so retinal regeneration is our best bet right now. I'm glad to hear this.

    • by ByOhTek ( 1181381 ) on Tuesday January 24, 2012 @01:46PM (#38807831) Journal

      The eye is a very complex organ though, so we would be behind. I'm glad to see progress, but even so, 4 months is a little short-term to say "no bad health effects". Given the cells are embryonic stem cells, I'm more concerned with the 10-20 year range.

      I have one of the issues listed, and I seriously hope that they can do something about it, I'd prefer a biological rather than mechanical solution, however, four months is not a lot of time, especially when you are messing with something as important as the sense of sight.

      • by Rui Lopes ( 599077 ) on Tuesday January 24, 2012 @01:57PM (#38807987) Homepage

        [...] I'm glad to see progress [...]

        I see what you did there. Oh wait...

      • by Samantha Wright ( 1324923 ) on Tuesday January 24, 2012 @02:00PM (#38808015) Homepage Journal

        While sight certainly is important, these kinds of treatments are so new that we can't really predict how long we'll actually have to watch before we really know for sure. It could be the case that in another week the new retinal tissue is chemically indistinguishable from what should have been there, or they might already be—that is, after all, the point of this trial, which is really more of an experiment.

        Suppositionally, though: given how the vision system develops in human infants, though, I would actually say that three years is probably enough time to be sure one of these treatments was a complete success. When people experience 5-10 year life spans after heart transplants, that's generally because of ancillary factors (replacement heart quality, vessels elsewhere in the body weakened by the same thing that led to the first heart giving out...) and not really the fault of the surgery (well, unless the weak spot is the point of fusion on the vessels.) Rejection happens pretty quick by comparison.

        • err, you are right, the eyes or one of the first things to fully develop aren't they? I forgot about that. It's been too long.

          With the use of stem cells especially since the differentiation and growth related factors won't be there in the same amounts as during development, i'd still be worried about things like cancer. Chances are, in an adult, they'll be missing the growth factors that would, nominally, cause those issues, but I'd still be a bit skeptical.

          • Actually, the absence of proper growth factors is a pretty fair thing to worry about. I don't know enough about stem cell treatments to make a proper comment, but having been exposed to my share of developmental biology I'm often surprised at how well these things actually work, because when a baby worm, human, or mouse is developing, there are a lot of growth factors that are responsible for directing the cells' development, and no tall of them are entirely inside of the cell. (For a basic example, think a
          • by geekoid ( 135745 )

            It's ok. I don't remember much about my eyes developing either. In my defense, I was young at the time.

      • by wbr1 ( 2538558 )
        Long term health effects need to be known. As it is stem cells, what if they reproduce incorrectly? This would essentially be cancer, and right at the optic nerve which is really an extension of the brain. Pretty much too close for comfort.
      • Re: (Score:3, Informative)

        by Dcnjoe60 ( 682885 )

        The eye is a very complex organ though, so we would be behind. I'm glad to see progress, but even so, 4 months is a little short-term to say "no bad health effects". Given the cells are embryonic stem cells, I'm more concerned with the 10-20 year range.

        I have one of the issues listed, and I seriously hope that they can do something about it, I'd prefer a biological rather than mechanical solution, however, four months is not a lot of time, especially when you are messing with something as important as the sense of sight.

        From the actual researchers, they have two major concerns - 1) whether the treatment is permanent and 2) rejection issues. Both are long term concerns like the 10-20 year range you worry about. With regards for the rejection issues, they are quite confident that they will be able to repeat the results using stem cells derived from the patient's skin.

        They say they didn't go this route, even though less risky to the patient, because their grant was specifically to use embryonic stem cells in the treatment.

        • Rejection is hardly a 10-20 year worry either, either the medicines handle it, or they don't. Although unlikely, potential cancer issues are a bigger concern, and I'm not sure "rejuvenated" (i.e. usually demethlyated) highly differentiated cells are going to be much better.

      • The eye is a very complex organ though, so we would be behind. I'm glad to see progress, but even so, 4 months is a little short-term to say "no bad health effects". Given the cells are embryonic stem cells, I'm more concerned with the 10-20 year range.

        As someone also suffering from one of the diseased potentially cured by this, I may not be ready to wait up to twenty years for long-term results, since I may very well be blind by then, thank you very much. With that said, four months is a very short time.

      • I suspect by "safe so far" they are worried less about long-term erosion of the gains to vision(which would be unfortunate; but if you are treating blind people, or those headed there fast, not a major reduction over the status quo); but the old "stem cells turning into delightful cancer, rather than the intended tissue" problem...

        That has, historically, been a major issue with using them. If you can get the little things to grow at all, they have a nasty tendency to exercise their pluripotent tendencies
        • My understanding of this (non scientist view) is that they found stem cells grown in isolation of other cells tended to become tumors. But when placed in the presence of similar cells or with cells of the areas of the body where they needed to grow, they were more likely to behave as hoped and turned into the needed cells. Maybe some kind of cellular chemical signature guidance to the stem cell of what to do. But what a gamble, you have to put the stem cells right into the affected area where if things g
      • ...if it don't work, you go blind?

        to my understanding, these folks are either already blind or going to be if untreated. between going/state blind versus gambling for a cure or going blind, I think being able to roll the dice is a good thing. do we really need to wait 10-20 year before approving a treatment that in the worst case cannot make it worst than what the patient is already now?

      • by geekoid ( 135745 )

        "Given the cells are embryonic stem cells, I'm more concerned with the 10-20 year range."

        wha? what do you think you will suddenly give birth to your own twin?

        And then he will builds a cyborg suit and try to kill you?

      • by mcgrew ( 92797 ) *

        4 months is a little short-term to say "no bad health effects".

        Er, if you're going blind anyway I'd think it was worth the risk, or I'd not have gotten my CrystaLens implant.

        I agree about the biological vs mechanical, provided the biological is from your own tissues (like this research) and not from a cadaver. I have a friend with donated corneas (and a donated liver) who has to take anti-rejection drugs the rest of his life. All other things being equal, I'd rather not have to take pills every day. I'm ver

    • by Samantha Wright ( 1324923 ) on Tuesday January 24, 2012 @01:51PM (#38807903) Homepage Journal
      The main reason for this (for those of you who haven't seen a neocognitron in a fourth-year machine learning course) is that the eye does a lot more pre-work for the brain than just blitting a grid of pixels down the optic nerve. Recent efforts [scienceagogo.com] attempted to do that, however. There's much more complex pattern recognition going on even at this most basic level, in addition to the loss of precision for the non-focal area, and that helps reduce the cognitive load to something we can fully utilize.
      • ... helps reduce the cognitive load to something we can fully utilize.

        Ah, the concept behind Peril Sensitive Sunglasses. Glad to see that nature figured it out first.

        • Not quite, although there's a better invention on the market: sunglasses pained black. Because we're all technically always in peril, and life is hard enough as it is.

          How neocognitrons (and to some extent the human visual cortex) actually work is that they crunch down a bunch of dots into progressively more meaningful shapes; e.g. if you see three black pixels next to each other on a white background, it can simplify that into a more complex representation that means there's a horizontal line at that positi

          • by geekoid ( 135745 )

            we're always in peril? what do you do for a living, attach lasers to sharks that aren't sdeiatd in an underwater mine field...while fighting of Aquaman?
            Always in peril, sheesh.

    • It would be better news if they could do this with adult steam cell. A lot less ethical issues involved with those.
    • by mcgrew ( 92797 ) *

      We're still way behind in visual prosthesis

      Only where the retina is concerned, and they've come a long, long way with that, too. I was extremely nearsighted all my life, 20/400, until I got a CrystaLens, (an artificial lens capable of focusing)implaned in my left eye in 2006. That eye is now 20/16, far better than normal vision. I used to wear contacts, and used reading glasses as well, now I need no corrective lenses at all! It also curres farsightedness (even age-related; I turn 60 this year), astigmatism

  • From the article:

    Researchers said that the procedure seemed to be safe and no signs of rejection or abnormal cell growth had been observed, and results show that patients’ vision improved slightly.

    Can anyone do a better job of defining what exactly that means? Can they see some light now? Shapes? What?

    • by fahrbot-bot ( 874524 ) on Tuesday January 24, 2012 @03:16PM (#38809129)
      From: Stem Cell Treatment for Eye Diseases Shows Promise [nytimes.com]

      Before the treatment, the woman with Stargardt’s was able to see the motion of a hand being waved in front of her but could not read any letters on an eye chart. Twelve weeks after the treatment, she was able to read five of the biggest letters on the eye chart with the treated eye, corresponding to 20/800 vision, according to the paper.

      Ms. Freeman, [another woman] who lives in Laguna Beach, Calif., went to 20/320 from 20/500 vision six weeks after the treatment.

  • by wierd_w ( 1375923 ) on Tuesday January 24, 2012 @02:23PM (#38808363)

    And I am excited about this research, but I would be much more interested in IPS stem cells. You see, my mom is one of those "abortion is bad m'kay?" Types who would oppose getting this treatment on moral grounds if the transplant wasn't cultured from her own tissue.

    She scientifically savvy enough to know the difference.
    (She does have a biology degree.)

    I understand that this is a preliminary trial, but given the information we know about embryonic stem cells and the risks of developing teratomas, cancer and tissue rejection from them, in addition to the ethical concerns, shouldn't the limited supply of embryonic cell lines remain in research labs, and out of patients?

    Using totipotent cells cultured from screend ips cells, guided in a petri dish to become macular precursor cells seems a more sensible solution, given that you reduce the risk of anomalous tissue growths (hair, etc...), reduce and or eliminate rejection, and the extended culture time let's you spot cancer precursor cells in the culture prior to transplant.

    Or am I missing something here?

    • The RPE cells that ACTC has in this trial were originally developed from a line that ended in termination of the fetus. ACTC does have a single cell extraction technique that extracts a single cell from the Blastomere stage of the embryo, but from what I've read changing to a line started from that process at this point would set the research back by introducing delays as the IND would need to be changed. NB: I own ACTC stock, I'm very interested and probably biased, but I'll try to accurately repeat wh
      • There is no doubt that embryonic stemcells can theoretically cure any age related degenerative disorder, and a number of genetically inherited degenerative disorders.

        Afterall, if left alone, these cells produce entire functioning bodies.

        The problem comes from understanding the complex game of chemical "charades" these cells play with one another to control the way the cells differintiate.

        I have no qualms about them being studied in a laboratory to unlock those secrets, but blindly injecting them into patien

        • Re: (Score:3, Informative)

          by guru zim ( 706204 )
          These are differentiated Retinal Epithelial Cells (RPE). http://download.thelancet.com/flatcontentassets/pdfs/S0140673612600282.pdf [thelancet.com] This is neither rash, nor precocious. This is a Phase I/II trial, not some mad scientist shooting up random cells into rubes in the woods. I'd recommend that anyone reading this exchange read the linked journal and not put an excessive amount of faith into people talking authoritatively and with big words :)
          • That does help, but the title is misleading. Embrionic stemcells are usually implied to be the pluripotent kind.

            This is an interesting development, as it means the researchers were successful in reliably creating retinal epithelial cells from such a culture.

            This increases my excitement about the trial. I still don't see why they elected to use an embryonic line instead of a host derived ips line.

            A prior poster commented that it was due to the wording of their trial's funding, which is why I ask. Why was the

            • The retinal cells of interest are neurons. Neurons differentiate very early in development - to my knowledge no one has yet developed an IPS that can reliably be made to differentiate into high-quality neurons.

              As to scarcity, in order to maintain the totipotentency of the existing lines my understanding is that they _must_ be divided occasionally (early blastocyte stage I think), or they devolve into pluripotent cells. The process generates spares by its very nature.

              • Not purpetually. Normal (non cancerous) cell lines can only be divided 50 times before reaching senecense.

                An aging stemcell line can only be reprimed that way for so long before the cells just sit in the dish and do nothing.

  • by tunapez ( 1161697 ) on Tuesday January 24, 2012 @02:26PM (#38808413)

    It's more profitable to treat the ailment than to cure it? I sure hope they don't pull a 'Geron'. [businessweek.com] Give them a few more months to solidify their findings ...

    • by geekoid ( 135745 )

      "It's more profitable to treat the ailment than to cure it?"
      except that's false in most cases, and i other case would rely on the current CEO and board being so kind, that let either their competitors discover it, or let the next generation of board member/CEO reap the benefits.

      Geron is about running out of money, nothing more.

      If there therapy worked, the share price would have gone through the roof as stock holders abandon there current companies to grab part of the cure.
      The CEO would have gotten a big pha

  • I can only imagine what we could be doing in the field of medicine if stem cell research had its doors blown wide open with no restrictions. If we can make blind people see again under the current provisions and laws regarding stem cell research, one can only imagine the possibilities if they were allowed unrestricted federal funding. All of the research using new lines of stem cells is being funded privately, as current laws don't allow for federal funding of research having to do with new lines of embryon
    • Re:Can You Imagine? (Score:5, Interesting)

      by wierd_w ( 1375923 ) on Tuesday January 24, 2012 @03:30PM (#38809321)

      Many of the ethical concerns over embryonic cells would be ended if the collection method was nondestructive.

      The problem was hamfisted legislation that treats embryonic blast collection as being equal to murdering babies.

      There are single cell extraction techniques which allow cells to be nondestructively collected. This process is used in screening for ivf, prior to embryo selection. (This is how they pick only safe embryos, and not ones likely to produce children with developmental disorders.)

      I would rather see legislation prohibiting destructive collection, than against any collection at all.

      The issue here, is that we have cells previously collected using the destructive methods prior to the moratorium sitting in freezers, when those tissues could be used for fundamental research.

      It is my understanding that demand for these lines is high, as many cultures were co-cultured with mouse tissue for purposes of expediency. This limits the number of "purely human" cultures that are suitale for medical research to a much smaller subset of the already limited cell lines available. (Note, the mouse contaminated lines are not genetically blended. They are just heterogenous.)

      What I would personally like to see is an end to the moratorium on federal funding for embryonic cells, with the provision that all NEW lines be derived nondestructively.

      Doing that would radically reduce the ethical concerns surrounding their use.

      Our ability to create, use, and evaluate adult stemcells is directly tied to the fundamental research done with embryonic ones.

      However, I don't support your position on unfettered research. To me that opens far too big of a pandora's box into the realm of public health. Oversight and good proceedure are vital to good research.

      • by geekoid ( 135745 )

        All that is because religious people aren't content to keeping to themselves, they want to force everyone else to their antiquated black and white views.
        See: Big Bang, evolution, AGW.

  • That's what my doctor told me three weeks ago before I started growing a FETUS IN MY E Y E ! ! !

  • I'd like to see the day when missing, extracted, or damaged teeth are routinely regrown instead of replaced with titanium and ceramic.

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