EW GLAUCOMA
82
October 2016
the trabecular meshwork that they
would start to take over the function
of the cells that we lost," Dr. Kuehn
said, adding that didn't happen.
Instead, investigators found that
through the transplantation they
were actually causing the endoge-
nous remaining cells in the trabecu-
lar meshwork to divide. "In the end,
the effect that we were measuring
on outflow wasn't the effect of stem
cells directly, but the effect of the
now-divided and re-established
endogenous cells," he said. "The
stem cells nudged them into another
round of cell division because they
usually don't do that in a non-em-
bryonic eye."
Clinical appeal
Clinically speaking, Dr. Kuehn is en-
couraged. This shows how it is possi-
ble not only to treat elevated IOP in
glaucoma but also to fix the con-
dition. "One of the problems that
we have clinically is that drops and
the surgical approaches work pretty
well, will lower pressure, but people
might not be taking their drops or
applying them incorrectly," he said.
That gets worse as people get older,
and the therapy is lifelong. "This is
the first time that we've gotten to a
point where it looks like we can fix
it—we can restore the function of
that tissue for years," he said.
Overall, Dr. Kuehn is excited
about the approach. "This worked
much better than I had anticipated,"
he said. "I am excited about the
prospect that our findings suggest
we don't need to have the stem cells
if we can identify what it is that they
do to make them divide." If this can
be determined, then the stem cells
can be cut out of the process entire-
ly, which would ultimately make
things faster, safer, and cheaper. EW
Reference
1. Zhu W, et al. Transplantation of iPSC-
derived TM cells rescues glaucoma phe-
notypes in vivo. Proc Natl Acad Sci USA.
2016;113:E3492–500.
Editors' note: Dr. Kuehn has no finan-
cial interests related to his comments.
Contact information
Kuehn: markus-kuehn@uiowa.edu
byline goes here plus fade
Stemming continued from page 81
Trabecular meshwork (TM) and Schlemm's canal (SC) in a human donor eye with glaucoma.
The blue dots are nuclei of cells.
Source: Markus Kuehn, PhD
