原发性开角型青光眼的诱导性多能干细胞治疗

Therapeutic effects of induced pluripotent stem cells on primary open angle glaucoma

青光眼是视网膜神经节细胞凋亡而导致视觉功能损害的一类眼科疾病。开角型青光眼是青光眼的主要类型之一，其主要致病因素为小梁网细胞凋亡导致的高眼压。随着干细胞研究的迅速发展，利用干细胞治疗小梁网退行性病变成为目前的研究热点，为开角型青光眼的治疗提供了新的途径。其中诱导性多能干细胞（iPSCs）作为新型干细胞，根据其自体来源的特性，成为潜在的可用于临床治疗的细胞类型。目前，利用iPSCs治疗开角型青光眼仍然是极具挑战性的任务。本文从iPSCs的特性的角度揭示其临床应用的困难及策略，并根据目前iPSCs在原发性青光眼治疗方面的相关研究，概括其在不同物种、不同原因、不同病理进程的开角型青光眼模型中的治疗效果。此外，iPSCs针对小梁网退行性病变的治疗仍存在其特有的问题，本文从相关治疗的安全性、时效性、特异靶向性方面进行阐述，并针对不同问题，结合目前研究热点提出针对性的解决策略，同时也旨在提供前沿的科学热点问题，及时对国内外的研究进展进行总结，期望在科研工作者们的共同努力下，推动iPSCs在临床应用研究方面的进展，最终为青光眼患者带来光明。

Glaucoma is an group of ocular disease associated with the degeneration of retinal ganglion cells and it finally causes vision loss. Primary open angle glaucoma （POAG） is a main type of glaucoma worldwide. The primary reason of POAG is elevated intraocular pressure （IOP） caused by the degeneration or dysfunction of the trabecular meshwork （TM）. Recent studies showed that stem cell-based therapy becomes a promising approach to treat the degenerative diseases, including POAG. Among multiple types of stem cells, induced pluripotent stem cell （iPSC） is the one with the most clinical potential due to its autologous derivation and non-ethical issue. In this paper, we summarized the encouraging therapeutic effects of iPSCs on POAG from different species, different etiological factors and different pathological stages. Although these encouraging studies suggest that iPSC is a fabulous stem cell type to regenerate the damaged tissue, more efforts are required for clinical application. In addition, we discussed several solutions to improve the safety of iPSCs and provided potential approaches to improve the therapeutic efficiency and specific targeting. Answering these questions will help us to better understand the characteristics of iPSCs and promote the development of bench to bedside research.