Global Treatment Approaches Part 1: Neuroprotection and Stem Cell Therapy

Gareth D Mercer1, Brian G Ballios1, Peter J Kertes2

  • 1Department of Ophthalmology & Vision Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Insights

Gene-agnostic therapies offer a promising approach for retinal degenerations by targeting common cellular stress pathways. These treatments benefit more patients than gene-specific options, including those with unidentified genetic causes.

Area of Science:

  • Ophthalmology
  • Regenerative Medicine
  • Gene Therapy

Background:

  • Retinal degenerations involve photoreceptor and retinal pigment epithelium (RPE) cell stress, dysfunction, and death.
  • Gene-specific therapies target individual genetic causes, incurring high R&D costs and benefiting limited patient populations.
  • A significant unmet need exists for treatments applicable to a broader range of retinal degeneration patients.

Purpose of the Study:

  • To define and categorize global treatment approaches for retinal degenerations.
  • To highlight the potential of gene-agnostic therapies as a scalable treatment strategy.
  • To discuss the advantages of gene-agnostic treatments over gene-specific therapies.

Main Methods:

  • Literature review and conceptual framework development for classifying global treatment strategies.
  • Analysis of existing and emerging therapeutic modalities for retinal degenerations.
  • Comparison of gene-agnostic and gene-specific treatment paradigms based on scope and patient applicability.

Main Results:

  • Global treatments address common pathophysiologic pathways in retinal degenerations, such as cellular stress and death.
  • These strategies are categorized into those that maintain/replace cells (neuroprotection, stem cells) and those that circumvent photoreceptor dysfunction (implants, optogenetics).
  • Gene-agnostic therapies offer a wider reach, potentially benefiting patients with unidentified genetic causes and reducing overall treatment development costs.

Conclusions:

  • Gene-agnostic therapies represent a significant advancement in managing retinal degenerations.
  • Their ability to target common disease mechanisms offers a more inclusive and potentially cost-effective therapeutic avenue.
  • Further research and development in gene-agnostic approaches are crucial for addressing the broad spectrum of retinal degenerative diseases.