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Published on: January 4, 2015
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.
Abstract:
Global treatment approaches, also called gene-agnostic therapies, are those that address pathophysiologic responses common to retinal degenerations, i.e., photoreceptor and RPE metabolic stress, dysfunction and, ultimately, cell death. Global treatment strategies may be classified as those that aim to maintain or replace dysfunctional photoreceptors and/or RPE (e.g., neuroprotective agents and stem cell therapies) or those that circumvent the dysfunctional photoreceptors entirely (e.g., bioelectronic retinal implants and optogenetics). The research and development costs of each gene-specific therapy are high relative to the number of individuals who can benefit from it. Gene agnostic treatments have the potential to benefit a significantly larger number of patients, including those for whom the genetic cause of their disease cannot be identified.
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.
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