You have joined hands with LV Prasad Eye Institute, Hyderabad to develop a new technique for delivering stem cell therapy to the eye. Can you throw more light on this collaboration?
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Sheila MacNeil
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LV Prasad Eye Institute is truly world-leading in terms of its pioneering, ground breaking work in the field of research and technology and has helped patients deal with a whole range of eye problems. We knew of them by reputation and thus, chose to work with them to develop a new technique which will help in the repair of eyes damaged by accident or disease.
To keep the cornea clear and scar-free, there are specialist stem cells located at the front of our eyes called limbal epithelial stem cells. The loss of these specialist cells leads to the growth of surrounding scar type tissue over the eye which results in reduced vision or even blindness. There are very few specialist centres around the world which are equipped to culture limbal epithelial cells from the unaffected eye, place the cells on small pieces of donor human amniotic membrane, grow these for several weeks in culture and then transplant these to the eye post removal of the scar tissue. Thus, in the last 15 years, limited numbers of patients have been able to access specialist treatment for this condition.
We are working together to simplify this technique. There are two steps in the development of this technique – regenerating a new corneal epithelium from a very small piece of the unaffected eye and producing a synthetic membrane as an alternative to the human amniotic membrane which can be stored and ready for use by surgeons anywhere.
What will be the benefit of this collaboration? What is your role in this collaboration and how will LV Prasad Eye Institute contribute?
The main benefit of this collaboration will be to make the treatment of cornea surface disease more accessible to more surgeons and therefore more patients. Corneal disease is the fourth most important cause of blindness worldwide (Source:WHO). In India, particularly, damage to the clear surface of the cornea is very common. Unfortunately, as mentioned earlier, access to this treatment is limited. There are relatively very few centres that have surgeons who are in a position to treat these patients. Thus, the therapy, which will be developed as a result of the collaboration, will help in curing patients who have damage in the front of their eye due to some accident or more rarely due to a disease.
Dr Virender Sangwan, Clinical Director of LV Prasad Eye Institute, has already tested out the first concept that a corneal epithelium can be regenerated on the eye starting with very small pieces of tissue. Now, together we have completed the development of a synthetic sterilised biodegradable membrane which can be stored at -20°C for at least a year before use. The University of Sheffield is taking the lead in developing this biodegradable membrane and Dr Sangwan of LV Prasad is working with us closely to confirm that what we develop will be appropriate for clinical use and he will lead the first clinical study in man once we’ve completed the development of this material.
Who has funded this project?
This UK-India collaboration project has been funded by the Wellcome Trust Foundation. This is a charitable foundation that funds breakthrough research, this time on an international basis. It has funded a small team of researchers on this project for three and half years.
How are these funds going to be utilised?
These funds have been utilised to fund research staff both in India and in the UK to develop the carrier and evaluate it in the laboratory and to do extensive tests to make sure that it will be fit for purpose for a clinical study in man. We are now near the end of the three and a half year project and the funds have supported a small team of researchers both in the UK in Sheffield and in LV Prasad to work very closely together to develop the biomaterials, evaluate them extensively, check that they can actually support the culture of cells and cells growing out from tissue explants and subject them to a battery of tests, which include sterilisation and storage for long periods of time. In brief to complete all of the work that is necessary before such membranes can be tested safely in patients.
You say that with this collaboration you will work towards simplifying this technique and making it more affordable and accessible for patients in India. Can you elaborate on this effort?
Standard treatments for corneal blindness are corneal transplants or grafting stem cells onto the eye using donor human amniotic membrane as a temporary carrier to deliver these cells to the eye. But we have developed a synthetic sterilised biodegradable membrane as an alternative to human amniotic membrane. This membrane can be sterilised and stored in a vacuum pack until needed and then combined with a small explant of the patient’s tissue from the contralateral eye for immediate use by surgeons anywhere thus making the treatment accessible. Also, we have used very simple materials (materials currently used in dissolvable sutures) in developing the synthetic membrane and the technology of producing the membranes is not itself expensive. Thus, we hope that once we have verified the success of the technique, we can make it available at a relatively low cost. That is the motivation behind our research, making regenerative medicine affordable.