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© Copyright, English Edition, 2015 for Jaypee - Highlights Medical Publishers, Inc.

Daniel H. Scorsetti, MD, PhD; Victor L. Perez, MD; Jose Alvaro Pereira Gomes, MD, PhD

“STEM CELLS IN OPHTHALMOLOGY”

Published for: Jaypee - Highlights Medical Publishers, Inc.

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4Medicine is constantly advancing and ophthalmology is one of the fields that best demonstrates this. Stem cells were discovered over 50-years ago, however a boom in publications as regenerative therapy only began in the year 2000, and has enjoyed steady growth since that time. In 2012, two Nobel Prizes were awarded to researchers, Sir John Gurdon and Shinya Yamanaka for their contributions to the field of stem cells, discovering that mature cells can be reprogrammed to become pluripotent. Their findings have revolutionized our understanding of how cells and organisms develop.

The ocular surface has had the privilege of being one of the pioneers in the field of stem cell use because of the ease of access and the clinical and scientific evidence of the presence of these cells in the limbus permitting reconstructed therapies using limbal stem cell transplantation. Other areas of ophthalmology, such as the retina, orbit and trabecular meshwork, etc., have evolved significantly, and now have very promising treatments.

My first book of Stem Cells in Ophthalmology was published in 2011, and its important repercussions coupled with the latest technological advances in the field convinced me to develop this new textbook with two long-time friends and world-renowned physician-scientists as co-editors. Without the intensive, unrivaled commitment, and remarkable meticulousness of Jose AP Gomes and Victor L. Perez, this book would not have been possible.

The value of this book has been greatly enhanced by the chapters written by our international expert colleagues. Their contribution is greatly appreciated and the main reason for the much anticipated success of this valuable resource to ophthalmologists and trainees worldwide.

Last but not least, I would like to thank Karen A. Hodous, who spared neither time nor effort coordinating the materials and liaising with each author. And to Felipe Valenzuela, who in the final hour of preparation and review, and with “fresh eyes”, provided review support and constructed the book index.

I would also like to thank the PanAmerican Cornea Society (PanCornea), the Bascom Palmer Eye Institute at the University of Miami, the School of Medicine at Salvador University in Buenos Aires (USAL) and the Universidade Federal de São Paulo (UNIFESP/EPM) for their support of this work.

Finally, a special thanks to our wives and children who have allowed us the time to work on this project.

5 The use of stem cell therapy in medicine has evolved from general ideas to structured concepts that are now on trial in different fields including ophthalmology. This book is certainly a testimony to what has been achieved, and most importantly, where we are and what still needs to be done in order to discover and develop new therapeutic approaches that will contribute to the control of a variety of ocular diseases.

Since the beginning, the cornea was seen as an important and easy target for conducting research because of its anatomy and other peculiar aspects, including the facility of observation and access. Therefore, it is not surprising that the studies on the cornea and the ocular surface of the eye have become one of the more advanced areas in cell biology. Nevertheless, in the last decade, investigators working on other parts of the eye, such as the retina, have also achieved promising results to be explored and confirmed in the near future. This amplification of the stem cell field in ophthalmology has also seen the realization of fantastic new discoveries in other fields of basic research showing just how important long-term investments in stem cell treatment and therapies are.

Drs. Victor L. Perez from Miami, Daniel H. Scorsetti from Buenos Aires and José AP Gomes from São Paulo, are excellent clinical and surgical ophthalmologists, who lead research teams with international recognition. This book represents part of the pioneering work done by them and by some of the most distinguished investigators that work in this still mostly experimental field. We expect (and we need) that it will continue to be developed, helping medicine to advance for the benefit of our patients.

I am certain that this book will be very useful to many who are interested in, or currently working in ophthalmology. It will help with the understanding of the present situation of research in the different subfields of ophthalmology. And most certainly, will be a “go to” resource in the planning of future research endeavors in stem cells, specifically.

The use of stem cell therapy to treat and potentially cure human diseases has become a realistic concept in the last decade. The field of regenerative medicine using cell-based therapy is here to stay and grow. Many fields in medicine are adopting this approach to treat patients with degenerative and acquired disorders where organ regeneration is necessary. This “vision” of hope has also become a very important part in the future of vision science research and translational ophthalmic medicine.

Interestingly, ophthalmology has been a pioneer specialty in the use of cell-based therapy, specifically, in the successful treatment of ocular surface disorders using limbal stem cell transplantation. In contrast to other organs, the eye provides a unique scenario where direct visualization and direct access to the target affected organ are readily accessible. This provides a perfect setting where end-points of success are clear and local delivery of cells can be efficiently performed. In fact, the eye may provide an excellent platform to test efficacy and safety of regenerative medicine.

Understanding, that the field of stem cell biology and therapy is rapidly evolving, we have tried to capture in present time where in ophthalmology we stand with respect to the use of stem cell therapy to regenerate all the structures of the visual system and ocular adnexa. From lacrimal gland to the optic nerve, the use of cell-based therapy has been applied to most of the structures of the eye. In some, major advances have been achieved, while in others, early steps have been initiated.

In this book, basic stem cell biology and immunity will be reviewed and unique advances or present state-of-the-art use of these cells in ocular tissue will also be covered. As we move into the practice of translational medicine, the final chapter will cover the description of the facilities and governmental requirements needed to establish an ocular stem cell program.

With the participation of recognized experts from all over the world, we hope that this comprehensive collection becomes a stepping stone to scientific interaction in the exciting field of cell therapy!

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