Retinal Pigment Epithelial Cell Replacement

Retinal pigment epithelial (RPE) cell replacement is a therapeutic strategy aimed at restoring or replacing the damaged RPE layer in the retina, primarily to treat degenerative retinal diseases such as age-related macular degeneration (AMD) and Stargardt disease. The RPE is a monolayer of pigmented cells that supports photoreceptor function and maintains retinal homeostasis. Cell sources for replacement include induced pluripotent stem cells (iPSCs), embryonic stem cells, and autologous peripheral retina-derived RPE. Delivery methods include subretinal injection of dissociated cells or transplantation as an intact monolayer sheet. The mechanism of action involves direct restoration of RPE functions and indirect paracrine support. Clinical trials have shown promising safety profiles and some efficacy signals, but challenges remain in ensuring long-term survival, overcoming immune rejection, and engineering biocompatible scaffolds.

Direct metabolic/trophic support and indirect paracrine effects by replacing damaged RPE cells with healthy RPE cells.