Scientists use 3D printing and patient stem cells to help millions with eye problems  

Scientists have found a way to create eye tissue using stem cells and 3D printing, in new research that could revolutionize the treatment of a number of degenerative eye diseases.

A team of researchers from the National Eye Institute (NEI), part of the National Institutes of Health, printed a combination of cells that make up the outer blood-retina barrier — the eye tissue that supports the retina’s light-sensitive photoreceptors.

Their techniques provide a theoretically unlimited source of patient-derived tissue to study degenerative retinal diseases such as age-related macular degeneration (AMD) and use them to better understand how to treat or cure these diseases.

Heading the NEI Division of Ocular and Stem Cell Translational Research, Ph.D. “We know that AMD starts at the outer blood-retina barrier,” said Kapil Bharti.

“However, the mechanisms of AMD initiation and progression to advanced dry and wet stages are not fully understood due to the lack of physiologically relevant human models,” he said in a statement.

The external blood-retina barrier of the eye consists of retinal pigment epithelium (RPE), separated from the choriocapillaris by Bruch’s membrane. The membrane regulates how nutrients and waste move between the RPE and the choriocapillaris.

In people with AMD, lipoprotein deposits called drusen build up outside of Bruch’s membrane and prevent it from functioning properly.

About 20 million Americans suffer from some form of age-related macular degeneration. It is the leading cause of vision loss in Americans aged 60 and older; it is also the leading cause of irreversible blindness and vision loss worldwide.

“Our collaborative efforts have resulted in very relevant retinal tissue models of degenerative eye diseases,” said co-author Marc Ferrer, director of the 3D Tissue Bioprinting Laboratory at the NIH’s National Center for the Advancement of Translational Sciences.

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“Such tissue models have many potential uses in translation applications, including therapeutic development.”

Bharti and colleagues combined three immature choroidal cell types in a hydrogel: pericytes and endothelial cells, which are key components of capillaries; and fibroblasts that give structure to tissues.

They then printed the gel on a biodegradable scaffold, and within a few days the cells began to grow into a dense network of capillaries.

On day ninth, the scientists seeded retinal pigment epithelial cells on the other side of the scaffold. A little over a month after that, the tissue reached full maturity.

The outer blood-retina barrier is the interface of the retina and choroid, including Bruch's membrane and choriocapillaris.

The outer blood-retina barrier is the interface of the retina and choroid, including Bruch’s membrane and choriocapillaris.

According to the researchers’ analysis and testing, the printed tissue looked and behaved similarly to the natural external blood-retina barrier.

Under induced stress, imprinted tissue exhibited early AMD patterns such as drusen deposits below the RPE and progression to late dry-stage AMD.

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“By printing cells, we facilitate the exchange of cellular cues necessary for normal external blood-retina barrier anatomy,” explained Bharti.

“For example, the presence of RPE cells induces gene expression changes in fibroblasts that contribute to the formation of Bruch’s membrane – something that was proposed years ago but was not proven until our model.”

The scientists published the results of their work today in Nature Methods.

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