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Retinal regeneration refers to the restoration of vision in vertebrates that have suffered retinal lesions or retinal degeneration. The two most well-studied mechanisms of retinal regeneration are cell-mediated regeneration and cellular transplantation. Regenerative processes may have applications in humans for treating degenerative retinal diseases, such as
retinitis pigmentosa Retinitis pigmentosa (RP) is a genetic disorder of the eyes that causes loss of vision. Symptoms include trouble seeing at night and decreasing peripheral vision (side and upper or lower visual field). As peripheral vision worsens, people may ...
. While mammals, such as humans and mice, lack the innate ability to regenerate the retina, lower vertebrates, such as
teleost Teleostei (; Greek ''teleios'' "complete" + ''osteon'' "bone"), members of which are known as teleosts ), is, by far, the largest infraclass in the class Actinopterygii, the ray-finned fishes, containing 96% of all extant species of fish. Tel ...
fish and salamanders, are capable of regenerating lost retinal tissue in the event of damage.


By creature


In zebrafish

Zebrafish The zebrafish (''Danio rerio'') is a freshwater fish belonging to the minnow family (Cyprinidae) of the order Cypriniformes. Native to South Asia, it is a popular aquarium fish, frequently sold under the trade name zebra danio (and thus often c ...
, like other teleost fish, possess the innate ability to regenerate retinal damage. This ability combined with the considerable similarity between teleost and mammalian retinal structure makes zebrafish an attractive model for the study of retinal regeneration.
Muller glia Muller is a surname. Notable people with the surname include: A–H *A. Charles Muller (born 1953), translator *Bauke Muller (born 1962), Dutch bridge player * Bennie Muller (born 1938), Dutch footballer * Bill Muller (1965–2007), US journalis ...
are a type of glial cell present in both the teleost and mammalian retina. Retinal regeneration in zebrafish is mediated by Muller glia, which dedifferentiate into stem-like cells and proliferate into neural progenitor cells in response to retinal damage. While Muller glia division is responsible for the regeneration of the retina in all cases of retinal damage, the case of photoreceptor loss due to light damage is particularly well characterized. In response to photoreceptor ablation, Muller glia dedifferentiate and undergo a single asymmetric division to produce a neural progenitor cell and a new Muller glia cell. The neural progenitor cell proliferates to form a cluster of neural progenitors, which migrate to the
outer nuclear layer The outer nuclear layer (or layer of outer granules or external nuclear layer), is one of the layers of the vertebrate retina, the light-detecting portion of the eye. Like the inner nuclear layer, the outer nuclear layer contains several strata o ...
of the retina and differentiate into photoreceptors to replace the lost cells. This process restores retinal function to the injured fish. Understanding the underlying mechanisms may provide insight into treatment options for degenerative retinal diseases in mammals. Several proteins and signaling pathways have been described and characterized in the process of retinal regeneration. The roles of a few important elements are summarized below:
Rod Rod, Ror, Ród, Rőd, Rød, Röd, ROD, or R.O.D. may refer to: Devices * Birch rod, made out of twigs from birch or other trees for corporal punishment * Ceremonial rod, used to indicate a position of authority * Connecting rod, main, coupling, ...
precursor differentiation is another mechanism by which zebrafish can replace lost retinal neurons. Rod precursors are produced during normal zebrafish growth and localize to the outer nuclear layer of the retina. In the event of chronic or small-scale rod photoreceptor death, rod precursors proliferate and differentiate into new rod photoreceptors. This population of progenitor cells can be induced to proliferate by means such as injection of
growth hormone Growth hormone (GH) or somatotropin, also known as human growth hormone (hGH or HGH) in its human form, is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in ...
or selective rod photoreceptor cell death. However, as this regenerative response is more limited than the Muller glia mediated response, much less is known about its underlying mechanisms.


In mice

Mice, like other mammals, do not show an innate capacity to regenerate retinal damage. Retinal damage in mammals instead typically results in
gliosis Gliosis is a nonspecific reactive change of glial cells in response to damage to the central nervous system (CNS). In most cases, gliosis involves the proliferation or hypertrophy of several different types of glial cells, including astrocytes, mi ...
and scar formation which interrupts normal retinal function. Previously, treating damaged eyes with
epidermal growth factor Epidermal growth factor (EGF) is a protein that stimulates cell growth and differentiation by binding to its receptor, EGFR. Human EGF is 6-k Da and has 53 amino acid residues and three intramolecular disulfide bonds. EGF was originally de ...
induced Muller glia proliferation in the mouse eye, but neuron generation only occurred with concurrent overexpression of
Ascl1 Achaete-scute homolog 1 is a protein that in humans is encoded by the ''ASCL1'' gene. Because it was discovered subsequent to studies on its homolog in Drosophila, the Achaete-scute complex, it was originally named MASH-1 for mammalian achaete sc ...
. More recently, robust Muller glia proliferation and subsequent neuronal differentiation has been seen using the alpha 7 nAChR agonist, PNU-282987. More information on the signaling pathways involved is required before Muller glia mediated regeneration will be a viable treatment method for restoring vision in mammalian retinas. Other approaches to retinal regeneration involve cellular transplantation treatments. In findings presented in the journal "''Proceedings of the National Academy of Sciences''" in 2012, a Nuffield Laboratory of Ophthalmology research team led by Dr
Robert MacLaren Robert E. MacLaren FMedSci FRCOphth FRCS FACS VR (born 14 November 1966) is a British ophthalmologist who has led pioneering work in the treatment of blindness caused by diseases of the retina. He is Professor of Ophthalmology at the Un ...
from the
University of Oxford The University of Oxford is a collegiate research university in Oxford, England. There is evidence of teaching as early as 1096, making it the oldest university in the English-speaking world and the world's second-oldest university in contin ...
restored sight to totally blind mice by injections of light-sensing cells into their eyes. The mice had suffered from a complete lack of
photoreceptor cells A photoreceptor cell is a specialized type of neuroepithelial cell found in the retina that is capable of visual phototransduction. The great biological importance of photoreceptors is that they convert light (visible electromagnetic radiati ...
in their
retinas The retina (from la, rete "net") is the innermost, light-sensitive layer of tissue of the eye of most vertebrates and some molluscs. The optics of the eye create a focused two-dimensional image of the visual world on the retina, which then p ...
, and had been unable to tell light from dark. Promising results using the same treatment had been achieved with night-blind mice. Despite questions about the quality of restored vision, this treatment gives hope to people with dysfunctional vision and including degenerative eye diseases such as
retinitis pigmentosa Retinitis pigmentosa (RP) is a genetic disorder of the eyes that causes loss of vision. Symptoms include trouble seeing at night and decreasing peripheral vision (side and upper or lower visual field). As peripheral vision worsens, people may ...
. The procedure involved injecting
rod Rod, Ror, Ród, Rőd, Rød, Röd, ROD, or R.O.D. may refer to: Devices * Birch rod, made out of twigs from birch or other trees for corporal punishment * Ceremonial rod, used to indicate a position of authority * Connecting rod, main, coupling, ...
precursors which formed an 'anatomically distinct and appropriately polarized
outer nuclear layer The outer nuclear layer (or layer of outer granules or external nuclear layer), is one of the layers of the vertebrate retina, the light-detecting portion of the eye. Like the inner nuclear layer, the outer nuclear layer contains several strata o ...
' - two weeks later a retina had formed with restored connections and sight, proving that it was possible to reconstruct the entire light-sensitive layer. Researchers at
Moorfields Eye Hospital Moorfields Eye Hospital is a specialist NHS eye hospital in Finsbury in the London Borough of Islington in London, England run by Moorfields Eye Hospital NHS Foundation Trust. Together with the UCL Institute of Ophthalmology, which is adjac ...
had already been using human embryonic stem cells to replace the pigmented lining of the retina in patients with
Stargardt's disease Stargardt disease is the most common inherited single-gene retinal disease. In terms of the first description of the disease, it follows an autosomal recessive inheritance pattern, which has been later linked to bi-allelic ABCA4 gene variants ...
. The team is also restoring vision to blind patients with an electronic
retinal implant Retinal prostheses for restoration of sight to patients blinded by retinal degeneration are being developed by a number of private companies and research institutions worldwide. The system is meant to partially restore useful vision to people who ...
which works on a similar principle of replacing the function of the light-sensing
photoreceptor cells A photoreceptor cell is a specialized type of neuroepithelial cell found in the retina that is capable of visual phototransduction. The great biological importance of photoreceptors is that they convert light (visible electromagnetic radiati ...
.


In humans

In February 2013, the
US Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food s ...
approved the use of the Argus II Retinal Prosthesis Syste

{{Cite news, url=https://www.reuters.com/article/us-secondsight-fda-eyeimplant/fda-approves-first-retinal-implant-for-rare-eye-disease-idUSBRE91D1AK20130214, title = FDA approves first retinal implant for rare eye disease, newspaper = Reuters, date = 14 February 2013 making it the first FDA-approved implant to treat retinal degeneration. The device may help adults with RP who have lost the ability to perceive shapes and movement to be more mobile and to perform day-to-day activities.


External links


Nuffield Laboratory of Ophthalmology


References

Blindness Vision