Tuesday’s Beacon told the story of Heather Barlow, a 23-year-old Warwick resident who traveled to Austria in May to receive adult stem cell transplant therapy for her dry macular degeneration. The treatment, Barlow was told, could help restore her vision; so far, Barlow said it’s doing just that.
The treatment is relatively new, says Dr. Robert Janigian, a board certified ophthalmologist and assistant clinical professor at Brown University School of Medicine.
According to Janigian, the first clinical trial of stem cell therapy for macular degeneration in the U.S. was done at the University of California, Los Angeles (UCLA) in 2011, and the results of the study were released in January of this year.
Barlow received treatment by American doctors in Vienna, Austria in late May, but Janigian said he has not seen anything about those trials published in peer reviews.
“Stem cell therapy is in its infancy,” he said. “A lot of safety issues have not been sorted out yet.”
The trials done at UCLA involved embryonic stem cells; cells that had been genetically manipulated to produce the types of cells necessary to restore lost vision. The UCLA study involved two patients who were safely treated, but Janigian said years of follow-up will be necessary before the procedure is Food and Drug Administration (FDA) approved.
The lack of FDA approval is what sent Barlow and her doctors to Austria, where the controversy surrounding stem cell research is minimal compared to that in the U.S.
Janigian said doctors in the U.S. have yet to find the optimal amount of cells to inject when treating patients, and are still unsure what the lasting effects of treatment will be. One of the biggest complications with stem cells is the possible formation of tumors.
“They can be like cancer cells,” said Janigian. “They’ll keep reproducing unless you program them properly.”
Janigian said he is mainly familiar with the use of embryonic or fetal stem cells, not the use of adult stem cells. For Barlow’s treatment, stem cells were taken from bone marrow in her hip and injected behind her eyes.
“[Adult stem] cells are not the best cells to do the job,” said Janigian, who said the embryonic stem cells are better equipped to grow and reproduce into various types of adult cells.
Janigian said it could be 10 years before the FDA approves stem cell treatment for macular degeneration.
In the meantime, there are studies being done on other ways to treat diseases like macular degeneration.
“It’s almost annoying when the television media gets a hold of [this information] and calls doctors,” said Janigian about some of the hype that’s surrounded stem cell therapy. He wants people suffering from vision loss to know there are other options out there.
Other treatments being developed include new pharmaceuticals and even an artificial retina. Janigian likened the artificial retina (which is about six years into development and tests) to a computer chip. The chip is implanted in the retina and turns light perceived into electrical signals that are sent to the optic nerve. The optic nerve sends the signals to the brain, which in turn, translates those signals into an image.
“It’s how the retina already works,” said Janigian.
Janigian said it’s likely the artificial retina, a technology being backed by the U.S. Department of Energy, will be ready and approved before stem cell therapy.
In the months and years following Barlow’s procedure, her progress will be closely monitored. She’s hopeful her vision will continue to improve.
Janigian, too, is hopeful that stem cell therapy will one day help many patients to see again.
“It’s very exciting to think about,” he said. “It’s very promising.”