The Hindu : Health / Medicine & Research : Using skin-derived stem cells to 
treat hereditary vision defects
CHENNAI, September 8, 2009

Using skin-derived stem cells to treat hereditary vision defects

R. PRASAD 
The picture shows the mouse skin fibroblast cells that have become induced 
Pluripotent Stem (iPS) cells. The iPS cell colony is seen in the foreground and
the background cells are the feeder cells. Photo: Special arrangement
The picture shows the mouse skin fibroblast cells that have become induced 
Pluripotent Stem (iPS) cells. The iPS cell colony is seen in the foreground and
the background cells are the feeder cells. Photo: Special arrangement 

The Hyderabad-based LV Prasad Eye Institute has successfully converted skin 
cells of mice into induced pluripotent stem cells (iPS cells) that behave like
embryonic stem cells. The Institute is trying to do the same with human skin 
cells. The goal is to use skin cells of patients with retinal problems and
reprogramme them into iPS cells. These cells will then be directed to become 
one of the types of retinal cells. As the iPS cells will still have the 
defective
gene, a normal gene, which will be synthesised and delivered into the iPS cells 
using a viral vector, is expected to cure the patient. 

After establishing a procedure to restore vision that has been damaged by 
physical or chemical injury by harvesting limbal stem cells from the healthy eye
and transplanting them to the eye that has been damaged, the Hyderabad based LV 
Prasad Eye Institute has moved to the next stage. The Institute has successfully
converted skin cells of mice into induced pluripotent stem cells (iPS cells) 
that behave like embryonic stem cells. 

The work on standardising the procedure of reprogramming skin cells into iPS 
cells started 6-7 months ago. It took 3-4 months to establish the protocol
for converting skin cells into iPS cells. 

"We were able to produce iPS cells 2-3 months ago," said. Dr. D. 
Balasubramanian, Research Director of the Institute. They are now in the 
process of characterising
the iPS cells in order to do the same with human skin cells. 

"The protocol [of converting human skin cells to iPS cells] is the same, but 
human cells [when compared to mouse cells] behave differently," he said. "The
real test is when we try doing it using human cells." 

The central idea behind the work on iPS cells is to find a way to treat people 
with hereditary (genetic) diseases such as retinitis pigmentosa. 

When the technique of producing human iPS cells is perfected, the skin cells of 
patients with retinal problems such as retinitis pigmentosa will be reprogrammed
into iPS cells. The iPS cells will then be directed to become one of the types 
of retinal cells. Since the iPS cells will still have the defective gene,
a normal gene will be synthesised and delivered into the iPS cells using a 
viral vector. The delivered normal gene is expected to cure the patient. 

"The presence of defective genes [in addition to the normal gene] will not be a 
problem. We want to see if the normal gene overrides the effect of the defective
gene," he said. 

There is hope that this procedure should work as research in 2007 at MIT, 
Cambridge, showed that a mouse suffering from sickle cell anaemia could be 
cured.
In this case, the researchers first converted the skin cells of the mouse into 
iPS cells and then directed the iPS cells to become red blood cells. A normal
gene was introduced into the iPS cells and these cells were then transplanted 
into the mouse. The mouse no longer suffered from anaemia. 

The LV Prasad Eye Institute is working on introducing the normal gene through 
two routes. The first will use a viral vector, mostly a weak attenuated adeno
virus that cannot cause any disease. The second alternative is the non-viral 
introduction. 

"The efficiency of gene delivery into the host cell is much higher when a viral 
vector is used," he said. "But we would prefer a non-viral vehicle." 

Having produced iPS cells using mice, work is on to deliver a normal gene into 
the iPS cells. "We should be able to convert human skin cells into iPS cells
and introduce the cells with the normal gene in a year's time," he said. A 
patient with retinitis pigmentosa has already been chosen for the human study
to treat the disease through cell therapy. 

The biggest advantage of using iPS cells is that skin cells from the patient 
suffering from a disease are used for the cell therapy. Therefore, the question
of rejection due to tissue mismatch does not arise. 

The iPS cells have another advantage. As adult cells from the skin are used, 
the technique sidesteps the ethical problems that embryonic stem cell research
faces. The technique of producing induced pluripotent stem cells by 
reprogramming adult skin cells was first done in 2006 by Dr. Shinya Yamanaka at 
Kyoto
University. 

Two Chinese teams in Beijing recently succeeded in producing mouse pups using 
iPS cells. Pups created by one of the teams were able to sire over 200 
second-generation
pups. More than 100 third-generation pups were also produced. 



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