Cell Therapy for Diabetic Retinopathy—A Work in Progress

As the incidence of diabetes continues to rise worldwide, the challenge in preventing vision loss secondary to diabetic retinopathy (DR) remains a formidable one. Current treatments are only indicated in advanced disease when vision loss is imminent or has already occurred. In recent years, due to the discovery that post-natal vasculogenesis plays a role in vascular repair, there has been increasing optimism that cell therapy using endothelial progenitor cells (EPCs) can be harnessed therapeutically for conditions such as DR. Although autologous EPC therapy offers promise for DR, EPCs from patients with diabetes are themselves dysfunctional, while the diabetic milieu itself contributes further to this dysfunctionality. Additional research is required to unravel the complete science of vasculogenesis and the role of EPCs in repair, so that treatment can be optimized in terms of actual cell choice, pre-conditioning prior to transplantation, maximizing cell survival in the recipient, and preparation of the recipient tissue to ensure an adequate therapeutic response.