Review Article

Bone Marrow-Derived Cells as a Therapeutic Approach to Optic Nerve Diseases

Table 1

Summary of published preclinical studies.

AnimalsCell injection(s)Effects, longest time analyzed after injuryDistribution, longest time analyzed after transplantationMechanismsReferences

Glaucoma models: rise of the intraocular pressure through several approaches, retinal ischemia/reperfusion

Adult female Wistar rats (MSCs were from male)ivit rat BM-MSCs or rat AT-MSCs 1 w after injury 
Dose: 200,000 cells
4 w; RGCs retrogradely labeled, % to uninjured: BM-MSCs (83%); AT-MSCs (85%); untreated (65%)4 w; cells were integrated into GCL and INLReduced TNF-α and interferon-γ;  
increased IL-1Ra and prostaglandin E2 receptor
[68]

Adult female Wistar ratsivit rat BM-MSCs 2 w after injury 
Dose: 200,000 cells
4 w; RGCs retrogradely labeled, % to uninjured: BM-MSC (88%); untreated (80%)8 w; ILM, NFL, GCLIncreased expression of bFGF and CNTF[69]

Adult brown Norway rats (sex not specified)ivit BDNF-expressing rat BM-MSCs; rat BM-MSCs 2 d after injury 
Dose: 200,000 cells
6 w; BDNF-BM-MSCs treated animals had better pupil light reflex, ERG function, and optic nerve integrity; RGCs (Brn3a-positive cells) % to uninjured: BDNF-MSCs (56%); MSCs (29%)6 w; GCL, vitreousChronic low dose delivery of BDNF[70]

Adult male Sprague-Dawley and Lewis rats ivit and IV rat live or dead BM-MSCs 1 w before the injury 
Dose: 30,000 cells
4 w; intravenous: no effect.  
Intravitreal: RGCs survival (optic nerve damage): Lewis: 92% (live BM-MSC); 74% (dead BM-MSCs) 
Sprague-Dawley: 89% (live BM-MSCs); 62% (dead BM-MSCs)
5 w: majority of cells in the vitreous, few in the ILM, NFL, and GCLn/a[71]

Adult male Sprague-Dawley ratsivit rat BM-MSCs 
Dose: 180,000
4 w: RGCs (nuclei counting in the GCL): 1.3 fold increase to untreated4 w: vitreous, ILM, GCLIncreased expression of bFGF, CNTF, and BDNF[72]

Aged male Sprague-Dawley ratsivit BM-MSCs 6 w after injury 
Dose: low (30,000 cells); high (100,000 cells)
10 w: RGCs retrogradely labeled, % to uninjured: 40% (untreated), 58% (low dose); 69% (high dose)  
Improved visual water box swimming test (better in high dose)
n/an/a[73]

Adult brown Norway female ratsant/cha murine BM-MSCs 
Dose: 100,000 cells
4 w: trabecular meshwork regeneration; decreased IOP; decreased RGCs degeneration (TUNEL+ cells)24 h: cells migrated to the damaged area 96 h: cells clearedSecretion of paracrine factors; recruitment of ocular progenitor cells[74]

Optic nerve crush or transection

Adult male and female Lister hooded ratsivit rat BM-MNCs immediately after injury 
Dose: 5,000,000 cells
2 w: RGCs retrogradely labeled, % to uninjured: BM-MNCs (40%); vehicle (24%); higher optic nerve regeneration; 8 w: RGCs regeneration and reconnection to the superior colliculus2 w: very few cells GCL, INL, optic nerveMüller glia modulation; bFGF, Tax1BP1, and SytIV increased expression[34, 75, 76]

Adult male Sprague-Dawley ratsivit rat BM-MSCs 
Dose: low: 30,000; high: 100,000
2 w: higher optic nerve regeneration. High dose had more regeneration than low dose of BM-MSCsn/an/a[77]

Adult Wistar rats (sex not specified)ivit NTF-secreting BM-MSCs; human BM-MSCs; rat BM-MSCs 3 d before the injury 
Dose: 400,000
8 d: RGCs retrogradely labeled, % to uninjured: human NTF-BMSCs (69%); human BM-MSCs (66%); vehicle (46%); rat BM-MSCs had no neuroprotective effect24 d: vitreousNeurotrophic factors secretion (GDNF, BDNF); possible inflammatory reaction to xenotransplantation[33]

Adult male and female Lister hooded ratsivit rat BM-MSCs 
Dose: 500,000
4 w: RGCs (Tuj1+ and Brn3a+ cells; % to uninjured): 21% and 5% MSCs; 9% and 2% vehicle 18 w: vitreousIncreased expression of bFGF and IL-1β[35]

Adult male Sprague-Dawley ratsivit rat DP-MSCs or rat BM-MSCs 
Dose: 150,000 cells
3 w: RGCs (β-III tub+ cells/mm): DP-MSCs (28), BM-MSCs (16), untreated (6.9); higher axon regeneration and RFNL thickness in both treated groups, best on DP-MSCs3 w: DP-MSCs in the vitreous; BM-MSCs n/aNeurotrophic factors release (NGF, BDNF, and NT-3); DP-MSCs release more NGF and BDNF than BM-MSCs; reduced scar tissue on the crush site[62]

In vitro: organotypical retinal explant culture

Adult Sprague-Dawley rats (sex not specified)A droplet containing 1,000–5,000 BM-MSCs was placed on the RGCs surface1 w: RGCs number increased ~2-fold (Islet-1; NeuN, β-III tub); increased NFL and IPL thickness1 w: adjacent to GCL, not integrated into the retinaSecretion of growth factors, specially PDGF (also tested in vivo in a glaucoma model)[61]

ant/cha: anterior chamber; AT-MSCs: adipose tissue-derived mesenchymal stem cells; BDNF: brain-derived neurotrophic factor; bFGF: basic fibroblast growth factor; BM-MNCs: bone marrow-derived mononuclear cells; BM-MSCs: bone marrow-derived mesenchymal stem cells; CNTF: ciliary neurotrophic factor; DP-MSCs: dental pulp-derived mesenchymal stem cells; GCL: ganglion cell layer; GDNF: glial cell line-derived neurotrophic factor; IL-1Ra: interleukin-1 receptor antagonist; ILM: inner limiting membrane; INL: inner nuclear layer; IOP: intraocular pressure; IPL: inner plexiform layer; IV: intravenous; ivit: intravitreal; NFL: nerve fiber layer; NTF: neurotrophic factors; PDGF: platelet-derived growth factor; RGCs: retinal ganglion cells; sub: subretinal; SytIV: synaptotagmin IV; Tax1BP1: Tax1-binding protein 1; TNF-α: tumor necrosis factor alpha.