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N Engl J Med. 2017 Mar 16;376(11):1038-1046. doi: 10.1056/NEJMoa1608368.

Autologous Induced Stem-Cell-Derived Retinal Cells for Macular Degeneration.

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From the Division of Ophthalmology, Institute of Biomedical Research and Innovation Hospital, Foundation for Biomedical Research and Innovation (M.M., Y. Kurimoto, Y.H., M.F., M.Y., S. Ohta, M. Takahashi), Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology (M.M., C.M., H.A., N.S., Y.S., M. Terada, H.K., S.S., A.O., M.Y., M. Takahashi), the Department of Ophthalmology, Kobe City Medical Center General Hospital (Y.Kurimoto, Y.H., M.F.), the Department of Clinical Trial Management, Institute of Biomedical Research and Innovation Hospital, Foundation for Biomedical Research and Innovation (T.I., K.F.), and Research and Development Center for Cell Therapy, Foundation for Biomedical Research and Innovation (S.K., M.J.G.), Kobe, Center for iPS Cell Research and Application (CiRA) (A.W., Y.N., M.N., J.K., Y. Kitano, N.A., M.U., F.K., A.T., N.T., S.Y.), Institute for Integrated Cell-Material Sciences (iCeMS) (A.W.), and Department of Pathology and Tumor Biology, Graduate School of Medicine (K.Y., S. Ogawa), Kyoto University, Kyoto, the Department of Biostatistics, Hyogo College of Medicine, Nishinomiya (T.D.), Platform of Therapeutics for Rare Disease, National Institutes of Biomedical Innovation, Health, and Nutrition, Ibaraki (H.A.), Mitsubishi Space Software, Tokyo (S.T., Y.O., C.O.), the Department of Ophthalmology, Kawasaki Medical School, Kurashiki (H.K.), Japan Tissue Engineering, Gamagori (C.S., K.H.), and HEALIOS K.K., Tokyo (M.S.) - all in Japan; and Gladstone Institute of Cardiovascular Disease, San Francisco (S.Y.).


We assessed the feasibility of transplanting a sheet of retinal pigment epithelial (RPE) cells differentiated from induced pluripotent stem cells (iPSCs) in a patient with neovascular age-related macular degeneration. The iPSCs were generated from skin fibroblasts obtained from two patients with advanced neovascular age-related macular degeneration and were differentiated into RPE cells. The RPE cells and the iPSCs from which they were derived were subject to extensive testing. A surgery that included the removal of the neovascular membrane and transplantation of the autologous iPSC-derived RPE cell sheet under the retina was performed in one of the patients. At 1 year after surgery, the transplanted sheet remained intact, best corrected visual acuity had not improved or worsened, and cystoid macular edema was present. (Funded by Highway Program for Realization of Regenerative Medicine and others; University Hospital Medical Information Network Clinical Trials Registry [UMIN-CTR] number, UMIN000011929 .).

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