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Optic cup-like structures were differentiated from hESCs in vitro. The brightfield (A, C, E, G) and fluorescence (B, D, F, H) images of the differentiation process. (A, B) Undifferentiated hESCs were cultured on feeder. (C, D) Embryoid bodies were formed *3 to 4 days after suspension culture of hESCs aggregated. (E, F) Neural rosettes were differentiated within weeks after adherent culture of embryoid bodies. (G, H) Optic cuplike structures were self-organized within 2 weeks after suspension culture of the neural epithelium. Scale bar = 200 mm (in A-D, G, H), scale bar = 50 mm (in E, F). hESCs, human embryonic stem cells. Color images are available online.

Optic cup-like structures were differentiated from hESCs in vitro. The brightfield (A, C, E, G) and fluorescence (B, D, F, H) images of the differentiation process. (A, B) Undifferentiated hESCs were cultured on feeder. (C, D) Embryoid bodies were formed *3 to 4 days after suspension culture of hESCs aggregated. (E, F) Neural rosettes were differentiated within weeks after adherent culture of embryoid bodies. (G, H) Optic cuplike structures were self-organized within 2 weeks after suspension culture of the neural epithelium. Scale bar = 200 mm (in A-D, G, H), scale bar = 50 mm (in E, F). hESCs, human embryonic stem cells. Color images are available online.

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Human embryonic stem cells (hESCs) have the potential to differentiate along the retinal lineage. We have efficiently differentiated human pluripotent stem cells into optic cup-like structures by using a novel retinal differentiation medium (RDM). The purpose of this study was to determine whether the retinal progenitor cells (RPCs) derived from hE...

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... enhanced green fluorescent protein-expressing human ES (H9 inGFPhES) cell line was gifted from the laboratory of SuChun Zhang (Waisman Center and Wicell Research Institute). Cells were maintained in ESC medium (see Supplementary Table S1 for media) for several passages for acclimation to culture conditions, and then were differentiated according to previously established methods (Supplementary Fig. S1). Partially differentiated colonies were manually removed before differentiation analysis. ...
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... hESCs were maintained in the undifferentiated state using mouse fibroblasts, and the morphology of stem cell clones were well defined (Fig. 1A, B). In particular, differentiated colonies were manually removed before subculture and differentiation analysis. The hESCs were identified by expression of the stem cell markers Nanog and Oct 3/4 ( Supplementary Fig. S2). Following our published efficient differentiation protocol for producing optic cup-like structures from hESCs, the ...
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... colonies were manually removed before subculture and differentiation analysis. The hESCs were identified by expression of the stem cell markers Nanog and Oct 3/4 ( Supplementary Fig. S2). Following our published efficient differentiation protocol for producing optic cup-like structures from hESCs, the embryoid bodies were formed on days 3-4 (Fig. 1C, D) after detaching the hESC clones from the feeder. On days 14-16, hESC-derived neural tube-like rosettes were observed (Fig. 1E, F). On days 28-35, the optic cup-like structures were formed spontaneously and self-organized (Fig. 1G, H), and the transparent neuroepithelia structures were clearly observed within ...
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... stem cell markers Nanog and Oct 3/4 ( Supplementary Fig. S2). Following our published efficient differentiation protocol for producing optic cup-like structures from hESCs, the embryoid bodies were formed on days 3-4 (Fig. 1C, D) after detaching the hESC clones from the feeder. On days 14-16, hESC-derived neural tube-like rosettes were observed (Fig. 1E, F). On days 28-35, the optic cup-like structures were formed spontaneously and self-organized (Fig. 1G, H), and the transparent neuroepithelia structures were clearly observed within ...
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... protocol for producing optic cup-like structures from hESCs, the embryoid bodies were formed on days 3-4 (Fig. 1C, D) after detaching the hESC clones from the feeder. On days 14-16, hESC-derived neural tube-like rosettes were observed (Fig. 1E, F). On days 28-35, the optic cup-like structures were formed spontaneously and self-organized (Fig. 1G, H), and the transparent neuroepithelia structures were clearly observed within ...
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... helix-loop-helix transcription factor that is specifically expressed by RPCs. This is required not only for cell cycle progression but also for early multiple retinal neuronal differentiation, including RGCs, photoreceptor, horizontal, and amacrine cells [25][26][27]. The vast majority of cells in optic cup-like structures were Math5 positive (Fig. 2A1), suggesting that these cells were ...
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... climbing pieces of the cells extracted from the optic cup-like structures were collected and detected by using double immunofluorescence. As expected, we found abundant expression of a number of transcription factors, including Math5 (Fig. 3A1) and Pax6 (Fig. 3B1). Previous studies have shown that these markers were specially expressed by RPCs. Meanwhile, all nuclei of the cells derived from hESCs were efficiently labeled with human nuclei antigen (hNu) (Fig. 3A2, B2). To characterize hNu, it is more convenient to identify and quantify the transplanting cells than the GFP ...
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... climbing pieces of the cells extracted from the optic cup-like structures were collected and detected by using double immunofluorescence. As expected, we found abundant expression of a number of transcription factors, including Math5 (Fig. 3A1) and Pax6 (Fig. 3B1). Previous studies have shown that these markers were specially expressed by RPCs. Meanwhile, all nuclei of the cells derived from hESCs were efficiently labeled with human nuclei antigen (hNu) (Fig. 3A2, B2). To characterize hNu, it is more convenient to identify and quantify the transplanting cells than the GFP cells, although the ...
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... were Math5+/Brn3b+. Nuclei were stained with hNu (green) (A2, B2) and DAPI (blue) (A3, B3). Merged images are shown in A4 and B4. Scale bar = 50 mm. Color images are available online. [31]. Therefore, on the fourth week after transplantation, a significant reduction in Brn3a-positive cells (red) were observed in the NMDA-treated retina (Fig. 4A1, B1) compared with the control group. This demonstrated that the experimental glaucoma models were made successfully. Meanwhile, many hNu-positive cells were also clearly observed in the host retina (Fig. 4A2, B2). These data showed that the transplanting cells migrated from the vitreous cavity to the retina and survived. Surprisingly, it ...
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... visual function of the host. To determine whether the RGCs could be generated by the transplanting RPCs derived from hESCs, the host retinas were analyzed by using triple immunofluorescence staining on the fifth week after transplantation (Fig. 5). Brn3a, a mature ganglion cell marker, was used to label the host residual RGCs in the mouse retina (Fig. 5A1, B1). As expected, the complementary distribution of hNupositive cells and Brn3a-positive cells was also observed in the GCL of mouse retinas (Fig. 5A4). Surprisingly, a small number of hNu-positive cells were colabeled with Brn3a (Fig. 6B1, C1, D1, E1), which indicated that the mature RGCs have been generated even although the expression ...
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... 5). Brn3a, a mature ganglion cell marker, was used to label the host residual RGCs in the mouse retina (Fig. 5A1, B1). As expected, the complementary distribution of hNupositive cells and Brn3a-positive cells was also observed in the GCL of mouse retinas (Fig. 5A4). Surprisingly, a small number of hNu-positive cells were colabeled with Brn3a (Fig. 6B1, C1, D1, E1), which indicated that the mature RGCs have been generated even although the expression level of Brn3a was lower than in the host conventional RGCs. The aforementioned data showed that the transplanting RPCs contained the ganglion cell progenitors, but the percentage is lower; some new RGCs may be differentiated from RPCs under ...
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... aforementioned data showed that the transplanting RPCs contained the ganglion cell progenitors, but the percentage is lower; some new RGCs may be differentiated from RPCs under the influence of the host retina microenvironment. Furthermore, the same results were further certified from the level of retinal sections ( Supplementary Fig. S5); the surviving transplanted cells (hNu + ) (red) were clearly observed in the host retina GCL (Supplementary Fig. S5A1, A2), and they also expressed Brn3a (pink) ( Supplementary Fig. S5B1, B2), which is a classic marker of mature RGCs, confirming their potential to differentiate into RGCs. Meanwhile, other surviving transplanting cells localized in the GCL were Brn3a negative (Fig. 6F1). ...
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... aforementioned data showed that the transplanting RPCs contained the ganglion cell progenitors, but the percentage is lower; some new RGCs may be differentiated from RPCs under the influence of the host retina microenvironment. Furthermore, the same results were further certified from the level of retinal sections ( Supplementary Fig. S5); the surviving transplanted cells (hNu + ) (red) were clearly observed in the host retina GCL (Supplementary Fig. S5A1, A2), and they also expressed Brn3a (pink) ( Supplementary Fig. S5B1, B2), which is a classic marker of mature RGCs, confirming their potential to differentiate into RGCs. Meanwhile, other surviving transplanting cells localized in the GCL were Brn3a negative (Fig. 6F1). ...
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... (hNu + ) (red) were clearly observed in the host retina GCL (Supplementary Fig. S5A1, A2), and they also expressed Brn3a (pink) ( Supplementary Fig. S5B1, B2), which is a classic marker of mature RGCs, confirming their potential to differentiate into RGCs. Meanwhile, other surviving transplanting cells localized in the GCL were Brn3a negative (Fig. 6F1). These cells may be amacrine cells or another type of ganglion cell. Either way, the complementary distribution of these cells with remaining host RGCs might be helpful for the retina. On the whole, the overall efficiency integration was poor (*5%) on the fifth week after transplantation. Excitingly, there was no teratoma appeared in ...

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Citations

... RO-derived cells have exceptional promise for regenerative medicine; they have emerged as a valuable and unlimited resource for cell replacement therapy ( Fig. 3(2)). Transplanting retinal cells or RPCs from ROs following selection by flow cytometry or transplantation of retinal sheets has been extensively investigated in preclinical studies (Wang et al. 2019;Zou et al. 2019). To increase the benefit of the grafted cells, many studies have combined cells or retinal sheets with biodegradable scaffolds to help with cell survival, migration, and integration (Luo et al. 2021). ...
Chapter
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Human embryonic stem cells (hESCs)- and induced pluripotent stem cells (hiPSCs)-derived retinal organoids (ROs) are three-dimensional laminar structures that recapitulate the developmental trajectory of the human retina. The ROs provide a fascinating tool for basic science research, eye disease modeling, treatment development, and biobanking for tissue/cell replacement. Here we review the previous studies that paved the way for RO technology, the two most widely accepted, standardized protocols to generate ROs, and the utilization of ROs in medical discovery. This review is conducted from the perspective of basic science research, transplantation for regenerative medicine, disease modeling, and therapeutic development for drug screening and gene therapy. ROs have opened avenues for new technologies such as assembloids, coculture with other organoids, vasculature or immune cells, microfluidic devices (organ-on-chip), extracellular vesicles for drug delivery, biomaterial engineering, advanced imaging techniques, and artificial intelligence (AI). Nevertheless, some shortcomings of ROs currently limit their translation for medical applications and pose a challenge for future research. Despite these limitations, ROs are a powerful tool for functional studies and therapeutic strategies for retinal diseases.KeywordsDrug discoveryDrug screeningEye diseasesGene therapyGenetic editingHuman ESCsHuman iPSCsRegenerative medicineRetinal degenerative diseasesRetinal organoids (ROs)Transplantation
... Next, researchers collected donor cells by enzymatically dissociating organoids, generating mostly retinal progenitor cells. One study showed that five weeks after injection into NMDA-treated mice, 0.5% of donor progenitors integrated into host retinas and differentiated into RGC-like cells in vivo (Wang et al., 2019). ...
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Glaucoma, characterized by a degenerative loss of retinal ganglion cells, is the second leading cause of blindness worldwide. There is currently no cure for vision loss in glaucoma because retinal ganglion cells do not regenerate and are not replaced after injury. Human stem cell-derived retinal ganglion cell transplant is a potential therapeutic strategy for retinal ganglion cell degenerative diseases. In this review, we first discuss a 2D protocol for retinal ganglion cell differentiation from human stem cell culture, including a rapid protocol that can generate retinal ganglion cells in less than two weeks and focus on their transplantation outcomes. Next, we discuss using 3D retinal organoids for retinal ganglion cell transplantation, comparing cell suspensions and clusters. This review provides insight into current knowledge on human stem cell-derived retinal ganglion cell differentiation and transplantation, with an impact on the field of regenerative medicine and especially retinal ganglion cell degenerative diseases such as glaucoma and other optic neuropathies.
... Therefore, subsequent studies have attempted to transplant RPCs, which stay on an earlier stage of development. Compared with photoreceptor cells and RPE cells, RPCs have greater developmental potential and may achieve a better therapeutic effect [143,144]. However, how to lead the transplanted RPC properly differentiate in vivo and improve retinal function is still remain unknown. ...
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... Although further experiments are needed to clearly demonstrate their integration into the host retina, our data are consistent with previous studies reporting 10% integration efficiency of postnatal rat RGCs (Venugopalan et al., 2016). A recent study suggested that retinal progenitors derived from human embryonic stem cells (hESCs) could differentiate into RGClike cells in the host GCL 4 weeks after transplantation in NMDA-injured retina, but no morphological maturation was reported (Wang et al., 2019). However, injection of a cell population that may contain mitotic cells seems hazardous, with the risk of cell hyperproliferation within the vitreous. ...
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... Subretinal transplantation of hESC-derived RPE cells in a preclinical mouse model of AMD showed no tumor growth with the transplanted cells detected at the injection site seven months after injection, 8 and some injected cells formed an RPE monolayer above the native layer. 9 In a similar study, RPCs derived from hESCs integrated into the mouse ganglion cell layer (GCL), expressed retinal ganglion cells (RGCs) marker Brn3a, 10 and outer nuclear layer (ONL) thickness increased in the injected animals. 11 In a study involving non-human primates, subretinal transplantation of hESC-derived retinal organoids was well tolerated and the transplanted cells integrated into the retinal layer in the injury site created by laser ablation. ...
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... Although further experiments are needed to clearly demonstrate their integration into the host retina, our data are consistent with previous studies reporting 10% integration efficiency of postnatal rat RGCs (Venugopalan et al., 2016). A recent study suggested that retinal progenitors derived from human embryonic stem cells (hESCs) could differentiate into RGClike cells in the host GCL 4 weeks after transplantation in NMDA-injured retina, but no morphological maturation was reported (Wang et al., 2019). However, injection of a cell population that may contain mitotic cells seems hazardous, with the risk of cell hyperproliferation within the vitreous. ...
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Optic neuropathies are a major cause of visual impairment due to retinal ganglion cell (RGC) degeneration. Human induced-pluripotent stem cells (iPSCs) represent a powerful tool for studying both human RGC development and RGC-related pathological mechanisms. Because RGC loss can be massive before the diagnosis of visual impairment, cell replacement is one of the most encouraging strategies. The present work describes the generation of functional RGCs from iPSCs based on innovative 3D/2D stepwise differentiation protocol. We demonstrate that targeting the cell surface marker THY1 is an effective strategy to select transplantable RGCs. By generating a fluorescent GFP reporter iPSC line to follow transplanted cells, we provide evidence that THY1-positive RGCs injected into the vitreous of mice with optic neuropathy can survive up to 1 month, intermingled with the host RGC layer. These data support the usefulness of iPSC-derived RGC exploration as a potential future therapeutic strategy for optic nerve regeneration.
... However, limited studies have utilized PSCderived RGCs for transplantation. In an encouraging study, RPCs were extracted from hESC-derived retinal organoids and transplanted into the vitreous cavity of a mouse model with RGC injury, where the transplanted cells migrated and integrated into the ganglion cell layer in the host retina [130]. Further development to upscale generation and purification of the stem cell-derived retinal cells would facilitate new treatment for retinal regeneration. ...
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Stem cell and cell reprogramming technology represent a rapidly growing field in regenerative medicine. A number of novel neural reprogramming methods have been established, using pluripotent stem cells (PSCs) or direct reprogramming, to efficiently derive specific neuronal cell types for therapeutic applications. Both in vitro and in vivo cellular reprogramming provide diverse therapeutic pathways for modeling neurological diseases and injury repair. In particular, the retina has emerged as a promising target for clinical application of regenerative medicine. Herein, we review the potential of neuronal reprogramming to develop regenerative strategy, with a particular focus on treating retinal degenerative diseases and discuss future directions and challenges in the field.