Exploring trabecular meshwork stem cells: potential roles, therapeutic implications and challenges in glaucoma

Abstract

Introduction: Recent investigations surrounding trabecular mesh (TM) stem cells have generated significant interest due to their possible role in glaucoma treatment. Trabecular mesh cells are crucial in maintaining IOP (intraocular pressure), and their dysfunction is involved in glaucoma pathogenesis. Several studies highlight innovative models for studying glaucomatous function and the regeneration of TM. For example, Buffault et al. provide an overview of current TM glaucomatous models, emphasizing their importance in the mechanism of open-angle glaucoma and testing the possible therapies (Buffault J., 2023). The purpose of this review is to provide an overview of TMSCs, their capacity for regeneration, and their therapeutic uses in glaucoma. Material and methods: A literature review was conducted using the PubMed, Scopus, and Web of Science databases. Keywords used:”trabecular meshwork stem cells”, “glaucoma”, “regenerative therapy” and “stem cell-based treatment”. Of 102 abstracts selected for the 2015-2025 period, just 64 were selected based on preclinical data. Results: Research suggests that TM stem cells are found in the juxtacanalicular area of the TM and are capable of multipotent differentiation and self-renewal. Studies conducted in vivo show that the stem cells can develop into functional TM-like cells, which restore outflow capability, lower the IOP in glaucomatous patients, and preserves retinal ganglion cells. Furthermore, TM stem cell transplantation has demonstrated potential in decreasing fibrotic alterations and encouraging TM repair. Clinical applicability is still hampered by issues like immune response mitigation, long-term survival, and cell delivery method optimization. In conclusion, the investigation of TM stem cells offers a critical path forward for the study and treatment of glaucoma. Even if preclinical research indicates that cell-based therapies are effective, further investigation is needed to improve them, evaluate their long-term safety, and provide standardized procedures for clinical use. Developments in tissue engineering and stem cell biology could open the door to successful TMSC-based treatments for the treatment of irreversible vision loss brought on by this life-threatening condition.