Here we present a community accepted protocol in multimedia format for subretinally injecting a bolus of RPE cells in rats and mice. This approach can be used for determining rescue potentials, safety profiles, and survival capacities of grafted RPE cells upon implantation in animal models of retinal degeneration.
La conversión de la luz en impulsos eléctricos se produce en la retina externa y se lleva a cabo en gran medida por conos y bastones fotorreceptores y células del epitelio pigmentario de la retina (RPE). RPE proporcionar apoyo crítico a los fotorreceptores y la muerte o la disfunción de las células del EPR es característico de la degeneración macular asociada a la edad (DMAE), la principal causa de la pérdida permanente de la visión en personas mayores de 55 años. Si bien no hay cura para la DMAE ha sido identificado, la implantación de RPE saludable en ojos enfermos puede llegar a ser un tratamiento efectivo, y un gran número de células del EPR puede generarse fácilmente a partir de células madre pluripotentes. Varias preguntas interesantes sobre la seguridad y eficacia de la entrega de células RPE todavía pueden ser examinadas en modelos animales, y los protocolos bien aceptados utilizados para inyectar RPE se han desarrollado. La técnica descrita aquí ha sido utilizado por varios grupos en diversos estudios y consiste en crear primero un agujero en el ojo con una aguja afilada. A continuación, una jeringa con una blunt aguja cargada con células se inserta a través del agujero y pasa a través del humor vítreo hasta que toque suavemente el RPE. El uso de este método de inyección, que es relativamente simple y requiere un mínimo de equipo, logramos la integración coherente y eficaz de las células RPE derivadas de células madre en entre el RPE host que impide cantidad significativa de degeneración de los fotorreceptores en modelos animales. Aunque no es parte del protocolo real, también se describe cómo determinar la extensión de la trauma inducido por la inyección, y cómo verificar que las células fueron inyectadas en el espacio subretiniano pt el uso de técnicas de imagen in vivo. Finalmente, el uso de este protocolo no se limita a las células del RPE; puede utilizarse para inyectar cualquier compuesto o de células en el espacio subretiniano.
The sensory retina is organized in functional tiers of neurons, glia, and endothelial cells. Photoreceptors at the back of the retina are activated by light; through phototransduction they convert photons into electrical signals that are refined by interneurons and transmitted to the visual cortex in the brain. Phototransduction cannot occur without the coordinated efforts of Mueller glia and retinal pigment epithelium (RPE) cells. RPE are organized in a monolayer directly behind the photoreceptors and perform multiple and diverse functions integral to photoreceptor function and homeostasis. In fact, RPE and photoreceptors are so co-dependent that they are considered to be one functional unit. Death or dysfunction of RPE results in devastating secondary effects on photoreceptors and is associated with age-related macular degeneration (AMD), the leading cause of blindness in the elderly1,2.
While no cure has been discovered for AMD, several clinical studies have shown that RPE cell replacement may be a promising therapeutic option3-13. With the advent of stem cell technology, it is now possible to generate large numbers of RPE cells in vitro from embryonic and induced pluripotent stem cells (hES and hiPS) that strongly resemble their somatic counterparts functionally and anatomically14-26. Stem cell-derived RPE have also been shown to function in vivo by multiple independent groups, including our own, to significantly slow retinal degeneration in rat and mouse lines with spontaneous retinal degeneration16,18,21,22,25,28,29. This combination of clinical and preclinical supporting evidence is so compelling that several clinical trials to prevent retinal degeneration using stem cell-derived RPE cells are now ongoing30,31.
RPE can be readily derived from hES and/or hiPS and implanted in the subretinal space of rodents using various derivation and injection techniques32,33. (See Westenskow et al. for a methods paper in multimedia format demonstrating the directed differentiation protocol we employ)34. There are critical remaining questions regarding the safety, survival, and functional capacity of exogenously delivered RPE cells upon implantation, therefore the ability to perform subretinal injections in rodents is a critical skill16,18,21,29,36,37. The delivery of RPE is not trivial, and the field is divided on the most effective injection technique. The protocol we describe here is a simple and effective way to deliver of bolus of RPE cells subretinally, and was used in the first clinical trial for stem cell-derived RPE transplantation31. (The reader may also refer to another JoVE article by Eberle et al. for an alternative depiction of subretinal injections in rodents.38)
The technique outlined in this manuscript cannot be visualized and trauma is unavoidable (as with any subretinal injection technique). It is performed by making a hole just under the limbus vessels and inserting a blunt needle along a transscleral route to inject a bolus of cells under the diametrically opposed retina. The person doing the injection will feel resistance as the blunt needle touches the retina. The cells may be directly visualized after the injection, however, and the degree of the induced retinal detachment can be determined by labeling the RPE cells with a transient fluorescent marker and detecting them with a confocal scanning ophthalmoscope (cSLO). An optical coherence tomography (OCT) system can also be used to monitor the trauma and easily identify the injection site.
En este artículo se describe un método relativamente simple para realizar inyecciones subretinianas de células del EPR en suspensión en ratas y ratones. El protocolo es fácil de aprender y más experiencia con la técnica se traducirá en un menor número de traumas (Figura 3, lo que representa uno de los mejores inyecciones), especialmente si se utiliza un micromanipulador (Figura 1A). Cualquier trauma se puede monitorizar in vivo con un sistema de cSLO y OCT (Fig…
The authors have nothing to disclose.
We wish to thank Alison Dorsey for helping to develop the subretinal injection technique. We also acknowledge the National Eye Institute (NEI grants EY11254 and EY021416), California Institute for Regenerative Medicine (CIRM grant TR1-01219), and the Lowy Medical Research Institute (LMRI) for very generous funding for this project.
Name of Material/ Equipment (A-Z) | Company | Catalog Number | Comments/Description |
2-Mercaptoethanol (55 mM) | Gibco | 21985-023 | 50 mL x 1 |
Cell Scapers | VWR | 89260-222 | Case x 1 |
CellTracker Green CMFDA | Molecular Probes | C34552 | 50 ug x 20 |
DPBS, no calcium, no magnesium | Gibco | 14190-144 | 500 mL x 1 |
Fast Green | Sigma-Aldrich | F7258 | 25 g x 1 |
Genteal Geldrops Moderate to Severe Lubricant Eye Drops | Walmart | 4060941 | 25 mL x 1 |
Hamilton Model 62 RN SYR | Hamilton | 87942 | Syringe x 1 |
Hamilton Needle 33 gauge, 0.5", point 3 (304 stainless steel) | Hamilton | 7803-05 | Needles x 6 |
Knockout DMEM | Gibco | 10829-018 | 500 mL x 1 |
KnockOut Serum Replacement | Gibco | 10828-028 | 500 mL x 1 |
L-Glutamine 200 mM | Gibco | 25030-081 | 100 mL x 1 |
Magnetic Stand | Leica Biosystems | 39430216 | Stand x 1 |
MEM Non-Essential Amino Acids Solution 100X | Gibco | 11140-050 | 100 mL x 1 |
Micromanipulator | Leica Biosystems | 3943001 | Manipulator x 1 |
Penicillin-Streptomycin (10,000 U/mL) | Gibco | 15140-122 | 100 mL x 1 |
Slip Tip Syringes without Needles BD (3 mL) | VWR | BD309656 | Pack x 1 |
Specialty-Use Needles BD (30 gauge, 1") | VWR | BD305128 | Box x 1 |
TrypLE Express Enzyme (1X), no phenol red | Gibco | 12604013 | 100 mL x 1 |