Una retina de células madre abre las puertas del trasplante

Shinya Yamanaka, padre de la reprogramación celular, aseguraba en una entrevista concedida tras recibir el premio de la Fundación BBVA que el primer órgano reproducido en el laboratorio sería la retina. Sus predicciones, como cabría esperar, parecen bastante acertadas. Aunque no son exactamente retinas humanas ‘artificiales’, las copas ópticas fabricadas por un grupo de científicos nipones sitúa los trasplantes a un tiro de piedra.

El equipo de la Universidad de Kobe (Japón) dirigido por Yoshiri Sasai sigue avanzando en el campo de la medicina regenerativa del ojo. Hace algo más de un año, presentaron en la revista ‘Nature’ la generación ‘in vitro’ de copas ópticas -las estructuras embrionarias de las que surgen las retinas– a partir de células madre embrionarias de ratones. Ahora, lo han hecho con células humanas y los resultados son muy llamativos y «prometedores», según Shomi Bhattacharya, director del Centro Andaluz de Biología Molecular y Medicina Regenerativa (CABIMER).

«La imagen es muy impresionantes porque son estructuras muy similares a las que se observan durante el desarrollo embrionario», explica a ELMUNDO.es Paola Bovolenta, especialista en biología del desarrollo y profesora de investigación en el Centro de Medicina Regenerativa Severo Ochoa.

El éxito del grupo de Sasai, que tiene una sólida reputación en el sector, es la reproducción casi perfecta de la copa óptica. Gracias a un cuidadoso sistema de cultivo, las células madre embrionarias dieron lugar de forma espontánea a una estructura invaginada compuesta por dos capas: una interna, que da lugar a la retina neural, y una externa, que conforma el epitelio retinal pigmentario.

El proceso fue similar al que habían observado antes con las células madre de ratón pero el resultado fue ligeramente distinto. «Han demostrado que existen variaciones en el desarrollo entre especies, algo muy importante», señala Bovolenta. «Las células de ratón generaron una retina más pequeña que las humanas, que originaron una estructura más grande y con una proporción de células similar a la que hay en el ojo humano».

Una opción para varias enfermedades

«Hasta ahora, no se habían reproducido tan bien los tejidos de la retina ocular», comenta Nuria Montserrat, investigadora del Centro de Medicina Regenerativa de Barcelona (CMRB) que trabaja en la diferenciación de células madre e iPS. «Han logrado una disposición espacial, con las dos capas, igual a la realidad. Es casi como un ojo en un plato de cultivo».

Las primeras aplicaciones podrían estar cerca. «En particular, para la retinitis pigmentosa, donde los fotorreceptores de degeneran gradualmente», explica Sasai a este medio. También se podría emplear, «en combinación con células iPS, para crear modelos de enfermedades en los que estudiar la patogénesis y explorar nuevos tratamientos», añade el investigador japonés.

«Este estudio abre las puertas al trasplante», asegura Monserrat. Pero tal vez no a la clásica idea de trasplante, donde un órgano dañado es sustituido por uno nuevo. El problema está, coinciden los autores y los expertos consultados por este medio, en que conectar una retina con el nervio óptico puede ser demasiado complicado.

«Probablemente, no sea necesario reintegrarla entera, sobre todo en algunas enfermedades», señala Bovolenta. Como en la degeneración de la retina, donde «parece razonable hacer un injerto lo suficientemente maduro para contener un gran número de precursores de fotorreceptores», apuntan los autores en las páginas de ‘Cell Stem Cell‘.

El ojo, el órgano perfecto

Habrá que esperar a que se lleven a cabo nuevos estudios, pero, de momento, esto es lo más cerca de la clínica que están las células madre embrionarias. La clave está, según Montserrat, en que «con 50.000-80.000 células, muchas menos de las que se necesitan en otros órganos, puedes empezar a tener resultados». Además, los problemas de rechazo y el riesgo de aparición de tumores parecen escasos.

En nuestro país, hay varios grupos que se dedican a la investigación en este campo. En el CMRB, han «empezado a hacer cultivos con células madre e iPS» pero aún están en fases preliminares, explica esta experta.

En el Instituto Universitario de Oftalmología Aplicada (IOBA) de la Universidad de Valladolid hay un grupo dedicado a la retina en donde también están «intentando crear estructuras en 3D de tejido usando células madre», explica Girish Kumar, que trabaja allí. Allí trabajan con células madre de la grasa, diferenciándolas a células de la retina. También buscan un tratamiento para la Degeneración Macular Asociada a la Industria y tienen algunos estudios con animales en los que usan células madre para proteger el epitelio pigmentario. En todos estos campos, subraya Kumar, «este trabajo nos va a ayudar mucho«.

Gracias a todos estos esfuerzos, es muy probable que la retina sea la primera aplicación clínica de las células madre embrionarias pero los expertos reclaman más. «El ojo es muy asequible -insiste Montserrat- pero hay que ir más allá, hacia algo más relevante para la salud mundial, como la patología cardiovascular».

Fuente:  elmundo.es

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