Dear Editor, Visual rehabilitation achieved with peripheral RPE autografts in exudative AMD is only modest. Moreover, complication rates using the popular RPE–choroid patch technique remain relatively high. Tissue-engineered transplants might improve the outcome of RPE transplantation. A culturing step could place cells on a substrate prior to transplantation, thereby optimizing delivery and long-term function [1]. This would require sufficient cellular plasticity (i.e., response to environmental stimuli) to achieve a well-differentiated, functional graft. While culture plasticity was confirmed for fetal cells or RPE cell lines [2, 3], only sparse information is available for aged RPE [4]. We studied the influence of culture conditions on select differentiation characteristics in long-term primary RPE cultures from ten human donors above age 55, and compared them to a 23-year-old and two fetal donors (20 and 21 weeks of gestation respectively). The main outcome measures at 6 weeks post-confluence (PC) were morphology and transepithelial resistance (TER), an electrophysiological method for assessing tight junctions build-up. Eyes were preserved within 6 hours of death. Adult primary RPE cultures (aRPE) were initiated from: (1) mechanically scraped RPE, or (2) collagenase pretreated (1 mg/ml for 40 minutes, CLS I, Worthington Biochemical Corp, Lakewood, NJ, USA) and mechanically scraped RPE, or (3) fetal (fRPE) and adult cultures started from floater passages [2]. Cells were grown on permeable polyester inserts (Transwells, Corning Inc., Corning, NY, USA) in modified Hu & Bok media [2], containing 2% calf serum, basic FGF (5 ng/ml), L-alanyl-L-glutamine (2 mM), Albumax (200 μg/ml), and antibiotics/antimycotics. RPE culture purity was confirmed by a uniform pancytokeratin staining. Experimental matrices analyzed the influence of above harvesting methods, seeding density, laminin coating (2 μg/cm), and media composition (2% vs 10% serum until confluence, or calcium switch at confluence, or 5 mM vs 25 mM glucose) on above outcome measures. Morphology was monitored weekly in all and transepithelial resistance (TER) in all conditions, except the laminin matrix (i.e., seven of ten aged donors). Presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, FL, USA, April 30–May 4 2006.
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