G. S. L. Peh, H. S. Ong, K. Adnan, H.-P. Ang, C. N. Lwin, X.-Y. Seah, S.-J. Lin, and J. S. Mehta, “Functional Evaluation of Two Corneal Endothelial Cell-Based Therapies: Tissue-Engineered Construct and Cell Injection,” Scientific Reports, vol. 9, no. 1, 2019.
About the article authors
Gary S.L. Peh and Hon Shing Ong, both from the Singapore National Eye Centre, are the two major contributors to this paper.
The authors of this paper experimented with engineered tissues to reverse vision loss due to corneal blindness. While this is normally done using a donor’s tissues and implanting them into the patient, tissue engineering researchers are taking out the difficult task of finding a donor by making these tissues from scratch. This study looked at the use of cell-based therapeutics and the delivery technique for improvement in vision in animals. Specifically, this study used the regulatory compliant human corneal endothelial cells (CEnCs) for rabbits, delivered by one of two methods – tissue-engineered endothelial keroplasty or corneal endothelial cell injection.
Peh and Ong et. al. found that the corneas in the rabbits significantly increased and maintained corneal clarity. An immunohistochemistry, a test to find the contents of a tissue, found that the tissue was reactive to an antibody specific to human corneas which signals that corneal recovery is taking place. Both findings, the compatibility of the therapeutic cell therapy and successful cell delivery, are steps in the direction towards alternatives to donor-based corneal transplantations.
While this paper was not steered with an ethical argument, tissue engineering does spark a large ethical discussion in many scientific communities. The technology may be rapidly improving, but it is nowhere near the complexity of a real human tissue. This can be okay for simple, less critical tissues, but not for tissues in the eye, or brain, among a multitude of others.
The ethical arguments in tissue engineering primarily come from the recognition that the human body is an unparalleled and completely unique set of features and any intervention with fake implants taint its perfection. While most would prefer that our bodies be compatible with everyday needs without intervention, cellular therapy could mean vision for the blind and walking for paraplegics. While these are perks to a beating heart and breathing lungs, some diseases are incompatible with life and engineered tissue could mean a transplant before a donor was available or a customized organ no donor could match. Engineered tissues can improve and save lives. While engineered tissues are still being studied to further mimic those in the body and increase their biocompatibility, they have yet to be perfected. As they have such great potential, they should not be discouraged or turned away.