ROP Protection

Around one in every 10 births recorded worldwide are premature, meaning that millions of infants are at heightened risk of certain health issues, including retinopathy of prematurity (ROP), every year. ROP can be treated by laser, cryotherapy, or intravitreal injections of anti-VEGF, but access to such options is reliant on medical infrastructure and trained personnel, which may not adequate low- and middle-income countries, where premature births are more common.

Now, a team of researchers from the University of Regensburg, Germany, has developed and tested (in mice) a nanoparticle-based therapeutic that prevents ROP with a single intravenous injection, allowing for healthy retinal development (1). The active agent is cyclosporin A, which inhibits the excessive vascularization and inflammation that causes retinal damage and lasting vision problems.

But the real key to the solution is the ability of the nanoparticles to target and then accumulate in the retinal pigment epithelium (RPE) to deliver the cyclosporin A where it is needed. The solution is technical but elegant. First, the nanoparticles in question are made from lipid nanocapsules that are similar to very low density lipoproteins, and therefore are able to traverse the biological barriers en route to the RPE. Second, the nanocapsules have a shell and core that promote infiltration and uptake through the choroid. Third, a specific sequence of amino acids (cyclo-RGD) preferentially binds to two cell surface integrin receptors expressed by RPE and endothelial cells, allowing the nanoparticles to target multiple RPE targets, promoting accumulation and biological effect.

Importantly, this advanced targeting approach facilitates intravenous injection, removing the need for trained personnel or specialized equipment. The researchers say they set out to develop a simple, affordable, accessible, and effective treatment for ROP – and with further clinical research and testing, this clever nanoparticle-based solution could represent a viable alternative for low- and middle-income countries, preventing millions of premature infants from developing ROP.