Center/Research Area Affiliations
Dr. Jurkunas performs corneal and refractive surgery at Mass. Eye and Ear, and her two main research areas are the study of the pathogenesis of Fuchs endothelial corneal dystrophy (FECD) with emphasis on the role of oxidative stress in endothelial cell death seen in FECD, and development of cultivated epithelial (stem) cell transplantation for the treatment of limbal stem cell deficiency. The latter studies have led to the translational development of stem cell therapy in corneal disorders. She is in the process of filing an Investigational New Drug (IND) application to the FDA to perform a Phase I/II study using stem cells and to treat corneal blindness.
Fuchs’ Endothelial Corneal Dystrophy (FECD): The first goal of Dr. Jurkunas’ research is to identify the cause of FECD, which is a female predominant, age-related disease. It is one of the most common causes of blindness from corneal swelling and a second most common cause of corneal transplants done in the U.S. Because little is known of what triggers corneal endothelial cells to die in FECD, there is no effective treatment, and corneal transplantation is the only currently available measure to restore lost vision. Over past several years, Dr. Jurkunas has developed techniques to analyze differences in protein composition between normal and FECD corneal endothelial cells. The most striking findings were the discovery of an intricate protein system in normal endothelium that regulates cellular ability to respond to oxidative stress and regulates cell-to-cell interactions. Altered amounts of these crucial proteins were noted in FECD cells, implicating a potential cellular mechanism of the disease. Such insights into the mechanism of what triggers corneal endothelium to die will lead to the development of preventive and therapeutic approaches to this common blinding condition.
Dr. Jurkunas was recently awarded a $ 2,500,000 grant from National Eye Institute of NIH to study “The Role of oxidative stress in the pathogenesis of Fuchs Endothelial Corneal Dystrophy.” The research proposal specifically seeks to understand why there is greater female prevalence of FECD by studying reactive estrogen metabolites, mitochondrial biogenesis, and DNA damage response pathways in Fuchs dystrophy. Dr. Jurkunas will collaborate with the Wiggs and Vandenberghe laboratories, in order to understand how the underlying genetic causes of FECD lead to the mitochondrial dysfunction and cell death. These studies are significant as they have great potential to lead to the development of novel cytoprotective and anti-aging therapies for FECD patients.
Corneal Stem Cell Deficiency: Dr. Jurkunas’ second main area of research is the development of alternative corneal transplantation techniques for the patients suffering from the destruction of corneal stem cells. Corneal epithelial stem cells are located in the periphery of the cornea and are very susceptible to multiple infections and inflammatory disorders. The attempts to treat the ocular surface with a standard corneal transplant in these patients have been unsuccessful due to immunologic rejection and subsequent graft failure. Dr. Jurkunas is in the process of investigating the alternative sources of corneal epithelium, one of which is oral (mouth) mucosa. Dr. Jurkunas has been successful in harvesting mouth cells and is now planning to transfer this technique to the patient care. The development of the methodology of cultivated oral mucosal epithelial transplantation gives a great promise in the area of regenerative medicine and offers hope for a significant number of blind patients worldwide.