What the Future Holds

Published in Wilmer - Annual Report 2021

Thomas Johnson III, M.D., Ph.D., is on a mission to turn findings in the lab into therapies that will dramatically improve the lives of patients. He leads a translational neuroscience laboratory that focuses on stem cell transplantation to regenerate damaged optic nerves. This work has the potential to someday restore vision damaged by conditions like eye stroke, an injury to the optic nerve caused by restricted blood flow in the eye, as well as by diseases like glaucoma, the world’s second leading cause of blindness.

His 2-year-old lab is part of an effort dubbed the Audacious Goals Initiative for Regenerative Medicine by the National Eye Institute. The title is appropriately respectful of the challenges, Johnson says, “but I think the science in the last 20 years has come so far. Twenty years ago, people thought the work we’re doing now was science fiction.”

Over those two decades, the accumulated research and scientific evidence have shown it should be possible to turn human stem cells into the retinal ganglion cells that make up the optic nerve, Johnson says. It should be possible to get retinal ganglion cells to regrow their long fibers from the eyeball to the brain and reconnect. “So now, how do we put all these different processes together to replace this entire pathway?”

The Allan and Shelley Holt Rising Professorship, part of the Sanford and Susan Greenberg Center to End Blindness at the Wilmer Eye Institute, aims to speed those answers. The professorship provides financial support for an assistant professor that is equivalent to Wilmer’s traditional professorships for senior faculty members. That means a tremendous jump in resources for researchers who are still beginning their careers. Johnson is one of the first recipients of a rising professorship.

“A rising professorship is an opportunity for our best and brightest to get their research programs up to speed years sooner than would happen through the traditional standard pathway,” says Wilmer Director Peter J. McDonnell, M.D., counting off some of the issues that the new professorships will address.

First, the competition for resources in the biomedical field is fierce, and younger researchers are disadvantaged compared to established scientists with large teams. Clinician-scientists like Johnson are often closest to the patients and their needs and concerns but don’t always have the opportunity to transfer that practical knowledge into research. Finally, the average age for a standard biomedical grant from the National Institutes of Health is 45, resulting in perhaps 20 years of research before retirement, while the new professorships can add a decade to that.

“The question is always, if somebody gets an endowed chair when they’re a full professor and world famous, what would they have accomplished if they received a professorship at 30 instead of 60? How much more could have been accomplished?” McDonnell says. “It will change the whole trajectory of our top young scientists.”

For Allan Holt, a member of the Wilmer Eye Institute Board of Governors, the professorship that bears his and his wife’s name is personal. Two close family members suffered vision loss from non-arteritic anterior ischemic optic neuropathy (NAION), a disruption of the blood flow to the optic nerve. “I have tremendous respect and admiration for Sandy and Susan Greenberg, and frankly it was an easy decision to support their work and their center at Wilmer,” Holt says.

Holt says he’s inspired by the prospect of someday ending blindness. “It’s a noble goal,” he says. “And it’s near and dear to me because two family members had NAION. Other family members might have it potentially down the road.”

Johnson, who calls the professorship “transformative” for his work, estimates that with the new resources, he can conduct the experiments he expected to take three years in just half that time.

As a glaucoma specialist, Johnson says: “My patients with blindness often ask me, how far away are we? I honestly can’t put a number on it. I think it’s unlikely that anyone’s going to be doing clinical trials for eight to 10 years, but I do think something on that horizon may very well be feasible. We could be looking at trying this in people in a decade.”