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Momtazi L, Dartt DA, Nilsen O, Eidet JR. Molecular layer deposition builds biocompatible substrates for epithelial cells. J Biomed Mater Res A 2018; 106:3090-3098. [DOI: 10.1002/jbm.a.36499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 05/29/2018] [Accepted: 06/27/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Leva Momtazi
- Department of Chemistry; University of Oslo; P.O.Box 1033 Blindern Oslo, NO, N-0315, Oslo Norway
| | - Darlene A. Dartt
- Schepens Eye Research Institute, Massachusetts Eye and Ear; Department of Ophthalmology, Harvard Medical School; 20 Staniford, St. Boston Massachusetts
| | - Ola Nilsen
- Department of Chemistry; University of Oslo; P.O.Box 1033 Blindern Oslo, NO, N-0315, Oslo Norway
| | - Jon Roger Eidet
- Department of Ophthalmology; Oslo University Hospital; Kirkeveien 166, 0407, Oslo Norway
- Department of Ophthalmology; Hospital of Southern Norway; Arendal, Sykehusveien 1, 4838, Arendal Norway
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Abstract
BACKGROUND Reconstruction of the conjunctiva is an essential part of ocular surface reconstruction. Clinically applied and experimentally tested tissue- and stem-cell-based approaches are presented and evaluated. MATERIALS AND METHODS Current literature and our own results will be presented. RESULTS Autologous conjunctiva, mucous membrane of the mouth or nose, and amniotic membrane are routinely used for conjunctival reconstruction. Limitations are limited availability, involvement in autoimmune diseases, donor heterogeneity, and degradation in an inflamed environment. Experimentally tested matrices as tissues made from extracellular matrix proteins, synthetic polymers, temperature-sensitive culture dishes, and decellularized conjunctiva have been tested in vitro and partly in vivo. To replace conjunctival cells, cells of conjunctiva and mucous membrane of mouth and nose have been evaluated and show progenitor cell properties as well as secretory capacity (goblet cell differentiation). CONCLUSIONS Although different matrices are available for conjunctival reconstruction there is-due to specific limitations of existing tissues-a need for the development of new therapies for conjunctival replacement. Matrices produced in the laboratory have already been partly investigated in vivo and may thus be clinically applicable in the near future. Adult mucous membrane cells show many properties of conjunctival epithelium after expansion in vitro and thus are a promising cell source for conjunctival tissue engineering. Other stem cells sources require further evaluation.
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Kasbekar S, Kaye SB, Williams RL, Stewart RMK, Leow-Dyke S, Rooney P. Development of decellularized conjunctiva as a substrate for the ex vivo expansion of conjunctival epithelium. J Tissue Eng Regen Med 2017; 12:e973-e982. [PMID: 28112872 DOI: 10.1002/term.2419] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 01/09/2017] [Accepted: 01/16/2017] [Indexed: 12/12/2022]
Abstract
This study was performed to develop a method to decellularize human conjunctiva and to characterize the tissue in terms of its deoxyribose nucleic acid (DNA) content, tensile strength, collagen denaturation, basement membrane, extracellular matrix components and its potential to support conjunctival epithelial growth. Human conjunctival tissues were subjected to a decellularization process involving hypotonic detergent and nuclease buffers. Variations in sodium dodecyl sulfate concentration (0.05-0.5%, w/v) were tested to determine the appropriate concentration of detergent buffer. DNA quantification, collagen denaturation, cytotoxicity and tensile strength were investigated. Human conjunctival cell growth by explant culture on the decellularized tissue substrate was assessed after 28 days in culture. Samples were fixed and paraffin embedded for immunohistochemistry including conjunctival epithelial cell markers and extracellular matrix proteins. Conjunctival tissue from 20 eyes of 10 donors (age range 65-92 years) was used. Decellularization of human conjunctiva was achieved to 99% or greater DNA removal (p < 0.001) with absence of nuclear staining. This was reproducible at the lowest concentration of sodium dodecyl sulfate (0.05% w/v). No collagen denaturation (p = 0.74) and no difference in tensile strength parameters was demonstrated following decellularization. No significant difference was noted in the immunolocalization of collagen IV, laminin and fibronectin, or in the appearance of periodic acid-Schiff-stained basement membranes following decellularization. The decellularized tissue did not exhibit any cytotoxicity and explant culture resulted in the growth of stratified conjunctival epithelium. Allogeneic decellularized human conjunctiva can be successfully decellularized using the described protocol. It represents a novel substrate to support the expansion of conjunctival epithelium for ocular surface cellular replacement therapies. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shivani Kasbekar
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Stephen B Kaye
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Rachel L Williams
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Rosalind M K Stewart
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Sophie Leow-Dyke
- National Health Service Blood and Transplant Tissue Services, Speke, Liverpool, UK
| | - Paul Rooney
- National Health Service Blood and Transplant Tissue Services, Speke, Liverpool, UK
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Islam R, Eidet JR, Badian RA, Lippestad M, Messelt E, Griffith M, Dartt DA, Utheim TP. Tissue Harvesting Site and Culture Medium Affect Attachment, Growth, and Phenotype of Ex Vivo Expanded Oral Mucosal Epithelial Cells. Sci Rep 2017; 7:674. [PMID: 28386069 PMCID: PMC5428414 DOI: 10.1038/s41598-017-00417-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/23/2017] [Indexed: 11/18/2022] Open
Abstract
Transplantation of cultured oral mucosal epithelial cells (OMECs) is a promising treatment strategy for limbal stem cell deficiency. In order to improve the culture method, we investigated the effects of four culture media and tissue harvesting sites on explant attachment, growth, and phenotype of OMECs cultured from Sprague-Dawley rats. Neither choice of media or harvesting site impacted the ability of the explants to attach to the culture well. Dulbecco’s modified Eagle’s medium/Ham’s F12 (DMEM) and Roswell Park Memorial Institute 1640 medium (RPMI) supported the largest cellular outgrowth. Fold outgrowth was superior from LL explants compared to explants from the buccal mucosa (BM), HP, and transition zone of the lower lip (TZ) after six-day culture. Putative stem cell markers were detected in cultures grown in DMEM and RPMI. In DMEM, cells from TZ showed higher colony-forming efficiency than LL, BM, and HP. In contrast to RPMI, DMEM both expressed the putative stem cell marker Bmi-1 and yielded cell colonies. Our data suggest that OMECs from LL and TZ cultured in DMEM give rise to undifferentiated cells with high growth capacity, and hence are the most promising for treatment of limbal stem cell deficiency.
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Affiliation(s)
- Rakibul Islam
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA. .,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway. .,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
| | - Jon Roger Eidet
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Reza A Badian
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Faculty of Visual Sciences, University College of Southeast Norway, Kongsberg, Norway.,Department of Ophthalmology, Innlandet Hospital Trust, Elverum, Norway
| | - Marit Lippestad
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Edward Messelt
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - May Griffith
- Integrative Regenerative Medicine (IGEN) Centre, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Darlene A Dartt
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tor Paaske Utheim
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.,Department of Ophthalmology, Innlandet Hospital Trust, Elverum, Norway
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Eidet JR, Dartt DA, Utheim TP. Concise Review: Comparison of Culture Membranes Used for Tissue Engineered Conjunctival Epithelial Equivalents. J Funct Biomater 2015; 6:1064-84. [PMID: 26690486 PMCID: PMC4695911 DOI: 10.3390/jfb6041064] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/02/2015] [Accepted: 12/07/2015] [Indexed: 02/06/2023] Open
Abstract
The conjunctival epithelium plays an important role in ensuring the optical clarity of the cornea by providing lubrication to maintain a smooth, refractive surface, by producing mucins critical for tear film stability and by protecting against mechanical stress and infectious agents. A large number of disorders can lead to scarring of the conjunctiva through chronic conjunctival inflammation. For controlling complications of conjunctival scarring, surgery can be considered. Surgical treatment of symblepharon includes removal of the scar tissue to reestablish the deep fornix. The surgical defect is then covered by the application of a tissue substitute. One obvious limiting factor when using autografts is the size of the defect to be covered, as the amount of healthy conjunctiva is scarce. These limitations have led scientists to develop tissue engineered conjunctival equivalents. A tissue engineered conjunctival epithelial equivalent needs to be easily manipulated surgically, not cause an inflammatory reaction and be biocompatible. This review summarizes the various substrates and membranes that have been used to culture conjunctival epithelial cells during the last three decades. Future avenues for developing tissue engineered conjunctiva are discussed.
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Affiliation(s)
- Jon Roger Eidet
- Department of Ophthalmology, Oslo University Hospital, Oslo 0424, Norway.
| | - Darlene A Dartt
- Schepens Eye Research Institute, Massachusetts Eye and Ear/Harvard Medical School, Boston, MA 02114, USA.
| | - Tor Paaske Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo 0424, Norway.
- Department of Oral Biology, University of Oslo, Oslo 0316, Norway.
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen 3004, Norway.
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Bobba S, Chow S, Watson S, Di Girolamo N. Clinical outcomes of xeno-free expansion and transplantation of autologous ocular surface epithelial stem cells via contact lens delivery: a prospective case series. Stem Cell Res Ther 2015; 6:23. [PMID: 25889475 PMCID: PMC4396082 DOI: 10.1186/s13287-015-0009-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/10/2014] [Accepted: 02/17/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction Depletion of limbal stem cells leads to a debilitating condition known as limbal stem cell deficiency, characterised by impaired corneal wound healing and poor vision. The aim of this study was to determine whether delivering progenitor cells on a contact lens is a viable and effective alternative to current transplantation techniques, which are complicated by biological and xenogeneic materials. Methods Sixteen eyes of 16 patients who had total (n = 14) and partial (n = 2) limbal stem cell deficiency (chemical burns, five eyes; iatrogenic causes, four eyes; aniridia, three eyes; trachoma-induced, two eyes; contact lens over-wear, one eye; and cicatrising conjunctivitis, one eye) and who had failed prior therapy were recruited prospectively into the study. Autologous limbal (n = 7) or conjunctival epithelial (n = 9) biopsies were harvested from patients and placed on the concave surface of silicone hydrogel contact lenses. Cells were expanded in culture with autologous serum and transplanted onto the ocular surface. Results Restoration of a transparent avascular and clinically stable corneal epithelium was attained in 10 of 16 eyes (63%) at a median follow-up time of 2.5 years (range of 0.8 to 5.8 years). Although minor complications occurred in two eyes of two patients because of contact lens insertion or removal, these were not associated with long-term sequelae. Conclusions This is the first and largest study to evaluate the mid-term outcomes of autologous limbal/conjunctival stem cell transplantation via a US Food and Drug Administration-approved contact lens, demonstrating that delivery of ocular progenitor cells via this procedure offers a viable, effective, and xeno-free alternative to current transplantation methodologies. Trial registration Australian New Zealand Clinical Trials Registry ACTRN012607000211460. Registered 17 April 2007.
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Affiliation(s)
- Samantha Bobba
- School of Medical Sciences, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia. .,Faculty of Medicine, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
| | - Sharron Chow
- School of Medical Sciences, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
| | - Stephanie Watson
- Save Sight Institute, University of Sydney, 8 Macquarie Street, Sydney, 2000, Australia. .,Sydney Eye Hospital, 8 Macquarie Street, Sydney, 2000, Australia. .,Faculty of Medicine, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
| | - Nick Di Girolamo
- School of Medical Sciences, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
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Zhou H, Lu Q, Guo Q, Chae J, Fan X, Elisseeff JH, Grant MP. Vitrified collagen-based conjunctival equivalent for ocular surface reconstruction. Biomaterials 2014; 35:7398-406. [PMID: 24933512 DOI: 10.1016/j.biomaterials.2014.05.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/13/2014] [Indexed: 11/17/2022]
Abstract
The main functions of the conjunctiva, an essential part of the ocular surface, are to maintain the equilibrium of the tear film and to protect the eye. Upon injuries, the prerequisite to successful ocular surface repair is conjunctival reconstruction. Tissue engineering techniques, including transplantation of autografts, amniotic membranes and numerous synthetic/natural materials, have been developed. However, none of these strategies is completely satisfactory due to lack of goblet cell repopulation, poor mechanical properties or non-standardized preparation procedure. Here, we cultured conjunctival epithelial cells on vitrified collagen membranes and developed a tissue equivalent for repairing damaged conjunctiva. Optimized vitrified collagen has superior mechanical and optical properties to previous biomaterials for ocular surface application, and its unique fibrillar structure significantly benefited conjunctival epithelial cell growth and the phenotypic development in vitro. In a rabbit model, vitrified collagen greatly promoted conjunctival regeneration with rapid re-epithelization, sufficient repopulation of goblet cells and minimized fibrosis and wound contracture, proved by gene expression analyses and histological staining. In conclusion, we have demonstrated the potential suitability of utilizing vitrified collagen-based tissue equivalent in ocular surface reconstruction.
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Affiliation(s)
- Huifang Zhou
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA; Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China; Oculoplastics Division, Ocular and Orbital Trauma Center, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA
| | - Qiaozhi Lu
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA
| | - Qiongyu Guo
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA
| | - Jemin Chae
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Jennifer H Elisseeff
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA.
| | - Michael P Grant
- Oculoplastics Division, Ocular and Orbital Trauma Center, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA.
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