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Zhan G, Yu L, Wang Q, Jin L, Yin X, Cao X, Gao H. Patterned collagen films loaded with miR-133b@MBG-NH 2for potential applications in corneal stromal injury repair. Biomed Mater 2024; 19:035009. [PMID: 38422520 DOI: 10.1088/1748-605x/ad2ed2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/29/2024] [Indexed: 03/02/2024]
Abstract
Corneal stromal injury is a common surgical disease. With the development of tissue engineering materials, many artificial corneal scaffolds have been developed to replace allograft corneal transplantation and solve the problem of corneal donor shortage. However, few researchers have paid attention to corneal stromal wound healing. Herein, a nanocomposite of amino modified mesoporous bioactive glass (MBG-NH2) and microRNA-133b (miR-133b) was introduced into the patterned collagen films to achieve corneal stromal injury repair. MBG-NH2nanoparticles as a nano delivery carrier could efficiently load miR-133b and achieve the slow release of miR-133b. The physicochemical properties of collagen films were characterized and found the microgrooved collagen films loaded with miR-133b@MBG-NH2nanoparticles possessed similar swelling properties, optical clarity, and biodegradability to the natural cornea.In vitrocell experiments were also conducted and proved that the patterned collagen films with miR-133b@MBG-NH2possessed good biocompatibility, and miR-133b@MBG-NH2nanoparticles could be significantly uptake by rabbit corneal stromal cells (RCSCs) and have a significant impact on the orientation, proliferation, migration, and gene expression of RCSCs. More importantly, the patterned collagen films with miR-133b@MBG-NH2could effectively promote the migration of RCSCs and accelerate wound healing process, and down-regulate the expression levels ofα-SMA, COL-I, and CTGF genes associated with myofibroblast differentiation of corneal stromal cells, which has a potential application prospect in the repair of corneal stromal injury.
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Affiliation(s)
- Guancheng Zhan
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
| | - Lixia Yu
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
| | - Qiqi Wang
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
| | - Longyang Jin
- Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510655, People's Republic of China
| | - Xiaohong Yin
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
| | - Xiaodong Cao
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510641, People's Republic of China
- National Engineering Research Centre for Tissue Restoration and Reconstruction, Guangzhou 510006, People's Republic of China
- Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, People's Republic of China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, People's Republic of China
| | - Huichang Gao
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
- National Engineering Research Centre for Tissue Restoration and Reconstruction, Guangzhou 510006, People's Republic of China
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2
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Kate A, Basu S. Corneal blindness in the developing world: The role of prevention strategies. F1000Res 2024; 12:1309. [PMID: 38618022 PMCID: PMC11009612 DOI: 10.12688/f1000research.141037.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/16/2024] Open
Abstract
Corneal blindness is an important contributor to the burden of global blindness and has a greater prevalence in low-income countries of the developing world where resources and infrastructure are limited. The causes of corneal blindness too are different from high-income countries and include infectious keratitis, ocular trauma, and xerophthalmia. Persons with these indications tend to have unfavourable outcomes after corneal transplantation, limiting their chances of benefitting from this sight-saving procedure. However, most causes of corneal blindness in the developing world are preventable. This highlights the importance of understanding the unique challenges in these regions and the need for targeted interventions. This article discusses various prevention strategies, including primordial, primary, and secondary prevention, aimed at reducing the burden of corneal blindness in low-income countries. These include capacity building, training, and awareness campaigns to reduce the risk factors of ocular trauma, infectious keratitis, and to improve access to first aid. It is also important to promote safe eye practices and tackle nutritional deficiencies through public health interventions and policy changes. Providing the required training to general ophthalmologists in the management of basic corneal surgeries and diseases and enhancing the accessibility of eye care services in rural areas will ensure early treatment and prevent sequelae. Current treatment modalities belong to the tertiary level of prevention and are largely limited to corneal transplantation. In developing nations, there is a scarcity of donor corneal tissue necessitating an urgent expansion of eye banking services. Alternative approaches to corneal transplantation such as 3D printed corneas, cultured stem cells, and biomaterials should also be explored to meet this demand. Thus, there is a need for collaborative efforts between healthcare professionals, policymakers, and communities to implement effective prevention strategies and reduce the prevalence of corneal blindness in the developing world.
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Affiliation(s)
- Anahita Kate
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Sayan Basu
- Centre for Ocular Regeneration (CORE), Prof. Brien Holden Eye Research Centre, Champalimaud Translational Centre for Eye Research, LV Prasad Eye Institute, Hyderabad, Telangana, India
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
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3
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Simoliunas E, Ruedas-Torres I, Jiménez-Gómez Y, Edin E, Aghajanzadeh-Kiyaseh M, Zamani-Roudbaraki M, Asoklis R, Alksne M, Thathapudi NC, Poudel BK, Rinkunaite I, Asoklis K, Iesmantaite M, Ortega-Llamas L, Makselis A, Munoz M, Baltriukiene D, Bukelskiene V, Gómez-Laguna J, González-Andrades M, Griffith M. Inflammation-suppressing cornea-in-a-syringe with anti-viral GF19 peptide promotes regeneration in HSV-1 infected rabbit corneas. NPJ Regen Med 2024; 9:11. [PMID: 38429307 PMCID: PMC10907611 DOI: 10.1038/s41536-024-00355-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/15/2024] [Indexed: 03/03/2024] Open
Abstract
Pathophysiologic inflammation, e.g., from HSV-1 viral infection, can cause tissue destruction resulting in ulceration, perforation, and ultimately blindness. We developed an injectable Cornea-in-a-Syringe (CIS) sealant-filler to treat damaged corneas. CIS comprises linear carboxylated polymers of inflammation-suppressing 2-methacryloyloxyethyl phosphorylcholine, regeneration-promoting collagen-like peptide, and adhesive collagen-citrate glue. We also incorporated GF19, a modified anti-viral host defense peptide that blocked HSV-1 activity in vitro when released from silica nanoparticles (SiNP-GF19). CIS alone suppressed inflammation when tested in a surgically perforated and HSV-1-infected rabbit corneal model, allowing tissue and nerve regeneration. However, at six months post-operation, only regenerated neocorneas previously treated with CIS with SiNP-GF19 had structural and functional features approaching those of normal healthy corneas and were HSV-1 virus-free. We showed that composite injectable biomaterials can be designed to allow regeneration by modulating inflammation and blocking viral activity in an infected tissue. Future iterations could be optimized for clinical application.
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Affiliation(s)
- Egidijus Simoliunas
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Inés Ruedas-Torres
- Department of Anatomy and Comparative Pathology and Toxicology, Pathology and Immunology Group (UCO-PIG), UIC Zoonosis y Enfermedades Emergentes ENZOEM, University of Córdoba, International Excellence Agrifood Campus 'CeiA3', 14014, Córdoba, Spain
| | - Yolanda Jiménez-Gómez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, 14004, Cordoba, Spain
| | - Elle Edin
- Department of Ophthalmology and Institute of Biomedical Engineering, University of Montreal, Montrea, QC, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Mozhgan Aghajanzadeh-Kiyaseh
- Department of Ophthalmology and Institute of Biomedical Engineering, University of Montreal, Montrea, QC, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Mostafa Zamani-Roudbaraki
- Department of Ophthalmology and Institute of Biomedical Engineering, University of Montreal, Montrea, QC, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Rimvydas Asoklis
- Department of Ophthalmology, Vilnius University Hospital, Vilnius, Lithuania
| | - Milda Alksne
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Neethi C Thathapudi
- Department of Ophthalmology and Institute of Biomedical Engineering, University of Montreal, Montrea, QC, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Bijay K Poudel
- Department of Ophthalmology and Institute of Biomedical Engineering, University of Montreal, Montrea, QC, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Ieva Rinkunaite
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Kasparas Asoklis
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Monika Iesmantaite
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Laura Ortega-Llamas
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, 14004, Cordoba, Spain
| | - Almantas Makselis
- Department of Ophthalmology, Vilnius University Hospital, Vilnius, Lithuania
| | - Marcelo Munoz
- Heart Institute, University of Ottawa, Ottawa, ON, Canada
| | - Daiva Baltriukiene
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Virginija Bukelskiene
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania.
| | - Jaime Gómez-Laguna
- Department of Anatomy and Comparative Pathology and Toxicology, Pathology and Immunology Group (UCO-PIG), UIC Zoonosis y Enfermedades Emergentes ENZOEM, University of Córdoba, International Excellence Agrifood Campus 'CeiA3', 14014, Córdoba, Spain.
| | - Miguel González-Andrades
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, 14004, Cordoba, Spain.
| | - May Griffith
- Department of Ophthalmology and Institute of Biomedical Engineering, University of Montreal, Montrea, QC, Canada.
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada.
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Zhao JY, He YX, Wu ML, Wang RQ. The application of high-throughput sequencing technology in corneal diseases. Int Ophthalmol 2024; 44:53. [PMID: 38340174 PMCID: PMC10858842 DOI: 10.1007/s10792-024-03049-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 01/18/2024] [Indexed: 02/12/2024]
Abstract
High-throughput sequencing technology, also known as next-generation sequencing technology, can explore new biomarkers and specific gene mutations. It has a pivotal role in promoting the gene research, which can limit the detection area, lessen the time needed for sequencing. Also, it can quickly screen out the suspected pathogenic genes of patients, gain the necessary genetic data, and provide the basis for clinical diagnosis and genetic counseling. In the research of corneal diseases, through the DNA sequencing of patients' diseased cells, it can provide a deeper understanding of corneal diseases and improve the diagnosis, classification and treatment alternatives of various corneal diseases. This article will introduce the application progress of high-throughput sequencing technology in corneal diseases, which will help to understand the application of this technology in various corneal diseases.
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Affiliation(s)
- Jing Yi Zhao
- The Second Clinical Medical College of Jilin University, Changchun, 130012, Jilin, China
| | - Yu Xi He
- The Eye Center, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - Mei Liang Wu
- The Eye Center, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - Rui Qing Wang
- The Eye Center, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China.
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5
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Vrehen AF, Rutten MGTA, Dankers PYW. Development of a Fully Synthetic Corneal Stromal Construct via Supramolecular Hydrogel Engineering. Adv Healthc Mater 2023; 12:e2301392. [PMID: 37747759 DOI: 10.1002/adhm.202301392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/14/2023] [Indexed: 09/26/2023]
Abstract
Recent advances in the field of ophthalmology show great potential in the design of bioengineered constructs to mimic the corneal stroma. Hydrogels based on synthetic supramolecular polymers, are attractive synthetic mimics of the natural highly hydrated corneal stroma. Here, a fully synthetic corneal stromal construct is developed via engineering of an injectable supramolecular hydrogel based on ureido-pyrimidinone (UPy) moieties. The hydrogel displays a dynamic and tunable behavior, which allows for control of biochemical and mechanical cues. Two hydrogels are developed, a fully synthetic hydrogel functionalized with a bioactive cyclic arginine-glycine-aspartate UPy (UPy-cRGD) additive, and a hybrid hydrogel based on UPy-moieties mixed with collagen type I fibers. Both hydrogels supported cell encapsulation and associated cellular deposition of extracellular matrix (ECM) proteins after 21 days. Excitingly, the hydrogels support the activation of isolated primary keratocytes into stromal fibroblasts as well as the differentiation toward more quiescent corneal stromal keratocytes, demonstrated by their characteristic long dendritic protrusions and a substantially diminished cytokine secretion. Furthermore, cells survive shear stresses during an injectability test. Together, these findings highlight the development of an injectable supramolecular hydrogel as a synthetic corneal stromal microenvironment able to host primary keratocytes.
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Affiliation(s)
- Annika F Vrehen
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Cell and Tissue Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology, Groene Loper 7, Eindhoven, 5612 AZ, The Netherlands
| | - Martin G T A Rutten
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Cell and Tissue Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology, Groene Loper 7, Eindhoven, 5612 AZ, The Netherlands
| | - Patricia Y W Dankers
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Cell and Tissue Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology, Groene Loper 7, Eindhoven, 5612 AZ, The Netherlands
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6
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Bhattacharjee P, Madden PW, Patriarca E, Ahearne M. Optimization and evaluation of oxygen-plasma-modified, aligned, poly (Є-caprolactone) and silk fibroin nanofibrous scaffold for corneal stromal regeneration. BIOMATERIALS AND BIOSYSTEMS 2023; 12:100083. [PMID: 37731910 PMCID: PMC10507194 DOI: 10.1016/j.bbiosy.2023.100083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 09/22/2023] Open
Abstract
The shortage of human donor corneas for transplantation necessitates the exploration of tissue engineering approaches to develop corneal substitutes. However, these substitutes must possess the necessary strength, transparency, and ability to regulate cell behaviour before they can be used in patients. In this study, we investigated the effectiveness of an oxygen plasma surface-modified poly-ε-caprolactone (PCL) combined with silk fibroin (SF) nanofibrous scaffold for corneal stromal regeneration. To fabricate the electrospun scaffolds, PCL and SF blends were used on a rotating mandrel. The optimization of the blend aimed to replicate the structural and functional properties of the human cornea, focusing on nanofibre alignment, mechanical characteristics, and in vitro cytocompatibility with human corneal stromal keratocytes. Surface modification of the scaffold resulted in improved transparency and enhanced cell interaction. Based on the evaluation, a composite nanofibrous scaffold with a 1:1 blend of PCL and SF was selected for a more comprehensive analysis. The biological response of keratocytes to the scaffold was assessed through cellular adhesion, proliferation, cytoskeletal organization, gene expression, and immunocytochemical staining. The scaffold facilitated the adhesion of corneal stromal cells, supporting cell proliferation, maintaining normal cytoskeletal organization, and promoting increased expression of genes associated with healthy corneal stromal keratocytes. These findings highlight the potential of a surface-modified PCL/SF blend (1:1) as a promising scaffolding material for corneal stromal regeneration. The developed scaffold not only demonstrated favourable biological interactions with corneal stromal cells but also exhibited characteristics aligned with the requirements for successful corneal tissue engineering. Further research and refinement of these constructs could lead to significant advancements in addressing the shortage of corneas for transplantation, ultimately improving the treatment outcomes for patients in need.
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Affiliation(s)
- Promita Bhattacharjee
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Peter W. Madden
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Enzo Patriarca
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Mark Ahearne
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, University of Dublin, Dublin, Ireland
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7
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Dou S, Liu X, Shi W, Gao H. New dawn for keratoconus treatment: potential strategies for corneal stromal regeneration. Stem Cell Res Ther 2023; 14:317. [PMID: 37932824 PMCID: PMC10629149 DOI: 10.1186/s13287-023-03548-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023] Open
Abstract
Keratoconus is a progressive, ectatic and blinding disorder of the cornea, characterized by thinning of corneal stroma. As a highly prevalent among adolescents, keratoconus has been a leading indication for corneal transplantation worldwide. However, the severe shortage of donor corneas is a global issue, and the traditional corneal transplantation surgeries may superinduce multiple complications, necessitating efforts to develop more effective strategies for keratoconus treatment. In this review, we summarized several strategies to promote corneal stromal regeneration or improve corneal stromal thickness, including cell-based therapies, biosynthetic alternatives for inducing corneal regeneration, minimally invasive intrastromal implantation and bioengineered tissues for implantation. These strategies provided more accessible but safer alternatives from various perspectives for keratoconus treatment, paving the way for arresting the keratoconus progression in its earlier stage. For the treatments of corneal ectatic diseases beyond keratoconus, these approaches will provide important references and widen the therapy options in a donor tissue-independent manner.
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Affiliation(s)
- Shengqian Dou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Xiaoxue Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
- Eye Hospital of Shandong First Medical University, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Weiyun Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
- Eye Hospital of Shandong First Medical University, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.
- Eye Hospital of Shandong First Medical University, Jinan, China.
- School of Ophthalmology, Shandong First Medical University, Jinan, China.
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8
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Xue Q, Hu H, Wang W, Li Q, Ma L, Ma J, Ye C, Yang H, Zhang B. Liquid-Phase Integrated 3D Printed Biological Lenses for Lamellar Corneal Substitute. Adv Healthc Mater 2023; 12:e2300600. [PMID: 37543431 DOI: 10.1002/adhm.202300600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/25/2023] [Indexed: 08/07/2023]
Abstract
Compared to traditional biological lenses that are used to correct optical systems, such as contact lenses, vision correction surgery, and corneal and lens replacement, 3D printed biological lenses offer a customizable solutions. However, the layer-by-layer principle of 3D printing leads to a staircase effect, which cannot meet the critical requirements of surface quality during the manufacturing process of biological lens, particularly with soft materials. Here, a liquid-phase printing strategy and a surface tension-dependent (STD) post-processing method are proposed that use the surface tension of the liquid to reconstruct the air-liquid interface. This eliminates the staircase effect caused by the stacking of units during 3D printing. The coordinates of integrated printing enable high-accuracy shape control of soft materials. Using a typical biological lens as an example, this method improves the surface quality of printed lamellar corneal substitutes (LCS) from ±20.0 to ±0.2 µm and reduces thickness feature size from ±500 to ±150 µm. This approach can match human cornea curvature and thickness, achieving ≈85% visible light transmittance and biocompatibility. Liquid-phase 3D printed biological lenses outperform molded ones in animal experiments. This method can advance artificial biological lens printing research and holds promise for future clinical applications.
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Affiliation(s)
- Qian Xue
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Hanyi Hu
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016, China
- School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Weiwei Wang
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016, China
- School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Qi Li
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Liang Ma
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Jien Ma
- College of Electrical Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Cathy Ye
- Institute of Biomedical Engineering, University of Oxford, Oxford, OX3 7DQ, UK
| | - Huayong Yang
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Bin Zhang
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310058, China
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9
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Wang X, Elbahrawi RT, Abdukadir AM, Ali ZM, Chan V, Corridon PR. A proposed model of xeno-keratoplasty using 3D printing and decellularization. Front Pharmacol 2023; 14:1193606. [PMID: 37799970 PMCID: PMC10548234 DOI: 10.3389/fphar.2023.1193606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023] Open
Abstract
Corneal opacity is a leading cause of vision impairment and suffering worldwide. Transplantation can effectively restore vision and reduce chronic discomfort. However, there is a considerable shortage of viable corneal graft tissues. Tissue engineering may address this issue by advancing xeno-keratoplasty as a viable alternative to conventional keratoplasty. In particular, livestock decellularization strategies offer the potential to generate bioartificial ocular prosthetics in sufficient supply to match existing and projected needs. To this end, we have examined the best practices and characterizations that have supported the current state-of-the-art driving preclinical and clinical applications. Identifying the challenges that delimit activities to supplement the donor corneal pool derived from acellular scaffolds allowed us to hypothesize a model for keratoprosthesis applications derived from livestock combining 3D printing and decellularization.
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Affiliation(s)
- Xinyu Wang
- Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Rawdah Taha Elbahrawi
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Azhar Mohamud Abdukadir
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Zehara Mohammed Ali
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Vincent Chan
- Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Peter R. Corridon
- Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University, Abu Dhabi, United Arab Emirates
- Hleathcare, Engineering and Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
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10
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Vanathi M. Changing inclinations of eye banking. Indian J Ophthalmol 2023; 71:3121-3122. [PMID: 37602594 PMCID: PMC10565921 DOI: 10.4103/ijo.ijo_2170_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Affiliation(s)
- M Vanathi
- Cornea and Ocular Surface, Cataract and Refractive Services, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. E-mail:
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11
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Vautier A, Bourges JL, Gabison E, Chaventre F, Lefevre S, Toubeau D, Arnoult C, Albou-Ganem C, Boyer O, Muraine M. An Efficient Technique for the Long-term Preservation of SMILE Lenticules Using Desiccation. J Refract Surg 2023; 39:491-498. [PMID: 37449510 DOI: 10.3928/1081597x-20230609-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
PURPOSE To evaluate a desiccation protocol for the long-term preservation of human small incision lenticule extraction (SMILE) lenticules and to study their integration in an in vivo rabbit model. METHODS Lenticules were retrieved after SMILE procedures in patients, then desiccated according to a novel protocol. Histologic and electron microscopic analyses were performed. Six rabbit eyes received grafts with an inlay technique, which consisted of inserting a desiccated lenticule into a stromal pocket. Rabbits were killed at different times between 6 and 24 weeks. Rabbit corneas were analyzed using optical coherence tomography, histology, and DAPI staining. RESULTS Microscopic analysis of desiccated lenticules showed a preserved stromal architecture after rehydration. A decellularization of the lenticules after desiccation was observed without any chemical treatment. All rabbit corneas remained clear after grafting human lenticules and no rejection occurred. Optical coherence tomography showed regular lenticular implantation and no decrease in lenticule thickness. Histologic analysis showed no inflammatory infiltration around lenticules and no nuclear material inside lenticules after 6 months. CONCLUSIONS A favorable integration of desiccated human SMILE lenticules in rabbit corneas was observed. The refractive issue of lenticular implantation must be investigated next. Clinical trials are needed to evaluate the use of desiccated SMILE lenticules to treat hyperopia or keratoconus in humans. [J Refract Surg. 2023;39(7):491-498.].
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Pramanik B, Islam MM, Patra HK. Rational design of peptide-based implants for corneal bioengineering. Curr Opin Biotechnol 2023; 81:102947. [PMID: 37163824 DOI: 10.1016/j.copbio.2023.102947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 05/12/2023]
Abstract
Regeneration of damaged cornea can save vision for millions of patients. Most of these patients are waiting for transplantation of a donor cornea or suitable substitute to restore vision. Although donor cornea transplantation is the most clinically accepted treatment, shortage of donor cornea results in almost 69 out of every 70 patients untreated with the waiting list for transplantation drastically increasing every year according to a prepandemic estimation. Therefore, corneal replacements are coming up as a cutting-edge alternative strategy. In view of the peptides, especially collagen-like peptides and peptide amphiphiles with bioactive functional motifs demonstrate promising avenue for the corneal tissue engineering and promoting regeneration, by their hierarchical self-assembling propensity to acquire desired nano- to macroscale 3D architecture. Here, we analyze rational peptide designing, self-assembly, and strategies of peptide/peptide-based nanoscale building blocks to create the extracellular matrix mimetic implants for functional regeneration of the cornea.
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Affiliation(s)
- Bapan Pramanik
- Department of Chemistry, Ben Gurion University of the Negev, Be'er Sheva 84105, Israel; School of Pharmacy, University of Nottingham, NG7 2RD Nottingham, United Kingdom
| | - Mohammad M Islam
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Harvard Medical School, Boston, MA 02114, USA
| | - Hirak K Patra
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, NW3 2PF, United Kingdom.
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13
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Hwang SA, Shin KC, Park KS, Ahn YR, Kim WS, Kang HJ, Kim JS, Chee HK, Yang HS, Oh KB, Hwang JH, Yun IJ. Comparison of Graft Survival Between Full-Thickness and Lamellar Pig-to-Monkey Corneal Xenotransplantation from the Same Genetically Engineered Pig Model with Minimal Immunosuppression. Transplant Proc 2023:S0041-1345(23)00226-9. [PMID: 37147194 DOI: 10.1016/j.transproceed.2023.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND The graft survival rate of full-thickness corneal xenotransplantation (XTP) with minimal immunosuppression in genetically engineered pigs is unknown, whereas lamellar corneal XTP shows satisfactory results. We compared graft survival between full-thickness and lamellar transplantations in the same genetically engineered pig. METHODS Six pig-to-monkey corneal transplantations were performed on 3 transgenic pigs. Two corneas harvested from 1 pig were transplanted into 2 monkeys using full-thickness and lamellar corneal xenotransplantation. The transgenic donor pigs used were α1,3-galactosyltransferase gene-knockout + membrane cofactor protein (GTKO+CD46) in one recipient and GTKO+CD46+ thrombomodulin (TBM) in the other. RESULTS The graft survival time for GTKO+CD46 XTP was 28 days. With the addition of TBM, the survival differences between lamellar and full-thickness XTP were 98 days versus 14 days and >463 days (ongoing) versus 21 days, respectively. An excessive number of inflammatory cells was observed in failed grafts, but none were in the recipient's stromal bed. CONCLUSIONS Unlike full-thickness corneal XTP, lamellar xenocorneal transplantation does not exhibit surgical complications, such as retrocorneal membrane or anterior synechia. The graft survival of lamellar XTP in this study was not as good as in our previous experiments, although the survival period was superior to that of full-thickness XTP. The difference in graft survival based on transgenic type is not definitive. Further studies using transgenic pigs and minimal immunosuppression need to focus on improving graft survival of lamellar XTP and using a larger sample size to determine the potential of full-thickness corneal XTP.
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Affiliation(s)
- Sun Ae Hwang
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Seoul, South Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Yu Rim Ahn
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University School of Medicine, Seoul, South Korea
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang-si, South Korea
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyun Suk Yang
- Department of Cardiology, Konkuk University School of Medicine, Seoul, South Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, Wanju-gun, South Korea
| | - Jeong Ho Hwang
- Non-Human Primate Minipig Translational Toxicology Research, Korea Institute of Toxicology, Jeonbuk, Jeollabuk-do, South Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea.
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14
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Lee JY, Knight RJ, Deng SX. Future regenerative therapies for corneal disease. Curr Opin Ophthalmol 2023; 34:267-272. [PMID: 36602407 DOI: 10.1097/icu.0000000000000938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW To highlight the progress and future direction of stem-cell based regenerative therapies for the treatment of corneal disease. RECENT FINDINGS Corneal stem cell-based therapies, such as limbal stem cell transplantation, corneal stromal stem cell transplantation, endothelial stem cell transplantation, and stem cell-derived extracellular vesicles have demonstrated promising results in the laboratory. Although most are still in preclinical development or early phase clinical trials, these stem cell-based therapies hold potential to facilitate tissue regeneration, restore native function, and inhibit pathologic disease processes such as fibrosis, inflammation, and neovascularization. SUMMARY Stem cell-based therapy offers a promising therapeutic option that can circumvent several of the challenges and limitations of traditional surgical treatment. This concise review summarizes the progress in stem-cell based therapies for corneal diseases along with their history, underlying mechanisms, limitations, and future areas for development.
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Affiliation(s)
- John Y Lee
- Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine
| | - Robert J Knight
- Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine
| | - Sophie X Deng
- Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine
- Molecular Biology Institute, University of California, Los Angeles, California, USA
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15
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Jia S, Bu Y, Lau DSA, Lin Z, Sun T, Lu WW, Lu S, Ruan C, Chan CHJ. Advances in 3D bioprinting technology for functional corneal reconstruction and regeneration. Front Bioeng Biotechnol 2023; 10:1065460. [PMID: 36686254 PMCID: PMC9852906 DOI: 10.3389/fbioe.2022.1065460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
Corneal transplantation constitutes one of the major treatments in severe cases of corneal diseases. The lack of cornea donors as well as other limitations of corneal transplantation necessitate the development of artificial corneal substitutes. Biosynthetic cornea model using 3D printing technique is promising to generate artificial corneal structure that can resemble the structure of the native human cornea and is applicable for regenerative medicine. Research on bioprinting artificial cornea has raised interest into the wide range of materials and cells that can be utilized as bioinks for optimal clarity, biocompatibility, and tectonic strength. With continued advances in biomaterials science and printing technology, it is believed that bioprinted cornea will eventually achieve a level of clinical functionality and practicality as to replace donated corneal tissues, with their associated limitations such as limited or unsteady supply, and possible infectious disease transmission. Here, we review the literature on bioprinting strategies, 3D corneal modelling, material options, and cellularization strategies in relation to keratoprosthesis design. The progress, limitations and expectations of recent cases of 3D bioprinting of artifial cornea are discussed. An outlook on the rise of 3D bioprinting in corneal reconstruction and regeneration is provided.
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Affiliation(s)
- Shuo Jia
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yashan Bu
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dzi-Shing Aaron Lau
- Department of Orthopedic and Traumatology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zhizhen Lin
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tianhao Sun
- Department of Orthopedic and Traumatology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China,Shenzhen Gangqing Biomedical Technology Co. Ltd, Shenzhen, China
| | - Weijia William Lu
- Department of Orthopedic and Traumatology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China,Research Center for Human Tissues and Organs Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Sheng Lu
- Department of Orthopedic Surgery, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Changshun Ruan
- Research Center for Human Tissues and Organs Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Cheuk-Hung Jonathan Chan
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Cheuk-Hung Jonathan Chan,
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16
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Alves AL, Carvalho AC, Machado I, Diogo GS, Fernandes EM, Castro VIB, Pires RA, Vázquez JA, Pérez-Martín RI, Alaminos M, Reis RL, Silva TH. Cell-Laden Marine Gelatin Methacryloyl Hydrogels Enriched with Ascorbic Acid for Corneal Stroma Regeneration. BIOENGINEERING (BASEL, SWITZERLAND) 2023; 10:bioengineering10010062. [PMID: 36671634 PMCID: PMC9854711 DOI: 10.3390/bioengineering10010062] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/27/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023]
Abstract
Corneal pathologies from infectious or noninfectious origin have a significant impact on the daily lives of millions of people worldwide. Despite the risk of organ rejection or infection, corneal transplantation is currently the only effective treatment. Finding safe and innovative strategies is the main goal of tissue-engineering-based approaches. In this study, the potential of gelatin methacryloyl (GelMA) hydrogels produced from marine-derived gelatin and loaded with ascorbic acid (as an enhancer of the biological activity of cells) was evaluated for corneal stromal applications. Marine GelMA was synthesized with a methacrylation degree of 75%, enabling effective photocrosslinking, and hydrogels with or without ascorbic acid were produced, encompassing human keratocytes. All the produced formulations exhibited excellent optical and swelling properties with easy handling as well as structural stability and adequate degradation rates that may allow proper extracellular matrix remodeling by corneal stromal cells. Formulations loaded with 0.5 mg/mL of ascorbic acid enhanced the biological performance of keratocytes and induced collagen production. These results suggest that, in addition to marine-derived gelatin being suitable for the synthesis of GelMA, the hydrogels produced are promising biomaterials for corneal regeneration applications.
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Affiliation(s)
- Ana L. Alves
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Ana C. Carvalho
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Inês Machado
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Gabriela S. Diogo
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Emanuel M. Fernandes
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Vânia I. B. Castro
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Ricardo A. Pires
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - José A. Vázquez
- Group of Recycling and Valorization of Waste Materials (REVAL), Instituto de Investigaciones Marinas (IIM-CSIC), C/Eduardo Cabello 6, CP36208 Vigo, Spain
| | - Ricardo I. Pérez-Martín
- Group of Food Biochemistry, Instituto de Investigaciones Marinas (IIM-CSIC), C/Eduardo Cabello 6, CP36208 Vigo, Spain
| | - Miguel Alaminos
- Department of Histology and Tissue Engineering Group, Faculty of Medicine, University of Granada and Instituto de Investigación Biosanitaria (ibs.GRANADA), E18016 Granada, Spain
| | - Rui L. Reis
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Tiago H. Silva
- 3B’s Research Group, i3B’s—Research Institute on Biomaterials, Bisodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
- Correspondence:
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Rathod S. Interpenetrating polymeric network (IPNs) in ophthalmic drug delivery: Breaking the barriers. Int Ophthalmol 2022; 43:1063-1074. [PMID: 36053474 DOI: 10.1007/s10792-022-02482-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
To maintain the therapeutic drug concentration for a prolonged period of time in aqueous and vitreous humor is primary challenge for ophthalmic drug delivery. Majority of the locally administered drug into the eye is lost as to natural reflexes like blinking and lacrimation resulting in the short span of drug residence. Consequently, less than 5% of the applied drug penetrate through the cornea and reaches the intraocular tissues. The major targets for optimal ophthalmic drug delivery are increasing drug residence time in cul-de-sac of the eye, prolonging intraocular exposure, modulating drug release from the delivery system, and minimizing pre-corneal drug loss. Development of in situ gel, contact lens, intraocular lens, inserts, artificial cornea, scaffold, etc., for ophthalmic drug delivery are few approaches to achieve these major targeted objectives for delivering the drug optimally. Interpenetrating polymeric network (IPN) or smart hydrogels or stimuli sensitive hydrogels are the class of polymers that can help to achieve the targets in ophthalmic drug delivery due to their versatility, biocompatibility and biodegradability. These novel ''smart" materials can alter their molecular configuration and result in volume phase transition in response to environmental stimuli, such as temperature, pH, ionic strength, electric and magnetic field. Hydrogel and tissue interaction, mechanical/tensile properties, pore size and surface chemistry of IPNs can also be modulated for tuning the drug release kinetics. Stimuli sensitive IPNs has been widely exploited to prepare in situ gelling formulations for ophthalmic drug delivery. Low refractive index hydrogel biomaterials with high water content, soft tissue-like physical properties, wettability, oxygen, glucose permeability and desired biocompatibility makes IPNs versatile candidate for contact lenses and corneal implants. This review article focuses on the exploration of these smart polymeric networks/IPNs for therapeutically improved ophthalmic drug delivery that has unfastened novel arenas in ophthalmic drug delivery.
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Affiliation(s)
- Sachin Rathod
- Maliba Pharmacy College, UKA Tarsadia University, Gopal-Vidyanagar Campus, Surat, 394350, India. .,Parul Institute of Pharmacy and Research, Parul University, Waghodia, Vadodara, 391760, India.
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18
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Yazdanpanah G, Shen X, Nguyen T, Anwar KN, Jeon O, Jiang Y, Pachenari M, Pan Y, Shokuhfar T, Rosenblatt MI, Alsberg E, Djalilian AR. A Light-Curable and Tunable Extracellular Matrix Hydrogel for In Situ Suture-Free Corneal Repair. ADVANCED FUNCTIONAL MATERIALS 2022; 32:2113383. [PMID: 35692510 PMCID: PMC9187264 DOI: 10.1002/adfm.202113383] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Corneal injuries are a major cause of blindness worldwide. To restore corneal integrity and clarity, there is a need for regenerative bio-integrating materials for in-situ repair and replacement of corneal tissue. Here, we introduce Light-curable COrnea Matrix (LC-COMatrix), a tunable material derived from decellularized porcine cornea extracellular matrix containing un-denatured collagen and sulfated glycosaminoglycans. It is a functionalized hydrogel with proper swelling behavior, biodegradation, and viscosity that can be cross-linked in situ with visible light, providing significantly enhanced biomechanical strength, stability, and adhesiveness. Cross-linked LC-COMatrix strongly adheres to human corneas ex vivo and effectively closes full-thickness corneal perforations with tissue loss. Likewise, in vivo, LC-COMatrix seals large corneal perforations, replaces partial-corneal stromal defects and bio-integrates into the tissue in rabbit models. LC-COMatrix is a natural ready-to-apply bio-integrating adhesive that is representative of native corneal matrix with potential applications in corneal and ocular surgeries.
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Affiliation(s)
- Ghasem Yazdanpanah
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago; Chicago, Illinois, USA
- Department of Biomedical Engineering, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Xiang Shen
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Tara Nguyen
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Khandaker N Anwar
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Oju Jeon
- Department of Biomedical Engineering, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Yizhou Jiang
- Department of Mechanical and Industrial Engineering, University of Illinois at Chicago; Chicago, IL, USA
| | - Mohammad Pachenari
- Department of Mechanical and Industrial Engineering, University of Illinois at Chicago; Chicago, IL, USA
| | - Yayue Pan
- Department of Mechanical and Industrial Engineering, University of Illinois at Chicago; Chicago, IL, USA
| | - Tolou Shokuhfar
- Department of Biomedical Engineering, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Eben Alsberg
- Department of Biomedical Engineering, University of Illinois at Chicago; Chicago, Illinois, USA
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago; Chicago, Illinois, USA
- Department of Biomedical Engineering, University of Illinois at Chicago; Chicago, Illinois, USA
- Corresponding author:
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19
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Li Q, Zhao H, Wang H, Zhao G. Properties of the acellular porcine cornea crosslinked with UVA/riboflavin as scaffolds for Boston Keratoprosthesis. BIOMATERIALS ADVANCES 2022; 137:212822. [PMID: 35929237 DOI: 10.1016/j.bioadv.2022.212822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/29/2022] [Accepted: 04/20/2022] [Indexed: 06/15/2023]
Abstract
The Boston Keratoprosthesis type I (B-KPro) is widely used in the world, but the lack of donor corneas limits its application. This study aims to prepare the acellular porcine cornea (APC) crosslinked with ultraviolet A (UVA)/riboflavin instead of donor corneas as the scaffold for B-KPro. Decellularization of freeze-thaw combined with biological enzymes resulted in approximately 5 ng/mg DNA residue, the a-Gal removal rate of 99%, and glycosaminoglycans retention at a high level of 46.66 ± 2.59 mg/mg. UVA/ riboflavin cross-linking was adopted to induce the formation of new chemical bonds between adjacent collagen chains in the corneal stroma to improve the mechanical properties and resistance to enzymatic hydrolysis. Through comprehensive analysis of the biomechanics, enzyme degradation, immunogenicity and histological structure of the APC crosslinked at different times, CL3 (irradiation conditions, 365 nm, 3 mW/cm, 80 min, both sides) was selected and transplanted into the rabbit cornea model through interlamellar keratoplasty and penetrating keratoplasty as the scaffold of the B-KPro. Compared with the native porcine cornea (NPC) and APC, the experiment of interlamellar pocket indicated that the structure of CL3 was homogeneous without degradation and vascularization in vivo at 12 weeks after surgery. Simultaneously, the results of transplantation of B-KPro showed complete epithelialization of CL3 within 1 week, and neovascularization of the cornea indicated rejection but could be controlled with immunosuppressants. At 3 months postoperatively, the lens of B-KPro remained transparent, and the structure of CL3 was compact and uniform, accompanied by the migration and proliferation of a large number of stromal cells without degradation, suggesting the CL3 could be a promising corneal substitute.
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Affiliation(s)
- Qing Li
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, School of Materials Science and Engineering, Shandong University, Jinan, Shandong, China
| | - Haibin Zhao
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, School of Materials Science and Engineering, Shandong University, Jinan, Shandong, China; Shenzhen Research Institute of Shandong University, Shenzhen, Guangdong, China.
| | - Hongmei Wang
- Qingdao Chunghao Tissue Engineering Co., Ltd., Qingdao, Shandong, China
| | - Guoqun Zhao
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, School of Materials Science and Engineering, Shandong University, Jinan, Shandong, China
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20
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Corneal stromal repair and regeneration. Prog Retin Eye Res 2022; 91:101090. [DOI: 10.1016/j.preteyeres.2022.101090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 01/02/2023]
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21
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Barroso IA, Man K, Hall TJ, Robinson TE, Louth SET, Cox SC, Ghag AK. Photocurable antimicrobial silk‐based hydrogels for corneal repair. J Biomed Mater Res A 2022; 110:1401-1415. [PMID: 35257514 PMCID: PMC9313849 DOI: 10.1002/jbm.a.37381] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/06/2022] [Accepted: 03/01/2022] [Indexed: 12/13/2022]
Abstract
Corneal transplantation is the current gold standard treatment to restore visual acuity to patients with severe corneal diseases and injuries. Due to severe donor tissue shortage, efforts to develop a corneal equivalent have been made but the challenge remains unmet. Another issue of concern in ocular surgery is the difficult instillation and fast drainage of antibiotic ocular eye drops as bacterial infections can jeopardize implant success by delaying or impairing tissue healing. In this study, we developed antimicrobial silk‐based hydrogels that have the potential to be photoactivated in situ, fully adapting to the corneal injury shape. Gentamicin‐loaded methacrylated‐silk (SilkMA) hydrogels were prepared within minutes using low UV intensity (3 mW/cm2). SilkMA gels provided a Young's modulus between 21 and 79 kPa together with a light transmittance spectrum and water content (83%–90%) similar to the human cornea. Polymer concentration (15%–25%) was found to offer a tool for tailoring the physical properties of the hydrogels. We confirmed that the methacrylation did not affect the material's in vitro degradation and biocompatibility by observing fibroblast adhesion and proliferation. Importantly, agar diffusion tests showed that the synthesized hydrogels were able to inhibit Staphylococcus aureus and Pseudomonas aeruginosa growth for 72 h. These characteristics along with their injectability and viscoelasticity demonstrate the potential of SilkMA hydrogels to be applied in several soft tissue engineering fields. As such, for the first time we demonstrate the potential of photocurable antimicrobial SilkMA hydrogels as a novel biomaterial to facilitate corneal regeneration.
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Affiliation(s)
- Inês A. Barroso
- School of Chemical Engineering University of Birmingham Birmingham UK
| | - Kenny Man
- School of Chemical Engineering University of Birmingham Birmingham UK
| | - Thomas J. Hall
- School of Chemical Engineering University of Birmingham Birmingham UK
| | | | | | - Sophie C. Cox
- School of Chemical Engineering University of Birmingham Birmingham UK
| | - Anita K. Ghag
- School of Chemical Engineering University of Birmingham Birmingham UK
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22
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Li H, Dong M, Zhou Q, Zhao L, Wang F, Wang X, Liu T, Xie L, Shi W. Corneal calcification of acellular porcine corneal stroma following lamellar keratoplasty. Acta Ophthalmol 2022; 100:164-174. [PMID: 33258298 DOI: 10.1111/aos.14665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/20/2020] [Accepted: 10/12/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the corneal calcification of acellular porcine corneal stroma (APCS) following lamellar keratoplasty (LKP) and identify risk factors. METHODS Two cases of APCS calcification were evaluated by slit-lamp photography and anterior segment optical coherence tomography (AS-OCT). von Kossa staining and scanning electron microscope/energy-dispersive spectrometry (SEM/EDS) were performed on pathologic tissue. Associated graft and postoperative risk factors were analysed. Acellular porcine corneal stroma (APCS) cleanliness and element content after rinsing with sterilized water were observed by SEM/EDS and inductively coupled plasma mass spectrometry. Calcium metabolism-related proteins were analysed by protein mass spectrometry. Corneal epithelial defects and postoperative medications were reviewed. RESULTS Two cases of APCS calcification occurred at 23 and 22 days postoperatively. Anterior segment optical coherence tomography (AS-OCT) and von Kossa staining demonstrated calcium deposition in the superficial stroma composed of calcium, phosphorus and oxygen conforming to the Ca/P ratio of hydroxyapatite. Phosphate crystals were present on the APCS surface and decreased with number of rinsing times. The phosphorus content of APCS was minimal after rinsing 10 times and avoiding excessive corneal swelling. Calcium metabolism-related proteins were downregulated in APCS. Patients with corneal calcification had 1-week postoperative corneal epithelial defects and were treated with three types of phosphorous eyedrops. CONCLUSIONS Acellular porcine corneal stroma (APCS) calcification occurs in the superficial corneal stroma about 1 month after LKP. The application of AS-OCT, von Kossa staining and SEM/EDS provides a basis for the clinical and pathological diagnosis of corneal calcification. The associated risk factors were mainly high phosphorus content and downregulated calcium metabolism-related proteins in APCS. Postoperative epithelial defects, inflammation and use of phosphorous eyedrops may promote corneal calcification.
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Affiliation(s)
- Hua Li
- Department of Ophthalmology Clinical Medical College of Shandong University Jinan China
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
| | - Muchen Dong
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
- Eye Hospital of Shandong First Medical University Jinan China
| | - Qingjun Zhou
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
- Qingdao Eye Hospital of Shandong First Medical University Qingdao China
| | - Long Zhao
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
| | - Fuyan Wang
- Department of Ophthalmology Clinical Medical College of Shandong University Jinan China
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
| | - Xin Wang
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
- Eye Hospital of Shandong First Medical University Jinan China
| | - Ting Liu
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
- Qingdao Eye Hospital of Shandong First Medical University Qingdao China
| | - Lixin Xie
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
- Qingdao Eye Hospital of Shandong First Medical University Qingdao China
| | - Weiyun Shi
- State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong First Medical University & Shandong Academy of Medical Sciences Qingdao China
- Eye Hospital of Shandong First Medical University Jinan China
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23
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Kumar A, Yun H, Funderburgh ML, Du Y. Regenerative therapy for the Cornea. Prog Retin Eye Res 2022; 87:101011. [PMID: 34530154 PMCID: PMC8918435 DOI: 10.1016/j.preteyeres.2021.101011] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022]
Abstract
The cornea is the outmost layer of the eye, unique in its transparency and strength. The cornea not only transmits the light essential for vision, also refracts light, giving focus to images. Each of the three layers of the cornea has properties essential for the function of vision. Although the epithelium can often recover from injury quickly by cell division, loss of limbal stem cells can cause severe corneal surface abnormalities leading to corneal blindness. Disruption of the stromal extracellular matrix and loss of cells determining this structure, the keratocytes, leads to corneal opacity. Corneal endothelium is the inner part of the cornea without self-renewal capacity. It is very important to maintain corneal dehydration and transparency. Permanent damage to the corneal stroma or endothelium can be effectively treated by corneal transplantation; however, there are drawbacks to this procedure, including a shortage of donors, the need for continuing treatment to prevent rejection, and limits to the survival of the graft, averaging 10-20 years. There exists a need for new strategies to promote regeneration of the stromal structure and restore vision. This review highlights critical contributions in regenerative medicine with the aim of corneal reconstruction after injury or disease. These approaches include corneal stromal stem cells, corneal limbal stem cells, embryonic stem cells, and other adult stem cells, as well as induced pluripotent stem cells. Stem cell-derived trophic factors in the forms of secretomes or exosomes for corneal regeneration are also discussed. Corneal sensory nerve regeneration promoting corneal transparency is discussed. This article provides description of the up-to-date options for corneal regeneration and presents exciting possible avenues for future studies toward clinical applications for corneal regeneration.
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Affiliation(s)
- Ajay Kumar
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA 15213
| | - Hongmin Yun
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA 15213
| | | | - Yiqin Du
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; Department of Developmental Biology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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24
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Sharifi S, Sharifi H, Akbari A, Lei F, Dohlman CH, Gonzalez-Andrades M, Guild C, Paschalis EI, Chodosh J. Critical media attributes in E-beam sterilization of corneal tissue. Acta Biomater 2022; 138:218-227. [PMID: 34755604 PMCID: PMC8738149 DOI: 10.1016/j.actbio.2021.10.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 01/17/2023]
Abstract
When ionizing irradiation interacts with a media, it can form reactive species that can react with the constituents of the system, leading to eradication of bioburden and sterilization of the tissue. Understanding the media's properties such as polarity is important to control and direct those reactive species to perform desired reactions. Using ethanol as a polarity modifier of water, we herein generated a series of media with varying relative polarities for electron beam (E-beam) irradiation of cornea at 25 kGy and studied how the irradiation media's polarity impacts properties of the cornea. After irradiation of corneal tissues, mechanical (tensile strength and modulus, elongation at break, and compression modulus), chemical, optical, structural, degradation, and biological properties of the corneal tissues were evaluated. Our study showed that irradiation in lower relative polarity media improved structural properties of the tissues yet reduced optical transmission; higher relative polarity reduced structural and optical properties of the cornea; and intermediate relative polarity (ethanol concentrations = 20-30% (v/v)) improved the structural properties, without compromising optical characteristics. Regardless of media polarity, irradiation did not negatively impact the biocompatibility of the corneal tissue. Our data shows that the absorbed ethanol can be flushed from the irradiated cornea to levels that are nontoxic to corneal and retinal cells. These findings suggest that the relative polarity of the irradiation media can be tuned to generate sterilized tissues, including corneal grafts, with engineered properties that are required for specific biomedical applications. STATEMENT OF SIGNIFICANCE: Extending the shelf-life of corneal tissue can improve general accessibility of cornea grafts for transplantation. Irradiation of donor corneas with E-beam is an emerging technology to sterilize the corneal tissues and enable their long-term storage at room temperature. Despite recent applications in clinical medicine, little is known about the effect of irradiation and preservation media's characteristics, such as polarity on the properties of irradiated corneas. Here, we have showed that the polarity of the media can be a valuable tool to change and control the properties of the irradiated tissue for transplantation.
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Affiliation(s)
- Sina Sharifi
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA,Corresponding authors: James Chodosh, MD MPH, Massachusetts Eye and Ear, Boston, MA, 02114, USA. , Sina Sharifi, PhD, Massachusetts Eye and Ear, Boston, MA, 02114, USA.
| | - Hannah Sharifi
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Ali Akbari
- Solid Tumor Research Center, Research Institute for Cellular and Molecular Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Fengyang Lei
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Claes H. Dohlman
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Miguel Gonzalez-Andrades
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain
| | | | - Eleftherios I. Paschalis
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - James Chodosh
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA,Corresponding authors: James Chodosh, MD MPH, Massachusetts Eye and Ear, Boston, MA, 02114, USA. , Sina Sharifi, PhD, Massachusetts Eye and Ear, Boston, MA, 02114, USA.
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25
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In vivo biocompatibility evaluation of in situ-forming polyethylene glycol-collagen hydrogels in corneal defects. Sci Rep 2021; 11:23913. [PMID: 34903788 PMCID: PMC8668970 DOI: 10.1038/s41598-021-03270-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/01/2021] [Indexed: 12/26/2022] Open
Abstract
The available treatment options include corneal transplantation for significant corneal defects and opacity. However, shortage of donor corneas and safety issues in performing corneal transplantation are the main limitations. Accordingly, we adopted the injectable in situ-forming hydrogels of collagen type I crosslinked via multifunctional polyethylene glycol (PEG)-N-hydroxysuccinimide (NHS) for treatment and evaluated in vivo biocompatibility. The New Zealand White rabbits (N = 20) were randomly grouped into the keratectomy-only and keratectomy with PEG-collagen hydrogel-treated groups. Samples were processed for immunohistochemical evaluation. In both clinical and histologic observations, epithelial cells were able to migrate and form multilayers over the PEG-collagen hydrogels at the site of the corneal stromal defect. There was no evidence of inflammatory or immunological reactions or increased IOP for PEG-collagen hydrogel-treated corneas during the four weeks of observation. Immunohistochemistry revealed the presence of α-smooth muscle actin (α-SMA) in the superior corneal stroma of the keratectomy-only group (indicative of fibrotic healing), whereas low stromal α-SMA expression was detected in the keratectomy with PEG-collagen hydrogel-treated group. Taken together, we suggest that PEG-collagen may be used as a safe and effective alternative in treating corneal defect in clinical setting.
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26
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Duffy GL, Liang H, Williams RL, Wellings DA, Black K. 3D reactive inkjet printing of poly-ɛ-lysine/gellan gum hydrogels for potential corneal constructs. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 131:112476. [PMID: 34857261 DOI: 10.1016/j.msec.2021.112476] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/27/2021] [Accepted: 10/02/2021] [Indexed: 01/10/2023]
Abstract
Corneal opacities are the 4th leading cause of blindness, and the only current treatment method is the replacement of damaged tissue with a donor cornea. The worldwide shortage of donor eye bank tissue has influenced research into biomaterial substrates for both partial and full thickness corneal implantation. Here, polymer hydrogels based on natural peptides, poly-ɛ-lysine and gellan gum, can be manufactured using reactive inkjet printing (RIJ). The inks used for printing were optimised based on their rheological properties. Printing alternating layers of ink forms a unique surface pattern, based on the immediate formation of ionic bonds between polymers of opposing charges. This surface pattern resembles a repeating honeycomb-like structure, visible by both optical and scanning electron microscopy. The structure of the printed hydrogels can be modified to include pores, a feature of interest for the tissue engineering of full thickness corneal constructs. Printed poly-ɛ-lysine/gellan gum hydrogels demonstrated a transparency of 80% and cyto-compatibility with both corneal epithelial and endothelial cells. Both corneal cell types demonstrated cell attachment across the surface of the printed hydrogel arrays, displaying their typical cell morphology. This gives confidence of the cyto-compatibility of these hydrogels in vitro. Reactive inkjet printing can produce 3D structures with a high resolution, producing printed tracks in the micron range. Additionally, RIJ demonstrates versatility, as constructs can be tailored to meet various dimension and thickness requirements. Furthermore, this work demonstrates for the first time that reactive inkjet printing can been used to produce hydrogel constructs based on these two inks, with the aim of producing constructs for corneal tissue engineering.
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Affiliation(s)
- Georgia L Duffy
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool L7 8TX, UK
| | - He Liang
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool L7 8TX, UK
| | - Rachel L Williams
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool L7 8TX, UK
| | - Don A Wellings
- SpheriTech Ltd, Business and Technical Park, The Heath, Runcorn WA7 4QX, UK
| | - Kate Black
- School of Engineering, Brownlow Hill, Liverpool L69 3GH, UK.
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27
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Holland G, Pandit A, Sánchez-Abella L, Haiek A, Loinaz I, Dupin D, Gonzalez M, Larra E, Bidaguren A, Lagali N, Moloney EB, Ritter T. Artificial Cornea: Past, Current, and Future Directions. Front Med (Lausanne) 2021; 8:770780. [PMID: 34869489 PMCID: PMC8632951 DOI: 10.3389/fmed.2021.770780] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/15/2021] [Indexed: 12/13/2022] Open
Abstract
Corneal diseases are a leading cause of blindness with an estimated 10 million patients diagnosed with bilateral corneal blindness worldwide. Corneal transplantation is highly successful in low-risk patients with corneal blindness but often fails those with high-risk indications such as recurrent or chronic inflammatory disorders, history of glaucoma and herpetic infections, and those with neovascularisation of the host bed. Moreover, the need for donor corneas greatly exceeds the supply, especially in disadvantaged countries. Therefore, artificial and bio-mimetic corneas have been investigated for patients with indications that result in keratoplasty failure. Two long-lasting keratoprostheses with different indications, the Boston type-1 keratoprostheses and osteo-odonto-keratoprostheses have been adapted to minimise complications that have arisen over time. However, both utilise either autologous tissue or an allograft cornea to increase biointegration. To step away from the need for donor material, synthetic keratoprostheses with soft skirts have been introduced to increase biointegration between the device and native tissue. The AlphaCor™, a synthetic polymer (PHEMA) hydrogel, addressed certain complications of the previous versions of keratoprostheses but resulted in stromal melting and optic deposition. Efforts are being made towards creating synthetic keratoprostheses that emulate native corneas by the inclusion of biomolecules that support enhanced biointegration of the implant while reducing stromal melting and optic deposition. The field continues to shift towards more advanced bioengineering approaches to form replacement corneas. Certain biomolecules such as collagen are being investigated to create corneal substitutes, which can be used as the basis for bio-inks in 3D corneal bioprinting. Alternatively, decellularised corneas from mammalian sources have shown potential in replicating both the corneal composition and fibril architecture. This review will discuss the limitations of keratoplasty, milestones in the history of artificial corneal development, advancements in current artificial corneas, and future possibilities in this field.
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Affiliation(s)
- Gráinne Holland
- School of Medicine, College of Medicine, Nursing and Health Sciences, Regenerative Medicine Institute, National University of Ireland Galway, Galway, Ireland
| | - Abhay Pandit
- CÚRAM Science Foundation Ireland Research Centre for Medical Devices, National University of Ireland, Galway, Ireland
| | - Laura Sánchez-Abella
- CIDETEC, Basque Research and Technology Alliance, Parque Científico y Tecnológico de Gipuzkoa, Donostia-San Sebastián, Spain
| | - Andrea Haiek
- CIDETEC, Basque Research and Technology Alliance, Parque Científico y Tecnológico de Gipuzkoa, Donostia-San Sebastián, Spain
| | - Iraida Loinaz
- CIDETEC, Basque Research and Technology Alliance, Parque Científico y Tecnológico de Gipuzkoa, Donostia-San Sebastián, Spain
| | - Damien Dupin
- CIDETEC, Basque Research and Technology Alliance, Parque Científico y Tecnológico de Gipuzkoa, Donostia-San Sebastián, Spain
| | | | | | - Aritz Bidaguren
- Ophthalmology Department, Donostia University Hospital, San Sebastián, Spain
| | - Neil Lagali
- Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - Elizabeth B. Moloney
- School of Medicine, College of Medicine, Nursing and Health Sciences, Regenerative Medicine Institute, National University of Ireland Galway, Galway, Ireland
- CÚRAM Science Foundation Ireland Research Centre for Medical Devices, National University of Ireland, Galway, Ireland
| | - Thomas Ritter
- School of Medicine, College of Medicine, Nursing and Health Sciences, Regenerative Medicine Institute, National University of Ireland Galway, Galway, Ireland
- CÚRAM Science Foundation Ireland Research Centre for Medical Devices, National University of Ireland, Galway, Ireland
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28
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Sharifi S, Sharifi H, Akbari A, Koza D, Dohlman CH, Paschalis EI, Chodosh J. Photo-cross-linked Gelatin Glycidyl Methacrylate/N-Vinylpyrrolidone Copolymeric Hydrogel with Tunable Mechanical Properties for Ocular Tissue Engineering Applications. ACS APPLIED BIO MATERIALS 2021; 4:7682-7691. [PMID: 35006715 DOI: 10.1021/acsabm.1c00905] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Corneal transplantation is currently the primary treatment for corneal blindness. However, severe global scarcity of donor corneas is driving the scientific community to find novel solutions. One potential solution is to replace the damaged tissue with a biocompatible artificial cornea. Here, gelatin glycidyl methacrylate (GM) and N-vinylpyrrolidone (VP) were cocrosslinked to afford a hybrid bicomponent copolymeric hydrogel with excellent mechanical, structural, and biological properties. Our studies showed that the GM/VP ratio can be adjusted to generate a construct with high tensile modulus and strength of 1.6 and 1.0 MPa, respectively, compared to 14 and 7.5 MPa for human cornea. The construct can tolerate up to 22.4 kPa pressure before retention sutures can tear through it. Due to the presence of a synthetic component, it has a significantly higher stability against collagenase induced degradation, yet it is biocompatible and promotes cellular adhesion, proliferation, and migration under in vitro settings.
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Affiliation(s)
- Sina Sharifi
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Hannah Sharifi
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Ali Akbari
- Solid Tumor Research Center, Research Institute for Cellular and Molecular Medicine, Urmia University of Medical Sciences, 57147, Urmia, Iran
| | - Darrell Koza
- Department of Physical Sciences, Eastern Connecticut State University, Willimantic, Connecticut 06226, United States
| | - Claes H Dohlman
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Eleftherios I Paschalis
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - James Chodosh
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, United States
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29
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Madl AC, Myung D. Supramolecular Host-Guest Hydrogels for Corneal Regeneration. Gels 2021; 7:163. [PMID: 34698163 PMCID: PMC8544529 DOI: 10.3390/gels7040163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 12/12/2022] Open
Abstract
Over 6.2 million people worldwide suffer from moderate to severe vision loss due to corneal disease. While transplantation with allogenic donor tissue is sight-restoring for many patients with corneal blindness, this treatment modality is limited by long waiting lists and high rejection rates, particularly in patients with severe tissue damage and ocular surface pathologies. Hydrogel biomaterials represent a promising alternative to donor tissue for scalable, nonimmunogenic corneal reconstruction. However, implanted hydrogel materials require invasive surgeries and do not precisely conform to tissue defects, increasing the risk of patient discomfort, infection, and visual distortions. Moreover, most hydrogel crosslinking chemistries for the in situ formation of hydrogels exhibit off-target effects such as cross-reactivity with biological structures and/or result in extractable solutes that can have an impact on wound-healing and inflammation. To address the need for cytocompatible, minimally invasive, injectable tissue substitutes, host-guest interactions have emerged as an important crosslinking strategy. This review provides an overview of host-guest hydrogels as injectable therapeutics and highlights the potential application of host-guest interactions in the design of corneal stromal tissue substitutes.
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Affiliation(s)
- Amy C. Madl
- Department of Chemical Engineering, Stanford University, Stanford, CA 94305, USA;
| | - David Myung
- Department of Chemical Engineering, Stanford University, Stanford, CA 94305, USA;
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA 94303, USA
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
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30
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Li S, Ding C, Guo Y, Zhang Y, Wang H, Sun X, Zhang J, Cui Z, Chen J. Mechanotransduction Regulates Reprogramming Enhancement in Adherent 3D Keratocyte Cultures. Front Bioeng Biotechnol 2021; 9:709488. [PMID: 34568299 PMCID: PMC8460903 DOI: 10.3389/fbioe.2021.709488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/27/2021] [Indexed: 11/18/2022] Open
Abstract
Suspended spheroid culture using ultralow attachment plates (ULAPs) is reported to effect corneal fibroblast reprogramming. Polydimethylsiloxane (PDMS), with hydrophobic and soft substrate properties, facilitates adherent spheroid formation that promotes cellular physical reprogramming into stem-like cells without using transcription factors. However, it is still unknown whether the biophysical properties of PDMS have the same effect on adult human corneal keratocyte reprogramming. Here, PDMS and essential 8 (E8) medium were utilized to culture keratocyte spheroids and fibroblast spheroids, and the reprogramming results were compared. We provide insights into the probable mechanisms of the PDMS effect on spheroids. qPCR analysis showed that the expression of some stem cell marker genes (OCT4, NANOG, SOX2, KLF4, CMYC, ABCG2 and PAX6) was significantly greater in keratocyte spheroids than in fibroblast spheroids. The endogenous level of stemness transcription factors (OCT4, NANOG, SOX2, KLF4 and CMYC) was higher in keratocytes than in fibroblasts. Immunofluorescence staining revealed Klf4, Nanog, Sox2, ABCG2 and Pax6 were positively stained in adherent 3D spheroids but weakly or negatively stained in adherent 2D cells. Furthermore, OCT4, NANOG, SOX2, KLF4, HNK1, ABCG2 and PAX6 gene expression was significantly higher in adherent 3D spheroids than in adherent 2D cells. Meanwhile, SOX2, ABCG2 and PAX6 were more upregulated in adherent 3D spheroids than in suspended 3D spheroids. The RNA-seq analysis suggested that regulation of the actin cytoskeleton, TGFβ/BMP and HIF-1 signaling pathways induced changes in mechanotransduction, the mesenchymal-to-epithelial transition and hypoxia, which might be responsible for the effect of PDMS on facilitating reprogramming. In conclusion, compared to corneal fibroblasts, keratocytes were more susceptible to reprogramming due to higher levels of endogenous stemness transcription factors. Spheroid culture of keratocytes using PDMS had a positive impact on promoting the expression of some stem cell markers. PDMS, as a substrate to form spheroids, was better able to promote reprogramming than ULAPs. These results indicated that the physiological cells and culture conditions herein enhance reprogramming. Therefore, adherent spheroid culture of keratocytes using PDMS is a promising strategy to more safely promote reprogramming, suggesting its potential application for developing clinical implants in tissue engineering and regenerative medicine.
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Affiliation(s)
- Shenyang Li
- Aier School of Ophthalmology, Central South University, Changsha, China
| | | | - Yonglong Guo
- Key Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, China
| | - Yanan Zhang
- Key Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, China
| | - Hao Wang
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Xihao Sun
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Jun Zhang
- Key Laboratory of Optoelectronic Information and Sensing Technologies of Guangdong Higher Educational Institutes, Jinan University, Guangzhou, China
| | - Zekai Cui
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier Eye Institute, Changsha, China
| | - Jiansu Chen
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier Eye Institute, Changsha, China.,Key Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, China
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31
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Poudel BK, Robert MC, Simpson FC, Malhotra K, Jacques L, LaBarre P, Griffith M. In situ Tissue Regeneration in the Cornea from Bench to Bedside. Cells Tissues Organs 2021; 211:506-526. [PMID: 34380144 DOI: 10.1159/000514690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/22/2021] [Indexed: 11/19/2022] Open
Abstract
Corneal blindness accounts for 5.1% of visual deficiency and is the fourth leading cause of blindness globally. An additional 1.5-2 million people develop corneal blindness each year, including many children born with or who later develop corneal infections. Over 90% of corneal blind people globally live in low- and middle-income regions (LMIRs), where corneal ulcers are approximately 10-fold higher compared to high-income countries. While corneal transplantation is an effective option for patients in high-income countries, there is a considerable global shortage of corneal graft tissue and limited corneal transplant programs in many LMIRs. In situ tissue regeneration aims to restore diseases or damaged tissues by inducing organ regeneration. This can be achieved in the cornea using biomaterials based on extracellular matrix (ECM) components like collagen, hyaluronic acid, and silk. Solid corneal implants based on recombinant human collagen type III were successfully implanted into patients resulting in regeneration of the corneal epithelium, stroma, and sub-basal nerve plexus. As ECM crosslinking and manufacturing methods improve, the focus of biomaterial development has shifted to injectable, in situ gelling formulations. Collagen, collagen-mimetic, and gelatin-based in situ gelling formulas have shown the ability to repair corneal wounds, surgical incisions, and perforations in in-vivo models. Biomaterial approaches may not be sufficient to treat inflammatory conditions, so other cell-free therapies such as treatment with tolerogenic exosomes and extracellular vesicles may improve treatment outcomes. Overall, many of the technologies described here show promise as future medical devices or combination products with cell or drug-based therapies. In situ tissue regeneration, particularly with liquid formulas, offers the ability to triage and treat corneal injuries and disease with a single regenerative solution, providing alternatives to organ transplantation and improving patient outcomes.
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Affiliation(s)
- Bijay K Poudel
- Département d'Ophtalmologie, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
| | - Marie-Claude Robert
- Département d'Ophtalmologie, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.,Département d'Opthalmologie, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Fiona C Simpson
- Département d'Ophtalmologie, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.,Département d'Opthalmologie, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Institut du Génie Biomédicale, Université de Montréal, Montréal, Québec, Canada
| | - Kamal Malhotra
- Département d'Ophtalmologie, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.,Département d'Opthalmologie, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Ludovic Jacques
- Département d'Ophtalmologie, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
| | | | - May Griffith
- Département d'Ophtalmologie, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.,Département d'Opthalmologie, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Institut du Génie Biomédicale, Université de Montréal, Montréal, Québec, Canada
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32
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Baird PN, Machin H, Brown KD. Corneal supply and the use of technology to reduce its demand: A review. Clin Exp Ophthalmol 2021; 49:1078-1090. [PMID: 34310836 DOI: 10.1111/ceo.13978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022]
Abstract
Recovery and access to end-of-life corneal tissue for corneal transplantation, training and research is globally maldistributed. The reasons for the maldistribution are complex and multifaceted, and not well defined or understood. Currently there are few solutions available to effectively address these issues. This review provides an overview of the system, key issues impacting recovery and allocation and emphasises how end-user ophthalmologists and researchers, with support from administrators and the wider sector, can assist in increasing access long-term through sustaining eye banks nationally and globally. We posit that prevention measures and improved surgical techniques, together with the development of novel therapies will play a significant role in reducing demand and enhance the equitable allocation of corneas.
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Affiliation(s)
- Paul N Baird
- Department of Surgery, Ophthalmology, University of Melbourne, Melbourne, Victoria, Australia
| | - Heather Machin
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Lions Eye Donation Service, Melbourne, Australia
| | - Karl D Brown
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
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33
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Menzel-Severing J, Salla S, Geerling G. Eye Banks: Future Perspectives. Klin Monbl Augenheilkd 2021; 238:674-678. [PMID: 34157769 DOI: 10.1055/a-1478-4277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Technological progress and societal change are transforming medicine, and cornea banks are no exception. New infectiological factors, statutory requirements, management concepts, globalisation and digitalisation are also influencing how such facilities will operate in the future. The goal of providing high quality material to patients with corneal disease remains unaltered. The present article seeks to shed light on the type of material this will involve and under what circumstances it is to be obtained.
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Affiliation(s)
| | - Sabine Salla
- Klinik für Augenheilkunde, Uniklinik RWTH Aachen, Deutschland
| | - Gerd Geerling
- Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Deutschland
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34
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Salimi A, Watt H, Elhawary H, Darvish-Zargar M, Harissi-Dagher M. Awareness and attitudes toward corneal donation among Canadians: informational and motivational videos can increase willingness toward corneal donation. Can J Ophthalmol 2021; 57:297-306. [PMID: 34126061 DOI: 10.1016/j.jcjo.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/16/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the knowledge of corneal transplantation, willingness toward corneal donation, and the efficacy of a short informational and motivational video in increasing the willingness toward corneal donation among Canadian adults. METHODS Cross-sectional interventional study. A survey targeted Canadian adults, assessing their knowledge and attitude toward corneal donation and the efficacy of a 1-minute-long informative and motivational video on increasing willingness toward corneal donation. RESULTS The survey was accessed by 1361 individuals and 1013 completed the questionnaire (74% completion rate). The sample consisted of 36% males and 64% females, with an average age of 37.0 ± 15.3 years. The majority (58%) thought to lack basic knowledge about corneal donation. Similarly, objective knowledge of corneal donation was relatively low, with an average score of 7.8 ± 4.5 (out of 20). In our sample, 44% had not opted-in for organ donation, among whom willingness to donate one's own cornea increased from 59% pre-video to 79% post-video (relative increase of 34%; p < 0.001). Lack of awareness about the benefits of corneal donation was the most commonly cited reason for unwillingness to donate. CONCLUSIONS The results demonstrated a general lack of awareness of corneal donation among the Canadian population and highlighted the efficacy of a short informative and motivational video in increasing willingness to donate corneal tissue. With lack of awareness about the benefits of corneal donation being among the primary reasons for the unwillingness to donate, simple but efficacious interventions via informative and motivational videos can increase tissue donors and help reduce corneal tissue shortage.
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Affiliation(s)
- Ali Salimi
- Department of Ophthalmology, Faculty of Medicine, McGill University, Montreal, Que..
| | - Harrison Watt
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Hassan Elhawary
- Division of Plastic and Reconstructive Surgery, Faculty of Medicine, McGill University, Montreal, Que
| | | | - Mona Harissi-Dagher
- Department of Ophthalmology, Faculty of Medicine, University of Montreal, Montreal, Que
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35
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Xiao YT, Zhao XY, Liu X, Xie HT, Zhang MC. Ten-Year Follow-up of Lamellar Keratoplasty Treatment With Acellular Porcine Corneal Stroma: A Case Report. Cornea 2021; 41:623-626. [PMID: 34116537 DOI: 10.1097/ico.0000000000002772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a 10-year follow-up case of the first lamellar keratoplasty treatment with acellular porcine corneal stroma (APCS). METHODS A 62-year-old woman was diagnosed with a fungal corneal ulcer and received lamellar keratoplasty treatment with APCS in 2010. The 10-year follow-up results were evaluated by slit lamp biomicroscopy, anterior segment optical coherence tomography, in vivo confocal microscopy, and corneal biomechanics analysis. RESULTS The APCS graft maintained good biocompatibility and physical properties in transparency, stromal regeneration, elasticity, and deformation resistance. However, some disadvantages were observed, including a protracted course to eventual clearing, a decreased thickness, corneal depositions, sparsely distributed neural fibers, and low stiffness. CONCLUSIONS This case indicated that APCS remains stable over a 10-year follow-up period. APCS can serve as a functional stromal surrogate where donor human corneal tissue is unavailable.
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Affiliation(s)
- Yu-Ting Xiao
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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36
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Islam R, Islam MM, Nilsson PH, Mohlin C, Hagen KT, Paschalis EI, Woods RL, Bhowmick SC, Dohlman CH, Espevik T, Chodosh J, Gonzalez-Andrades M, Mollnes TE. Combined blockade of complement C5 and TLR co-receptor CD14 synergistically inhibits pig-to-human corneal xenograft induced innate inflammatory responses. Acta Biomater 2021; 127:169-179. [PMID: 33785451 DOI: 10.1016/j.actbio.2021.03.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/18/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022]
Abstract
Inadequate supplies of donor corneas have evoked an escalating interest in corneal xenotransplantation. However, innate immune responses contribute significantly to the mechanism of xenograft rejection. We hypothesized that complement component C5 and TLR co-receptor CD14 inhibition would inhibit porcine cornea induced innate immune responses. Therefore, we measured cytokine release in human blood, induced by three forms of corneal xenografts with or without inhibitors. Native porcine cornea (NPC) induced interleukins (IL-1β, IL-2, IL-6, IL-8, IL-1ra), chemokines (MCP-1, MIP-1α, MIP-1β) and other cytokines (TNF, G-CSF, INF-γ, FGF-basic). Decellularized (DPC) and gamma-irradiated cornea (g-DPC) elevated the release of those cytokines. C5-blockade by eculizumab inhibited all the cytokines except G-CSF when induced by NPC. However, C5-blockade failed to reduce DPC and g-DPC induced cytokines. Blockade of CD14 inhibited DPC-induced cytokines except for IL-8, MCP-1, MIP-1α, and G-CSF, while it inhibited all of them when induced by g-DPC. Combined blockade of C5 and CD14 inhibited the maximum number of cytokines regardless of the xenograft type. Finally, by using the TLR4 specific inhibitor Eritoran, we showed that TLR4 activation was the basis for the CD14 effect. Thus, blockade of C5, when combined with TLR4 inhibition, may have therapeutic potential in pig-to-human corneal xenotransplantation. STATEMENT OF SIGNIFICANCE: Bio-engineered corneal xenografts are on the verge of becoming a viable alternative to allogenic human-donor-cornea, but the host's innate immune response is still a critical barrier for graft acceptance. By overruling this barrier, limited graft availability would no longer be an issue for treating corneal diseases. We showed that the xenograft induced inflammation is initiated by the complement system and toll-like receptor activation. Intriguingly, the inflammatory response was efficiently blocked by simultaneously targeting bottleneck molecules in the complement system (C5) and the TLR co-receptor CD14 with pharmaceutical inhibitors. We postulate that a combination of C5 and CD14 inhibition could have a great therapeutic potential to overcome the immunologic barrier in pig-to-human corneal xenotransplantation.
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37
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Lace R, Duffy GL, Gallagher AG, Doherty KG, Maklad O, Wellings DA, Williams RL. Characterization of Tunable Poly-ε-Lysine-Based Hydrogels for Corneal Tissue Engineering. Macromol Biosci 2021; 21:e2100036. [PMID: 33955160 DOI: 10.1002/mabi.202100036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/23/2021] [Indexed: 12/15/2022]
Abstract
A family of poly-ε-lysine hydrogels can be synthesized by crosslinking with bis-carboxylic acids using carbodiimide chemistry. In addition to creating hydrogels using a simple cast method, a fragmented method is used to introduce increased porosity within the hydrogel structure. Both methods have created tunable characteristics ranging in their mechanical properties, transparency, and water content, which is of interest to corneal tissue engineering and can be tailored to specific cellular needs and applications. With a worldwide shortage of cornea donor tissue available for transplant and limitations including rejection and potential infection, a synthetic material that can be used as a graft, or a partial thickness corneal replacement, would be an advantageous treatment method. These hydrogels can be tuned to have similar mechanical and transparency properties to the human cornea. They also support the attachment and growth of corneal epithelial cells and the integration of corneal stromal cells.
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Affiliation(s)
- Rebecca Lace
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, L7 8TX, UK
| | - Georgia L Duffy
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, L7 8TX, UK
| | - Andrew G Gallagher
- SpheriTech Ltd., Business and Technical Park, The Heath, Runcorn, WA7 4QX, UK
| | - Kyle G Doherty
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, L7 8TX, UK
| | - Osama Maklad
- School of Engineering, University of Liverpool, Brownlow Hill, Liverpool, L69 3GH, UK
| | - Donald A Wellings
- SpheriTech Ltd., Business and Technical Park, The Heath, Runcorn, WA7 4QX, UK
| | - Rachel L Williams
- Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, L7 8TX, UK
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38
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Hasenzahl M, Müsken M, Mertsch S, Schrader S, Reichl S. Cell sheet technology: Influence of culture conditions on in vitro-cultivated corneal stromal tissue for regenerative therapies of the ocular surface. J Biomed Mater Res B Appl Biomater 2021; 109:1488-1504. [PMID: 33538123 DOI: 10.1002/jbm.b.34808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 11/11/2022]
Abstract
The in vitro reconstruction of stromal tissue by long-term cultivation of corneal fibroblasts is a smart approach for regenerative therapies of ocular surface diseases. However, systematic investigations evaluating optimized cultivation protocols for the realization of a biomaterial are lacking. This study investigated the influence of supplements to the culture media of human corneal fibroblasts on the formation of a cell sheet consisting of cells and extracellular matrix. Among the supplements studied are vitamin C, fetal bovine serum, L-glutamine, components of collagen such as L-proline, L-4-hydroxyproline and glycine, and TGF-β1, bFGF, IGF-2, PDGF-BB and insulin. After long-term cultivation, the proliferation, collagen and glycosaminoglycan content and light transmission of the cell sheets were examined. Biomechanical properties were investigated by tensile tests and the ultrastructure was characterized by electron microscopy, small-angle X-ray scattering, antibody staining and ELISA. The synthesis of extracellular matrix was significantly increased by cultivation with insulin or TGF-β1, each with vitamin C. The sheets exhibited a high transparency and suitable material properties. The production of a transparent, scaffold-free, potentially autologous, in vitro-generated construct by culturing fibroblasts with extracellular matrix synthesis-stimulating supplements represents a promising approach for a biomaterial that can be used for ocular surface reconstruction in slowly progressing diseases.
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Affiliation(s)
- Meike Hasenzahl
- Institut für Pharmazeutische Technologie, Technische Universität Braunschweig, Braunschweig, Germany
| | - Mathias Müsken
- Helmholtz-Centre for Infection Research, Central Facility for Microscopy, Braunschweig, Germany
| | - Sonja Mertsch
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl von Ossietzky University, Oldenburg, Germany
| | - Stefan Schrader
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl von Ossietzky University, Oldenburg, Germany
| | - Stephan Reichl
- Institut für Pharmazeutische Technologie, Technische Universität Braunschweig, Braunschweig, Germany
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39
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Cen YJ, You DB, Wang W, Feng Y. Preliminary studies of constructing a tissue-engineered lamellar corneal graft by culturing mesenchymal stem cells onto decellularized corneal matrix. Int J Ophthalmol 2021; 14:10-18. [PMID: 33469478 DOI: 10.18240/ijo.2021.01.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/28/2020] [Indexed: 12/28/2022] Open
Abstract
AIM To construct a competent corneal lamellar substitute in order to alleviate the shortage of human corneal donor. METHODS Rabbit mesenchymal stem cells (MSCs) were isolated from bone marrow and identified by flow cytometric, osteogenic and adipogenic induction. Xenogenic decellularized corneal matrix (XDCM) was generated from dog corneas. MSCs were seeded and cultured on XDCM to construct the tissue-engineered cornea. Post-transplantation biocompatibility of engineered corneal graft were tested by animal experiment. Rabbits were divided into two groups then underwent lamellar keratoplasty (LK) with different corneal grafts: 1) XDCM group (n=5): XDCM; 2) XDCM-MSCs groups (n=4): tissue-engineered cornea made up with XDCM and MSCs. The ocular surface recovery procedure was observed while corneal transparency, neovascularization and epithelium defection were measured and compared. In vivo on focal exam was performed 3mo postoperatively. RESULTS Rabbit MSCs were isolated and identified. Flow cytometry demonstrated isolated cells were CD90 positive and CD34, CD45 negative. Osteogenic and adipogenic induction verified their multipotent abilities. MSC-XDCM grafts were constructed and observed. In vivo transplantation showed the neovascularization in XDCM-MSC group was much less than that in XDCM group postoperatively. Post-transplant 3-month confocal test showed less nerve regeneration and bigger cell-absent area in XDCM-MSC group. CONCLUSION This study present a novel corneal tissue-engineered graft that could reduce post-operatively neovascularization and remain transparency, meanwhile shows that co-transplantation of MSCs may help increase corneal transplantation successful rate and enlarge the source range of corneal substitute to overcome cornea donor shortage.
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Affiliation(s)
- Yu-Jie Cen
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - De-Bo You
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Wei Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
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40
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Yoon CH, Choi HJ, Kim MK. Corneal xenotransplantation: Where are we standing? Prog Retin Eye Res 2021; 80:100876. [PMID: 32755676 PMCID: PMC7396149 DOI: 10.1016/j.preteyeres.2020.100876] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/23/2020] [Accepted: 06/04/2020] [Indexed: 02/08/2023]
Abstract
The search for alternatives to allotransplants is driven by the shortage of corneal donors and is demanding because of the limitations of the alternatives. Indeed, current progress in genetically engineered (GE) pigs, the introduction of gene-editing technology by clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9, and advanced immunosuppressants have made xenotransplantation a possible option for a human trial. Porcine corneal xenotransplantation is considered applicable because the eye is regarded as an immune-privileged site. Furthermore, recent non-human primate studies have shown long-term survival of porcine xenotransplants in keratoplasty. Herein, corneal immune privilege is briefly introduced, and xenogeneic reactions are compared with allogeneic reactions in corneal transplantation. This review describes the current knowledge on special issues of xenotransplantation, xenogeneic rejection mechanisms, current immunosuppressive regimens of corneal xenotransplantation, preclinical efficacy and safety data of corneal xenotransplantation, and updates of the regulatory framework to conduct a clinical trial on corneal xenotransplantation. We also discuss barriers that might prevent xenotransplantation from becoming common practice, such as ethical dilemmas, public concerns on xenotransplantation, and the possible risk of xenozoonosis. Given that the legal definition of decellularized porcine cornea (DPC) lies somewhere between a medical device and a xenotransplant, the preclinical efficacy and clinical trial data using DPC are included. The review finally provides perspectives on the current standpoint of corneal xenotransplantation in the fields of regenerative medicine.
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Affiliation(s)
- Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Hyuk Jin Choi
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea; Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
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41
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Alió Del Barrio JL, Arnalich-Montiel F, De Miguel MP, El Zarif M, Alió JL. Corneal stroma regeneration: Preclinical studies. Exp Eye Res 2020; 202:108314. [PMID: 33164825 DOI: 10.1016/j.exer.2020.108314] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022]
Abstract
Corneal grafting is one of the most common and successful forms of human tissue transplantation in the world, but the need for corneal grafting is growing and availability of human corneal donor tissue to fulfill this increasing demand is not assured worldwide. The stroma is responsible for many features of the cornea, including its strength, refractive power and transparency, so enormous efforts have been put into replicating the corneal stroma in the laboratory to find an alternative to classical corneal transplantation. Unfortunately this has not been yet accomplished due to the extreme difficulty in mimicking the highly complex ultrastructure of the corneal stroma, and none of the obtained substitutes that have been assayed has been able to replicate this complexity yet. In general, they can neither match the mechanical properties nor recreate the local nanoscale organization and thus the transparency and optical properties of a normal cornea. In this context, there is an increasing interest in cellular therapy of the corneal stroma using Induced Pluripotent Stem Cells (iPSCs) or mesenchymal stem cells (MSCs) from either ocular or extraocular sources, as they have proven to be capable of producing new collagen within the host stroma, modulate preexisting scars and enhance transparency by corneal stroma remodeling. Despite some early clinical data is already available, in the current article we will summary the available preclinical evidence about the topic corneal stroma regeneration. Both, in vitro and in vivo experiments in the animal model will be shown.
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Affiliation(s)
- Jorge L Alió Del Barrio
- Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| | - Francisco Arnalich-Montiel
- IRYCIS. Ophthalmology Department. Ramón y Cajal University Hospital, Madrid, Spain; Cornea Unit. Hospital Vissum Madrid (Miranza Group), Madrid, Spain
| | - María P De Miguel
- Cell Engineering Laboratory, IdiPAZ, La Paz Hospital Research Institute, Madrid, Spain
| | | | - Jorge L Alió
- Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.
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42
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Li H, Zhao L, Wang F, Wang H, Dong M, Liu T, Ruan T, Zhou M, Zhou Q, Xie L. Natural cross-linker-stabilized acellular porcine corneal stroma for lamellar keratoplasty. Acta Biomater 2020; 114:270-284. [PMID: 32702529 DOI: 10.1016/j.actbio.2020.07.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 01/12/2023]
Abstract
Acellular porcine corneal stroma (APCS) is a promising alternative to human donor cornea for lamellar keratoplasty (LKP). However, the detergents, enzymes and physical forces used during decellularization unavoidably alter the cornea's extracellular matrix composition and disrupt its ultrastructure, making it less mechanically stable and liable to degradation both in vitro and in vivo. Herein, we systematically analyzed the low biomechanics and easy degradability of APCS in terms of structure and protein composition. Then, we introduced natural cross-linkers, namely proanthocyanidin (PA), epigallocatechin-3-gallate and genipin, to stabilize the APCS that exhibited color variations during crosslinking. Then, we developed a protective crosslinking system by combining cross-linkers with bovine serum albumin (BSA) to reduce color change, maintain transparency and improve the mechanical property of APCS. PA/BSA-crosslinked APCS (PA/BSA-APCS) shows favorable corneal transparency and swelling property; the improved overall and surface corneal biomechanics were comparable to those of human cornea, revealing strong resistance to enzymatic degradation and good biocompatibility. Results from LKP in the rabbit model showed complete re-epithelialization without graft melting, the stitches were scarcely loosened after the operation and more host keratocytes had migrated in PA/BSA-APCS at six months post-operation. Therefore, PA/BSA-APCS could be useful as a corneal substitute for tissue regeneration and the protective crosslinking system could be applicable in other bioengineering fields.
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Affiliation(s)
- Hua Li
- Department of Ophthalmology, Clinical Medical College of Shandong University, Jinan, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Long Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Fuyan Wang
- Department of Ophthalmology, Clinical Medical College of Shandong University, Jinan, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Hongwei Wang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China; Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Muchen Dong
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China; Eye Hospital of Shandong First Medical Universtiy, Jinan, China
| | - Ting Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China; Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Ting Ruan
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Mingming Zhou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China; Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Qingjun Zhou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China; Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.
| | - Lixin Xie
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China; Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.
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Martin C, Tschernig T, Loic H, Daas L, Seitz B. Corneae from body donors in anatomy department: valuable use for clinical transplantation and experimental research. BMC Ophthalmol 2020; 20:284. [PMID: 32660508 PMCID: PMC7359266 DOI: 10.1186/s12886-020-01546-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/03/2020] [Indexed: 11/18/2022] Open
Abstract
Background Explanted corneae are highly needed for the surgical management of patients with severe corneal diseases. The aim of this study was to determine whether the body donors from the Institute of Anatomy are a suitable source of donor corneae. Methods At the Institute of Anatomy at Saarland University Medical Center in Homburg, corneae are prelevated from body donors who had consented to the removal of tissues for transplantation purposes during their lifetime. Following the report of death, the LIONS Eye Bank is informed and the contraindications of corneal explantation are clarified. Obtaining a blood sample within 24 h postmortem is mandatory. Results The Institute of Anatomy had 150 body donors in the time period from January 2018 to June 2019. Out of these, 68 (45.3%) were reported to the Eye Bank. The age of the donors (median 82 years (range: 57–96)) is not critical since the quality of the corneae depends on the number of endothelial cells (mean: 2109 ± 67 cells/mm2 (range: 511–2944 cells/mm2)). Contraindications were present in 19 (12.6%) cases. The corneae were extracted from 49 (32.7%) body donors. Out of these 98 corneae, 46 (46.9%) were successfully transplanted. Of all non-transplanted corneae, 6 (6.1%) were microbiologically contaminated, 10 (10.2%) had a positive serology, 22 (22.5%) had an endothelial cell count < 2000 cells/mm2 and 6 (6.1%) are at time of this analysis still in culture medium. The non-transplanted tissues were used for research. Conclusions Explanted corneae from the Institute of Anatomy are a valuable option in obtaining grafts for corneal transplantation, which is why we are working toward on expanding cooperation with this department.
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Affiliation(s)
- Cristina Martin
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg, Germany
| | - Thomas Tschernig
- Institute of Anatomy and Cell Biology, Campus Homburg/Saar, Saarland University, Kirrberger Street, Building 61, 66424, Homburg/Saar, Germany.
| | - Hamon Loic
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg, Germany
| | - Loay Daas
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg, Germany
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Wang X, Majumdar S, Soiberman U, Webb JN, Chung L, Scarcelli G, Elisseeff JH. Multifunctional synthetic Bowman's membrane-stromal biomimetic for corneal reconstruction. Biomaterials 2020; 241:119880. [PMID: 32097748 PMCID: PMC7236884 DOI: 10.1016/j.biomaterials.2020.119880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/23/2020] [Accepted: 02/10/2020] [Indexed: 12/21/2022]
Abstract
As the outermost layer of the eye, the cornea is vulnerable to physical and chemical trauma, which can result in loss of transparency and lead to corneal blindness. Given the global corneal donor shortage, there is an unmet need for biocompatible corneal substitutes that have high transparency, mechanical integrity and regenerative potentials. Herein we engineered a dual-layered collagen vitrigel containing biomimetic synthetic Bowman's membrane (sBM) and stromal layer (sSL). The sBM supported rapid epithelial cell migration, maturation and multilayer formation, and the sSL containing tissue-derived extracellular matrix (ECM) microparticles presented a biomimetic lamellar ultrastructure mimicking the native corneal stroma. The incorporation of tissue-derived microparticles in sSL layer significantly enhanced the mechanical properties and suturability of the implant without compromising the transparency after vitrification. In vivo performance of the vitrigel in a rabbit anterior lamellar keratoplasty model showed full re-epithelialization within 14 days and integration of the vitrigel with the host tissue stroma by day 30. The migrated epithelial cells formed functional multilayer with limbal stem cell marker p63 K14 expressed in the lower layer, epithelial marker K3 and K12 expressed through the layers and tight junction protein ZO-1 expressed by the multilayers. Corneal fibroblasts migrated into the implants to facilitate host/implant integration and corneal stromal regeneration. In summary, these results suggest that the multi-functional layers of this novel collagen vitrigel exhibited significantly improved biological performance as corneal substitute by harnessing a fast re-epithelialization and stromal regeneration potential.
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Affiliation(s)
- Xiaokun Wang
- Translational Tissue Engineering Center, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Shoumyo Majumdar
- Translational Tissue Engineering Center, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Uri Soiberman
- Department of Ophthalmology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Joshua N Webb
- A. James Clark School of Bioengineering, University of Maryland, College Park, MD, USA
| | - Liam Chung
- Translational Tissue Engineering Center, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Giuliano Scarcelli
- A. James Clark School of Bioengineering, University of Maryland, College Park, MD, USA
| | - Jennifer H Elisseeff
- Translational Tissue Engineering Center, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Han Y, Li C, Cai Q, Bao X, Tang L, Ao H, Liu J, Jin M, Zhou Y, Wan Y, Liu Z. Studies on bacterial cellulose/poly(vinyl alcohol) hydrogel composites as tissue-engineered corneal stroma. Biomed Mater 2020; 15:035022. [DOI: 10.1088/1748-605x/ab56ca] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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46
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Griffith M, Poudel BK, Malhotra K, Akla N, González-Andrades M, Courtman D, Hu V, Alarcon EI. Biosynthetic alternatives for corneal transplant surgery. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1754798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- May Griffith
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Bijay Kumar Poudel
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Kamal Malhotra
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Naoufal Akla
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Miguel González-Andrades
- Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - David Courtman
- Department of Medicine, University of Ottawa, and Scientist, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Victor Hu
- London School of Hygiene and Tropical Medicine, International Center for Eye Health, London, UK
| | - Emilio I. Alarcon
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada
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Fernández-Pérez J, Kador KE, Lynch AP, Ahearne M. Characterization of extracellular matrix modified poly(ε-caprolactone) electrospun scaffolds with differing fiber orientations for corneal stroma regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 108:110415. [DOI: 10.1016/j.msec.2019.110415] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 10/25/2022]
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Wang Y, Ma J, Jiang X, Liu Z, Yang J, Li X. Development of Transparent Acellular Dermal Matrix as Tissue-Engineered Stroma Substitute for Central Lamellar Keratoplasty. Invest Ophthalmol Vis Sci 2020; 61:5. [PMID: 31999820 PMCID: PMC7205104 DOI: 10.1167/iovs.61.1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose To improve the transparency of the acellular dermal matrix (ADM) and investigate the optical, mechanical and histologic properties and biocompatibility of transparent ADM (TADM) in lamellar keratoplasty. Methods A stepwise sectioning strategy was applied to determine the transparency distribution of the ADM, and TADM was fabricated accordingly. Transmittance measurements, uniaxial tension testing, and histologic staining were applied to detect its properties. Lamellar keratoplasty was performed in rabbits with TADM, and postoperative evaluations were conducted including the transmittance of the transplant area and histologic staining. Results The transmittance of the ADM increased with increasing depth, and TADM was isolated mechanically at the deepest level. There was a significant improvement in the transmittance of the TADM compared with the ADM, and no significant difference in transmittance between dehydrated TADM and cornea was observed. The elastic modulus of TADM was significantly stronger than that of normal cornea (P = 0.004). TADM consisted of dense collagen fibrils, mainly collagen type I, and the collagen fibril diameter and interfibrillar spacing were determined to be larger than corneal stroma. After lamellar keratoplasty in rabbits, the TADM was well integrated with the host cornea, and transparent cornea without neovascularization was observed at 6 months. Re-epithelization was completed at 1 month, and keratocyte repopulation and collagen remodeling were observed in the graft 3 and 6 months after surgery. Conclusions This study presents the transparency distribution of the ADM and a method for obtaining TADM, which demonstrates ideal transparency, strong mechanical properties, and satisfactory biocompatibility when applied in lamellar keratoplasty.
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Islam MM, Sharifi R, Mamodaly S, Islam R, Nahra D, Abusamra DB, Hui PC, Adibnia Y, Goulamaly M, Paschalis EI, Cruzat A, Kong J, Nilsson PH, Argüeso P, Mollnes TE, Chodosh J, Dohlman CH, Gonzalez-Andrades M. Effects of gamma radiation sterilization on the structural and biological properties of decellularized corneal xenografts. Acta Biomater 2019; 96:330-344. [PMID: 31284096 PMCID: PMC7043233 DOI: 10.1016/j.actbio.2019.07.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/21/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022]
Abstract
To address the shortcomings associated with corneal transplants, substantial efforts have been focused on developing new modalities such as xenotransplantion. Xenogeneic corneas are anatomically and biomechanically similar to the human cornea, yet their applications require prior decellularization to remove the antigenic components to avoid rejection. In the context of bringing decellularized corneas into clinical use, sterilization is a crucial step that determines the success of the transplantation. Well-standardized sterilization methods, such as gamma irradiation (GI), have been applied to decellularized porcine corneas (DPC) to avoid graft-associated infections in human recipients. However, little is known about the effect of GI on decellularized corneal xenografts. Here, we evaluated the radiation effect on the ultrastructure, optical, mechanical and biological properties of DPC. Transmission electron microscopy revealed that gamma irradiated decellularized porcine cornea (G-DPC) preserved its structural integrity. Moreover, the radiation did not reduce the optical properties of the tissue. Neither DPC nor G-DPC led to further activation of complement system compared to native porcine cornea when exposed to plasma. Although, DPC were mechanically comparable to the native tissue, GI increased the mechanical strength, tissue hydrophobicity and resistance to enzymatic degradation. Despite these changes, human corneal epithelial, stromal, endothelial and hybrid neuroblastoma cells grew and differentiated on DPC and G-DPC. Thus, GI may achieve effective tissue sterilization without affecting critical properties that are essential for corneal transplant survival.
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Affiliation(s)
- Mohammad Mirazul Islam
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Roholah Sharifi
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Shamina Mamodaly
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Rakibul Islam
- Department of Immunology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Daniel Nahra
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Dina B Abusamra
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Pui Chuen Hui
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Yashar Adibnia
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Yeditepe University School of Medicine, Istanbul, Turkey
| | - Mehdi Goulamaly
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Eleftherios I Paschalis
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Andrea Cruzat
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jing Kong
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Per H Nilsson
- Department of Immunology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway; Linnaeus Center for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
| | - Pablo Argüeso
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway; Research Laboratory, Nordland Hospital, Bodø, and Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - James Chodosh
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Claes H Dohlman
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Miguel Gonzalez-Andrades
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain.
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50
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Dong M, Zhao L, Wang F, Hu X, Li H, Liu T, Zhou Q, Shi W. Rapid porcine corneal decellularization through the use of sodium N-lauroyl glutamate and supernuclease. J Tissue Eng 2019; 10:2041731419875876. [PMID: 31588337 PMCID: PMC6740050 DOI: 10.1177/2041731419875876] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/23/2019] [Indexed: 12/17/2022] Open
Abstract
Corneal decellularization represents a promising alternative source of human donor with global shortage. Multiple methods have been developed for the preparation of decellularized porcine corneal stroma. However, most strategies relied on long-time treatment to facilitate the entry of detergents or nucleases, which may cause irreversible ultrastructural damage. Here, we developed a rapid decellularization method for porcine corneal stroma through the combined mild detergent sodium N-lauroyl glutamate (SLG) and supernuclease. Compared with traditional methods, the novel decellularization method allowed the efficient removal of xenoantigen DNA within 3 h, while retaining the ultrastructure, transparency, and mechanical properties of porcine corneas. When transplanted in rabbit model for 1 month, the decellularized porcine corneal grafts presented favorable transparency and biocompatibility without immune rejection. Therefore, the combined use of detergent SLG and supernuclease may serve as a promising method for the clinical use of decellularized porcine cornea.
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Affiliation(s)
- Muchen Dong
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Long Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Fuyan Wang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Xiaoli Hu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Hua Li
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Ting Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Qingjun Zhou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Weiyun Shi
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
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