1
|
Burgos-Blasco B, Diaz-Valle D, Rego-Lorca D, Perez-Garcia P, Puebla-Garcia V, Fernandez-Vigo JI, Benitez-Del-Castillo JM, Gegundez-Fernandez JA. Topical insulin, a novel corneal epithelial regeneration agent in dry eye disease. Eur J Ophthalmol 2024; 34:719-725. [PMID: 37814519 DOI: 10.1177/11206721231206790] [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] [Indexed: 10/11/2023]
Abstract
OBJECTIVE To evaluate the efficacy of insulin eye drops for dry eye disease in reducing corneal staining and improving symptoms. METHODS In this retrospective case series, patients with dry eye disease treated with off-label use of insulin eye drops were collected. The main inclusion criterion was diagnosis of dry eye disease with epithelial damage and acceptance of the off-label use of topical insulin. Age, sex, type of dry eye disease, time since diagnosis, previous ocular surgeries, concomitant treatment, best corrected visual acuity, symptoms, conjunctival hyperemia and corneal staining were recorded. Data from the 1 and 3-month visit were included. RESULTS 16 patients (32 eyes) were treated with insulin (14 females and 2 males; mean age 61.3 ± 16.8 years). 12 patients (71%) were also on autologous serum and 10 patients (63%) on cyclosporine. Symptoms were 3.4 ± 1.3 (range 2-5) when scaled from 0 to 5. Mean hyperemia was 1.0 ± 0.9 (range 0-3) and corneal staining was 2.5 ± 1.3 (range 0-5). After 3 months, 5 patients (31%) referred to be much better, 6 (38%) better, 3 (19%) slightly better and 2 patients (13%) were subjectively similar, mean symptoms being 2.3 ± 1.0 (range 1-4; p = 0.001). Hyperemia was 0.3 ± 0.4 (range 0-1) and corneal staining was 1.1 ± 1.0 (range 0-3; both p < 0.001). Topical insulin was well tolerated with no adverse events. CONCLUSIONS The excellent results presented in these case series illustrate topical insulin as a promising treatment in dry eye disease with refractory epithelial damage.
Collapse
Affiliation(s)
- Barbara Burgos-Blasco
- Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | - David Diaz-Valle
- Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniela Rego-Lorca
- Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | - Pilar Perez-Garcia
- Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | | | - Jose Ignacio Fernandez-Vigo
- Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | - Jose Manuel Benitez-Del-Castillo
- Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Jose Antonio Gegundez-Fernandez
- Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| |
Collapse
|
2
|
Woronkowicz M, Roberts H, Skopiński P. The Role of Insulin-like Growth Factor (IGF) System in the Corneal Epithelium Homeostasis-From Limbal Epithelial Stem Cells to Therapeutic Applications. BIOLOGY 2024; 13:144. [PMID: 38534414 DOI: 10.3390/biology13030144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024]
Abstract
The corneal epithelium, comprising three layers of cells, represents the outermost portion of the eye and functions as a vital protective barrier while concurrently serving as a critical refractive structure. Maintaining its homeostasis involves a complex regenerative process facilitated by the functions of the lacrimal gland, tear film, and corneal nerves. Crucially, limbal epithelial stem cells located in the limbus (transitional zone between the cornea and the conjunctiva) are instrumental for the corneal epithelium integrity by replenishing and renewing cells. Re-epithelialization failure results in persistent defects, often associated with various ocular conditions including diabetic keratopathy. The insulin-like growth factor (IGF) system is a sophisticated network of insulin and other proteins essential for numerous physiological processes. This review examines its role in maintaining the corneal epithelium homeostasis, with a special focus on the interplay with corneal limbal stem cells and the potential therapeutic applications of the system components.
Collapse
Affiliation(s)
- Małgorzata Woronkowicz
- NDDH, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple EX31 4JB, UK
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London EC1V 2PD, UK
| | - Harry Roberts
- West of England Eye Unit, Royal Devon University Healthcare NHS Foundation Trust, Exeter EX2 5DW, UK
- University of Exeter Medical School, Exeter EX1 2HZ, UK
| | - Piotr Skopiński
- Department of Ophthalmology, SPKSO Ophthalmic University Hospital, Medical University of Warsaw, 00-576 Warsaw, Poland
- Department of Histology and Embryology, Medical University of Warsaw, 02-004 Warsaw, Poland
| |
Collapse
|
3
|
Shetty R, Mahendran K, Joshi PD, Jeyabalan N, Jayadev C, Das D. Corneal stromal regeneration-keratoconus cell therapy: a review. Graefes Arch Clin Exp Ophthalmol 2023; 261:3051-3065. [PMID: 37074409 DOI: 10.1007/s00417-023-06064-7] [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: 01/05/2023] [Revised: 03/28/2023] [Accepted: 04/05/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Keratoconus is a corneal ectatic disease caused by stromal thinning leading to astigmatism and progressive loss of vision. Loss of the keratocytes and excessive degradation of collagen fibres by matrix metalloproteinases are the molecular signatures of the disease. Despite several limitations, corneal collagen cross-linking and keratoplasty are the most widely used treatment options for keratoconus. In the pursuit of alternative treatment modalities, clinician scientists have explored cell therapy paradigms for treating the condition. METHODS Articles pertaining to keratoconus cell therapy with relevant key words were used to search in PubMed, Researchgate, and Google Scholar. The articles were selected based on their relevance, reliability, publication year, published journal, and accessibility. RESULTS Various cellular abnormalities have been reported in keratoconus. Diverse cell types such as mesenchymal stromal cells, dental pulp cells, bone marrow stem cells, haematopoietic stem cells, adipose-derived stem cells apart from embryonic and induced pluripotent stem cells can be used for keratoconus cell therapy. The results obtained show that there is a potential for these cells from various sources as a viable treatment option. CONCLUSION There is a need for consensus with respect to the source of cells, mode of delivery, stage of disease, and duration of follow-up, to establish a standard operating protocol. This would eventually widen the cell therapy options for corneal ectatic diseases beyond keratoconus.
Collapse
Affiliation(s)
- Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bangalore, India
| | - Krithikaa Mahendran
- Stem Cell Research Lab, GROW Lab, Narayana Nethralaya Foundation, Narayana Nethralaya, Bangalore, India
| | - Parth D Joshi
- Stem Cell Research Lab, GROW Lab, Narayana Nethralaya Foundation, Narayana Nethralaya, Bangalore, India
| | | | - Chaitra Jayadev
- Department of Vitreo-Retina, Narayana Nethralaya Eye Hospital, Bangalore, India
| | - Debashish Das
- Stem Cell Research Lab, GROW Lab, Narayana Nethralaya Foundation, Narayana Nethralaya, Bangalore, India.
- Stem Cell Lab, GROW Lab, Narayana Nethralaya Foundation, Narayana Nethralaya Eye Hospital, Narayana Health City, 258/A Bommasandra Industrial Area, Bangalore, 560099, Karnataka, India.
| |
Collapse
|
4
|
Balal S, Din N, Ashton C, Ahmad S. Healing of Chemical Injury-Related Persistent Corneal Epithelial Defects With Topical Insulin. Cornea 2023; 42:1000-1004. [PMID: 36729695 DOI: 10.1097/ico.0000000000003145] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/01/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the effectiveness of insulin eye drops for treating refractory persistent epithelial defects (PEDs). METHODS A prospective, single-center, case series was performed from March 2020 to September 2021. All patients were prescribed insulin eye drops for refractory PEDs that failed on maximum standard medical treatment (including serum eye drops). The drops were used 4 times/day. Patients were followed up at 2 weekly intervals with full slitlamp examination and serial anterior segment photography. The primary end point was resolution of the epithelial defect. RESULTS Eleven eyes of 10 patients were treated with insulin eye drops. The mean age of the cohort was 45.4 + 25 years with a mean follow-up of 195.7 + 114.3 days after re-epithelization. The most common causative condition was chemical injury (n = 5, 60%). Mean baseline PED defect was 41.3 + 55.2 mm 2 . Nine of 11 eyes (82%) fully re-epithelized within a mean time of 62.3 + 34.6 days (range 14-112). In 2 patients who did not achieve re-epithelization, one had a reduction in size from 12.25 mm 2 to 4.5 mm 2 and the other had no response. No recurrence in defect was observed in the group that had fully re-epithelized. CONCLUSIONS This study showed that the use of topical insulin eye drops led to a successful resolution of PED in 9 of 11 cases. We demonstrate the use of insulin for closure of PEDs in chemical eye injury. Larger controlled studies are required to further evaluate this novel therapy.
Collapse
Affiliation(s)
- Shafi Balal
- Moorfields Eye Hospital, London, United Kingdom; and
- UCL Institute of Ophthalmology, London, United Kingdom
| | - Nizar Din
- Moorfields Eye Hospital, London, United Kingdom; and
| | | | - Sajjad Ahmad
- Moorfields Eye Hospital, London, United Kingdom; and
| |
Collapse
|
5
|
Trosan P, Cabral JV, Smeringaiova I, Studeny P, Jirsova K. Interleukin-13 increases the stemness of limbal epithelial stem cells cultures. PLoS One 2022; 17:e0272081. [PMID: 35917378 PMCID: PMC9345474 DOI: 10.1371/journal.pone.0272081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
This study aimed to determine the effect of interleukin-13 (IL13) on the stemness, differentiation, proliferation, clonogenicity, and morphology of cultured limbal epithelial cells (LECs). Human limbal explants were used to culture LECs up to the second passage (P0-P2) with or without IL13 (IL13+ and IL13-, respectively). Cells were analyzed by qPCR (for the expression of ΔNp63α, BMI-1, keratin (K) 3, K7, K12, K14, K17, mucin 4, and MKI67) and immunofluorescence staining for p63α. The clonogenic ability was determined by colony-forming assay (CFA), and their metabolic activity was measured by WST-1 assay. The results of the CFA showed a significantly increased clonogenic ability in P1 and P2 cultures when LECs were cultured with IL13. In addition, the expression of putative stem cell markers (ΔNp63α, K14, and K17) was significantly higher in all IL13+ cultures compared to IL13-. Similarly, immunofluorescence analysis showed a significantly higher percentage of p63α positive cells in P2 cultures with IL13 than without it. LECs cultures without IL13 lost their cuboidal morphology with a high nucleocytoplasmic ratio after P1. The use of IL13 also led to significantly higher proliferation in P2, which can be reflected by a higher ability to reach confluence in P2 cultures. On the other hand, IL13 had no effect on corneal epithelial cell differentiation (K3 and K12 expression), and the expression of the conjunctival marker K7 significantly increased in all IL13+ cultures compared to the respective cell culture without IL13. This study showed that IL13 enhanced the stemness of LECs by increasing the clonogenicity and the expression of putative stem cell markers of LECs while maintaining their stem cell morphology. We established IL13 as a culture supplement for LESCs, which increases their stemness potential in culture, even after the second passage, and may lead to the greater success of LESCs transplantation in patients with LSCD.
Collapse
Affiliation(s)
- Peter Trosan
- Laboratory of the Biology and Pathology of the Eye, First Faculty of Medicine, Institute of Biology and Medical Genetics, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
- * E-mail:
| | - Joao Victor Cabral
- Laboratory of the Biology and Pathology of the Eye, First Faculty of Medicine, Institute of Biology and Medical Genetics, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ingrida Smeringaiova
- Laboratory of the Biology and Pathology of the Eye, First Faculty of Medicine, Institute of Biology and Medical Genetics, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Pavel Studeny
- Ophthalmology Department of 3 Medical Faculty and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Katerina Jirsova
- Laboratory of the Biology and Pathology of the Eye, First Faculty of Medicine, Institute of Biology and Medical Genetics, Charles University and General University Hospital in Prague, Prague, Czech Republic
| |
Collapse
|
6
|
Diaz‐Valle D, Burgos‐Blasco B, Rego‐Lorca D, Puebla‐Garcia V, Perez‐Garcia P, Benitez‐del‐Castillo JM, Herrero‐Vanrell R, Vicario‐de‐la‐Torre M, Gegundez‐Fernandez JA. Comparison of the efficacy of topical insulin with autologous serum eye drops in persistent epithelial defects of the cornea. Acta Ophthalmol 2022; 100:e912-e919. [PMID: 34407296 DOI: 10.1111/aos.14997] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/21/2021] [Accepted: 08/04/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE To investigate the effect of topical insulin on epithelization in persistent epithelial defects (PED) refractory to usual treatment compared to autologous serum. DESIGN Retrospective, consecutive case-control series. METHODS The charts of 61 consecutive patients with PED treated with topical insulin (case group) and 23 treated with autologous serum (control group) were reviewed. Primary efficacy end points were the percentage of patients in which epithelization was achieved, as well as the rate and time until epithelization. Secondary efficacy point was need for amniotic membrane transplantation (AMT) or other surgeries. RESULTS Mean time between PED diagnosis and start of topical insulin was 22.7 ± 18.5 days (range 13-115) and the mean area was 14.8 ± 16.2 mm2 (range 1.1-70.6). In the control group, mean time was 27.9 ± 16.8 days, mean epithelial defect area being 18.6 ± 15.0 mm2 (range 1.7-52.9). No differences in baseline characteristics were found between groups (p > 0.05). Epithelization was achieved in 51 patients (84%) on insulin and 11 patients (48%) on autologous serum (p = 0.002). In those patients, mean time until reepithelization was 32.6 ± 28.3 days (range 4-124) in the insulin group and 82.6 ± 82.4 days (range 13-231) in the autologous serum group (p = 0.011). The need for AMT was significantly lower in the insulin group (p = 0.005). PED recurrence was higher in patients treated on autologous serum (43%) compared with insulin (11%) (p = 0.002). CONCLUSIONS Topical insulin is an effective treatment and safely promotes healing of PED. In our series, topical insulin presented better epithelization outcomes than autologous serum and could thus be considered as a first-line treatment.
Collapse
Affiliation(s)
- David Diaz‐Valle
- Servicio de Oftalmología Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC) Hospital Clinico San Carlos Madrid Spain
| | - Barbara Burgos‐Blasco
- Servicio de Oftalmología Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC) Hospital Clinico San Carlos Madrid Spain
| | - Daniela Rego‐Lorca
- Servicio de Oftalmología Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC) Hospital Clinico San Carlos Madrid Spain
| | | | - Pilar Perez‐Garcia
- Servicio de Oftalmología Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC) Hospital Clinico San Carlos Madrid Spain
| | - Jose M. Benitez‐del‐Castillo
- Servicio de Oftalmología Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC) Hospital Clinico San Carlos Madrid Spain
| | - Rocio Herrero‐Vanrell
- Departamento de Farmacia y Tecnología Farmacéutica Facultad de Farmacia Universidad Complutense de Madrid Madrid España
| | - Marta Vicario‐de‐la‐Torre
- Departamento de Farmacia y Tecnología Farmacéutica Facultad de Farmacia Universidad Complutense de Madrid Madrid España
| | - Jose A. Gegundez‐Fernandez
- Servicio de Oftalmología Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC) Hospital Clinico San Carlos Madrid Spain
| |
Collapse
|
7
|
Li W, Shan T, Shi J, Fu Z, Qi S, Sun Y, Wang C, Lai W. Cell Growth Factor and Estrogen Inducing Menstrual Blood-Derived Stem Cells (MenSC) Differentiate into Endometrial Epithelial Cells. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.2929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Extracted MenSC (Menstrual blood-derived stem cells) from female menstrual blood. Added various exogenous factors in-vitro and simulated the female uterine environment to observe how to make MenSC differentiation into Endometrial epithelial cells by artificial induction. MenSCs
were divided into 4 groups: 2.5×10−5 mol/L E group, 1.613 nmol/L EGF group, 2.5×10−5 mol/L E+1.613 nmol/L EGF group, control Group (only MenSCs); the relevant indicators of the experiment includes cell staining and Western Blot to detect CK and
VIM protein content; RT-PCR to detect CK-19 mRNA and VIM mRNA. The cell staining results showed that E+EGF group had significant differentiation in 7 days and 14 days. CK-19mRNA of E+EGF group was significantly higher than other groups, and the EGF group expression was obviously higher than
that of E group, and VIMmRNA expression is opposite to that. The protein expression had the similar performance. MenSC can differentiate into endometrial epithelial cells after induced by E and EFG; and the co-culture of E and EFG can achieve better differentiation, which proves their work
together in MenSC differentiate towards endometrial epithelial cells.
Collapse
Affiliation(s)
- Wei Li
- Department of Obstetrics and Gynecology, Hebei University of Engineering, Handan, Hebei, 056038, China
| | - Tieying Shan
- Department of Histology and Embryology, Medical College, Hebei University of Engineering, Handan, Hebei, 056038, China
| | - Jianping Shi
- Pediatric Internal Medicine, Renqiu People’s Hospital, Cangzhou City, Hebei Province, 062550, China
| | - Zexian Fu
- Department of Oncology, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056038, China
| | - Shujing Qi
- Department of Nutrition, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056038, China
| | - Yuhang Sun
- Department of Plastic Surgery, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056038, China
| | - Congmin Wang
- Department of Neurology, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056038, China
| | - Weiyang Lai
- Department of Paediatrics, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056038, China
| |
Collapse
|
8
|
Nosrati H, Alizadeh Z, Nosrati A, Ashrafi-Dehkordi K, Banitalebi-Dehkordi M, Sanami S, Khodaei M. Stem cell-based therapeutic strategies for corneal epithelium regeneration. Tissue Cell 2020; 68:101470. [PMID: 33248403 DOI: 10.1016/j.tice.2020.101470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/13/2022]
Abstract
Any significant loss of vision or blindness caused by corneal damages is referred to as corneal blindness. Corneal blindness is the fourth most common cause of blindness worldwide, representing more than 5% of the total blind population. Currently, corneal transplantation is used to treat many corneal diseases. In some cases, implantation of artificial cornea (keratoprosthesis) is suggested after a patient has had a donor corneal transplant failure. The shortage of donors and the side effects of keratoprosthesis are limiting these approaches. Recently, researchers have been actively pursuing new approaches for corneal regeneration because of these limitations. Nowadays, tissue engineering of different corneal layers (epithelium, stroma, endothelium, or full thickness tissue) is a promising approach that has attracted a great deal of interest from researchers and focuses on regenerative strategies using different cell sources and biomaterials. Various sources of corneal and non-corneal stem cells have shown significant advantages for corneal epithelium regeneration applications. Pluripotent stem cells (embryonic stem cells and iPS cells), epithelial stem cells (derived from oral mucus, amniotic membrane, epidermis and hair follicle), mesenchymal stem cells (bone marrow, adipose-derived, amniotic membrane, placenta, umbilical cord), and neural crest origin stem cells (dental pulp stem cells) are the most promising sources in this regard. These cells could also be used in combination with natural or synthetic scaffolds to improve the efficacy of the therapeutic approach. As the ocular surface is exposed to external damage, the number of studies on regeneration of the corneal epithelium is rising. In this paper, we reviewed the stem cell-based strategies for corneal epithelium regeneration.
Collapse
Affiliation(s)
- Hamed Nosrati
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Zohreh Alizadeh
- Endometrium and Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; Department of Anatomical Sciences, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Nosrati
- School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Korosh Ashrafi-Dehkordi
- Department of Molecular Medicine, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mehdi Banitalebi-Dehkordi
- Department of Molecular Medicine, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samira Sanami
- Department of Medical Biotechnology, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohammad Khodaei
- Department of Materials Science and Engineering, Golpayegan University of Technology, Golpayegan, Iran
| |
Collapse
|
9
|
Diaz-Valle D, Burgos-Blasco B, Gegundez-Fernandez JA, Garcia-Caride S, Puebla-Garcia V, Peña-Urbina P, Benitez-Del-Castillo JM. Topical insulin for refractory persistent corneal epithelial defects. Eur J Ophthalmol 2020; 31:2280-2286. [PMID: 32951459 DOI: 10.1177/1120672120958307] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate insulin eye drops for persistent epithelial defects (PEDs) that are refractory to usual treatment in clinical practice and to analyze how it may improve epithelization. METHODS A prospective non-randomized hospital-based study was performed. Patients with PEDs that were refractory to conventional treatment were treated with insulin eye drops four times a day. Patients' demographics, PED etiology, concomitant treatments, and comorbidities were reviewed. The rate of PED closure and epithelial healing time were considered the primary outcome measures. RESULTS 21 patients were treated with insulin drops (12 females and 9 males; mean age 72.2 years). Mean PED area before treatment was 17.6 ± 16.5 mm2 (median 13.2; range 3.9-70.6). PED comorbidities included seven eyes with infectious keratitis (33%), five eyes with calcium keratopathy (24%), ocular surgery on three eyes (14%), three eyes with lagophthalmos (14%), two eyes with bullous keratopathy (10%), and one patient with herpetic eye disease (5%). The eyes of 17 patients (81%) with refractory PEDs had reepithelized and four patients (19%) had still presented an epithelial defect by the end of the study follow-up period, although it had decreased in size. In patients where PED closure was achieved, mean time until reepithelization was 34.8 ± 29.9 days (median 23; range 7-114). In the remaining patients, a mean area reduction of 91.5% was achieved for the PEDs. CONCLUSION Topical insulin can promote and accelerate corneal reepithelization of refractory PEDs. It also offers many other advantages, including excellent tolerance, availability, and cost-effectiveness.
Collapse
Affiliation(s)
- David Diaz-Valle
- Opthalmology Department and Health Research Institute (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | - Barbara Burgos-Blasco
- Opthalmology Department and Health Research Institute (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | - Jose A Gegundez-Fernandez
- Opthalmology Department and Health Research Institute (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | - Sara Garcia-Caride
- Opthalmology Department and Health Research Institute (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | | | - Pilar Peña-Urbina
- Opthalmology Department and Health Research Institute (IdISSC), Hospital Clinico San Carlos, Madrid, Spain
| | | |
Collapse
|
10
|
The Immunomodulatory Potential of Mesenchymal Stem Cells in a Retinal Inflammatory Environment. Stem Cell Rev Rep 2020; 15:880-891. [PMID: 31863334 DOI: 10.1007/s12015-019-09908-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Retinal degenerative disorders are characterized by a local upregulation of inflammatory factors, infiltration with cells of the immune system, a vascular dysfunction and by the damage of retinal cells. There is still a lack of treatment protocols for these diseases. Mesenchymal stem cell (MSC)-based therapy using immunoregulatory, regenerative and differentiating properties of MSCs offers a promising treatment option. In this study, we analyzed the immunomodulatory properties of mouse bone marrow-derived MSCs after their intravitreal delivery to the inflammatory environment in the eye, caused by the application of pro-inflammatory cytokines IL-1β, TNF-α and IFN-γ. The intravitreal administration of these cytokines induces an increased expression of pro-inflammatory molecules such as IL-1α, IL-6, inducible nitric oxide synthase, TNF-α and vascular endothelial growth factor in the retina. However, a significant decrease in the expression of genes for all these pro-inflammatory molecules was observed after the intravitreal injection of MSCs. We further showed that an increased infiltration of the retina with immune cells, mainly with macrophages, which was observed after pro-inflammatory cytokine application, was significantly reduced after the intravitreal application of MSCs. The similar immunosuppressive effects of MSCs were also demonstrated in vitro in cultures of cytokine-stimulated retinal explants and MSCs. Overall, the results show that intravitreal application of MSCs inhibits the early retinal inflammation caused by pro-inflammatory cytokines, and propose MSCs as a promising candidate for stem cell-based therapy of retinal degenerative diseases.
Collapse
|
11
|
Lu W, Xu W, Li J, Chen Y, Pan Y, Wu B. Effects of vascular endothelial growth factor and insulin growth factor‑1 on proliferation, migration, osteogenesis and vascularization of human carious dental pulp stem cells. Mol Med Rep 2019; 20:3924-3932. [PMID: 31485628 DOI: 10.3892/mmr.2019.10606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/15/2019] [Indexed: 11/05/2022] Open
Affiliation(s)
- Wanyu Lu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Wenan Xu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Jianjia Li
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Yan Chen
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Yuhua Pan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Buling Wu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| |
Collapse
|
12
|
Alió del Barrio JL, Alió JL. Cellular therapy of the corneal stroma: a new type of corneal surgery for keratoconus and corneal dystrophies. EYE AND VISION (LONDON, ENGLAND) 2018; 5:28. [PMID: 30410944 PMCID: PMC6211455 DOI: 10.1186/s40662-018-0122-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/17/2018] [Indexed: 12/13/2022]
Abstract
Cellular therapy of the corneal stroma, with either ocular or extraocular stem cells, has been gaining a lot of interest over the last decade. Multiple publications from different research groups are showing its potential benefits in relation to its capacity to improve or alleviate corneal scars, improve corneal transparency in metabolic diseases by enhancing the catabolism of the accumulated molecules, generate new organized collagen within the host stroma, and its immunosuppressive and immunomodulatory properties. Autologous extraocular stem cells do not require a healthy contralateral eye and they do not involve any ophthalmic procedures for their isolation. Mesenchymal stem cells have been the most widely assayed and have the best potential to differentiate into functional adult keratocytes in vivo and in vitro. While embryonic stem cells have been partially abandoned due to ethical implications, the discovery of the induced pluripotent stem cells (iPSC) has opened a new and very promising field for future research as they are pluripotent cells with the capacity to theoretically differentiate into any cell type, with the special advantage that they are obtained from adult differentiated cells. Cellular delivery into the corneal stroma has been experimentally assayed in vivo in multiple ways: systemic versus local injections with or without a carrier. Encouraging preliminary human clinical data is already available although still very limited, and further research is necessary in order to consolidate the clinical applications of this novel therapeutic line.
Collapse
Affiliation(s)
- Jorge L. Alió del Barrio
- Cornea, Cataract and Refractive Surgery Unit, Vissum Corporación, Alicante, Spain
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
- Vissum, Instituto Oftalmologico de Alicante, Avda de Denia s/n, 03016 Alicante, Spain
| | - Jorge L. Alió
- Cornea, Cataract and Refractive Surgery Unit, Vissum Corporación, Alicante, Spain
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| |
Collapse
|
13
|
Trosan P, Smeringaiova I, Brejchova K, Bednar J, Benada O, Kofronova O, Jirsova K. The enzymatic de-epithelialization technique determines denuded amniotic membrane integrity and viability of harvested epithelial cells. PLoS One 2018; 13:e0194820. [PMID: 29584778 PMCID: PMC5870984 DOI: 10.1371/journal.pone.0194820] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 03/09/2018] [Indexed: 12/20/2022] Open
Abstract
The human amniotic membrane (HAM) is widely used for its wound healing effect in clinical practice, as a feeder for the cell cultivation, or a source of cells to be used in cell therapy. The aim of this study was to find effective and safe enzymatic HAM de-epithelialization method leading to harvesting of both denuded undamaged HAM and viable human amniotic epithelial cells (hAECs). The efficiency of de-epithelialization using TrypLE Express, trypsin/ ethylenediaminetetraacetic (EDTA), and thermolysin was monitored by hematoxylin and eosin staining and by the measurement of DNA concentration. The cell viability was determined by trypan blue staining. Scanning electron microscopy and immunodetection of collagen type IV and laminin α5 chain were used to check the basement membrane integrity. De-epithelialized hAECs were cultured and their stemness properties and proliferation potential was assessed after each passage. The HAM was successfully de-epithelialized using all three types of reagents, but morphological changes in basement membrane and stroma were observed after the thermolysin application. About 60% of cells remained viable using trypsin/EDTA, approximately 6% using TrypLE Express, and all cells were lethally damaged after thermolysin application. The hAECs isolated using trypsin/EDTA were successfully cultured up to the 5th passage with increasing proliferation potential and decreased stem cell markers expression (NANOG, SOX2) in prolonged cell culture. Trypsin/EDTA technique was the most efficient for obtaining both undamaged denuded HAM and viable hAECs for consequent culture.
Collapse
Affiliation(s)
- Peter Trosan
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- * E-mail:
| | - Ingrida Smeringaiova
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Kristyna Brejchova
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jan Bednar
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Oldrich Benada
- Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Olga Kofronova
- Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Katerina Jirsova
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| |
Collapse
|
14
|
Hermankova B, Kossl J, Javorkova E, Bohacova P, Hajkova M, Zajicova A, Krulova M, Holan V. The Identification of Interferon-γ as a Key Supportive Factor for Retinal Differentiation of Murine Mesenchymal Stem Cells. Stem Cells Dev 2017; 26:1399-1408. [PMID: 28728472 DOI: 10.1089/scd.2017.0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Retinal disorders represent the main cause of decreased quality of vision and even blindness worldwide. The loss of retinal cells causes irreversible damage of the retina, and there are currently no effective treatment protocols for most retinal degenerative diseases. A promising approach for the treatment of retinal disorders is represented by stem cell-based therapy. The perspective candidates are mesenchymal stem cells (MSCs), which can differentiate into multiple cell types and produce a number of trophic and growth factors. In this study, we show the potential of murine bone marrow-derived MSCs to differentiate into cells expressing retinal markers and we identify the key supportive role of interferon-γ (IFN-γ) in the differentiation process. MSCs were cultured for 7 days with retinal extract and supernatant from T-cell mitogen concanavalin A-stimulated splenocytes, simulating the inflammatory site of retinal damage. MSCs cultured in such conditions differentiated to the cells expressing retinal cell markers such as rhodopsin, S antigen, retinaldehyde-binding protein, calbindin 2, recoverin, and retinal pigment epithelium 65. To identify a supportive molecule in the supernatants from activated spleen cells, MSCs were cultured with retinal extract in the presence of various T-cell cytokines. The expression of retinal markers was enhanced only in the presence of IFN-γ, and the supportive role of spleen cell supernatants was abrogated with the neutralization antibody anti-IFN-γ. In addition, differentiated MSCs were able to express a number of neurotrophic factors, which are important for retinal regeneration. Taken together, the results show that MSCs can differentiate into cells expressing retinal markers and that this differentiation process is supported by IFN-γ.
Collapse
Affiliation(s)
- Barbora Hermankova
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic .,2 Department of Cell Biology, Faculty of Science, Charles University , Prague, Czech Republic
| | - Jan Kossl
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic .,2 Department of Cell Biology, Faculty of Science, Charles University , Prague, Czech Republic
| | - Eliska Javorkova
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic .,2 Department of Cell Biology, Faculty of Science, Charles University , Prague, Czech Republic
| | - Pavla Bohacova
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic .,2 Department of Cell Biology, Faculty of Science, Charles University , Prague, Czech Republic
| | - Michaela Hajkova
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic .,2 Department of Cell Biology, Faculty of Science, Charles University , Prague, Czech Republic
| | - Alena Zajicova
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic
| | - Magdalena Krulova
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic .,2 Department of Cell Biology, Faculty of Science, Charles University , Prague, Czech Republic
| | - Vladimir Holan
- 1 Department of Transplantation Immunology, Institute of Experimental Medicine , Czech Academy of Sciences, Prague, Czech Republic .,2 Department of Cell Biology, Faculty of Science, Charles University , Prague, Czech Republic
| |
Collapse
|
15
|
The Roles of Insulin-Like Growth Factors in Mesenchymal Stem Cell Niche. Stem Cells Int 2017; 2017:9453108. [PMID: 28298931 PMCID: PMC5337393 DOI: 10.1155/2017/9453108] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/22/2016] [Accepted: 01/18/2017] [Indexed: 12/12/2022] Open
Abstract
Many tissues contain adult mesenchymal stem cells (MSCs), which may be used in tissue regeneration therapies. However, the MSC availability in most tissues is limited which demands expansion in vitro following isolation. Like many developing cells, the state of MSCs is affected by the surrounding microenvironment, and mimicking this natural microenvironment that supports multipotent or differentiated state in vivo is essential to understand for the successful use of MSC in regenerative therapies. Many researchers are, therefore, optimizing cell culture conditions in vitro by altering growth factors, extracellular matrices, chemicals, oxygen tension, and surrounding pH to enhance stem cells self-renewal or differentiation. Insulin-like growth factors (IGFs) system has been demonstrated to play an important role in stem cell biology to either promote proliferation and self-renewal or enhance differentiation onset and outcome, depending on the cell culture conditions. In this review, we will describe the importance of IGFs, IGF-1 and IGF-2, in development and in the MSC niche and how they affect the pluripotency or differentiation towards multiple lineages of the three germ layers.
Collapse
|
16
|
Jiang D, Gao F, Zhang Y, Wong DSH, Li Q, Tse HF, Xu G, Yu Z, Lian Q. Mitochondrial transfer of mesenchymal stem cells effectively protects corneal epithelial cells from mitochondrial damage. Cell Death Dis 2016; 7:e2467. [PMID: 27831562 PMCID: PMC5260876 DOI: 10.1038/cddis.2016.358] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/23/2016] [Accepted: 10/03/2016] [Indexed: 12/19/2022]
Abstract
Recent studies have demonstrated that mesenchymal stem cells (MSCs) can donate mitochondria to airway epithelial cells and rescue mitochondrial damage in lung injury. We sought to determine whether MSCs could donate mitochondria and protect against oxidative stress-induced mitochondrial dysfunction in the cornea. Co-culturing of MSCs and corneal epithelial cells (CECs) indicated that the efficiency of mitochondrial transfer from MSCs to CECs was enhanced by Rotenone (Rot)-induced oxidative stress. The efficient mitochondrial transfer was associated with increased formation of tunneling nanotubes (TNTs) between MSCs and CECs, tubular connections that allowed direct intercellular communication. Separation of MSCs and CECs by a transwell culture system revealed no mitochiondrial transfer from MSCs to CECs and mitochondrial function was impaired when CECs were exposed to Rot challenge. CECs with or without mitochondrial transfer from MSCs displayed a distinct survival capacity and mitochondrial oxygen consumption rate. Mechanistically, increased filopodia outgrowth in CECs for TNT formation was associated with oxidative inflammation-activated NFκB/TNFαip2 signaling pathways that could be attenuated by reactive oxygen species scavenger N-acetylcysteine (NAC) treatment. Furthermore, MSCs grown on a decellularized porcine corneal scaffold were transplanted onto an alkali-injured eye in a rabbit model. Enhanced corneal wound healing was evident following healthy MSC scaffold transplantation. And transferred mitochondria was detected in corneal epithelium. In conclusion, mitochondrial transfer from MSCs provides novel protection for the cornea against oxidative stress-induced mitochondrial damage. This therapeutic strategy may prove relevant for a broad range of mitochondrial diseases.
Collapse
Affiliation(s)
- Dan Jiang
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Fei Gao
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yuelin Zhang
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - David Sai Hung Wong
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Qing Li
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Hung-Fat Tse
- Department of Medicine, The University of Hong Kong, Hong Kong, China.,Shenzhen Institutes of Research and Innovation, University of Hong Kong, Hong Kong, China
| | - Goufeng Xu
- National Engineering Laboratory for Regenerative Medical Implantable Devices, 12 Yuyan Road, Guangzhou, China
| | - Zhendong Yu
- Central Laboratory, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Qizhou Lian
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Department of Medicine, The University of Hong Kong, Hong Kong, China.,Shenzhen Institutes of Research and Innovation, University of Hong Kong, Hong Kong, China
| |
Collapse
|