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Chameettachal S, Venuganti A, Parekh Y, Prasad D, Joshi VP, Vashishtha A, Basu S, Singh V, Bokara KK, Pati F. Human cornea-derived extracellular matrix hydrogel for prevention of post-traumatic corneal scarring: A translational approach. Acta Biomater 2023; 171:289-307. [PMID: 37683964 DOI: 10.1016/j.actbio.2023.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
Corneal scarring and opacification are a significant cause of blindness affecting millions worldwide. The current standard of care for corneal blindness is corneal transplantation, which suffers from several drawbacks. One alternative approach that has shown promise is the use of xenogeneic corneal extracellular matrix (ECM), but its clinical applicability is challenging due to safety concerns. This study reports the innovative use of human cornea-derived ECM to prevent post-traumatic corneal scarring. About 30 - 40% of corneas donated to the eye banks do not meet the standards defined for clinical use and are generally discarded, although they are completely screened for their safety. In this study, human cornea-derived decellularized ECM hydrogel was prepared from the non-transplantation grade human cadaveric corneas obtained from an accredited eye-bank. The prepared hydrogel was screened for its efficacy against corneal opacification following an injury in an animal model. Our in vivo study revealed that, the control collagen-treated group developed corneal opacification, while the prophylactic application of human cornea-derived hydrogel effectively prevented corneal scarring and opacification. The human hydrogel-treated corneas were indistinguishable from healthy corneas and comparable to those treated with the xenogeneic bovine corneal hydrogel. We also demonstrated that the application of the hydrogel retained the biological milieu including cell behavior, protein components, optical properties, curvature, and nerve regeneration by remodeling the corneal wound after injury. The hydrogel application is also sutureless, resulting in faster corneal healing. We envision that this human cornea-derived ECM-based hydrogel has potential clinical application in preventing scarring from corneal wounding. STATEMENT OF SIGNIFICANCE: There are significant challenges surrounding corneal regeneration after injury due to extensive scarring. Although there is substantial research on corneal regeneration, much of it uses synthetic materials with chemical cross-linking methods or xenogeneic tissue-based material devices which have to undergo exhaustive safety analysis before clinical trials. Herein, we demonstrate the potential application of a human corneal extracellular matrix hydrogel without any additional materials for scarless corneal tissue regeneration, and a method to reduce the wasting of donated allogenic corneal tissue from eye banks. We found no difference in efficacy between the usage of human tissues compared to xenogeneic sources. This may help ease clinical translation and can be used topically without sutures as an outpatient procedure.
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Affiliation(s)
- Shibu Chameettachal
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Kandi, Sangareddy 502285, Telangana, India
| | - Animith Venuganti
- Centre for Ocular Regeneration, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Yash Parekh
- CSIR-Center for Cellular and Molecular Biology, ANNEXE II, Medical Biotechnology Complex, Uppal Road, Hyderabad, Telangana, India
| | - Deeksha Prasad
- Centre for Ocular Regeneration, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Vineet P Joshi
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Kandi, Sangareddy 502285, Telangana, India; Centre for Ocular Regeneration, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anviti Vashishtha
- CSIR-Center for Cellular and Molecular Biology, ANNEXE II, Medical Biotechnology Complex, Uppal Road, Hyderabad, Telangana, India
| | - Sayan Basu
- Centre for Ocular Regeneration, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.
| | - Vivek Singh
- Centre for Ocular Regeneration, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.
| | - Kiran Kumar Bokara
- CSIR-Center for Cellular and Molecular Biology, ANNEXE II, Medical Biotechnology Complex, Uppal Road, Hyderabad, Telangana, India.
| | - Falguni Pati
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Kandi, Sangareddy 502285, Telangana, India.
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Jia HZ, Pang X, Peng XJ. Changes of matrix metalloproteinases in the stroma after corneal cross-linking in rabbits. Int J Ophthalmol 2021; 14:26-31. [PMID: 33469480 DOI: 10.18240/ijo.2021.01.04] [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: 03/04/2020] [Accepted: 08/13/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To observe changes in the content of matrix metalloproteinases (MMPs) in the corneal stroma after corneal cross-linking (CXL) in rabbits, and further explore the corneal pathophysiological process after CXL. METHODS Forty-two rabbits (42 eyes) were randomly divided into seven groups. One group served as the control group, while the other six groups were treated with CXL. The concentrations of MMPs in corneal stroma were evaluated through parallel reaction monitoring at baseline and 3, 7, 15, 30, 90, and 180d after treatment. RESULTS The levels of MMP-2 in the corneal stroma of rabbits were 0.76±0.07, 2.78±1.39, 4.12±0.69, 2.00±0.29, 2.00±0.30, 1.22±0.18, and 1.35±0.18 (10-9 mol/g) at baseline and 3, 7, 15, 30, 90, and 180d after treatment, respectively. The contents of tissue inhibitor of metalloproteinase-1 (TIMP-1) were 1.83±0.26, 7.94±0.58, 6.95±2.64, 3.81±0.48, 3.07±0.92, 1.72±0.19, and 1.69±0.74 (10-9 mol/g), respectively. The ratios of MMP-2/TIMP-1 were 0.42±0.33, 0.36±0.20, 0.62±0.10, 0.54±0.15, 0.68±0.13, 0.71±0.10, and 0.68±0.09, respectively. After CXL, the expression of MMP-2 and TIMP-1 in the rabbit corneal stroma was initially increased and subsequently decreased. The levels of MMP-2 remained higher than those recorded at baseline 180d after treatment, but it was not statistically significant. The levels of TIMP-1 returned to baseline levels at 90d after treatment. The ratio of MMP-2/TIMP-1 started to rise from 7d after CXL. It was significantly higher than that calculated at baseline 30-180d after CXL. The results for MMP-1, -3, -7, -9, -13, and TIMP-2 were negative. CONCLUSION CXL can lead to changes in the content of MMP-2 and TIMP-1 in the rabbit corneal stroma. The ratio of MMP-2/TIMP-1 remains higher versus baseline, indicating that MMP-2 is involved in the corneal pathophysiological process after CXL.
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Affiliation(s)
- Hong-Zhen Jia
- Department of Ophthalmology, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Xu Pang
- Department of Ophthalmology, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Xiu-Jun Peng
- Department of Ophthalmology, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
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Guo P, Miao Y, Jing Y, Akella S, Wang F, Park CY, Zhang C, Chuck RS. Changes in Collagen Structure and Permeability of Rat and Human Sclera After Crosslinking. Transl Vis Sci Technol 2020; 9:45. [PMID: 32934895 PMCID: PMC7463178 DOI: 10.1167/tvst.9.9.45] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 07/11/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To use second harmonic generation imaging and fluorescence recovery after photobleaching to demonstrate alterations in scleral collagen structure and permeability after crosslinking in rat and human eyes. Methods Excised rat and human scleras were imaged ex vivo with an inverted two-photon excitation fluorescence microscope before and after photochemical crosslinking using riboflavin and 405-nm laser light. Fluorescence recovery after photobleaching was applied to measure the diffusion of fluorescein isothiocyanate–dextran across the sclera. Results Crosslinking caused scleral collagen fibers to become wavier and more densely packed, with surface collagen being more affected than deeper collagen fibers. Crosslinked sclera showed significantly decreased permeability in the irradiation zone and also extended as far as 250 µm outside the irradiation zone. Conclusions Photochemical crosslinking induced changes in scleral structure and permeability that extended to tissue even outside the irradiation zone. Translational Relevance Ultrastructural changes associated with the emerging clinical technique of photochemical scleral crosslinking have not been well characterized. We demonstrate not only changes in scleral collagen by second harmonic generation imaging but also the associated functional changes in tissue permeability by fluorescence recovery after photobleaching. We report the novel finding of reduced permeability extending well beyond the direct irradiation zone. This has implications for control in the clinical setting.
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Affiliation(s)
- Peng Guo
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, USA.,Analytical Imaging Facility, Albert Einstein College of Medicine, Bronx, NY, USA.,Gruss-Lipper Biophotonics Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yuan Miao
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Aier School of Ophthalmology, Central South University, China
| | - Yang Jing
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Sruti Akella
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Fang Wang
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Choul Yong Park
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Cheng Zhang
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Roy S Chuck
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
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Histological Corneal Alterations in Keratoconus After Crosslinking—Expansion of Findings. Cornea 2019; 39:333-341. [DOI: 10.1097/ico.0000000000002144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alves A, Attik N, Bayon Y, Royet E, Wirth C, Bourges X, Piat A, Dolmazon G, Clermont G, Boutrand JP, Grosgogeat B, Gritsch K. Devising tissue ingrowth metrics: a contribution to the computational characterization of engineered soft tissue healing. Biomed Mater 2018; 13:035010. [DOI: 10.1088/1748-605x/aaa9d4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Koc M, Bostanci B, Demirel OO, Genc F, Tekin K, Koban Y, Dincel AS, Sen M, Yilmazbas P. The Effect of Ascorbic Acid (Vitamin C) on Transepithelial Corneal Cross-Linking in Rabbits. J Ocul Pharmacol Ther 2017; 33:525-529. [PMID: 28590790 DOI: 10.1089/jop.2017.0025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mustafa Koc
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Basak Bostanci
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Ozlem Ozbas Demirel
- Department of Biochemistry, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Feyza Genc
- Department of Chemistry, Hacettepe University, Ankara, Turkey
| | - Kemal Tekin
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Yaran Koban
- Department of Ophthalmology, FEBO, Kafkas University, Kars, Turkey
| | | | - Murat Sen
- Department of Chemistry, Hacettepe University, Ankara, Turkey
| | - Pelin Yilmazbas
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Wang M, Li M, Yan P, Luo Q, Zhang Y, Du Z. The Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Anterior Segment. J Ophthalmol 2017; 2017:6067890. [PMID: 28280636 PMCID: PMC5322416 DOI: 10.1155/2017/6067890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/12/2016] [Indexed: 12/28/2022] Open
Abstract
Purpose. To evaluate the safety of high-intensity focused ultrasound keratoplasty as a treatment for presbyopia by examining its effect on the rabbit anterior segment. Methods. The right corneas of 36 New Zealand rabbits were treated with HIFU keratoplasty. The animals were sacrificed at 1, 7, 15, 30, 60, and 90 days after operation. Collagen type I, MMP-2, and MMP-9 were evaluated using immunohistochemistry. For the detection of apoptosis, the TUNEL method was applied. The SOD and MDA levels were analyzed with assay kits. Results. Collagen type I, MMP-2, and MMP-9 levels were altered after the operation but returned to normal within 90 days. The apoptotic index (AI) of the corneal cells decreased from 1 to 30 days gradually. No apoptosis was observed in the epithelial cells of the lens, and the SOD and MDA levels were normal at any time point. Conclusion. After HIFU keratoplasty, the histomorphology of the cornea changed, the corneal collagen type I levels decreased, the corneal MMP-2 and MMP-9 levels increased, and the corneal cells underwent apoptosis for a period of time. Ninety days after the operation, the levels returned to normal, and the lenses were not affected. Thus, HIFU presents good biological safety for eyes.
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Affiliation(s)
- Menglei Wang
- Department of Ophthalmology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
| | - Meixuan Li
- Department of Ophthalmology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
| | - Pisong Yan
- Medal Eye Institute, Chongqing 400050, China
| | - Qiang Luo
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
| | - Yu Zhang
- Department of Ophthalmology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
| | - Zhiyu Du
- Department of Ophthalmology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
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