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Tonti E, Manco GA, Spadea L, Zeppieri M. Focus on limbal stem cell deficiency and limbal cell transplantation. World J Transplant 2023; 13:321-330. [PMID: 38174150 PMCID: PMC10758683 DOI: 10.5500/wjt.v13.i6.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/10/2023] [Accepted: 11/02/2023] [Indexed: 12/15/2023] Open
Abstract
Limbal stem cell deficiency (LSCD) causes severe vision impairment and can lead to blindness, representing one of the most challenging ocular surface disorders. Stem cell deficiency can be congenital or, more often, acquired. The categorization of ocular surface transplantation techniques is crucial to achieving treatment homogeneity and quality of care, according to the anatomic source of the tissue being transplanted, genetic source, autologous or allogenic transplantation (to reflect histocompatibility in the latter group), and cell culture and tissue engineering techniques. The aim of this minireview is to provide a summary of the management of LSCD, from clinical characteristics and therapeutic outcomes to the development of novel therapeutic approaches. The manuscript also briefly summarizes recent findings in the current literature and outlines the future challenges to overcome in the management of the major types of ocular surface failure.
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Affiliation(s)
- Emanuele Tonti
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | | | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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Moreno IY, Parsaie A, Gesteira TF, Coulson-Thomas VJ. Characterization of the Limbal Epithelial Stem Cell Niche. Invest Ophthalmol Vis Sci 2023; 64:48. [PMID: 37906057 PMCID: PMC10619699 DOI: 10.1167/iovs.64.13.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023] Open
Abstract
Purpose Limbal epithelial stem cells (LESCs) reside within a LSC niche (LSCN). We recently identified that hyaluronan (HA) is a major constituent of the LSCN, and that HA is necessary for maintaining LESCs in the "stem cell" state, both in vitro and in vivo. Herein, we characterized the LSCN to identify key components of the HA-specific LSCN. Methods The cornea and limbal rim were dissected from mouse corneas, subjected to mRNA extraction, and sequenced using a NextSeq 500 (Illumina) and data processed using CLC Genomics Workbench 20 (Qiagen) and the STRING database to identify key components of the LSCN. Their expression was confirmed by real-time PCR, Western blotting, and immunohistochemistry. Furthermore, the differential expression of key compounds in different corneal cell types were determined with single-cell RNA sequencing. Results We identified that the hyaladherins inter-alpha-inhibitor (IαI), TSG-6 and versican are highly expressed in the limbus. Specifically, HA/HC complexes are present in the LSCN, in the stroma underlying the limbal epithelium, and surrounding the limbal vasculature. For IαI, heavy chains 5 and 2 (HC5 and HC2) were found to be the most highly expressed HCs in the mouse and human limbus and were associate with HA-forming HA/HC-specific matrices. Conclusions The LSCN contains HA/HC complexes, which have been previously correlated with stem cell niches. The identification of HA/HC complexes in the LSCN could serve as a new therapeutic avenue for treating corneal pathology. Additionally, HA/HC complexes could be used as a substrate for culturing LESCs before LESC transplantation.
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Affiliation(s)
- Isabel Y. Moreno
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Arian Parsaie
- College of Optometry, University of Houston, Houston, Texas, United States
- College of Natural Science and Mathematics, University of Houston, Houston, Texas, United States
| | - Tarsis F. Gesteira
- College of Optometry, University of Houston, Houston, Texas, United States
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Toshida H, Kasahara T, Kiriyama M, Iwasaki Y, Sugita J, Ichikawa K, Ohta T, Miyahara K. Early Clinical Outcomes of the First Commercialized Human Autologous Ex Vivo Cultivated Oral Mucosal Epithelial Cell Transplantation for Limbal Stem Cell Deficiency: Two Case Reports and Literature Review. Int J Mol Sci 2023; 24:ijms24108926. [PMID: 37240280 DOI: 10.3390/ijms24108926] [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: 04/30/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
The first product in the world for ex vivo cultivated oral mucosal epithelial cell transplantation (COMET) to treat limbal stem cell deficiency (LSCD), named Ocural®, was launched in June 2021 in Japan. COMET was performed on two patients, including the first case in the post-marketing phase of Ocural®. Pathological and immunohistochemical examinations were also carried out using specimens obtained before and after COMET and the spare cell sheet. In case 1, the ocular surface remained free from epithelial defects for approximately six months. In case 2, although defect of the cornea-like epithelia was observed after COMET for one month, it was resolved after the insertion of lacrimal punctal plugs. In case 1, adjuvant treatment was interrupted due to an accident during the second month after COMET, resulting in conjunctival ingrowth and corneal opacity. Eventually, a lamellar keratoplasty was required at six months after COMET. Immunohistochemistry revealed the presence of markers for stem cells (p63, p75), proliferation (Ki-67), and differentiation (Keratin-3, -4, and -13) in both the cornea-like tissue after COMET and a cultivated oral mucosal epithelial cell sheet. In conclusion, Ocural® can be accomplished without major complications, and the stem cells derived from oral mucosa might be successfully engrafted.
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Affiliation(s)
- Hiroshi Toshida
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 410-2211, Japan
| | - Tomoto Kasahara
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 410-2211, Japan
| | - Masamichi Kiriyama
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 410-2211, Japan
| | - Yuma Iwasaki
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 410-2211, Japan
| | - Jobu Sugita
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 410-2211, Japan
| | - Kohei Ichikawa
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 410-2211, Japan
| | - Toshihiko Ohta
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 410-2211, Japan
| | - Katsumi Miyahara
- Laboratory of Morphology and Image Analysis, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
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Ying PX, Fu M, Huang C, Li ZH, Mao QY, Fu S, Jia XH, Cao YC, Hong LB, Cai LY, Guo X, Liu RB, Meng FK, Yi GG. Profile of biological characterizations and clinical application of corneal stem/progenitor cells. World J Stem Cells 2022; 14:777-797. [PMID: 36483848 PMCID: PMC9724387 DOI: 10.4252/wjsc.v14.i11.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/08/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022] Open
Abstract
Corneal stem/progenitor cells are typical adult stem/progenitor cells. The human cornea covers the front of the eyeball, which protects the eye from the outside environment while allowing vision. The location and function demand the cornea to maintain its transparency and to continuously renew its epithelial surface by replacing injured or aged cells through a rapid turnover process in which corneal stem/progenitor cells play an important role. Corneal stem/progenitor cells include mainly corneal epithelial stem cells, corneal endothelial cell progenitors and corneal stromal stem cells. Since the discovery of corneal epithelial stem cells (also known as limbal stem cells) in 1971, an increasing number of markers for corneal stem/progenitor cells have been proposed, but there is no consensus regarding the definitive markers for them. Therefore, the identification, isolation and cultivation of these cells remain challenging without a unified approach. In this review, we systematically introduce the profile of biological characterizations, such as anatomy, characteristics, isolation, cultivation and molecular markers, and clinical applications of the three categories of corneal stem/progenitor cells.
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Affiliation(s)
- Pei-Xi Ying
- Department of Ophthalmology, Zhujiang Hospital, The Second Clinical School, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Min Fu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Chang Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200030, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200030, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200030, China
| | - Zhi-Hong Li
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Lab of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou 510550, Guangdong Province, China
| | - Qing-Yi Mao
- The Second Clinical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Sheng Fu
- Hengyang Medical School, The University of South China, Hengyang 421001, Hunan Province, China
| | - Xu-Hui Jia
- The Second Clinical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Yu-Chen Cao
- The Second Clinical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Li-Bing Hong
- The Second Clinical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Li-Yang Cai
- The Second Clinical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Xi Guo
- Medical College of Rehabilitation, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Ru-Bing Liu
- The Second Clinical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Fan-ke Meng
- Emergency Department, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Guo-Guo Yi
- Department of Ophthalmology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
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Di Girolamo N, Park M. Cell identity changes in ocular surface Epithelia. Prog Retin Eye Res 2022:101148. [DOI: 10.1016/j.preteyeres.2022.101148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/13/2022] [Accepted: 11/09/2022] [Indexed: 11/21/2022]
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Urbinati F, García-Montesinos J, Rocha-de-Lossada C, García-Lorente M, Rodríguez-Calvo-de-Mora M. Further Indications for "Doughnut" Amniotic Membrane Transplantation. Cornea 2022; 41:e17. [PMID: 35389924 DOI: 10.1097/ico.0000000000003026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Facundo Urbinati
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - Carlos Rocha-de-Lossada
- Department of Ophthalmology, Qvision, Vithas, Almería, Spain
- Department of Ophthalmology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María García-Lorente
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Málaga, Spain
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Lohajaroensub R, Sawangmake C, Rodkhum C, Tuntivanich N. Expression of Antimicrobial Peptide Genes in the Canine Amniotic Membrane. Vet Sci 2022; 9:vetsci9050200. [PMID: 35622728 PMCID: PMC9146009 DOI: 10.3390/vetsci9050200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/03/2022] [Accepted: 04/18/2022] [Indexed: 01/27/2023] Open
Abstract
The human amniotic membrane has been successfully used in human ocular reconstruction. Several studies have demonstrated its properties, including antimicrobial features. As a result of the restricted availability of human amniotic membrane for veterinary use, canine amniotic membrane has become an attractive alternative. Clinical studies of the application of canine amniotic membrane in animals and the understanding of its biological properties are limited. This study aimed to determine the expression of peptide genes of natural antimicrobials in canine amniotic membrane. Expressions of canine β-defensin 1, 102, and 103, and canine Elafin were determined in healthy puppies by real-time quantitative polymerase chain reaction. Canine β-defensin 1, 103, and Elafin were expressed in all samples, possibly suggesting a role in the innate immune system of normal canine amniotic membrane. Further investigations of protein expression and localization are recommended.
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Affiliation(s)
- Rajit Lohajaroensub
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Chenphop Sawangmake
- Department of Veterinary Pharmacology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Channarong Rodkhum
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Nalinee Tuntivanich
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand;
- Correspondence: ; Tel.: +66-84-695-1295
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Inamochi A, Miyai T, Usui T, Aihara M, Yamagami S. Effects of corneal epithelial superficial keratectomy in patients with focal limbal stem cell disease. Am J Ophthalmol Case Rep 2021; 25:101239. [PMID: 34917856 PMCID: PMC8666511 DOI: 10.1016/j.ajoc.2021.101239] [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: 04/04/2021] [Revised: 09/23/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Irregular corneal epithelium in limbal stem cell disease can cause visual acuity to deteriorate substantially when it reaches the pupil. In this case series, we assessed the effectiveness of simple corneal epithelial superficial keratectomy in improving visual acuity in patients with irregular corneal epithelium in focal limbal stem cell disease covering the visual axis. Observations We performed simple corneal epithelial superficial keratectomy in four patients (five eyes) with irregular corneal epithelium covering the visual axis. The main outcome measures were best-corrected visual acuity, slit lamp findings with fluorescein staining, anterior segment optical coherence tomography and histopathology. In all five eyes, slit lamp findings showed uneven fluorescein staining in a spiral pattern, with impaired corneal epithelial smoothness and visual disturbance. We removed the irregular epithelium in all five eyes. Visual acuity in all the eyes was improved immediately after surgery, and good visual acuity and stable epithelium were maintained for the duration of the observation periods. Hematoxylin and eosin staining showed, normal squamous and columnar epithelial cells. Goblet cells were not detected. Conclusionsand Importance Corneal epithelial superficial keratectomy can lead to a pathological diagnosis by examining the removed epithelial tissues, and result in excellent therapeutic outcomes in focal limbal stem cell disease reaching the pupil.
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Affiliation(s)
- Aya Inamochi
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Takashi Miyai
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Tomohiko Usui
- Department of Ophthalmology, Graduate School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita-shi, Chiba-ken, 286-8686, Japan
| | - Makoto Aihara
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Satoru Yamagami
- Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, 30-1 Oyaguchikamicho Itabashi-ku, Tokyo, 173-0032, Japan
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Matsumura T, Yamaguchi T, Higa K, Inatani M, Shimazaki J. Long-Term Outcome After Superficial Keratectomy of the Abnormal Epithelium for Partial Limbal Stem Cell Deficiency. Am J Ophthalmol 2021; 231:134-143. [PMID: 34102156 DOI: 10.1016/j.ajo.2021.05.023] [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: 10/07/2020] [Revised: 05/16/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the etiology and long-term surgical prognosis of the abnormal epithelium for partial limbal stem cell deficiency (LSCD), following superficial keratectomy DESIGN: Retrospective, interventional case series METHODS: This single-center, retrospective study was conducted to assess the prognosis of consecutive patients who underwent superficial keratectomy, with or without amniotic membrane transplantation (AMT), for the treatment of partial LSCD, from 2010 to 2019. We analyzed the etiologies of partial LSCD, surgical success rate, prognosis for recurrent cases, and the improvement in visual acuity. RESULTS We included 40 patients (51 eyes) with partial LSCD. All eyes were in clinical stage II without dense fibrovascular tissue. Idiopathy was the most common etiology (39%), followed by multiple surgeries involving the corneoscleral limbus (19%). All eyes attained corneal reepithelialization and transparency. Furthermore, the visual acuity improved or remained unchanged postoperatively. We observed recurrence in 19 eyes (37%) with a mean follow-up period of 26.3 months. Despite no significant difference in the recurrence rates among different etiologies, postoperative delayed epithelialization and extensive limbal involvement were identified as risk factors for recurrence (P < .001 and P = .013, respectively). Repeat surgeries were performed in 16 eyes. The final success rate was 84%. CONCLUSIONS Superficial keratectomy is useful for the treatment of partial LSCD of varied etiologies, with an expected improvement in visual acuity postoperatively. Although the procedure can be repeated and have a high success rate, there have been several cases of recurrence in the long-term postoperative course.
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Mijanović O, Pylaev T, Nikitkina A, Artyukhova M, Branković A, Peshkova M, Bikmulina P, Turk B, Bolevich S, Avetisov S, Timashev P. Tissue Engineering Meets Nanotechnology: Molecular Mechanism Modulations in Cornea Regeneration. MICROMACHINES 2021; 12:mi12111336. [PMID: 34832752 PMCID: PMC8618371 DOI: 10.3390/mi12111336] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/23/2021] [Accepted: 10/14/2021] [Indexed: 12/13/2022]
Abstract
Nowadays, tissue engineering is one of the most promising approaches for the regeneration of various tissues and organs, including the cornea. However, the inability of biomaterial scaffolds to successfully integrate into the environment of surrounding tissues is one of the main challenges that sufficiently limits the restoration of damaged corneal tissues. Thus, the modulation of molecular and cellular mechanisms is important and necessary for successful graft integration and long-term survival. The dynamics of molecular interactions affecting the site of injury will determine the corneal transplantation efficacy and the post-surgery clinical outcome. The interactions between biomaterial surfaces, cells and their microenvironment can regulate cell behavior and alter their physiology and signaling pathways. Nanotechnology is an advantageous tool for the current understanding, coordination, and directed regulation of molecular cell-transplant interactions on behalf of the healing of corneal wounds. Therefore, the use of various nanotechnological strategies will provide new solutions to the problem of corneal allograft rejection, by modulating and regulating host-graft interaction dynamics towards proper integration and long-term functionality of the transplant.
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Affiliation(s)
- Olja Mijanović
- Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia; (A.N.); (M.A.); (M.P.); (P.B.); (B.T.); (P.T.)
- Correspondence:
| | - Timofey Pylaev
- Saratov Medical State University N.A. V.I. Razumovsky, 112 Bolshaya Kazachya St., 410012 Saratov, Russia;
- Institute of Biochemistry and Physiology of Plants and Microorganisms, Russian Academy of Sciences, 13 Prospekt Entuziastov, 410049 Saratov, Russia
| | - Angelina Nikitkina
- Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia; (A.N.); (M.A.); (M.P.); (P.B.); (B.T.); (P.T.)
| | - Margarita Artyukhova
- Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia; (A.N.); (M.A.); (M.P.); (P.B.); (B.T.); (P.T.)
| | - Ana Branković
- Department of Forensic Engineering, University of Criminal Investigation and Police Studies, 196 Cara Dušana St., Belgrade 11000, Serbia;
| | - Maria Peshkova
- Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia; (A.N.); (M.A.); (M.P.); (P.B.); (B.T.); (P.T.)
- World-Class Research Center “Digital biodesign and personalized healthcare”, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia
| | - Polina Bikmulina
- Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia; (A.N.); (M.A.); (M.P.); (P.B.); (B.T.); (P.T.)
- World-Class Research Center “Digital biodesign and personalized healthcare”, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia
| | - Boris Turk
- Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia; (A.N.); (M.A.); (M.P.); (P.B.); (B.T.); (P.T.)
- Department of Biochemistry and Molecular and Structural Biology, Jožef Stefan Institute, 1000 Ljubljana, Slovenia
- Faculty of Chemistry and Chemical Technology, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Sergey Bolevich
- Department of Human Pathology, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia;
| | - Sergei Avetisov
- Department of Eye Diseases, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia;
- Research Institute of Eye Diseases, 11 Rossolimo St., 119021 Moscow, Russia
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia; (A.N.); (M.A.); (M.P.); (P.B.); (B.T.); (P.T.)
- World-Class Research Center “Digital biodesign and personalized healthcare”, Sechenov University, 8-2 Trubetskaya St., 119991 Moscow, Russia
- Chemistry Department, Lomonosov Moscow State University, Leninskiye Gory 1-3, 119991 Moscow, Russia
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Singh V, Tiwari A, Kethiri AR, Sangwan VS. Current perspectives of limbal-derived stem cells and its application in ocular surface regeneration and limbal stem cell transplantation. Stem Cells Transl Med 2021; 10:1121-1128. [PMID: 33951336 PMCID: PMC8284782 DOI: 10.1002/sctm.20-0408] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/11/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022] Open
Abstract
Limbal stem cells are involved in replenishing and maintaining the epithelium of the cornea. Damage to the limbus due to chemical/physical injury, infections, or genetic disorders leads to limbal stem cell deficiency (LSCD) with partial or total vision loss. Presently, LSCD is treated by transplanting limbal stem cells from the healthy eye of the recipient, living-related, or cadaveric donors. This review discusses limbal-derived stem cells, the importance of extracellular matrix in stem cell niche maintenance, the historical perspective of treating LSCD, including related advantages and limitations, and our experience of limbal stem cell transplantation over the decades.
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Affiliation(s)
- Vivek Singh
- Stem Cell Biology Laboratory, Center for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, India
| | - Anil Tiwari
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Cornea and Uveitis, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Abhinav Reddy Kethiri
- Stem Cell Biology Laboratory, Center for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, India
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Visual Acuity and Number of Amniotic Membrane Layers as Indicators of Efficacy in Amniotic Membrane Transplantation for Corneal Ulcers: A Multicenter Study. J Clin Med 2021; 10:jcm10153234. [PMID: 34362018 PMCID: PMC8348886 DOI: 10.3390/jcm10153234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND To evaluate new indicators in the efficacy of amniotic membrane transplantation (AMT) for non-healing corneal ulcers (NHCUs). METHODS Retrospective, multicenter study. In total, 223 AMTs for NHCU in 191 patients were assessed. The main outcomes studied were the success rate of AMT (complete re-epithelization), postoperative visual acuity (VA) gain, and number of AM layers transplanted. RESULTS The overall AMT success rate was 74.4%. In 92% of our patients VA stability or improvement. Postoperative VA was significantly higher than preoperative VA in the entire cohort (p < 0.001) and in all etiological groups of ulcers (post-bacterial, p ≤ 0.001; post-herpetic, p ≤ 0.0038; neurotrophic ulcers, p ≤ 0.014; non-rheumatic peripheral, p ≤ 0.001; and ulcers secondary to lagophthalmos and eyelid malposition or trauma, p ≤ 0.004). Most participants (56.5%) presented a preoperative VA equal to or less than counting fingers (≤0.01). Of these, 13.5% reached a postoperative VA equal to or better than legal blindness (≥0.05) after AMT. A higher success rate was observed in the monolayer than in the multilayer AMT (79.5% and 64.9%, respectively; p = 0.018). No statistically significant values were found between the number of layers transplanted and VA gain (p = 0.509). CONCLUSION AMT is not only beneficial in achieving complete re-epithelialization in NHCUs but also in improving postoperative VA; these improvements are independent of etiologies of ulcers. Furthermore, the use of monolayer AMT seems to be a more appropriate option than multilayer AMT for NHCU since the multilayer AMT did not present better outcomes (success rate and VA gain) compared to monolayer AMT in the different types of ulcers studied.
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Abstract
PURPOSE In recent decades, the medical and surgical treatment of limbal stem cell deficiency (LSCD) has evolved significantly through the incorporation of innovative pharmacological strategies, surgical techniques, bioengineering, and cell therapy. With such a wide variety of options, there is a need to establish a global consensus on the preferred approaches for the medical and surgical treatment of LSCD. METHODS An international LSCD Working Group was established by the Cornea Society in 2012 and divided into subcommittees. Four face-to-face meetings, frequent email discussions, and teleconferences were conducted since then to reach agreement on a strategic plan and methods after a comprehensive literature search. A writing group drafted the current study. RESULTS A consensus in the medical and surgical management of LSCD was reached by the Working Group. Optimization of the ocular surface by eyelid and conjunctival reconstruction, antiinflammatory therapy, dry eye and meibomian gland dysfunction treatment, minimization of ocular surface toxicity from medications, topical medications that promote epithelialization, and use of a scleral lens is considered essential before surgical treatment of LSCD. Depending on the laterality, cause, and stage of LSCD, surgical strategies including conjunctival epitheliectomy, amniotic membrane transplantation, transplantation of limbal stem cells using different techniques and sources (allogeneic vs. autologous vs. ex vivo-cultivated), transplantation of oral mucosal epithelium, and keratoprosthesis can be performed as treatment. A stepwise flowchart for use in treatment decision-making was established. CONCLUSIONS This global consensus provides an up-to-date and comprehensive framework for the management of LSCD.
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Tong CM, He B, Iovieno A, Yeung SN. Diagnosis and management of limbal stem cell deficiency, challenges, and future prospects. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1933441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C. Maya Tong
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Canada
| | - Bonnie He
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Alfonso Iovieno
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Sonia N. Yeung
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
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15
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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: 2.3] [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.
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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
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16
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Nosrati H, Abpeikar Z, Mahmoudian ZG, Zafari M, Majidi J, Alizadeh A, Moradi L, Asadpour S. Corneal epithelium tissue engineering: recent advances in regeneration and replacement of corneal surface. Regen Med 2020; 15:2029-2044. [PMID: 33169642 DOI: 10.2217/rme-2019-0055] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Currently, many corneal diseases are treated by corneal transplantation, artificial corneal implantation or, in severe cases, keratoprosthesis. Owing to the shortage of cornea donors and the risks involved with artificial corneal implants, such as infection transmission, researchers continually seek new approaches for corneal regeneration. Corneal tissue engineering is a promising approach that has attracted much attention from researchers and is focused on regenerative strategies using various biomaterials in combination with different cell types. These constructs should have the ability to mimic the native tissue microenvironment and present suitable optical, mechanical and biological properties. In this article, we review studies that have focused on the current clinical techniques for corneal replacement. We also describe tissue-engineering and cell-based approaches for corneal regeneration.
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Affiliation(s)
- Hamed Nosrati
- Department of Tissue Engineering & Applied Cell Sciences, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Zahra Abpeikar
- Department of Tissue Engineering & Applied Cell Sciences, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Zahra Gholami Mahmoudian
- Department of Anatomical Sciences, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahdi Zafari
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Jafar Majidi
- Cellular & Molecular Research Center, Basic Health Science Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Akram Alizadeh
- Department of Tissue Engineering & Applied Cell Sciences, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Lida Moradi
- The Ronald O Perelman Department of Dermatology, New York University, School of Medicine, New York, NY 10016, USA.,Department of Cell Biology, New York University, School of Medicine, New York, NY, 10016 USA
| | - Shiva Asadpour
- Department of Tissue Engineering & Applied Cell Sciences, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran.,Cellular & Molecular Research Center, Basic Health Science Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
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17
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Gouveia RM, Connon CJ. Biomechanical Modulation Therapy-A Stem Cell Therapy Without Stem Cells for the Treatment of Severe Ocular Burns. Transl Vis Sci Technol 2020; 9:5. [PMID: 33240564 PMCID: PMC7671857 DOI: 10.1167/tvst.9.12.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/07/2020] [Indexed: 12/16/2022] Open
Abstract
Ocular injuries caused by chemical and thermal burns are often unmanageable and frequently result in disfigurement, corneal haze/opacification, and vision loss. Currently, a considerable number of surgical and pharmacological approaches are available to treat such injuries at either an acute or a chronic stage. However, these existing interventions are mainly directed at (and limited to) suppressing corneal inflammation and neovascularization while promoting re-epithelialization. Reconstruction of the ocular surface represents a suitable but last-option recourse in cases where epithelial healing is severely impaired, such as due to limbal stem cell deficiency. In this concise review, we discuss how biomechanical modulation therapy (BMT) may represent a more effective approach to promoting the regeneration of ocular tissues affected by burn injuries via restoration of the limbal stem cell niche. Specifically, the scientific basis supporting this new therapeutic modality is described, along with our growing understanding of the role that tissue biomechanics plays in stem cell fate and function. The potential impact of BMT as a future treatment option for the management of injuries affecting tissue compliance is also further discussed.
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Affiliation(s)
- Ricardo M Gouveia
- Biosciences Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Che J Connon
- Biosciences Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Newcastle upon Tyne, UK
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18
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Lacorzana J. Amniotic membrane, clinical applications and tissue engineering. Review of its ophthalmic use. ACTA ACUST UNITED AC 2019; 95:15-23. [PMID: 31784120 DOI: 10.1016/j.oftal.2019.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/06/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
The use of amniotic membrane in ophthalmology has been increasing in recent years due to its multiple biological and tectonic properties, improvement in the process of obtaining, ease of use, and advancement in tissue engineering. The amniotic membrane has become one of the main adjuvant treatments, in ophthalmic surgery as well as in other medical-surgical specialties. The development of tissue engineering has allowed it to be used, not only in its classic form, but also by the use of drops and other presentations. The different steps prior to its use (preparation and conservation), the different surgical techniques, and their main clinical applications are described throughout the article.
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Affiliation(s)
- J Lacorzana
- Departamento de Oftalmología, Hospital Universitario Virgen de las Nieves, Granada, España; Escuela de Doctorado y Posgrado, Universidad de Granada, Granada, España; Master en Ingeniería Tisular, Universidad de Granada. Granada, España.
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19
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Nanofiber-reinforced decellularized amniotic membrane improves limbal stem cell transplantation in a rabbit model of corneal epithelial defect. Acta Biomater 2019; 97:310-320. [PMID: 31437637 DOI: 10.1016/j.actbio.2019.08.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/13/2019] [Accepted: 08/15/2019] [Indexed: 12/13/2022]
Abstract
Human amniotic membrane (AM) offers unique advantages as a matrix to support the transplantation of limbal stem cells (LSCs) due to its inherent pro-regenerative and anti-inflammatory properties. However, the widespread use of AM in clinical treatments of ocular surface disorders is limited by its weak mechanical strength and fast degradation, and high cost associated with preserving freshly isolated AM. Here we constructed a composite membrane consisting of an electrospun bioabsorbable poly(ε-caprolactone) (PCL) nanofiber mesh to significantly improve the ultimate tensile strength, toughness, and suture retention strength by 4-10-fold in comparison with decellularized AM sheet. The composite membrane showed extended stability and conferred longer-lasting coverage on wounded cornea surface compared with dAM. The composite membrane maintained the pro-regenerative and immunomodulatory properties of dAM, promoted LSC survival, retention, and organization, improved re-epithelialization of the defect area, and reduced inflammation and neovascularization. This study demonstrates the translational potential of our composite membrane for stem cell-based treatment of ocular surface damage. STATEMENT OF SIGNIFICANCE: Human decellularized amniotic membrane (dAM) has been widely shown as a biodegradable and bioactive matrix for regenerative tissue repair. However, the weak mechanical property has limited its widespread use in the clinic. Here we constructed a composite membrane using a layer of electrospun poly(ε-caprolactone) (PCL) nanofiber mesh to reinforce the dAM sheet through covalent interfacial bonding, while retaining the unique bioactivity of dAM. In a rabbit model of limbal stem cell (LSC) deficiency induced by alkaline burn, we demonstrated the superior property of this PCL-dAM composite membrane for repairing damaged cornea through promoting LSC transplantation, improving re-epithelialization, and reducing inflammation and neovascularization. This new composite membrane offers great translational potential in supporting stem cell-based treatment of ocular surface damage.
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20
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Mobaraki M, Abbasi R, Omidian Vandchali S, Ghaffari M, Moztarzadeh F, Mozafari M. Corneal Repair and Regeneration: Current Concepts and Future Directions. Front Bioeng Biotechnol 2019; 7:135. [PMID: 31245365 PMCID: PMC6579817 DOI: 10.3389/fbioe.2019.00135] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/20/2019] [Indexed: 12/13/2022] Open
Abstract
The cornea is a unique tissue and the most powerful focusing element of the eye, known as a window to the eye. Infectious or non-infectious diseases might cause severe visual impairments that need medical intervention to restore patients' vision. The most prominent characteristics of the cornea are its mechanical strength and transparency, which are indeed the most important criteria considerations when reconstructing the injured cornea. Corneal strength comes from about 200 collagen lamellae which criss-cross the cornea in different directions and comprise nearly 90% of the thickness of the cornea. Regarding corneal transparency, the specific characteristics of the cornea include its immune and angiogenic privilege besides its limbus zone. On the other hand, angiogenic privilege involves several active cascades in which anti-angiogenic factors are produced to compensate for the enhanced production of proangiogenic factors after wound healing. Limbus of the cornea forms a border between the corneal and conjunctival epithelium, and its limbal stem cells (LSCs) are essential in maintenance and repair of the adult cornea through its support of corneal epithelial tissue repair and regeneration. As a result, the main factors which threaten the corneal clarity are inflammatory reactions, neovascularization, and limbal deficiency. In fact, the influx of inflammatory cells causes scar formation and destruction of the limbus zone. Current studies about wound healing treatment focus on corneal characteristics such as the immune response, angiogenesis, and cell signaling. In this review, studied topics related to wound healing and new approaches in cornea regeneration, which are mostly related to the criteria mentioned above, will be discussed.
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Affiliation(s)
- Mohammadmahdi Mobaraki
- Biomaterials Group, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Reza Abbasi
- Biomaterials Group, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Sajjad Omidian Vandchali
- Biomaterials Group, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Maryam Ghaffari
- Biomaterials Group, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Fathollah Moztarzadeh
- Biomaterials Group, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Masoud Mozafari
- Department of Tissue Engineering and Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
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21
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Calonge M, Pérez I, Galindo S, Nieto-Miguel T, López-Paniagua M, Fernández I, Alberca M, García-Sancho J, Sánchez A, Herreras JM. A proof-of-concept clinical trial using mesenchymal stem cells for the treatment of corneal epithelial stem cell deficiency. Transl Res 2019; 206:18-40. [PMID: 30578758 DOI: 10.1016/j.trsl.2018.11.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/18/2018] [Accepted: 11/18/2018] [Indexed: 01/02/2023]
Abstract
Ocular stem cell transplantation derived from either autologous or allogeneic donor corneoscleral junction is a functional cell therapy to manage extensive and/or severe limbal stem cell deficiencies that lead to corneal epithelial failure. Mesenchymal stem cells have been properly tested in animal models of this ophthalmic pathology, but never in human eyes despite their potential advantages. We conducted a 6- to 12-month proof-of-concept, randomized, and double-masked pilot trial to test whether allogeneic bone marrow-derived mesenchymal stem cell transplantation (MSCT], n = 17) was as safe and as equally efficient as allogeneic cultivated limbal epithelial transplantation (CLET), (n = 11) to improve corneal epithelial damage due to limbal stem cell deficiency. Primary endpoints demanded combination of symptoms, signs, and the objective improvement of the epithelial phenotype in central cornea by in vivo confocal microscopy. This proof-of-concept trial showed that MSCT was as safe and efficacious as CLET. Global success at 6-12 months was 72.7%-77.8% for CLET cases and 76.5%-85.7% for MSCT cases (not significant differences). Central corneal epithelial phenotype improved in 71.4% and 66.7% of MSCT and CLET cases, respectively at 12 months (P = 1.000). There were no adverse events related to cell products. This trial suggests first evidence that MSCT facilitated improvement of a diseased corneal epithelium due to lack of its stem cells as efficiently as CLET. Consequently, not only CLET but also MSCT deserves more preclinical investigational resources before the favorable results of this proof-of-concept trial could be transformed into the larger numbers of the multicenter trials that would provide stronger evidence. (ClinicalTrials.gov number, NCT01562002.).
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Affiliation(s)
- Margarita Calonge
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine), Carlos III National Institute of Health, Valladolid, Spain.
| | - Inmaculada Pérez
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Valladolid, Spain.
| | - Sara Galindo
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine), Carlos III National Institute of Health, Valladolid, Spain.
| | - Teresa Nieto-Miguel
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine), Carlos III National Institute of Health, Valladolid, Spain.
| | - Marina López-Paniagua
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine), Carlos III National Institute of Health, Valladolid, Spain.
| | - Itziar Fernández
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine), Carlos III National Institute of Health, Valladolid, Spain.
| | - Mercedes Alberca
- IBGM (Institute of Molecular Biology and Genetics), University of Valladolid and National Research Council (CSIC), and University Scientific Park, Valladolid, Spain.
| | - Javier García-Sancho
- IBGM (Institute of Molecular Biology and Genetics), University of Valladolid and National Research Council (CSIC), and University Scientific Park, Valladolid, Spain.
| | - Ana Sánchez
- IBGM (Institute of Molecular Biology and Genetics), University of Valladolid and National Research Council (CSIC), and University Scientific Park, Valladolid, Spain.
| | - José M Herreras
- IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine), Carlos III National Institute of Health, Valladolid, Spain.
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22
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Management of advanced ocular surface disease in patients with severe atopic keratoconjunctivitis. Ocul Surf 2019; 17:303-309. [DOI: 10.1016/j.jtos.2018.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/08/2018] [Accepted: 12/03/2018] [Indexed: 12/15/2022]
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23
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Zhu J, Slevin M, Guo BQ, Zhu SR. Induced pluripotent stem cells as a potential therapeutic source for corneal epithelial stem cells. Int J Ophthalmol 2018; 11:2004-2010. [PMID: 30588437 DOI: 10.18240/ijo.2018.12.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/12/2018] [Indexed: 12/13/2022] Open
Abstract
Corneal blindness caused by limbal stem cell deficiency (LSCD) is one of the most common debilitating eye disorders. Thus far, the most effective treatment for LSCD is corneal transplantation, which is often hindered by the shortage of donors. Pluripotent stem cell technology including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have opened new avenues for treating this disease. iPSCs-derived corneal epithelial cells provide an autologous and unlimited source of cells for the treatment of LSCD. On the other hand, iPSCs of LSCD patients can be used for iPSCs-corneal disease model and new drug discovery. However, prior to clinical trial, the efficacy and safety of these cells in patients with LSCD should be proved. Here we focused on the current status of iPSCs-derived corneal epithelial cells used for cell therapy as well as for corneal disease modeling. The challenges and potential of iPSCs-derived corneal epithelial cells as a choice for clinical treatment in corneal disease were also discussed.
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Affiliation(s)
- Jie Zhu
- Queen Mary School, Medical College of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Mark Slevin
- School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M15GD, United Kingdom.,Research Institute of Brain Vascular Disease, Weifang Medical University, Weifang 261000, Shandong Province, China
| | - Bao-Qiang Guo
- School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M15GD, United Kingdom.,Research Institute of Brain Vascular Disease, Weifang Medical University, Weifang 261000, Shandong Province, China
| | - Shou-Rong Zhu
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, Weifang 261000, Shandong Province, China
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24
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Update on the Surgical Reconstruction of Ocular Surface in Eyes with Limbal Stem Cell Deficiency. CURRENT OPHTHALMOLOGY REPORTS 2018. [DOI: 10.1007/s40135-018-0187-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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25
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RASHID HAWARQADIR, KARABULUT ENIS, CEVIK AYDIN. Effectiveness of polypropylene mesh coated bovine amniotic membrane with adhesion barrier (polyethylene glycol) in repair of abdominal wall hernias in rats. THE INDIAN JOURNAL OF ANIMAL SCIENCES 2018. [DOI: 10.56093/ijans.v88i9.83541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study was undertaken to investigate the effectiveness of polypropylene (PP) mesh coated bovine amniotic membrane (BAM) with 5% polyethylene glycol (PEG) 4000 as adhesion barrier in the repair of experimental 2 × 2 cm of abdominal hernias in rats. Rats (32) were divided into 4 groups. A 2 cm × 2 cm defect was created in the full thickness of abdominal muscle on the anterior abdominal wall. PP mesh was implanted in the abdominal cavity (Gr 1 to 4). BAM covered the abdominal face of the graft (Gr 3 and 4). It was given before the abdominal closure 5 ml of 5% PEG 4000 (Gr 2 and 4) and 5 ml of 0.9% NaCl (Gr 1 and 3). After 21 days following the operations, 32 rats were euthanized. Macroscopic and microscopic evaluations were performed according to the scoring systems. The differences between the groups was evaluated by Mann-Whitney U test and Kruskal Wallis analysis of variance. Highest adhesion percentage was observed in Gr 1 and lowest in Gr 4. Inflammatory reaction was observed in Gr 1 and 2. According to the results of this study, the combined use of BAM and 5% PEG 4000 was helpful to prevent the complications of PP mesh.
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26
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Seyed MA, Vijayaraghavan K. Evaluation of an Improved Chitosan Scaffold Cross-Linked With Polyvinyl Alcohol and Amine Coupling Through 1-Ethyl-3-(3-Dimethyl Aminopropyl)-Carbodiimide (EDC) and 2 N-Hydroxysuccinimide (NHS) for Corneal Applications. Open Access Maced J Med Sci 2018; 6:1561-1570. [PMID: 30337966 PMCID: PMC6182522 DOI: 10.3889/oamjms.2018.322] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND: Corneal blindness resulting from various medical conditions affects millions worldwide. The rapid developing tissue engineering field offers design of a scaffold with mechanical properties and transparency similar to that of the natural cornea. AIM: The present study aimed at to prepare and investigate the properties of PVA/chitosan blended scaffold by further cross-linking with 1-Ethyl-3-(3-dimethyl aminopropyl)-carbodiimide (EDC) and 2 N-Hydroxysuccinimide (NHS) as potential in vitro carrier for human limbal stem cells delivery. MATERIAL AND METHODS: Acetic acid dissolved chitosan was added to PVA solution, uniformly mixed with a homogenizer until the mixture was in a colloidal state, followed by H2SO4 and formaldehyde added and the sample was allowed to cool, subsequently it was poured into a tube and heated in an oven at 60°C for 50 minutes. Finally, samples were soaked in a cross-linking bath with EDC, NHS and NaOH in H2O/EtOH for 24 h consecutively stirred to cross-link the polymeric chains, reduce degradation. After soaking in the bath, the samples were carefully washed with 2% glycine aqueous solution several times to remove the remaining amount of cross-linkers, followed by washed with water to remove residual agents. Later the cross-linked scaffold subjected for various characterization and biological experiments. RESULTS: After viscosity measurement, the scaffold was observed by Fourier transform infrared (FT-IR). The water absorbency of PVA/Chitosan was increased 361% by swelling. Compression testing demonstrated that by increasing the amount of chitosan, the strength of the scaffold could be increased to 16×10−1 MPa. Our degradation results revealed by mass loss using equation shows that scaffold degraded gradually imply slow degradation. In vitro tests showed good cell proliferation and growth in the scaffold. Our assay results confirmed that the membrane could increase the cells adhesion and growth on the substrate. CONCLUSION: Hence, we strongly believe the use of this improved PVA/chitosan scaffold has potential to cut down the disadvantages of the human amniotic membrane (HAM) for corneal epithelium in ocular surface surgery and greater mechanical strength in future after successful experimentation with clinical trials.
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Affiliation(s)
- Mohamed Ali Seyed
- Department of Clinical Biochemistry, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Kavitha Vijayaraghavan
- Department of Chemical Engineering, Agni College of Technology, Old Mahabalipuram Road, Thalambur, Chennai, Tamil Nadu 600130, India
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27
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Borroni D, Wowra B, Romano V, Boyadzhieva M, Ponzin D, Ferrari S, Ahmad S, Parekh M. Simple limbal epithelial transplantation: a review on current approach and future directions. Surv Ophthalmol 2018; 63:869-874. [PMID: 29800578 DOI: 10.1016/j.survophthal.2018.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/02/2018] [Accepted: 05/07/2018] [Indexed: 10/16/2022]
Abstract
Simple limbal epithelial transplantation is a recently developed technique for treating limbal stem cell deficiency caused by ocular burns. A small limbal biopsy from the donor eye, usually from the patient's healthy eye, is excised and dissected into multiple pieces. An amniotic membrane is atttached using fibrin glue on the diseased eye after removing the conjunctivalized pannus from the corneal surface. The limbal biopsy pieces are placed onto the amniotic membrane, fixed with fibrin glue, followed by bandaging of the ocular surface with a contact lens. This technique (auto simple limbal epithelial transplantation) offers easier surgical manipulations and economic advantages over other techniques for the treatment of limbal stem cell deficiency. We therefore review simple limbal epithelial transplantation along with recent modifications in the technique and case studies, including challenges and failures.
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Affiliation(s)
- Davide Borroni
- Department of Ophthalmology, Riga Stradins University, Riga, Latvia; Department of Genetics, Riga Stradins University, Riga, Latvia
| | - Bogumil Wowra
- Department of Ophthalmology, Medical University of Silesia, Katowice, Poland
| | - Vito Romano
- Department of Corneal and External Eye Diseases, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK; Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Maria Boyadzhieva
- Department of Ophthalmology, Medical University of Varna, Varna, Bulgaria
| | - Diego Ponzin
- International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Venice, Italy
| | - Stefano Ferrari
- International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Venice, Italy
| | - Sajjad Ahmad
- Moorfields Eye Hospital NHS Foundation Trust, London, UK; University College London Institute of Ophthalmology, London, UK
| | - Mohit Parekh
- International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Venice, Italy.
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28
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Liu H, Zhou Z, Lin H, Wu J, Ginn B, Choi JS, Jiang X, Chung L, Elisseeff JH, Yiu S, Mao HQ. Synthetic Nanofiber-Reinforced Amniotic Membrane via Interfacial Bonding. ACS APPLIED MATERIALS & INTERFACES 2018; 10:14559-14569. [PMID: 29613762 DOI: 10.1021/acsami.8b03087] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Severe damage to the ocular surface can result in limbal stem cell (LSC) deficiency, which contributes to loss of corneal clarity, potential vision loss, chronic pain, photophobia, and keratoplasty failure. Human amniotic membrane (AM) is the most effective substrate for LSC transplantation to treat patients with LSC deficiency. However, the widespread use of the AM in the clinic remains a challenge because of the high cost for preserving freshly prepared AM and the weak mechanical strength of lyophilized AM. Here, we developed a novel composite membrane consisting of an electrospun bioabsorbable polymer fiber mesh bonded to a decellularized AM (dAM) sheet through interfacial conjugation. This membrane engineering approach drastically improved the tensile property and toughness of dAM, preserved similar levels of bioactivities as the dAM itself in supporting LSC attachment, growth, and maintenance, and retained significant anti-inflammatory capacity. These results demonstrate that the lyophilized nanofiber-dAM composite membrane offers superior mechanical properties for easy handling and suturing to the dAM, while presenting biochemical cues and basement membrane structure to facilitate LSC transplantation. This composite membrane exhibits major advantages for clinical applications in treating soft tissue damage and LSC deficiency.
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Affiliation(s)
| | - Zhengbing Zhou
- Department of Hand & Microsurgery , Xiangya Hospital of Central South University , Changsha , Hunan Province 410008 , P. R. China
| | | | - Juan Wu
- Wuhan Kangchuang Technology , Wuhan , Hubei Province 430073 , P. R. China
| | | | | | | | - Liam Chung
- Department of Biomedical Engineering, School of Medicine , Johns Hopkins University , Baltimore , Maryland 21205 , United States
| | - Jennifer H Elisseeff
- Department of Biomedical Engineering, School of Medicine , Johns Hopkins University , Baltimore , Maryland 21205 , United States
| | | | - Hai-Quan Mao
- Department of Biomedical Engineering, School of Medicine , Johns Hopkins University , Baltimore , Maryland 21205 , United States
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29
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Jie J, Yang J, He H, Zheng J, Wang W, Zhang L, Li Z, Chen J, Vimalin Jeyalatha M, Dong N, Wu H, Liu Z, Li W. Tissue remodeling after ocular surface reconstruction with denuded amniotic membrane. Sci Rep 2018; 8:6400. [PMID: 29686390 PMCID: PMC5913251 DOI: 10.1038/s41598-018-24694-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/05/2018] [Indexed: 12/16/2022] Open
Abstract
Amniotic membrane (AM) has been widely used as a temporary or permanent graft in the treatment of various ocular surface diseases. In this study, we compared the epithelial wound healing and tissue remodeling after ocular surface reconstruction with intact amniotic membrane (iAM) or denuded amniotic membrane (dAM). Partial limbal and bulbar conjunctival removal was performed on New Zealand rabbits followed by transplantation of cryo-preserved human iAM or dAM. In vivo observation showed that the epithelial ingrowth was faster on dAM compared to iAM after AM transplantation. Histological observation showed prominent epithelial stratification and increased goblet cell number on dAM after 2 weeks of follow up. Collagen VII degraded in dAM within 2 weeks, while remained in iAM even after 3 weeks. The number of macrophages and α-SMA positive cells in the stroma of remodelized conjunctiva in the dAM transplantation group was considerably less. In conclusion, dAM facilitates epithelial repopulation and goblet cell differentiation, further reduces inflammation and scar formation during conjunctival and corneal limbal reconstruction.
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Affiliation(s)
- Jing Jie
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
- Guilin Women and Children's Hospital, Guilin, Guangxi, China
| | - Jie Yang
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
- Zhengzhou Second Hospital, Zhengzhou, Henan, China
| | - Hui He
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Jianlan Zheng
- Xiamen University affiliated Chenggong Hospital, Xiamen, Fujian, China
| | - Wenyan Wang
- Xiamen University affiliated Chenggong Hospital, Xiamen, Fujian, China
| | - Liying Zhang
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
- Xiamen University affiliated Xiamen Eye Center, Xiamen, Fujian, China
| | - Zhiyuan Li
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Jingyao Chen
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - M Vimalin Jeyalatha
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Nuo Dong
- Xiamen University affiliated Xiamen Eye Center, Xiamen, Fujian, China
| | - Huping Wu
- Xiamen University affiliated Xiamen Eye Center, Xiamen, Fujian, China
| | - Zuguo Liu
- Eye Institute of Xiamen University, Xiamen, Fujian, China
- Medical College of Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
- Xiamen University affiliated Xiamen Eye Center, Xiamen, Fujian, China
| | - Wei Li
- Eye Institute of Xiamen University, Xiamen, Fujian, China.
- Medical College of Xiamen University, Xiamen, Fujian, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China.
- The Affiliated Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China.
- Xiamen University affiliated Xiamen Eye Center, Xiamen, Fujian, China.
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30
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Sanchez-Avila RM, Merayo-Lloves J, Riestra AC, Berisa S, Lisa C, Sánchez JA, Muruzabal F, Orive G, Anitua E. Plasma rich in growth factors membrane as coadjuvant treatment in the surgery of ocular surface disorders. Medicine (Baltimore) 2018; 97:e0242. [PMID: 29702971 PMCID: PMC5944476 DOI: 10.1097/md.0000000000010242] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
To evaluate the safety and efficacy of the surgical use of plasma rich in growth factors fibrin membrane (mPRGF) in different ocular surface pathologies.Fifteen patients with different corneal and conjunctival diseases were included in the study. Patients were grouped according to the use of mPRGF as graft (corneal and/or conjunctival) or dressing; they were also grouped according to the surgical subgroup of intervention (persistent corneal ulcer [PCU], keratoplasty, superficial keratectomy, corneal perforation, and pterygium). Best corrected visual acuity, intraocular pressure (IOP), inflammation control time (ICT), mPRGF AT (PRGF membrane absorption time), and the healing time of the epithelial defect (HTED) were evaluated throughout the clinical follow-up time. Safety assessment was also performed reporting all adverse events.mPRGF showed a total closure of the defect in 13 of 15 patients (86.7%) and a partial closure in 2 patients (13.3%). The mean follow-up time was 11.1 ± 4.2 (4.8-22.8) months, the mean ICT was 2.5 ± 1.1 (1.0-4.0) months, the mean mPRGF AT was 12.4 ± 2.0 (10.0-16.0) days, and for the global HTED the mean was 2.9 ± 1.2 (1-4.8) months. Results showed an improvement in BCVA in all patients, with an overall improvement of 2.9 in Vision Lines. The BCVA significantly improved (P < .05) in the groups of corneal graft and dressing. In the PCU subgroup (6 patients), the healing time of epithelial defect was significantly reduced (P < .05) in patients treated only with the mPRGF in comparison to those which mPRGF therapy was associated to the amniotic membrane. The IOP remained stable (P > .05) throughout the clinical follow-up time. No adverse events were reported after mPRGF use.The mPRGF is effective and safe as coadjuvant treatment in surgeries related with ocular surface disorders, being an alternative to the use of amniotic membrane. The mPRGF accelerates tissue regeneration after ocular surface surgery thus minimizing inflammation and fibrosis.
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Affiliation(s)
| | - Jesús Merayo-Lloves
- Fundación de Investigación Oftalmológica, Instituto Universitario Fernández-Vega, Oviedo
| | - Ana C. Riestra
- Fundación de Investigación Oftalmológica, Instituto Universitario Fernández-Vega, Oviedo
| | - Silvia Berisa
- Fundación de Investigación Oftalmológica, Instituto Universitario Fernández-Vega, Oviedo
| | - Carlos Lisa
- Fundación de Investigación Oftalmológica, Instituto Universitario Fernández-Vega, Oviedo
| | - José Alfonso Sánchez
- Fundación de Investigación Oftalmológica, Instituto Universitario Fernández-Vega, Oviedo
| | - Francisco Muruzabal
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua)
- Biotechnology Institute
| | - Gorka Orive
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua)
- Biotechnology Institute
- Laboratory of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of the Basque Country
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, SLFPB-EHU, Vitoria, Spain
| | - Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua)
- Biotechnology Institute
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31
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Saghizadeh M, Kramerov AA, Svendsen CN, Ljubimov AV. Concise Review: Stem Cells for Corneal Wound Healing. Stem Cells 2017; 35:2105-2114. [PMID: 28748596 PMCID: PMC5637932 DOI: 10.1002/stem.2667] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/16/2017] [Accepted: 07/02/2017] [Indexed: 02/06/2023]
Abstract
Corneal wound healing is a complex process that occurs in response to various injuries and commonly used refractive surgery. It is a significant clinical problem, which may lead to serious complications due to either incomplete (epithelial) or excessive (stromal) healing. Epithelial stem cells clearly play a role in this process, whereas the contribution of stromal and endothelial progenitors is less well studied. The available evidence on stem cell participation in corneal wound healing is reviewed, together with the data on the use of corneal and non-corneal stem cells to facilitate this process in diseased or postsurgical conditions. Important aspects of corneal stem cell generation from alternative cell sources, including pluripotent stem cells, for possible transplantation upon corneal injuries or in disease conditions are also presented. Stem Cells 2017;35:2105-2114.
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Affiliation(s)
- Mehrnoosh Saghizadeh
- Cedars‐Sinai Medical Center, Regenerative Medicine InstituteLos AngelesCaliforniaUSA
- David Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Andrei A. Kramerov
- Cedars‐Sinai Medical Center, Regenerative Medicine InstituteLos AngelesCaliforniaUSA
| | - Clive N. Svendsen
- Cedars‐Sinai Medical Center, Regenerative Medicine InstituteLos AngelesCaliforniaUSA
- David Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Alexander V. Ljubimov
- Cedars‐Sinai Medical Center, Regenerative Medicine InstituteLos AngelesCaliforniaUSA
- David Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
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