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Amjad F, Keshvari H, Dalman A, Montazeri L. In Vitro Development of Mouse Preantral Follicle with Using Amniotic Membrane Extract-Loaded Hydrogels. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2024; 18:286-292. [PMID: 38973283 PMCID: PMC11245589 DOI: 10.22074/ijfs.2023.1990652.1443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Indexed: 07/09/2024]
Abstract
An artificial ovary based on the alginate (ALG) hydrogel has been widely implemented to preserve prepubertal female fertility. However, this platform is not fully capable of successful an ovary microenvironment simulation for follicle development, holding great potential for its improvement. Therefore, this experimental study aimed to evaluate the effect of an amniotic membrane extract (AME) -loaded hydrogel on the mouse preantral follicles in vitro development. In order to have better follicle development, first, the impact of different concentrations of follicle-stimulating hormone (FSH) was evaluated on the mouse preantral follicles encapsulated in ALG. Later, the appropriate dose was adjusted for the follicles encapsulated in the ALG-AME hydrogel. Results demonstrated that 100 mIU/ml FSH showed a significant follicle survival rate compared with 10 mIU/ml FSH (P=0.005). According to MTT assay finding, the rate of weight loss, and rheology evaluations, ALG containing 1 mg/ml AME was identified as an optimal sample of follicle culture instead of other AME concentrations. Follicle diameter significantly increased in the ALG-AME 1 hydrogel compared with the ALG control group without AME (P=0.027). The storage modulus of ALG-AME 1 was 773 Pa and retained the follicle morphology for 13 days. No statistically substantial difference was seen in survival, antrum cavity formation, and competent oocyte in terms of the normal chromosomal arrangement and meiotic spindle rate in comparison with the control group. It can be concluded that ALG-AME 1 could not significantly impact the mouse preantral follicle.
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Affiliation(s)
- Fatemeh Amjad
- Biomedical Engineering Department, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hamid Keshvari
- Biomedical Engineering Department, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran.
| | - Azam Dalman
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Leila Montazeri
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Erkoc-Biradli FZ, Erenay B, Ozgun A, Öztatlı H, Işık F, Ateş U, Rasier R, Garipcan B. Mesenchymal stem cells derived-exosomes enhanced amniotic membrane extract promotes corneal keratocyte proliferation. Biotechnol Prog 2024:e3465. [PMID: 38602120 DOI: 10.1002/btpr.3465] [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: 08/23/2023] [Revised: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024]
Abstract
Amniotic membrane extract (AME) and Wharton's jelly mesenchymal stem cells derived-exosomes (WJ-MSC-Exos) are promising therapeutic solutions explored for their potential in tissue engineering and regenerative medicine, particularly in skin and corneal wound healing applications. AME is an extract form of human amniotic membrane and known to contain a plethora of cytokines and growth factors, making it a highly attractive option for topical applications. Similarly, WJ-MSC-Exos have garnered significant interest for their wound healing properties. Although WJ-MSC-Exos and AME have been used separately for wound healing research, their combined synergistic effects have not been studied extensively. In this study, we evaluated the effects of both AME and WJ-MSC-Exos, individually and together, on the proliferation of corneal keratocytes as well as their ability to promote in vitro cell migration, wound healing, and their impact on cellular morphology. Our findings indicated that the presence of both exosomes (3 × 105 Exo/mL) and AME (50 μg/mL) synergistically enhance the proliferation of corneal keratocytes. Combined use of these solutions (3 × 105 Exo/mL + 50 μg/mL) increased cell proliferation compared to only 50 μg/mL AME treatment on day 3 (**** p < 0.0001). This mixture treatment (3 × 105 Exo/mL + 50 μg/mL) increased wound closure rate compared to isolated WJ-MSC-Exo treatment (3 × 105 Exo/mL) (*p < 0.05). Overall, corneal keratocytes treated with AME and WJ-MSC-Exo (3 × 105 Exo/mL + 50 μg/mL) mixture resulted in enhanced proliferation and wound healing tendency. Utilization of combined use of AME and WJ-MSC-Exo can pave the way for a promising foundation for corneal repair research.
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Affiliation(s)
- Fatma Zehra Erkoc-Biradli
- Biomimetics and Bioinspired Biomaterials Research Laboratory, Institute of Biomedical Engineering, Bogaziçi University, Istanbul, Turkey
| | - Berkay Erenay
- Biomimetics and Bioinspired Biomaterials Research Laboratory, Institute of Biomedical Engineering, Bogaziçi University, Istanbul, Turkey
| | - Alp Ozgun
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Hayriye Öztatlı
- Biomimetics and Bioinspired Biomaterials Research Laboratory, Institute of Biomedical Engineering, Bogaziçi University, Istanbul, Turkey
| | - Ferda Işık
- Stembio Cord Blood Cell & Tissue Center, Kocaeli, Turkey
| | - Utku Ateş
- Stembio Cord Blood Cell & Tissue Center, Kocaeli, Turkey
| | - Rıfat Rasier
- Department of Ophthalmology, İstinye University, Istanbul, Turkey
| | - Bora Garipcan
- Biomimetics and Bioinspired Biomaterials Research Laboratory, Institute of Biomedical Engineering, Bogaziçi University, Istanbul, Turkey
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Shahraki T, Baradaran-Rafii A, Ayyala R, Arabi A, Jarstad J, Memar F. New advances in medical management of dry eye: optimizing treatment strategies for enhanced relief. Int Ophthalmol 2024; 44:49. [PMID: 38337030 DOI: 10.1007/s10792-024-02978-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Dry eye disease (DED) is a prevalent ocular surface disease that is conventionally characterized by tear film hyperosmolarity and instability. This review presents a summarized classification of DED, followed by a comprehensive discussion of the most recent topical and systemic medications and clinical recommendations for selecting the most appropriate option for each patient. METHODS An extensive literature search was conducted on electronic databases, such as PubMed, Scopus, and Web of Science, using keywords including "dry eye syndrome," "ocular surface disease," "medical management," "artificial tears," "topical immunomodulators," and "meibomian gland dysfunction." RESULTS The underlying reasons for DED can range from insufficient aqueous tear production to increased tear evaporation. Recent literature has provided a more in-depth understanding of the pathophysiology of DED by examining the tear film's lipid, aqueous, and mucin layers. However, despite these advancements, medical management of patients with symptomatic DED has not fully reflected this modernized knowledge of its pathophysiology. CONCLUSION To develop a rationalized strategy for treating DED, it is crucial to have updated knowledge of therapeutic options, their mechanisms of actions, and indications based on the DED type and underlying causes.
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Affiliation(s)
- Toktam Shahraki
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran.
| | - Alireza Baradaran-Rafii
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Ramesh Ayyala
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Amir Arabi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran
| | - John Jarstad
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Azimi-Alamouty M, Habibi MA, Ebrahimi Sadrabadi A, Jamalpoor Z. An in situ forming gelatin-based hydrogel loaded with soluble amniotic membrane promotes full-thickness wound regeneration in rats. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2024; 27:1005-1014. [PMID: 38911243 PMCID: PMC11193504 DOI: 10.22038/ijbms.2024.74290.16140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/11/2023] [Indexed: 06/25/2024]
Abstract
Objectives Early effective treatment and appropriate coverage are vital for full-thickness wounds. Amnion membrane-derived products have recently emerged in tissue engineering. However, the optimal concentration, carrier for controlled release, and handling have remained challenges. This study aims to develop and optimize an in situ forming, amniotic-based hydrogel for wound healing. Materials and Methods Here, a composite matrix was fabricated with gelatin hydrogel modified with methacrylate functional group conjugated (GelMA) and keratose (wt.1%), loaded with mesenchymal stem cells (MSCs, 1×105 cell/ml) and optimized soluble amniotic membrane (SAM, 0.5 mg/ml). The physicochemical properties of the final subject were evaluated in vitro and in vivo environments. Results The results of the in vitro assay demonstrated that conjugation of the methacryloyl group with gelatin resulted in the formation of GelMA hydrogel (26.7±1.2 kPa) with higher mechanical stability. Modification of GelMA with a glycosaminoglycan sulfate (Keratose) increased controlled delivery of SAM (47.3% vs. 84.3%). Metabolic activity (93%) and proliferation (21.2 ± 1.5 µg/ml) of MSCs encapsulated in hydrogel improved by incorporation of SAM (0.5 mg/ml). Furthermore, the migration of fibroblasts was facilitated in the scratched assay by SAM (0.5 mg/ml)/MSCs (1×105 cell/ml) conditioned medium. The GelMA hydrogel groupes revealed regeneration of full-thickness skin defects in rats after 3 weeks due to the high angiogenesis (6.3 ± 0.3), cell migration, and epithelialization. Conclusion The results indicated in situ forming and tunable GelMA hydrogels containing SAM and MSCs could be used as efficient substrates for full-thickness wound regeneration.
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Affiliation(s)
- Mohammad Azimi-Alamouty
- Trauma Research Center, Aja University of Medical Sciences, Tehran, Iran
- Department of Tissue Engineering, Faculty of Basic Sciences and Advanced Technologies in Medicine, Royan Institute, ACECR, Tehran, Iran
| | - Mohammad amin Habibi
- Iranian Tissue Bank and Research Center, Gene, Cell and Tissue Institute, Tehran university of Medical Sciences, Tehran, Iran
| | - Amin Ebrahimi Sadrabadi
- Department of Tissue Engineering, Faculty of Basic Sciences and Advanced Technologies in Medicine, Royan Institute, ACECR, Tehran, Iran
| | - Zahra Jamalpoor
- Trauma Research Center, Aja University of Medical Sciences, Tehran, Iran
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Yates KM, Stilwell NK, Fontenot RL, Betbeze CM. In vitro antibacterial efficacy of autologous conditioned plasma and amniotic membrane eye drops. Vet Ophthalmol 2023; 26:548-554. [PMID: 37317517 DOI: 10.1111/vop.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/18/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To determine the in vitro antibacterial efficacy of equine and canine autologous conditioned plasma (ACP) and amniotic membrane extract eye drops (AMEED) against aerobic bacteria common to the corneal surface. PROCEDURES Canine (n = 4) and equine (n = 4) anticoagulated whole blood samples were sterilely collected, pooled for each species, and processed using the Arthrex ACP® Double-Syringe System. Platelet counts were performed on ACP and pooled blood. AMEED were obtained from a commercial source. An electronic medical records search (2013-2022) identified aerobic bacteria cultured from canine and equine corneal ulcers at Mississippi State University College of Veterinary Medicine (MSU-CVM). Ten commonly isolated bacteria for each species were collected from cultures submitted to the MSU-CVM Microbiology Diagnostic Service and frozen at -80°C. The Kirby-Bauer disk diffusion method was used to determine the sensitivities of these isolates to ACP and AMEED. Bacterial isolates were plated onto Mueller-Hinton +5% sheep blood agar and blank sterile discs saturated with 20 μL of ACP or AMEED were tested in duplicate. Imipenem discs served as positive controls and blank discs as negative controls. Zones of inhibition were measured at 18 h. RESULTS ACP platelet counts were 1.06 and 1.65 times higher than blood for equine and canine samples, respectively. Growth of a multi-drug resistant Enterococcus faecalis was partially inhibited by canine and equine ACP. AMEED did not inhibit growth of any examined bacteria. CONCLUSIONS Canine and equine ACP partially inhibited E. faecalis growth in vitro. Further studies using varying concentrations of ACP against bacterial isolates from corneal ulcers are warranted.
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Affiliation(s)
- Kelsey M Yates
- Department of Clinical Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | - Natalie K Stilwell
- Department of Pathobiology and Population Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Robin L Fontenot
- Department of Pathobiology and Population Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Caroline M Betbeze
- Department of Clinical Sciences, Mississippi State University, Mississippi State, Mississippi, USA
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Hofmann N, Rennekampff HO, Salz AK, Börgel M. Preparation of human amniotic membrane for transplantation in different application areas. FRONTIERS IN TRANSPLANTATION 2023; 2:1152068. [PMID: 38993896 PMCID: PMC11235369 DOI: 10.3389/frtra.2023.1152068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/20/2023] [Indexed: 07/13/2024]
Abstract
The human amniotic membrane (hAM) is the inner layer of the placenta and plays protective and nutritional roles for the fetus during pregnancy. It contains multiple growth factors and proteins that mediate unique regenerative properties and enhance wound healing in tissue regeneration. Due to these characteristics hAM has been successfully utilized in ophthalmology for many decades. This material has also found application in a variety of additional therapeutic areas. Particularly noteworthy are the extraordinary effects in the healing of chronic wounds and in the treatment of burns. But hAM has also been used successfully in gynecology, oral medicine, and plastic surgery and as a scaffold for in vitro cell culture approaches. This review aims to summarize the different graft preparation, preservation and storage techniques that are used and to present advantages and disadvantages of these methods. It shows the characteristics of the hAM according to the processing and storage methods used. The paper provides an overview of the currently mainly used application areas and raises new application possibilities. In addition, further preparation types like extracts, homogenates, and the resulting treatment alternatives are described.
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Affiliation(s)
- Nicola Hofmann
- German Society for Tissue Transplantation (DGFG) gGmbH, Hannover, Germany
| | - Hans-Oliver Rennekampff
- Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Rhein-Maas Klinikum GmbH, Würselen, Germany
| | | | - Martin Börgel
- German Society for Tissue Transplantation (DGFG) gGmbH, Hannover, Germany
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Romanov YA. [Corneal regeneration: is there a place for tissues of perinatal origin?]. Vestn Oftalmol 2023; 139:121-128. [PMID: 37942606 DOI: 10.17116/oftalma2023139051121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The article reviews the main properties of the cornea and the mechanisms of its physiological regeneration and repair in response to damage and describes the most promising methods of treatment aimed at stimulating limbal stem cells and based on the use of native tissues of perinatal origin, umbilical cord mesenchymal stromal cells, and cell-free therapeutic products.
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Affiliation(s)
- Yu A Romanov
- National Medical Research Center of Cardiology Named After Academician E.I. Chazov, Moscow, Russia
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8
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Bowen CM, Ditmars FS, Gupta A, Reems JA, Fagg WS. Cell-Free Amniotic Fluid and Regenerative Medicine: Current Applications and Future Opportunities. Biomedicines 2022; 10:biomedicines10112960. [PMID: 36428527 PMCID: PMC9687956 DOI: 10.3390/biomedicines10112960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Amniotic fluid (AF) provides critical biological and physical support for the developing fetus. While AF is an excellent source of progenitor cells with regenerative properties, recent investigations indicate that cell-free AF (cfAF), which consists of its soluble components and extracellular vesicles, can also stimulate regenerative and reparative activities. This review summarizes published fundamental, translational, and clinical investigations into the biological activity and potential use of cfAF as a therapeutic agent. Recurring themes emerge from these studies, which indicate that cfAF can confer immunomodulatory, anti-inflammatory, and pro-growth characteristics to the target cells/tissue with which they come into contact. Another common observation is that cfAF seems to promote a return of cells/tissue to a homeostatic resting state when applied to a model of cell stress or disease. The precise mechanisms through which these effects are mediated have not been entirely defined, but it is clear that cfAF can safely and effectively treat cutaneous wounds and perhaps orthopedic degenerative conditions. Additional applications are currently being investigated, but require further study to dissect the fundamental mechanisms through which its regenerative effects are mediated. By doing so, rational design can be used to fully unlock its potential in the biotechnology lab and in the clinic.
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Affiliation(s)
- Charles M. Bowen
- Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Frederick S. Ditmars
- Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
- BioIntegrate, Lawrenceville, GA 30043, USA
- South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX 78045, USA
- Regenerative Orthopaedics, Noida 201301, UP, India
| | - Jo-Anna Reems
- Merakris Therapeutics, RTP Frontier 800 Park Offices Dr. Suite 3322, Research Triangle Park, NC 27709, USA
- Department of Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - William Samuel Fagg
- Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Regenerative Orthopaedics, Noida 201301, UP, India
- Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Correspondence:
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Moshirfar M, Brown AH, Sulit CA, Corbin WM, Ronquillo YC, Hoopes PC. Corneal Refractive Surgery Considerations in Patients with Cystic Fibrosis and Cystic Fibrosis Transmembrane Conductance Regulator-Related Disorders. Int Med Case Rep J 2022; 15:647-656. [PMID: 36388243 PMCID: PMC9656410 DOI: 10.2147/imcrj.s381078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
This article discusses common ocular manifestations of cystic fibrosis (CF) and cystic fibrosis transmembrane conductance regulator-related disorders (CFTR-RD). A structured approach for assessing and treating patients with CF/CFTR-RD seeking corneal refractive surgery is proposed, as well as a novel surgical risk scoring system. We also report two patients with various manifestations of CFTR dysfunction who presented for refractive surgery and the outcomes of the procedures. Surgeons seeking to perform refractive surgery on patients with CF/CFTR-RD should be aware of mild to severe clinical manifestations of CFTR dysfunction. Specific systemic and ocular manifestations of CF include chronic obstructive pulmonary disease (COPD), bronchiectasis, recurrent pulmonary infections, CF-related diabetes and liver disease, pancreatic insufficiency, conjunctival xerosis, night blindness, meibomian gland dysfunction (MGD), and blepharitis. Corneal manifestations include dry eye disease (DED), punctate keratitis (PK), filamentary keratitis (FK), xerophthalmia, and decreased endothelial cell density and central corneal thickness. Utilization of the appropriate review of systems (ROS) and screening tests will assist in determining if the patient is a suitable candidate for refractive surgery, as CF/CFTR-RD can impact the health of the cornea. Collaboration with other medical professionals who care for these patients is encouraged to ensure that their CF/CFTR-RD symptoms are best controlled via systemic and other treatment options. This will assist in reducing the severity of their ocular manifestations before and after surgery.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA
- Utah Lions Eye Bank, Murray, UT, USA
| | - Alex H Brown
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Christian A Sulit
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Wyatt M Corbin
- Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
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Hu S, Wang Z, Jin C, Chen Q, Fang Y, Jin J, Chen J, Lu L, Tian H, Xu J, Gao F, Wang J, Zhang J, Cui HP, Xu GT, Ou Q. Human amniotic epithelial cell-derived extracellular vesicles provide an extracellular matrix-based microenvironment for corneal injury repair. J Tissue Eng 2022; 13:20417314221122123. [PMID: 36093432 PMCID: PMC9452818 DOI: 10.1177/20417314221122123] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022] Open
Abstract
To study the biological functions and applications of human amniotic epithelial cell-derived extracellular vesicles (hAEC-EVs), the cargos of hAEC-EVs were analyzed using miRNA sequencing and proteomics analysis. The hAECs and hAEC-EVs in this study had specific characteristics. Multi-omics analyses showed that extracellular matrix (ECM) reorganization, inhibition of excessive myofibroblasts, and promotion of target cell adhesion to the ECM were their primary functions. We evaluated the application of hAEC-EVs for corneal alkali burn healing in rabbits and elucidated the fundamental mechanisms. Slit-lamp images revealed that corneal alkali burns induced central epithelial loss, stromal haze, iris, and pupil obscurity in rabbits. Slit-lamp examination and histological findings indicated that hAEC-EVs facilitated re-epithelialization of the cornea after alkali burns, reduced scar formation and promoted the restoration of corneal tissue transparency. Significantly fewer α-SMA-positive myofibroblasts were observed in the hAEC-EV-treated group than the PBS group. HAEC-EVs effectively promoted the proliferation and migration of hCECs and hCSCs in vitro and activated the focal adhesion signaling pathway. We demonstrated that hAEC-EVs were excellent cell-free candidates for the treatment of ECM lesion-based diseases, including corneal alkali burns. HAEC-EVs promoted ECM reorganization and cell adhesion of target tissues or cells via orderly activation of the focal adhesion signaling pathway.
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Affiliation(s)
- Shuqin Hu
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Zhe Wang
- Department of Ophthalmology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.,Department of Physiology, Second Military Medical University, Shanghai, China
| | - Caixia Jin
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Qizhen Chen
- Department of Obstetrics and Gynecology, Wusong Branch, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yuchen Fang
- Department of General Surgery, Affiliated Renhe Hospital, Shanghai University, Shanghai, China
| | - Jiahui Jin
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Jie Chen
- Department of Ophthalmology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lixia Lu
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Haibin Tian
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Jingying Xu
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Furong Gao
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Juan Wang
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Jieping Zhang
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Hong-Ping Cui
- Department of Ophthalmology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Guo-Tong Xu
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
| | - Qingjian Ou
- Department of Ophthalmology of Tongji Hospital and Laboratory of Clinical and Visual Sciences of Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China
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Castiglia D, Fortugno P, Condorelli AG, Barresi S, De Luca N, Pizzi S, Neri I, Graziano C, Trojan D, Ponzin D, Rossi S, Zambruno G, Tartaglia M. A Novel Phenotype of Junctional Epidermolysis Bullosa with Transient Skin Fragility and Predominant Ocular Involvement Responsive to Human Amniotic Membrane Eyedrops. Genes (Basel) 2021; 12:716. [PMID: 34064633 PMCID: PMC8151857 DOI: 10.3390/genes12050716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Junctional epidermolysis bullosa (JEB) is a clinically and genetically heterogeneous skin fragility disorder frequently caused by mutations in genes encoding the epithelial laminin isoform, laminin-332. JEB patients also present mucosal involvement, including painful corneal lesions. Recurrent corneal abrasions may lead to corneal opacities and visual impairment. Current treatments are merely supportive. We report a novel JEB phenotype distinguished by the complete resolution of skin fragility in infancy and persistent ocular involvement with unremitting and painful corneal abrasions. Biallelic LAMB3 mutations c.3052-5C>G and c.3492_3493delCG were identified as the molecular basis for this phenotype, with one mutation being a hypomorphic splice variant that allows residual wild-type laminin-332 production. The reduced laminin-332 level was associated with impaired keratinocyte adhesion. Then, we also investigated the therapeutic power of a human amniotic membrane (AM) eyedrop preparation for corneal lesions. AM were isolated from placenta donors, according to a procedure preserving the AM biological characteristics as a tissue, and confirmed to contain laminin-332. We found that AM eyedrop preparation could restore keratinocyte adhesion in an in vitro assay. Of note, AM eyedrop administration to the patient resulted in long-lasting remission of her ocular manifestations. Our findings suggest that AM eyedrops could represent an effective, non-invasive, simple-to-handle treatment for corneal lesions in patients with JEB and possibly other EB forms.
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Affiliation(s)
- Daniele Castiglia
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Paola Fortugno
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Angelo Giuseppe Condorelli
- Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.C.); (G.Z.)
| | - Sabina Barresi
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
| | - Naomi De Luca
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Simone Pizzi
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
| | - Iria Neri
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy;
| | - Claudio Graziano
- Medical Genetics, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy;
| | | | - Diego Ponzin
- The Veneto Eye Bank Foundation, 30174 Venice, Italy;
| | - Sabrina Rossi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Giovanna Zambruno
- Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.C.); (G.Z.)
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
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Shahriary A, Sabzevari M, Jadidi K, Yazdani F, Aghamollaei H. The Role of Inflammatory Cytokines in Neovascularization of Chemical Ocular Injury. Ocul Immunol Inflamm 2021; 30:1149-1161. [PMID: 33734925 DOI: 10.1080/09273948.2020.1870148] [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] [Indexed: 10/21/2022]
Abstract
Aim: Chemical injuries can potentially lead to the necrosis anterior segment of the eye, and cornea in particular. Inflammatory cytokines are the first factors produced after chemical ocular injuries. Inflammation via promoting the angiogenesis factor tries to implement the wound healing mechanism in the epithelial and stromal layer of the cornea. Methods: Narrative review.Results: In our review, we described the patterns of chemical injuries in the cornea and their molecular mechanisms associated with the expression of inflammatory cytokines. Moreover, the effects of inflammation signals on angiogenesis factors and CNV were explained. Conclusion: The contribution of inflammation and angiogenesis causes de novo formation of blood vessels that is known as the corneal neovascularization (CNV). The new vascularity interrupts cornea clarity and visual acuity. Inflammation also depleted the Limbal stem cells (LSCs) in the limbus causing the failure of normal corneal epithelial healing and conjunctivalization of the cornea.
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Affiliation(s)
- Alireza Shahriary
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Milad Sabzevari
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Khosrow Jadidi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Farshad Yazdani
- Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hossein Aghamollaei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Dadkhah Tehrani F, Firouzeh A, Shabani I, Shabani A. A Review on Modifications of Amniotic Membrane for Biomedical Applications. Front Bioeng Biotechnol 2021; 8:606982. [PMID: 33520961 PMCID: PMC7839407 DOI: 10.3389/fbioe.2020.606982] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
The amniotic membrane (AM) is the innermost layer of the fetal placenta, which surrounds and protects the fetus. Its unique structure, in addition to its physical and biological properties, makes it a useful substance in many applications related to regenerative medicine. The use of this fantastic substance with a century-old history has produced remarkable results in vivo, in vitro, and even in clinical studies. While the intact or preserved AM is widely used for these purposes, the addition of further modifications to AM can be considered as a relatively new subject in its applications. These modifications are applied to improve AM properties, ease of handling, and durability. Here, we will discuss the cases in which AM has undergone additional modifications besides the required processes for sterilization and preservation. In this article, we have categorized these modifications and discussed their applications and results.
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Affiliation(s)
- Fatemeh Dadkhah Tehrani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Arezoo Firouzeh
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Iman Shabani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Azadeh Shabani
- Preventative Gynecology Research Center, Department of Gynecology and Obstetrics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yang Z, Li X, Zhang C, Sun N, Guo T, Lin J, Li F, Zhang J. Amniotic Membrane Extract Protects Islets From Serum-Deprivation Induced Impairments and Improves Islet Transplantation Outcome. Front Endocrinol (Lausanne) 2020; 11:587450. [PMID: 33363516 PMCID: PMC7753361 DOI: 10.3389/fendo.2020.587450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/04/2020] [Indexed: 11/25/2022] Open
Abstract
Islet culture prior to transplantation is a standard practice in many transplantation centers. Nevertheless, the abundant islet mass loss and function impairment during this serum-deprivation culture period restrain the success of islet transplantation. In the present study, we used a natural biomaterial derived product, amniotic membrane extract (AME), as medium supplementation of islet pretransplant cultivation to investigate its protective effect on islet survival and function and its underlying mechanisms, as well as the engraftment outcome of islets following AME treatment. Results showed that AME supplementation improved islet viability and function, and decreased islet apoptosis and islet loss during serum-deprived culture. This was associated with the increased phosphorylation of PI3K/Akt and MAPK/ERK signaling pathway. Moreover, transplantation of serum-deprivation stressed islets that were pre-treated with AME into diabetic mice revealed better blood glucose control and improved islet graft survival. In conclusion, AME could improve islet survival and function in vivo and in vitro, and was at least partially through increasing phosphorylation of PI3K/Akt and MAPK/ERK signaling pathway.
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Affiliation(s)
| | | | | | | | | | | | | | - Jialin Zhang
- Department of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, China
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15
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Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review. J Ophthalmol 2020; 2020:3949735. [PMID: 33133675 PMCID: PMC7568795 DOI: 10.1155/2020/3949735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/14/2020] [Accepted: 03/24/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose To determine the effectiveness and safety of trabeculectomy along with amniotic membrane transplantation (AMT) for glaucoma. Methods This systematic review was performed using RevMan 5.3. We searched PubMed, EMBASE, and the Cochrane Library and included studies published until September 2019. The treatment group included patients with AMT and trabeculectomy (group A), and the control group had only trabeculectomy (group B). We only included randomized controlled trials. The outcomes were intraocular pressure (IOP), complete success rate, number of antiglaucoma medications, and complications. Results Five studies, including 174 eyes (87 eyes in the AMT group and 87 eyes in the control group), were eligible in this review. The parameters had no significant difference in heterogeneity between the AMT and control groups preoperatively. In the AMT group, the mean IOP was significantly lower at 3 and 12 months after operation (P < 0.0001 and P = 0.02, respectively), while the number of complete successes in the AMT group was significantly higher at 6 and 12 months (P = 0.02 and P = 0.003, respectively) compared with the control group. Complications, including a flat anterior chamber and hyphema, appeared to be decreased in the AMT group compared to the control group (P = 0.02 and P = 0.02, respectively). No differences were observed in the number of antiglaucoma medications, hypotony, encapsulated bleb, or choroidal detachment. Conclusion Compared with only trabeculectomy, it is more efficient and safer to add AMT to trabeculectomy during glaucoma filtering surgery.
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Mahdavi SS, Abdekhodaie MJ, Mashayekhan S, Baradaran-Rafii A, Djalilian AR. Bioengineering Approaches for Corneal Regenerative Medicine. Tissue Eng Regen Med 2020; 17:567-593. [PMID: 32696417 PMCID: PMC7373337 DOI: 10.1007/s13770-020-00262-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/06/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Since the cornea is responsible for transmitting and focusing light into the eye, injury or pathology affecting any layer of the cornea can cause a detrimental effect on visual acuity. Aging is also a reason for corneal degeneration. Depending on the level of the injury, conservative therapies and donor tissue transplantation are the most common treatments for corneal diseases. Not only is there a lack of donor tissue and risk of infection/rejection, but the inherent ability of corneal cells and layers to regenerate has led to research in regenerative approaches and treatments. METHODS In this review, we first discussed the anatomy of the cornea and the required properties for reconstructing layers of the cornea. Regenerative approaches are divided into two main categories; using direct cell/growth factor delivery or using scaffold-based cell delivery. It is expected delivered cells migrate and integrate into the host tissue and restore its structure and function to restore vision. Growth factor delivery also has shown promising results for corneal surface regeneration. Scaffold-based approaches are categorized based on the type of scaffold, since it has a significant impact on the efficiency of regeneration, into the hydrogel and non-hydrogel based scaffolds. Various types of cells, biomaterials, and techniques are well covered. RESULTS The most important characteristics to be considered for biomaterials in corneal regeneration are suitable mechanical properties, biocompatibility, biodegradability, and transparency. Moreover, a curved shape structure and spatial arrangement of the fibrils have been shown to mimic the corneal extracellular matrix for cells and enhance cell differentiation. CONCLUSION Tissue engineering and regenerative medicine approaches showed to have promising outcomes for corneal regeneration. However, besides proper mechanical and optical properties, other factors such as appropriate sterilization method, storage, shelf life and etc. should be taken into account in order to develop an engineered cornea for clinical trials.
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Affiliation(s)
- S Sharareh Mahdavi
- Department of Chemical and Petroleum Engineering, Sharif University of Technology, 1393 Azadi Ave., Tehran, 11365-11155, Iran
| | - Mohammad J Abdekhodaie
- Department of Chemical and Petroleum Engineering, Sharif University of Technology, 1393 Azadi Ave., Tehran, 11365-11155, Iran.
| | - Shohreh Mashayekhan
- Department of Chemical and Petroleum Engineering, Sharif University of Technology, 1393 Azadi Ave., Tehran, 11365-11155, Iran
| | - Alireza Baradaran-Rafii
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, SBUMS, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, 19839-63113, Iran
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1200 W Harrison St, Chicago, IL, 60607, USA
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Hou L, Fu W, Liu Y, Wang Q, Wang L, Huang Y. Agrin Promotes Limbal Stem Cell Proliferation and Corneal Wound Healing Through Hippo-Yap Signaling Pathway. Invest Ophthalmol Vis Sci 2020; 61:7. [PMID: 32392315 PMCID: PMC7405682 DOI: 10.1167/iovs.61.5.7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose To investigate the effect and mechanism of Agrin on limbal stem cell proliferation and corneal wound healing. Methods Limbal stem cells were isolated and treated with different concentrations of Agrin. CCK-8 and cell proliferation markers (Ki67 and pH3) were detected to evaluate cell numbers or proliferative potential of limbal stem cells. The corneal epithelium wound model was induced by debridement of central corneal epithelial, and the effects of Agrin on limbal stem cell proliferation and corneal epithelial wound healing rate were determined. Results Agrin promoted the proliferation of cultured limbal stem cells in vitro and increased the expression level of p63α rather than keratin 12. Furthermore, Agrin accelerated the wound healing rate of corneal epithelium through activating limbal stem cell proliferation in vivo. In terms of mechanism, Agrin could facilitate the dephosphorylation of Yap1, which contributed to the nuclear translocation of Yap1 and expression of Cyclin D1, and subsequently promoted proliferation of limbal stem cells. Conclusions Agrin promotes the proliferation of limbal stem cells and accelerates the healing rate of corneal wound through Hippo-Yap signaling pathway.
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Selecting Appropriate Reference Genes for Quantitative Real-Time Polymerase Chain Reaction Studies in Isolated and Cultured Ocular Surface Epithelia. Sci Rep 2019; 9:19631. [PMID: 31873107 PMCID: PMC6927975 DOI: 10.1038/s41598-019-56054-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022] Open
Abstract
The introduction of tissue engineering has allowed scientists to push the boundaries and treat seriously damaged ocular surface epithelia. They have managed to do this through the development of biological substitutes that restore, maintain or improve tissue function. To ensure the generation of a therapeutically safe and effective graft, knowledge on the transcriptional profile of native and cultured ocular surface epithelia is of undeniable value. Gene expression studies are, however, only as reliable as their proper selection of internal reaction controls or reference genes. In this study, we determined the expression stability of a number of reference genes: 18s rRNA, ACTB, ATP5B, CyC1, EIF4A2, GAPDH, RPL13A, SDHA, TOP1, UBC, and YWHAZ in primary isolates as well as in ex vivo cultured ocular surface epithelia explants (day 0 and/or day 14). Expression stability of the reference genes was assessed with both the geNorm and NormFinder software that use a pairwise comparison and a model-based approach, respectively. Our results extend the general recommendation of using multiple reference genes for normalization purposes to our model systems and provide an overview of several references genes that are likely to be stable in similar culture protocols.
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Strategies for reconstructing the limbal stem cell niche. Ocul Surf 2019; 17:230-240. [PMID: 30633966 DOI: 10.1016/j.jtos.2019.01.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/21/2018] [Accepted: 01/07/2019] [Indexed: 12/19/2022]
Abstract
The epithelial cell layer that covers the surface of the cornea provides a protective barrier while maintaining corneal transparency. The rapid and effective turnover of these epithelial cells depends, in part, on the limbal epithelial stem cells (LESCs) located in a specialized microenvironment known as the limbal niche. Many disorders affecting the regeneration of the corneal epithelium are related to deficiency and/or dysfunction of LESCs and the limbal niche. Current approaches for regenerating the corneal epithelium following significant injuries such as burns and inflammatory attacks are primarily aimed at repopulating the LESCs. This review summarizes and assesses the clinical feasibility and efficacy of current and emerging approaches for reconstruction of the limbal niche. In particular, the application of mesenchymal stem cells along with appropriate biological scaffolds appear to be promising strategies for long-term revitalization of the limbal niche.
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CHEN M, CHANG CK, LIN SY, CHEN M. A Pilot Study of the Short Term Effectiveness and Safety of Amniotic Fluid in Severe Dry Eye Disease. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2019; 8:81-84. [PMID: 31263717 PMCID: PMC6592303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim of this study was to evaluate if amniotic fluid (AF) mixed with artificial tears or soaked with a soft contact lens (SCL) as a treatment for severe dry eye disease (DED) would improve its signs or symptoms. In this retrospective pilot study 22 consecutive eyes of 11 patients with level 3 DED classified by DEWS 1 (Dry Eye WorkShop 1 2007), were included in the study between June 1 and September 30 in 2017. The study was conducted before DEWS II (Dry Eye WorkShop II 2017), which was published in October 2017. Therefore, DEWS II was not adopted for this study. Soft Contact Lens Acuvue Oasys of Plano with 8.8 base curve and 14 mm diameters by Johnson and Johnson were used to soak in FloGraft, which is an AF, for 30 minutes before placing in 12 eyes in Group 1. The contact lenses were placed in the left eye for 1 week. In Group 2, 10 eyes used 6 mL of artificial tears mixed with 0.25 mL of AF, which were applied to the eye four times a day for 1 week. No other eye medications were used. The eyes that were included had diffuse punctate staining and fast tear breaking times of <5 seconds with severe ocular symptoms (DEWS 1 level 3-4). Photos of fluorescein stain corneas before the treatment and 1 week after the treatment were used to compare the distribution of punctate staining as the objective outcomes for signs. Several questions adopted from the Ocular Surface disease Index (OSDI) about subjective symptoms before and after the treatment were asked, and documented on the chart. Improvement either in symptoms or signs or both of DED after 1 week at follow-up examination was recorded. Group 1, with SCL 46% had improvement after 1 week and Group 2, with artificial tears 50% had improvement after 1 week. Improvement means either symptom relief or comparatively decreased distribution of punctate staining on the cornea or both. No cases had inflammation, infection, irritation or blurred vision. We concluded that FloGraft as an AF can safely improve the symptoms or the signs of severe DED either as a mix with artificial tears or soaked with SCL by about 50% in this case series without evidence of irritation, inflammation or blurred vision in the short term.
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Affiliation(s)
- Ming CHEN
- John A. Burns School of Medicine, University of Hawaii, USA
| | - Chao Kai CHANG
- John A. Burns School of Medicine, University of Hawaii, USA
| | - Szu Yuan LIN
- John A. Burns School of Medicine, University of Hawaii, USA
| | - Mindy CHEN
- John A. Burns School of Medicine, University of Hawaii, USA
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Vaidyanathan U, Hopping GC, Liu HY, Somani AN, Ronquillo YC, Hoopes PC, Moshirfar M. Persistent Corneal Epithelial Defects: A Review Article. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2019; 8:163-176. [PMID: 31598519 PMCID: PMC6778469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Persistent corneal epithelial defects (PEDs or PCEDs) result from the failure of rapid re-epithelialization and closure within 10-14 days after a corneal injury, even with standard supportive treatment. Disruptions in the protective epithelial and stromal layers of the cornea can render the eye susceptible to infection, stromal ulceration, perforation, scarring, and significant vision loss. Although several therapies exist and an increasing number of novel approaches are emerging, treatment of PEDs can still be quite challenging. It is important to treat the underlying causative condition, which may include an infection, limbal stem cell deficiency, or diabetes, in order to facilitate wound healing. Standard treatments, such as bandage contact lenses (BCLs) and artificial tears (ATs), aim to provide barrier protection to the epithelial layer. Recently-developed medical treatments can target the re-epithelialization process by facilitating access to growth factors and anti-inflammatory agents, and novel surgical techniques can provide re-innervation to the cornea. PEDs should be treated within 7-10 days to avoid secondary complications. These interventions, along with a step-wise approach to management, can be useful in patients with PEDs that are refractory to standard medical treatment. In this review, we discuss the epidemiology, etiology, diagnosis, current and novel management, and prognosis of persistent epithelial defects.
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Affiliation(s)
- Uma Vaidyanathan
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | - Grant C. Hopping
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | - Harry Y. Liu
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | - Anisha N. Somani
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | | | - Phillip C. Hoopes
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA
| | - Majid Moshirfar
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA, John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Utah Salt Lake City, UT, USA, Utah Lions Eye Bank, Murray, UT, USA
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