1
|
Trujillo Cubillo L, Gurdal M, Zeugolis DI. Corneal fibrosis: From in vitro models to current and upcoming drug and gene medicines. Adv Drug Deliv Rev 2024; 209:115317. [PMID: 38642593 DOI: 10.1016/j.addr.2024.115317] [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: 03/06/2023] [Revised: 02/29/2024] [Accepted: 04/18/2024] [Indexed: 04/22/2024]
Abstract
Fibrotic diseases are characterised by myofibroblast differentiation, uncontrolled pathological extracellular matrix accumulation, tissue contraction, scar formation and, ultimately tissue / organ dysfunction. The cornea, the transparent tissue located on the anterior chamber of the eye, is extremely susceptible to fibrotic diseases, which cause loss of corneal transparency and are often associated with blindness. Although topical corticosteroids and antimetabolites are extensively used in the management of corneal fibrosis, they are associated with glaucoma, cataract formation, corneoscleral melting and infection, imposing the need of far more effective therapies. Herein, we summarise and discuss shortfalls and recent advances in in vitro models (e.g. transforming growth factor-β (TGF-β) / ascorbic acid / interleukin (IL) induced) and drug (e.g. TGF-β inhibitors, epigenetic modulators) and gene (e.g. gene editing, gene silencing) therapeutic strategies in the corneal fibrosis context. Emerging therapeutical agents (e.g. neutralising antibodies, ligand traps, receptor kinase inhibitors, antisense oligonucleotides) that have shown promise in clinical setting but have not yet assessed in corneal fibrosis context are also discussed.
Collapse
Affiliation(s)
- Laura Trujillo Cubillo
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Charles Institute of Dermatology, Conway Institute of Biomolecular & Biomedical Research and School of Mechanical & Materials Engineering, University College Dublin (UCD), Dublin, Ireland
| | - Mehmet Gurdal
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Charles Institute of Dermatology, Conway Institute of Biomolecular & Biomedical Research and School of Mechanical & Materials Engineering, University College Dublin (UCD), Dublin, Ireland
| | - Dimitrios I Zeugolis
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Charles Institute of Dermatology, Conway Institute of Biomolecular & Biomedical Research and School of Mechanical & Materials Engineering, University College Dublin (UCD), Dublin, Ireland.
| |
Collapse
|
2
|
Sun Z, Lu K, He Q, Tang Y, Li H, Pazo EE, Hu L, Wei R. INOS ablation promotes corneal wound healing via activation of Akt signaling. Exp Eye Res 2024; 243:109886. [PMID: 38583755 DOI: 10.1016/j.exer.2024.109886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/24/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
Corneal injury leads to impaired normal structure of the cornea. Improving the wound healing process in epithelial cells significantly contributes to ocular damage treatments. Here, we aimed to investigate the potential mechanisms of nitric oxide (NO) and its mediator, inducible nitric oxide synthase (iNOS), in the process of corneal wound healing. We established a corneal injury model of iNOS-/- mice, and treated human corneal epithelial cell lines (HCE-2) with the iNOS inhibitor L-INL, with or without NO replenishment by supplying sodium nitroferricyanide dihydrate (SNP). Our findings showed that inhibition of NO/iNOS accelerated corneal repair, enhanced uPAR (a receptor protein indicating the migration ability), and improved epithelial cell migration. Furthermore, NO/iNOS ablation activated Akt phosphorylation, reduced neutrophil marker protein MPO expression, and downregulated the transcription of inflammation cytokines CXCL-1, CXCL-2, IL-1β, IL-6, and TNF-α. However, the protective effects of NO/iNOS inhibition are significantly reduced by NO replenishment when treated with SNP. Therefore, we confirmed that inhibiting NO/iNOS improved the corneal wound healing by facilitating epithelial cell migration and reducing inflammatory reactions, which might be related to the activation of the Akt signaling pathway.
Collapse
Affiliation(s)
- Ziwen Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300070, Tianjin, China
| | - Kunpeng Lu
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, 300070, Tianjin, China
| | - Qing He
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300070, Tianjin, China
| | - Yang Tang
- Qingdao State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, 266071, Qingdao, China
| | - Haoru Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300070, Tianjin, China
| | - Emmanuel Eric Pazo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300070, Tianjin, China
| | - Lizhi Hu
- Basic Medical College, Immunology Department, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), Tianjin Medical University, Tianjin, 300070, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300070, Tianjin, China.
| |
Collapse
|
3
|
Chen T, Li N, Ge T, Lin Y, Wu X, Gao H, Liu M. Regional analysis of posterior corneal elevation after laser refractive surgeries for correction of myopia of different degrees. Indian J Ophthalmol 2024; 72:824-830. [PMID: 38317325 DOI: 10.4103/ijo.ijo_2127_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/19/2023] [Indexed: 02/07/2024] Open
Abstract
PURPOSE To evaluate regional changes in the posterior corneal elevation after three laser refractive surgeries for correction of myopia of different degrees. SETTINGS AND DESIGN Retrospective, comparative, and non-randomized study. METHODS Two hundred patients (200 eyes) who underwent laser epithelial keratoplasty (LASEK), femtosecond-assisted laser in-situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE) were included in this study. According to preoperative spherical equivalent (SE), each surgical group was divided into two refractive subgroups: low-to-moderate myopia (LM group) and high myopia (H group). The posterior corneal elevation from Pentacam Scheimpflug tomography was analyzed preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. Three subregions of the posterior cornea were divided in this study as the central, paracentral, and peripheral regions. STATISTICAL ANALYSIS USED Generalized Estimating Equations (GEE). RESULTS For all three surgical groups, similar changing trends were seen in the two refractive subgroups. H group presented a larger changing magnitude than the LM group in FS-LASIK over time ( P < 0.05), whereas no significant difference was noted in the two refractive subgroups of LASEK or SMILE ( P > 0.05). At 12 months postoperatively, the central posterior corneal elevation returned to the preoperative level in LASEK ( P > 0.05) but shifted forward significantly in FS-LASIK and SMILE ( P < 0.05). CONCLUSION Different posterior corneal regions respond differently to corneal refractive surgeries. LASEK, FS-LASIK, and SMILE demonstrate different trends in the regional changes in posterior corneal elevation. The corneal shape seems more stable in LASEK than in FS-LASIK and SMILE.
Collapse
Affiliation(s)
- Tong Chen
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China
- School of Ophthalmology, Shandong First Medical University, China
| | - Na Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China
- School of Ophthalmology, Shandong First Medical University, China
| | - Tian Ge
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China
- School of Ophthalmology, Shandong First Medical University, China
| | - Yue Lin
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China
- School of Ophthalmology, Shandong First Medical University, China
| | - Xiaohui Wu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China
- School of Ophthalmology, Shandong First Medical University, China
| | - Hua Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China
- School of Ophthalmology, Shandong First Medical University, China
| | - Mingna Liu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China
- School of Ophthalmology, Shandong First Medical University, China
| |
Collapse
|
4
|
Iyer KS, Maruri DP, Schmidtke DW, Petroll WM, Varner VD. Treatment with both TGF-β1 and PDGF-BB disrupts the stiffness-dependent myofibroblast differentiation of corneal keratocytes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.29.582803. [PMID: 38496568 PMCID: PMC10942298 DOI: 10.1101/2024.02.29.582803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
During corneal wound healing, stromal keratocytes transform into a repair phenotype that is driven by the release of cytokines, like transforming growth factor-beta 1 (TGF-β1) and platelet-derived growth factor-BB (PDGF-BB). Previous work has shown that TGF-β1 promotes the myofibroblast differentiation of corneal keratocytes in a manner that depends on PDGF signaling. In addition, changes in mechanical properties are known to regulate the TGF-β1-mediated differentiation of cultured keratocytes. While PDGF signaling acts synergistically with TGF-β1 during myofibroblast differentiation, how treatment with multiple growth factors affects stiffness-dependent differences in keratocyte behavior is unknown. Here, we treated primary corneal keratocytes with PDGF-BB and TGF-β1 and cultured them on polyacrylamide (PA) substrata of different stiffnesses. In the presence of TGF-β1 alone, the cells underwent stiffness-dependent myofibroblast differentiation. On stiff substrata, the cells developed robust stress fibers, exhibited high levels of ⍺-SMA staining, formed large focal adhesions (FAs), and exerted elevated contractile forces, whereas cells in a compliant microenvironment showed low levels of ⍺-SMA immunofluorescence, formed smaller focal adhesions, and exerted decreased contractile forces. When the cultured keratocytes were treated simultaneously with PDGF-BB however, increased levels of ⍺-SMA staining and stress fiber formation were observed on compliant substrata, even though the cells did not exhibit elevated contractility or focal adhesion size. Pharmacological inhibition of PDGF signaling disrupted the myofibroblast differentiation of cells cultured on substrata of all stiffnesses. These results indicate that treatment with PDGF-BB can decouple molecular markers of myofibroblast differentiation from the elevated contractile phenotype otherwise associated with these cells, suggesting that crosstalk in the mechanotransductive signaling pathways downstream of TGF-β1 and PDGF-BB can regulate the stiffness-dependent differentiation of cultured keratocytes. Statement of Significance In vitro experiments have shown that changes in ECM stiffness can regulate the differentiation of myofibroblasts. Typically, these assays involve the use of individual growth factors, but it is unclear how stiffness-dependent differences in cell behavior are affected by multiple cytokines. Here, we used primary corneal keratocytes to show that treatment with both TGF-β1 and PDGF-BB disrupts the dependency of myofibroblast differentiation on substratum stiffness. In the presence of both growth factors, keratocytes on soft substrates exhibited elevated ⍺-SMA immunofluorescence without a corresponding increase in contractility or focal adhesion formation. This result suggests that molecular markers of myofibroblast differentiation can be dissociated from the elevated contractile behavior associated with the myofibroblast phenotype, suggesting potential crosstalk in mechanotransductive signaling pathways downstream of TGF-β1 and PDGF-BB.
Collapse
|
5
|
Poole K, Iyer KS, Schmidtke DW, Petroll WM, Varner VD. Investigating transcriptional differences in mechanotransductive and ECM related genes in cultured primary corneal keratocytes, fibroblasts and myofibroblasts. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.28.582620. [PMID: 38464034 PMCID: PMC10925317 DOI: 10.1101/2024.02.28.582620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
After a stromal injury in the cornea, the release of growth factors and pro-inflammatory cytokines typically results in the activation of quiescent keratocytes toward migratory fibroblast and/or fibrotic myofibroblast phenotypes. The persistence of the myofibroblast phenotype can lead to corneal fibrosis and scarring, which are leading causes of blindness worldwide. The primary goal of this study was to establish comprehensive transcriptional profiles for cultured corneal keratocytes, fibroblasts, and myofibroblasts to gain insights into the mechanisms through which changes in phenotype may occur. Here, we cultured primary rabbit corneal keratocytes on collagen-coated glass coverslips in serum free media (SF), serum containing media (FBS), or in the presence of TGF-β1 to induce keratocyte, fibroblast, and myofibroblast phenotypes, respectively. Total RNA was collected and sent to Novogene for bulk RNA sequencing. Subsequent bioinformatic analysis included gene expression quantification, differential expression, and functional analysis. When comparing FBS and TGF-β1 conditions to SF, genes characteristic of a quiescent keratocyte phenotype were downregulated (e.g. KERA, LUM, ALDH1A1), while genes commonly associated with fibroblasts or myofibroblasts were upregulated (e.g. VIM, TNC, FN1, ITGA5, ACTA2). Functional analysis of genes differentially expressed between fibroblasts and keratocytes highlighted pathways related to proliferation (e.g. DNA replication, PI3K-Akt signaling) and cell migration (e.g. Rap1 signaling, ECM-receptor interactions). Enriched pathways for the comparison of myofibroblasts to keratocytes included focal adhesion, regulation of actin cytoskeleton, hippo signaling, and ECM-receptor interaction pathways. Together, these pathways support changes in cytoskeletal organization, cell contractility, mechanotransduction, and cell-ECM interactions in myofibroblasts compared to keratocytes. Overall, these data demonstrate that there are distinct transcriptional differences between cultured corneal keratocytes, fibroblasts, and myofibroblasts. In our initial analysis, we have identified genes and signaling pathways that may play important roles in keratocyte differentiation, including many related to proliferation, cell mechanical activity, and ECM interactions. Furthermore, our findings reveal novel markers for each cell type as well as possible targets for modulating cell behavior and differentiation to promote physiological corneal wound healing.
Collapse
|
6
|
Thomasy SM, Leonard BC, Greiner MA, Skeie JM, Raghunathan VK. Squishy matters - Corneal mechanobiology in health and disease. Prog Retin Eye Res 2024; 99:101234. [PMID: 38176611 DOI: 10.1016/j.preteyeres.2023.101234] [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: 09/01/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
The cornea, as a dynamic and responsive tissue, constantly interacts with mechanical forces in order to maintain its structural integrity, barrier function, transparency and refractive power. Cells within the cornea sense and respond to various mechanical forces that fundamentally regulate their morphology and fate in development, homeostasis and pathophysiology. Corneal cells also dynamically regulate their extracellular matrix (ECM) with ensuing cell-ECM crosstalk as the matrix serves as a dynamic signaling reservoir providing biophysical and biochemical cues to corneal cells. Here we provide an overview of mechanotransduction signaling pathways then delve into the recent advances in corneal mechanobiology, focusing on the interplay between mechanical forces and responses of the corneal epithelial, stromal, and endothelial cells. We also identify species-specific differences in corneal biomechanics and mechanotransduction to facilitate identification of optimal animal models to study corneal wound healing, disease, and novel therapeutic interventions. Finally, we identify key knowledge gaps and therapeutic opportunities in corneal mechanobiology that are pressing for the research community to address especially pertinent within the domains of limbal stem cell deficiency, keratoconus and Fuchs' endothelial corneal dystrophy. By furthering our understanding corneal mechanobiology, we can contextualize discoveries regarding corneal diseases as well as innovative treatments for them.
Collapse
Affiliation(s)
- Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA, United States; Department of Ophthalmology & Vision Science, School of Medicine, University of California - Davis, Davis, CA, United States; California National Primate Research Center, Davis, CA, United States.
| | - Brian C Leonard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA, United States; Department of Ophthalmology & Vision Science, School of Medicine, University of California - Davis, Davis, CA, United States
| | - Mark A Greiner
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA, United States; Iowa Lions Eye Bank, Coralville, IA, United States
| | - Jessica M Skeie
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA, United States; Iowa Lions Eye Bank, Coralville, IA, United States
| | | |
Collapse
|
7
|
Wu Y, Du L, Xu X, Hu Y, Liu J, Zhang J, Lei L, He W, Sheng Z, Ni Y, Qu J, Li X, Jiang J. Nano Self-Assemblies of Caffeic Acid-Fibronectin Mimic a Peptide Conjugate for the Treatment of Corneal Epithelial Injury. Mol Pharm 2023; 20:5937-5946. [PMID: 37871179 DOI: 10.1021/acs.molpharmaceut.3c00861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Rapid corneal re-epithelialization is important for corneal wound healing. Corneal epithelial cell motility and oxidative stress are important targets for therapeutic intervention. In this study, we covalently conjugated the antioxidant caffeic acid (CA) with a bioactive peptide sequence (PHSRN) to generate a CA-PHSRN amphiphile, which was formulated into nanoparticular eye drops with an average size of 43.21 ± 16 nm. CA-PHSRN caused minimal cytotoxicity against human corneal epithelial cells (HCECs) and RAW264.7 cells, exhibited an excellent free radical scavenging ability, and remarkably attenuated reactive oxygen species (ROS) levels in H2O2-stimulated HCECs. The antioxidant and anti-inflammatory activities of CA-PHSRN were assessed in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. The results show that CA-PHSRN treatment effectively prevented LPS-induced DNA damage and significantly reduced the levels of LPS-induced pro-inflammatory cytochemokines (i.e., iNOS, NO, TNF-α, IL-6, and COX-2) in a dose-dependent manner. Moreover, using a rabbit corneal epithelial ex vivo migration assay, we demonstrated that the proposed CA-PHSRN accelerated corneal epithelial cell migration and exhibited high ocular tolerance and ocular bioavailability after topical instillation. Taken together, the proposed CA-PHSRN nanoparticular eye drops are a promising therapeutic formulation for the treatment of corneal epithelial injury.
Collapse
Affiliation(s)
- Yiping Wu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Lulu Du
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Xiaoning Xu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Yuhan Hu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Jia Liu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Jingwei Zhang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Lei Lei
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Wenfang He
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Zihao Sheng
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Yuanao Ni
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Jia Qu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Xingyi Li
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| | - Jun Jiang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, China
| |
Collapse
|
8
|
Yu F, Gong D, Yan D, Wang H, Witman N, Lu Y, Fu W, Fu Y. Enhanced adipose-derived stem cells with IGF-1-modified mRNA promote wound healing following corneal injury. Mol Ther 2023; 31:2454-2471. [PMID: 37165618 PMCID: PMC10422019 DOI: 10.1016/j.ymthe.2023.05.002] [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: 11/28/2022] [Revised: 04/11/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023] Open
Abstract
The cornea serves as an important barrier structure to the eyeball and is vulnerable to injuries, which may lead to scarring and blindness if not treated promptly. To explore an effective treatment that could achieve multi-dimensional repair of the injured cornea, the study herein innovatively combined modified mRNA (modRNA) technologies with adipose-derived mesenchymal stem cells (ADSCs) therapy, and applied IGF-1 modRNA (modIGF1)-engineered ADSCs (ADSCmodIGF1) to alkali-burned corneas in mice. The therapeutic results showed that ADSCmodIGF1 treatment could achieve the most extensive recovery of corneal morphology and function when compared not only with simple ADSCs but also IGF-1 protein eyedrops, which was reflected by the healing of corneal epithelium and limbus, the inhibition of corneal stromal fibrosis, angiogenesis and lymphangiogenesis, and also the repair of corneal nerves. In vitro experiments further proved that ADSCmodIGF1 could more significantly promote the activity of trigeminal ganglion cells and maintain the stemness of limbal stem cells than simple ADSCs, which were also essential for reconstructing corneal homeostasis. Through a combinatorial treatment regimen of cell-based therapy with mRNA technology, this study highlighted comprehensive repair in the damaged cornea and showed the outstanding application prospect in the treatment of corneal injury.
Collapse
Affiliation(s)
- Fei Yu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Danni Gong
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Dan Yan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Huijing Wang
- Institute of Pediatric Translational Medicine, Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Nevin Witman
- Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden
| | - Yang Lu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China.
| | - Wei Fu
- Institute of Pediatric Translational Medicine, Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
| | - Yao Fu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China.
| |
Collapse
|
9
|
Petroll WM, Miron-Mendoza M, Sunkara Y, Ikebe HR, Sripathi NR, Hassaniardekani H. The impact of UV cross-linking on corneal stromal cell migration, differentiation and patterning. Exp Eye Res 2023; 233:109523. [PMID: 37271309 PMCID: PMC10825899 DOI: 10.1016/j.exer.2023.109523] [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: 01/23/2023] [Revised: 05/09/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Previous studies have demonstrated that UV cross-linking (CXL) increases stromal stiffness and produces alterations in extracellular matrix (ECM) microstructure. In order to investigate how CXL impacts both keratocyte differentiation and patterning within the stroma, and fibroblast migration and myofibroblast differentiation on top of the stroma, we combined CXL with superficial phototherapeutic keratectomy (PTK) in a rabbit model. Twenty-six rabbits underwent a 6 mm diameter, 70 μm deep phototherapeutic keratectomy (PTK) with an excimer laser to remove the epithelium and anterior basement membrane. In 14 rabbits, standard CXL was performed in the same eye immediately after PTK. Contralateral eyes served as controls. In vivo confocal microscopy through focusing (CMTF) was used to analyze corneal epithelial and stromal thickness, as well as stromal keratocyte activation and corneal haze. CMTF scans were collected pre-operatively, and from 7 to 120 days after the procedure. A subset of rabbits was sacrificed at each time point, and corneas were fixed and labeled in situ for multiphoton fluorescence microscopy and second harmonic generation imaging. In vivo and in situ imaging demonstrated that haze after PTK was primarily derived from a layer of myofibroblasts that formed on top of the native stroma. Over time, this fibrotic layer was remodeled into more transparent stromal lamellae, and quiescent cells replaced myofibroblasts. Migrating cells within the native stroma underneath the photoablated area were elongated, co-aligned with collagen, and lacked stress fibers. In contrast, following PTK + CXL, haze was derived primarily from highly reflective necrotic "ghost cells" in the anterior stroma, and fibrosis on top of the photoablated stroma was not observed at any time point evaluated. Cells formed clusters as they migrated into the cross-linked stromal tissue and expressed stress fibers; some cells at the edge of the CXL area also expressed α-SM actin, suggesting myofibroblast transformation. Stromal thickness increased significantly between 21 and 90 days after PTK + CXL (P < 0.001) and was over 35 μm higher than baseline at Day 90 (P < 0.05). Overall, these data suggest that cross-linking inhibits interlamellar cell movement, and that these changes lead to a disruption of normal keratocyte patterning and increased activation during stromal repopulation. Interestingly, CXL also prevents PTK-induced fibrosis on top of the stroma, and results in long term increases in stromal thickness in the rabbit model.
Collapse
Affiliation(s)
- W Matthew Petroll
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA; Department of Biomedical Engineering, UT Southwestern Medical Center, Dallas, TX, USA.
| | | | - Yukta Sunkara
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Hikaru R Ikebe
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nishith R Sripathi
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA
| | | |
Collapse
|
10
|
Moore BA, Jalilian I, Kim S, Mizutani M, Mukai M, Chang C, Entringer AM, Dhamodaran K, Raghunathan VK, Teixeira LBC, Murphy CJ, Thomasy SM. Collagen crosslinking impacts stromal wound healing and haze formation in a rabbit phototherapeutic keratectomy model. Mol Vis 2023; 29:102-116. [PMID: 37859806 PMCID: PMC10584030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 07/14/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose The purpose of this study was to evaluate the elastic modulus, keratocyte-fibroblast-myocyte transformation, and haze formation of the corneal stroma following combined phototherapeutic keratectomy (PTK) and epithelium-off UV-A/riboflavin corneal collagen crosslinking (CXL) using an in vivo rabbit model. Methods Rabbits underwent PTK and CXL, PTK only, or CXL 35 days before PTK. Rebound tonometry, Fourier-domain optical coherence tomography, and ultrasound pachymetry were performed on days 7, 14, 21, 42, 70, and 90 post-operatively. Atomic force microscopy, histologic inflammation, and immunohistochemistry for α-smooth muscle actin (α-SMA) were assessed post-mortem. Results Stromal haze formation following simultaneous PTK and CXL was significantly greater than in corneas that received PTK only and persisted for more than 90 days. No significant difference in stromal haze was noted between groups receiving simultaneous CXL and PTK and those receiving CXL before PTK. Stromal inflammation did not differ between groups at any time point, although the intensity of α-SMA over the number of nuclei was significantly greater at day 21 between groups receiving simultaneous CXL and PTK and those receiving CXL before PTK. The elastic modulus was significantly greater in corneas receiving simultaneous CXL and PTK compared with those receiving PTK alone. Conclusions We showed that stromal haze formation and stromal stiffness is significantly increased following CXL, regardless of whether it is performed at or before the time of PTK. Further knowledge of the biophysical cues involved in determining corneal wound healing duration and outcomes will be important for understanding scarring following CXL and for the development of improved therapeutic options.
Collapse
Affiliation(s)
- Bret A. Moore
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Iman Jalilian
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Soohyun Kim
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Makiko Mizutani
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Madison Mukai
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Connor Chang
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Alec M. Entringer
- Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, TX
| | - Kamesh Dhamodaran
- Department of Basic Sciences, College of Optometry, University of Houston, Houston, TX
| | - Vijay Krishna Raghunathan
- Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, TX
- Department of Basic Sciences, College of Optometry, University of Houston, Houston, TX
| | - Leandro B. C. Teixeira
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - Christopher J. Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
- Department of Ophthalmology & Vision Science, School of Medicine, University of California-Davis, Sacramento, CA
| | - Sara M. Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
- Department of Ophthalmology & Vision Science, School of Medicine, University of California-Davis, Sacramento, CA
| |
Collapse
|
11
|
Pot SA, Lin Z, Shiu J, Benn MC, Vogel V. Growth factors and mechano-regulated reciprocal crosstalk with extracellular matrix tune the keratocyte-fibroblast/myofibroblast transition. Sci Rep 2023; 13:11350. [PMID: 37443325 PMCID: PMC10345140 DOI: 10.1038/s41598-023-37776-9] [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: 02/14/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Improper healing of the cornea after injury, infections or surgery can lead to corneal scar formation, which is associated with the transition of resident corneal keratocytes into activated fibroblasts and myofibroblasts (K-F/M). Myofibroblasts can create an extracellular matrix (ECM) niche in which fibrosis is promoted and perpetuated, resulting in progressive tissue opacification and vision loss. As a reversion back to quiescent keratocytes is essential to restore corneal transparency after injury, we characterized how growth factors with demonstrated profibrotic effects (PDGF, FGF, FBS, TGFβ1) induce the K-F/M transition, and whether their withdrawal can revert it. Indeed, the upregulated expression of αSMA and the associated changes in cytoskeletal architecture correlated with increases in cell contractility, fibronectin (Fn) and collagen matrix density and Fn fiber strain, as revealed by 2D cell culture, nanopillar cellular force mapping and a FRET-labeled Fn tension probe. Substrate mechanosensing drove a more complete K-F/M transition reversal following growth factor withdrawal on nanopillar arrays than on planar glass substrates. Using decellularized ECM scaffolds, we demonstrated that the K-F/M transition was inhibited in keratocytes reseeded onto myofibroblast-assembled, and/or collagen-1-rich ECM. This supports the presence of a myofibroblast-derived ECM niche that contains cues favoring tissue homeostasis rather than fibrosis.
Collapse
Affiliation(s)
- Simon A Pot
- Laboratory of Applied Mechanobiology, Department of Health Sciences and Technology, ETH Zurich, Vladimir-Prelog-Weg 4, 8093, Zurich, Switzerland.
- Ophthalmology Section, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
| | - Zhe Lin
- Ruisi (Fujian) Biomedical Engineering Research Center Co Ltd, 26-1 Wulongjiang Road, Fuzhou, 350100, People's Republic of China
| | - Jauye Shiu
- Laboratory of Applied Mechanobiology, Department of Health Sciences and Technology, ETH Zurich, Vladimir-Prelog-Weg 4, 8093, Zurich, Switzerland
- Graduate Institute of Biomedical Sciences, China Medical University, No. 91, Xueshi Rd, North District, Taichung City, Taiwan
| | - Mario C Benn
- Laboratory of Applied Mechanobiology, Department of Health Sciences and Technology, ETH Zurich, Vladimir-Prelog-Weg 4, 8093, Zurich, Switzerland
| | - Viola Vogel
- Laboratory of Applied Mechanobiology, Department of Health Sciences and Technology, ETH Zurich, Vladimir-Prelog-Weg 4, 8093, Zurich, Switzerland.
| |
Collapse
|
12
|
Guo Y, Wang H. Sodium hyaluronate promotes proliferation, autophagy, and migration of corneal epithelial cells by downregulating miR-18a in the course of corneal epithelial injury. Eur J Histochem 2023; 67. [PMID: 37322995 DOI: 10.4081/ejh.2023.3663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/27/2023] [Indexed: 06/17/2023] Open
Abstract
Corneal epithelium can resist the invasion of external pathogenic factors to protect the eye from external pathogens. Sodium hyaluronate (SH) has been confirmed to promote corneal epithelial wound healing. However, the mechanism by which SH protects against corneal epithelial injury (CEI) is not fully understood. CEI model mice were made by scratching the mouse corneal epithelium, and in vitro model of CEI were constructed via curettage of corneal epithelium or ultraviolet radiation. The pathologic structure and level of connective tissue growth factor (CTGF) expression were confirmed by Hematoxylin and Eosin staining and immunohistochemistry. CTGF expression was detected by an IHC assay. The levels of CTGF, TGF-β, COLA1A, FN, LC3B, Beclin1, and P62 expression were monitored by RT-qPCR, ELISA, Western blotting or immunofluorescence staining. Cell proliferation was detected by the CCK-8 assay and EdU staining. Our results showed that SH could markedly upregulate CTGF expression and downregulate miR-18a expression in the CEI model mice. Additionally, SH could attenuate corneal epithelial tissue injury, and enhance the cell proliferation and autophagy pathways in the CEI model mice. Meanwhile, overexpression of miR-18a reversed the effect of SHs on cell proliferation and autophagy in CEI model mice. Moreover, our data showed that SH could induce the proliferation, autophagy, and migration of CEI model cells by downregulating miR-18a. Down-regulation of miR-18a plays a significant role in the ability of SH to promote corneal epithelial wound healing. Our results provide a theoretical basis for targeting miR-18a to promote corneal wound healing.
Collapse
Affiliation(s)
- Yingzhuo Guo
- Department of Optometry, Hunan Provincial People's Hospital, Hunan Normal University, Changsha, Hunan.
| | - Hua Wang
- Department of Optometry, Hunan Provincial People's Hospital, Hunan Normal University, Changsha, Hunan.
| |
Collapse
|
13
|
Chen J, Mo Q, Long Q, Sheng R, Chen Z, Luo Y, Liu C, Backman LJ, Zhang Y, Zhang W. Hydroxycamptothecin and Substratum Stiffness Synergistically Regulate Fibrosis of Human Corneal Fibroblasts. ACS Biomater Sci Eng 2023; 9:959-967. [PMID: 36705297 DOI: 10.1021/acsbiomaterials.2c01302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Corneal fibrosis is a common outcome of inappropriate repair associated with trauma or ocular infection. Altered biomechanical properties with increased corneal stiffness is a feature of fibrosis that cause corneal opacities, resulting in severe visual impairment and even blindness. The present study aims to determine the effect of hydroxycamptothecin (HCPT) and matrix stiffness on transforming growth factor-β1 (TGF-β1)-induced fibrotic processes in human corneal fibroblasts (HTK cells). HTK cells were cultured on substrates with different stiffnesses ("soft", ∼261 kPa; "stiff", ∼2.5 × 103 kPa) and on tissue culture plastic (TCP, ∼106 kPa) and simultaneously treated with or without 1 μg/mL HCPT and 10 ng/mL TGF-β1. We found that HCPT induced decreased cell viability and antiproliferative effects on HTK cells. TGF-β1-induced expression of fibrosis-related genes (FN1, ACTA2) was reduced if the cells were simultaneously treated with HCPT. Substrate stiffness did not affect the expression of fibrosis-related genes. The TGF-β1 induced expression of FN1 on both soft and stiff substrates was reduced if cells were simultaneously treated with HCPT. However, this trend was not seen for ACTA2, i.e., the TGF-β1 induced expression of ACTA2 was not reduced by simultaneous treatment of HCPT in either soft or stiff substrate. Instead, HCPT treatment in the presence of TGF-β1 resulted in increased gene expression of keratocyte phenotype makers (LUM, KERA, AQP1, CHTS6) on both substrate stiffnesses. In addition, the protein expression of keratocyte phenotype makers LUM and ALDH3 was increased in HTK cells simultaneously treated with TGF-β1 and HCPT on stiff substrate as compared to control, i.e., without HCPT. In conclusion, we found that HCPT can reduce TGF-β1-induced fibrosis and promote the keratocyte phenotype in a substrate stiffness dependent manner. Thus, HCPT stimulation might be an approach to stimulate keratocytes in the appropriate healing stage to avoid or reverse fibrosis and achieve more optimal corneal wound healing.
Collapse
Affiliation(s)
- Jialin Chen
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China.,Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, Nanjing 210096, China.,China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou 310058, China
| | - Qingyun Mo
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China
| | - Qiuzi Long
- Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China.,Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Renwang Sheng
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China
| | - Zhixuan Chen
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China
| | - Yifan Luo
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China
| | - Chuanquan Liu
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China
| | - Ludvig J Backman
- Department of Integrative Medical Biology, Anatomy, Umeå University, Umeå SE-901 87, Sweden.,Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå SE-901 87, Sweden
| | - Yanan Zhang
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China
| | - Wei Zhang
- School of Medicine, Southeast University, Nanjing 210009, China.,Center for Stem Cell and Regenerative Medicine, Southeast University, Nanjing 210009, China.,Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, Nanjing 210096, China.,China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou 310058, China
| |
Collapse
|
14
|
Bao F, Lopes BT, Zheng X, Ji Y, Wang J, Elsheikh A. Corneal Biomechanics Losses Caused by Refractive Surgery. Curr Eye Res 2023; 48:137-143. [PMID: 36001080 DOI: 10.1080/02713683.2022.2103569] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Recent advances, specifically in the understanding of the biomechanical properties of the cornea and its response to diseases and surgical interventions, have significantly improved the safety and surgical outcomes of corneal refractive surgery, whose popularity and demand continue to grow worldwide. However, iatrogenic keratectasia resulting from the deterioration in corneal biomechanics caused by surgical interventions, although rare, remains a global concern. On one hand, in vivo biomechanical evaluation, enabled by clinical imaging systems such as the ORA and the Corvis ST, has significantly improved the risk profiling of patients for iatrogenic keratectasia. That is despite the fact the biomechanical metrics provided by these systems are considered indicators of the cornea's overall stiffness rather than its intrinsic material properties. On the other hand, new surgical modalities including SMILE were introduced to offer superior biomechanical performance to LASIK, but this superiority could not be proven clinically, creating more myths than answers. The literature also includes sound evidence that tPRK provided the highest preservation of corneal biomechanics when compared to both LASIK and SMILE. The aim of this review is twofold; to discuss the importance of corneal biomechanical evaluation prior to refractive surgery, and to assess the current understanding of cornea's biomechanical deterioration caused by mainstream corneal refractive surgeries. The review has led to an observation that new imaging techniques, parameters and evaluation systems may be needed to reflect the true advantages of specific refractive techniques and when these advantages are significant enough to offer better protection against post-surgery complications.
Collapse
Affiliation(s)
- FangJun Bao
- Eye Hospital, Wenzhou Medical University, Wenzhou, China.,The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - Bernardo T Lopes
- School of Engineering, University of Liverpool, Liverpool, UK.,Department of Ophthalmology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - XiaoBo Zheng
- Eye Hospital, Wenzhou Medical University, Wenzhou, China.,The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - YuXin Ji
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - JunJie Wang
- Eye Hospital, Wenzhou Medical University, Wenzhou, China.,The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, UK.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China.,National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| |
Collapse
|
15
|
The TGM2 inhibitor cysteamine hydrochloride does not impact corneal epithelial and stromal wound healing in vitro and in vivo. Exp Eye Res 2023; 226:109338. [PMID: 36470430 PMCID: PMC10120528 DOI: 10.1016/j.exer.2022.109338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Corneal wound healing is integral for resolution of corneal disease or for post-operative healing. However, corneal scarring that may occur secondary to this process can significantly impair vision. Tissue transglutaminase 2 (TGM2) inhibition has shown promising antifibrotic effects and thus holds promise to prevent or treat corneal scarring. The commercially available ocular solution for treatment of ocular manifestations of Cystinosis, Cystaran®, contains the TGM2 inhibitor cysteamine hydrochloride (CH). The purpose of this study is to assess the safety of CH on corneal epithelial and stromal wounds, its effects on corneal wound healing, and its efficacy against corneal scarring following wounding. Quantitative polymerase chain reaction (qPCR) and immunohistochemistry (IHC) were first used to quantify and localize TGM2 expression in the cornea. Subsequently, (i) the in vitro effects of CH at 0.163, 1.63, and 16.3 mM on corneal epithelial cell migration was assessed with an epithelial cell migration assay, and (ii) the in vivo effects of application of 1.63 mM CH on epithelial and stromal wounds was assessed in a rabbit model with ophthalmic examinations, inflammation scoring, color and fluorescein imaging, optical coherence tomography (OCT), and confocal biomicroscopy. Post-mortem assessment of corneal tissue post-stromal wounding included biomechanical characterization (atomic force microscopy (AFM)), histology (H&E staining), and determining incidence of myofibroblasts (immunostaining against α-SMA) in wounded corneal tissue. TGM2 expression was highest in corneal epithelial cells. Application of the TGM2 inhibitor CH did not affect in vitro epithelial cell migration at the two lower concentrations tested. At 16.3 mM, decreased cell migration was observed. In vivo application of CH at 57 mM was well tolerated and did not adversely affect wound healing. No difference in corneal scarring was found between CH treated and vehicle control eyes. This study shows that the TGM2 inhibitor CH, at the FDA-approved dose, is well tolerated in a rabbit model of corneal wound healing and does not adversely affect epithelial or stromal wound healing. This supports the safe use of this medication in Cystinosis patients with open corneal wounds. CH did not have an effect on corneal scarring in this study, suggesting that Cystaran® administration to patients with corneal wounds is unlikely to decrease corneal fibrosis.
Collapse
|
16
|
Lin X, Mekonnen T, Verma S, Zevallos-Delgado C, Singh M, Aglyamov SR, Gesteira TF, Larin KV, Coulson-Thomas VJ. Hyaluronan Modulates the Biomechanical Properties of the Cornea. Invest Ophthalmol Vis Sci 2022; 63:6. [PMID: 36478198 PMCID: PMC9733656 DOI: 10.1167/iovs.63.13.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Hyaluronan (HA) is a major constituent of the extracellular matrix (ECM) that has high viscosity and is essential for maintaining tissue hydration. In the cornea, HA is enriched in the limbal region and is a key component of the limbal epithelial stem cell niche. HA is upregulated after injury participating in the formation of the provisional matrix, and has a key role in regulating the wound healing process. This study investigated whether changes in the distribution of HA before and after injury affects the biomechanical properties of the cornea in vivo. Methods Corneas of wild-type (wt) mice and mice lacking enzymes involved in the biosynthesis of HA were analyzed before, immediately after, and 7 and 14 days after a corneal alkali burn (AB). The corneas were evaluated using both a ring light and fluorescein stain by in vivo confocal microscopy, optical coherence elastography (OCE), and immunostaining of corneal whole mounts. Results Our results show that wt mice and mice lacking HA synthase (Has)1 and 3 present an increase in corneal stiffness 7 and 14 days after AB without a significant increase in HA expression and absence of scarring at 14 days after AB. In contrast, mice lacking Has2 present a significant decrease in corneal stiffness, with a significant increase in HA expression and scarring at 14 days after AB. Conclusions Our findings show that the mechanical properties of the cornea are significantly modulated by changes in HA distribution following alkali burn.
Collapse
Affiliation(s)
- Xiao Lin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Taye Mekonnen
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | - Sudhir Verma
- College of Optometry, University of Houston, Houston, Texas, United States,Department of Zoology, Deen Dayal Upadhyaya College, University of Delhi, Delhi, India
| | | | - Manmohan Singh
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | - Salavat R. Aglyamov
- Department of Mechanical Engineering, University of Houston, Houston, Texas, United States
| | - Tarsis F. Gesteira
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Kirill V. Larin
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | | |
Collapse
|
17
|
Chen F, Mundy DC, Le P, Seo YA, Logan CM, Fernandes-Cunha GM, Basco CA, Myung D. In Situ-Forming Collagen-Hyaluronate Semi-Interpenetrating Network Hydrogel Enhances Corneal Defect Repair. Transl Vis Sci Technol 2022; 11:22. [PMID: 36239965 PMCID: PMC9586141 DOI: 10.1167/tvst.11.10.22] [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] [Indexed: 11/30/2022] Open
Abstract
Purpose Millions worldwide suffer vision impairment or blindness from corneal injury, and there remains an urgent need for a more effective and accessible way to treat corneal defects. We have designed and characterized an in situ-forming semi-interpenetrating polymer network (SIPN) hydrogel using biomaterials widely used in ophthalmology and medicine. Methods The SIPN was formed by cross-linking collagen type I with bifunctional polyethylene glycol using N-hydroxysuccinimide ester chemistry in the presence of linear hyaluronic acid (HA). Gelation time and the mechanical, optical, swelling, and degradation properties of the SIPN were assessed. Cytocompatibility with human corneal epithelial cells and corneal stromal stem cells (CSSCs) was determined in vitro, as was the spatial distribution of encapsulated CSSCs within the SIPN. In vivo wound healing was evaluated by multimodal imaging in an anterior lamellar keratectomy injury model in rabbits, followed by immunohistochemical analysis of treated and untreated tissues. Results The collagen-hyaluronate SIPN formed in situ without an external energy source and demonstrated mechanical and optical properties similar to the cornea. It was biocompatible with human corneal cells, enhancing CSSC viability when compared with collagen gel controls and preventing encapsulated CSSC sedimentation. In vivo application of the SIPN significantly reduced stromal defect size compared with controls after 7 days and promoted multilayered epithelial regeneration. Conclusions This in situ-forming SIPN hydrogel may be a promising alternative to keratoplasty and represents a step toward expanding treatment options for patients suffering from corneal injury. Translational Relevance We detail the synthesis and initial characterization of an SIPN hydrogel as a potential alternative to lamellar keratoplasty and a tunable platform for further development in corneal tissue engineering and therapeutic cell delivery.
Collapse
Affiliation(s)
- Fang Chen
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.,VA Palo Alto HealthCare System, Palo Alto, CA, USA
| | - David C Mundy
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Peter Le
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.,VA Palo Alto HealthCare System, Palo Alto, CA, USA
| | - Youngyoon Amy Seo
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Caitlin M Logan
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Chris A Basco
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - David Myung
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.,VA Palo Alto HealthCare System, Palo Alto, CA, USA.,Department of Chemical Engineering, Stanford University, Palo Alto, CA, USA
| |
Collapse
|
18
|
Zhang J, Kim K, Kim HJ, Meyer D, Park W, Lee SA, Dai Y, Kim B, Moon H, Shah JV, Harris KE, Collar B, Liu K, Irazoqui P, Lee H, Park SA, Kollbaum PS, Boudouris BW, Lee CH. Smart soft contact lenses for continuous 24-hour monitoring of intraocular pressure in glaucoma care. Nat Commun 2022; 13:5518. [PMID: 36127347 PMCID: PMC9489713 DOI: 10.1038/s41467-022-33254-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/09/2022] [Indexed: 11/09/2022] Open
Abstract
Continuous monitoring of intraocular pressure, particularly during sleep, remains a grand challenge in glaucoma care. Here we introduce a class of smart soft contact lenses, enabling the continuous 24-hour monitoring of intraocular pressure, even during sleep. Uniquely, the smart soft contact lenses are built upon various commercial brands of soft contact lenses without altering their intrinsic properties such as lens power, biocompatibility, softness, transparency, wettability, oxygen transmissibility, and overnight wearability. We show that the smart soft contact lenses can seamlessly fit across different corneal curvatures and thicknesses in human eyes and therefore accurately measure absolute intraocular pressure under ambulatory conditions. We perform a comprehensive set of in vivo evaluations in rabbit, dog, and human eyes from normal to hypertension to confirm the superior measurement accuracy, within-subject repeatability, and user comfort of the smart soft contact lenses beyond current wearable ocular tonometers. We envision that the smart soft contact lenses will be effective in glaucoma care.
Collapse
Affiliation(s)
- Jinyuan Zhang
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Kyunghun Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Ho Joong Kim
- Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN, USA
| | - Dawn Meyer
- School of Optometry, Indiana University, Bloomington, IN, USA
| | - Woohyun Park
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Seul Ah Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Yumin Dai
- School of Materials Engineering, Purdue University, West Lafayette, IN, USA
| | - Bongjoong Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.,Department of Mechanical and System Design Engineering, Hongik University, Seoul, 04066, Republic of Korea
| | - Haesoo Moon
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Jay V Shah
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Keely E Harris
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA
| | - Brett Collar
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Kangying Liu
- Department of Chemistry, Purdue University, West Lafayette, IN, USA
| | - Pedro Irazoqui
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Hyowon Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.,Center for Implantable Devices, Purdue University, West Lafayette, IN, USA.,Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA
| | - Shin Ae Park
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA.
| | - Pete S Kollbaum
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA. .,School of Optometry, Indiana University, Bloomington, IN, USA.
| | - Bryan W Boudouris
- Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN, USA. .,Department of Chemistry, Purdue University, West Lafayette, IN, USA. .,Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA.
| | - Chi Hwan Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA. .,School of Optometry, Indiana University, Bloomington, IN, USA. .,School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA. .,School of Materials Engineering, Purdue University, West Lafayette, IN, USA. .,Center for Implantable Devices, Purdue University, West Lafayette, IN, USA. .,Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA.
| |
Collapse
|
19
|
Mekonnen T, Lin X, Zevallos-Delgado C, Singh M, Aglyamov SR, Coulson-Thomas V, Larin KV. Longitudinal assessment of the effect of alkali burns on corneal biomechanical properties using optical coherence elastography. JOURNAL OF BIOPHOTONICS 2022; 15:e202200022. [PMID: 35460537 PMCID: PMC11057918 DOI: 10.1002/jbio.202200022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/29/2022] [Accepted: 04/22/2022] [Indexed: 06/14/2023]
Abstract
Eye injury due to alkali burn is a severe ocular trauma that can profoundly affect corneal structure and function, including its biomechanical properties. Here, we assess the changes in the mechanical behavior of mouse corneas in response to alkali-induced injury by conducting longitudinal measurements using optical coherence elastography (OCE). A non-contact air-coupled ultrasound transducer was used to induce elastic waves in control and alkali-injured mouse corneas in vivo, which were imaged with phase-sensitive optical coherence tomography. Corneal mechanical properties were estimated using a modified Rayleigh-Lamb wave model, and results show that Young's modulus of alkali-burned corneas were significantly greater than that of their healthy counterparts on days 7 (p = 0.029) and 14 (p = 0.026) after injury. These findings, together with the changes in the shear viscosity coefficient postburn, indicate that the mechanical properties of the alkali-burned cornea are significantly modulated during the wound healing process.
Collapse
Affiliation(s)
- Taye Mekonnen
- Department of Biomedical Engineering, University of Houston, 3517 Cullen Blvd., Room 2027, Houston, TX 77204, USA
| | - Xiao Lin
- College of Optometry, University of Houston, 4901 Calhoun Road, Houston, TX 77204‑2020, USA
| | - Christian Zevallos-Delgado
- Department of Biomedical Engineering, University of Houston, 3517 Cullen Blvd., Room 2027, Houston, TX 77204, USA
| | - Manmohan Singh
- Department of Biomedical Engineering, University of Houston, 3517 Cullen Blvd., Room 2027, Houston, TX 77204, USA
| | - Salavat R. Aglyamov
- Department of Mechanical Engineering, University of Houston, Houston, TX 77204, USA
| | - Vivien Coulson-Thomas
- College of Optometry, University of Houston, 4901 Calhoun Road, Houston, TX 77204‑2020, USA
| | - Kirill V. Larin
- Department of Biomedical Engineering, University of Houston, 3517 Cullen Blvd., Room 2027, Houston, TX 77204, USA
| |
Collapse
|
20
|
BMP3 inhibits TGFβ2-mediated myofibroblast differentiation during wound healing of the embryonic cornea. NPJ Regen Med 2022; 7:36. [PMID: 35879352 PMCID: PMC9314337 DOI: 10.1038/s41536-022-00232-9] [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: 12/02/2021] [Accepted: 07/06/2022] [Indexed: 11/29/2022] Open
Abstract
Often acute damage to the cornea initiates drastic tissue remodeling, resulting in fibrotic scarring that disrupts light transmission and precedes vision impairment. Very little is known about the factors that can mitigate fibrosis and promote scar-free cornea wound healing. We previously described transient myofibroblast differentiation during non-fibrotic repair in an embryonic cornea injury model. Here, we sought to elucidate the mechanistic regulation of myofibroblast differentiation during embryonic cornea wound healing. We found that alpha-smooth muscle actin (αSMA)-positive myofibroblasts are superficial and their presence inversely correlates with wound closure. Expression of TGFβ2 and nuclear localization of pSMAD2 were elevated during myofibroblast induction. BMP3 and BMP7 were localized in the corneal epithelium and corresponded with pSMAD1/5/8 activation and absence of myofibroblasts in the healing stroma. In vitro analyses with corneal fibroblasts revealed that BMP3 inhibits the persistence of TGFβ2-induced myofibroblasts by promoting disassembly of focal adhesions and αSMA fibers. This was confirmed by the expression of vinculin and pFAK. Together, these data highlight a mechanism to inhibit myofibroblast persistence during cornea wound repair.
Collapse
|
21
|
Iyer KS, Maruri DP, Peak KE, Schmidtke DW, Petroll WM, Varner VD. ECM stiffness modulates the proliferation but not the motility of primary corneal keratocytes in response to PDGF-BB. Exp Eye Res 2022; 220:109112. [PMID: 35595094 PMCID: PMC10163834 DOI: 10.1016/j.exer.2022.109112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/25/2022] [Accepted: 05/11/2022] [Indexed: 11/04/2022]
Abstract
During corneal wound healing, keratocytes present within the corneal stroma become activated into a repair phenotype upon the release of growth factors, such as transforming growth factor-beta 1 (TGF-β1) and platelet-derived growth factor-BB (PDGF-BB). The process of injury and repair can lead to changes in the mechanical properties of the tissue, and previous work has shown that the TGF-β1-mediated myofibroblast differentiation of corneal keratocytes depends on substratum stiffness. It is still unclear, however, if changes in stiffness can modulate keratocyte behavior in response to other growth factors, such as PDGF-BB. Here, we used a polyacrylamide (PA) gel system to determine whether changes in stiffness influence the proliferation and motility of primary corneal keratocytes treated with PDGF-BB. In the presence of PDGF-BB, cells on stiffer substrata exhibited a more elongated morphology and had higher rates of proliferation than cells in a more compliant microenvironment. Using a freeze-injury to assay cell motility, however, we did not observe any stiffness-dependent differences in the migration of keratocytes treated with PDGF-BB. Taken together, these data highlight the importance of biophysical cues during corneal wound healing and suggest that keratocytes respond differently to changes in ECM stiffness in the presence of different growth factors.
Collapse
Affiliation(s)
- Krithika S Iyer
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
| | - Daniel P Maruri
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
| | - Kara E Peak
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
| | - David W Schmidtke
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA; Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - W Matthew Petroll
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Victor D Varner
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA; Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
| |
Collapse
|
22
|
Aghamirsalim M, Mobaraki M, Soltani M, Kiani Shahvandi M, Jabbarvand M, Afzali E, Raahemifar K. 3D Printed Hydrogels for Ocular Wound Healing. Biomedicines 2022; 10:biomedicines10071562. [PMID: 35884865 PMCID: PMC9313212 DOI: 10.3390/biomedicines10071562] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 12/21/2022] Open
Abstract
Corneal disease is one of the most significant causes of blindness around the world. Presently, corneal transplantation is the only way to treat cornea blindness. It should be noted that the amount of cornea that people donate is so much less than that required (1:70). Therefore, scientists have tried to resolve this problem with tissue engineering and regenerative medicine. Fabricating cornea with traditional methods is difficult due to their unique properties, such as transparency and geometry. Bioprinting is a technology based on additive manufacturing that can use different biomaterials as bioink for tissue engineering, and the emergence of 3D bioprinting presents a clear possibility to overcome this problem. This new technology requires special materials for printing scaffolds with acceptable biocompatibility. Hydrogels have received significant attention in the past 50 years, and they have been distinguished from other materials because of their unique and outstanding properties. Therefore, hydrogels could be a good bioink for the bioprinting of different scaffolds for corneal tissue engineering. In this review, we discuss the use of different types of hydrogel for bioink for corneal tissue engineering and various methods that have been used for bioprinting. Furthermore, the properties of hydrogels and different types of hydrogels are described.
Collapse
Affiliation(s)
- Mohamadreza Aghamirsalim
- Translational Ophthalmology Research Center, Tehran University of Medical Science, Tehran 14176-14411, Iran; (M.A.); (M.J.)
| | - Mohammadmahdi Mobaraki
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran P.O. Box 15875-4413, Iran;
| | - Madjid Soltani
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran 19967-15433, Iran;
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- Advanced Bioengineering Initiative Center, Multidisciplinary International Complex, K. N. Toosi University of Technology, Tehran 14176-14411, Iran
- Centre for Biotechnology and Bioengineering (CBB), University of Waterloo, Waterloo, ON N2L 3G1, Canada
- Correspondence:
| | - Mohammad Kiani Shahvandi
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran 19967-15433, Iran;
| | - Mahmoud Jabbarvand
- Translational Ophthalmology Research Center, Tehran University of Medical Science, Tehran 14176-14411, Iran; (M.A.); (M.J.)
| | - Elham Afzali
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Science, Kerman 76169-13555, Iran;
| | - Kaamran Raahemifar
- Data Science and Artificial Intelligence Program, College of Information Sciences and Technology (IST), Penn State University, State College, PA 16801, USA;
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
- Faculty of Science, School of Optometry and Vision Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| |
Collapse
|
23
|
Maruri DP, Iyer KS, Schmidtke DW, Petroll WM, Varner VD. Signaling Downstream of Focal Adhesions Regulates Stiffness-Dependent Differences in the TGF- β1-Mediated Myofibroblast Differentiation of Corneal Keratocytes. Front Cell Dev Biol 2022; 10:886759. [PMID: 35693927 PMCID: PMC9177138 DOI: 10.3389/fcell.2022.886759] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/06/2022] [Indexed: 12/05/2022] Open
Abstract
Following injury and refractive surgery, corneal wound healing can initiate a protracted fibrotic response that interferes with ocular function. This fibrosis is related, in part, to the myofibroblast differentiation of corneal keratocytes in response to transforming growth factor beta 1 (TGF-β1). Previous studies have shown that changes in the mechanical properties of the extracellular matrix (ECM) can regulate this process, but the mechanotransductive pathways that govern stiffness-dependent changes in keratocyte differentiation remain unclear. Here, we used a polyacrylamide (PA) gel system to investigate how mechanosensing via focal adhesions (FAs) regulates the stiffness-dependent myofibroblast differentiation of primary corneal keratocytes treated with TGF-β1. Soft (1 kPa) and stiff (10 kPa) PA substrata were fabricated on glass coverslips, plated with corneal keratocytes, and cultured in defined serum free media with or without exogenous TGF-β1. In some experiments, an inhibitor of focal adhesion kinase (FAK) activation was also added to the media. Cells were fixed and stained for F-actin, as well as markers for myofibroblast differentiation (α-SMA), actomyosin contractility phosphorylated myosin light chain (pMLC), focal adhesions (vinculin), or Smad activity (pSmad3). We also used traction force microscopy (TFM) to quantify cellular traction stresses. Treatment with TGF-β1 elicited stiffness-dependent differences in the number, size, and subcellular distribution of FAs, but not in the nuclear localization of pSmad3. On stiff substrata, cells exhibited large FAs distributed throughout the entire cell body, while on soft gels, the FAs were smaller, fewer in number, and localized primarily to the distal tips of thin cellular extensions. Larger and increased numbers of FAs correlated with elevated traction stresses, increased levels of α-SMA immunofluorescence, and more prominent and broadly distributed pMLC staining. Inhibition of FAK disrupted stiffness-dependent differences in keratocyte contractility, FA patterning, and myofibroblast differentiation in the presence of TGF-β1. Taken together, these data suggest that signaling downstream of FAs has important implications for the stiffness-dependent myofibroblast differentiation of corneal keratocytes.
Collapse
Affiliation(s)
- Daniel P. Maruri
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States
| | - Krithika S. Iyer
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States
| | - David W. Schmidtke
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States,Department of Surgery, UT Southwestern Medical Center, Dallas, TX, United States
| | - W. Matthew Petroll
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, United States
| | - Victor D. Varner
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States,Department of Surgery, UT Southwestern Medical Center, Dallas, TX, United States,*Correspondence: Victor D. Varner,
| |
Collapse
|
24
|
Extracellular Vesicles in Corneal Fibrosis/Scarring. Int J Mol Sci 2022; 23:ijms23115921. [PMID: 35682600 PMCID: PMC9180085 DOI: 10.3390/ijms23115921] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Communication between cells and the microenvironment is a complex, yet crucial, element in the development and progression of varied physiological and pathological processes. Accumulating evidence in different disease models highlights roles of extracellular vesicles (EVs), either in modulating cell signaling paracrine mechanism(s) or harnessing their therapeutic moiety. Of interest, the human cornea functions as a refractive and transparent barrier that protects the intraocular elements from the external environment. Corneal trauma at the ocular surface may lead to diminished corneal clarity and detrimental effects on visual acuity. The aberrant activation of corneal stromal cells, which leads to myofibroblast differentiation and a disorganized extracellular matrix is a central biological process that may result in corneal fibrosis/scarring. In recent years, understanding the pathological and therapeutic EV mechanism(s) of action in the context of corneal biology has been a topic of increasing interest. In this review, we describe the clinical relevance of corneal fibrosis/scarring and how corneal stromal cells contribute to wound repair and their generation of the stromal haze. Furthermore, we will delve into EV characterization, their subtypes, and the pathological and therapeutic roles they play in corneal scarring/fibrosis.
Collapse
|
25
|
Laser In Situ Keratomileusis (LASIK) Combined with Prophylactic Corneal Cross-Linking for Correction of Myopia: Regional Analysis of Corneal Morphology. Ophthalmol Ther 2022; 11:1423-1439. [PMID: 35532880 PMCID: PMC9253232 DOI: 10.1007/s40123-022-00510-1] [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: 01/30/2022] [Accepted: 04/07/2022] [Indexed: 11/03/2022] Open
Abstract
Introduction Methods Results Conclusions
Collapse
|
26
|
Xin Y, Lopes BT, Wang J, Wu J, Zhu M, Jiang M, Miao Y, Lin H, Cao S, Zheng X, Eliasy A, Chen S, Wang Q, Ye Y, Bao F, Elsheikh A. Biomechanical Effects of tPRK, FS-LASIK, and SMILE on the Cornea. Front Bioeng Biotechnol 2022; 10:834270. [PMID: 35433653 PMCID: PMC9009506 DOI: 10.3389/fbioe.2022.834270] [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: 12/13/2021] [Accepted: 02/15/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose: The objective of this study is to evaluate the in vivo corneal biomechanical response to three laser refractive surgeries. Methods: Two hundred and twenty-seven patients who submitted to transepithelial photorefractive keratectomy (tPRK), femtosecond laser-assisted in-situ keratomileusis (FS-LASIK), or small-incision lenticule extraction (SMILE) were included in this study. All cases were examined with the Corvis ST preoperatively (up to 3 months) and postoperatively at 1, 3, and 6 months, and the differences in the main device parameters were assessed. The three groups were matched in age, gender ratio, corneal thickness, refractive error corrections, optical zone diameter, and intraocular pressure. They were also matched in the preoperative biomechanical metrics provided by the Corvis ST including stiffness parameter at first applanation (SP-A1), integrated inverse radius (IIR), deformation amplitude (DA), and deformation amplitude 2 mm away from apex and the apical deformation (DARatio2mm). Results: The results demonstrated a significant decrease post-operation in SP-A1 and significant increases in IIR, DA, and DARatio2mm (p < 0.05), all of which indicated reductions in overall corneal stiffness. Inter-procedure comparisons provided evidence that the smallest overall stiffness reduction was in the tPRK group, followed by the SMILE, and then the FS-LASIK group (p < 0.05). These results remained valid after correction for the change in CCT between pre and 6 months post-operation and for the percentage tissue altered. In all three surgery groups, higher degrees of refractive correction resulted in larger overall stiffness losses based on most of the biomechanical metrics. Conclusion: The corneal biomechanical response to the three surgery procedures varied significantly. With similar corneal thickness loss, the reductions in overall corneal stiffness were the highest in FS-LASIK and the lowest in tPRK.
Collapse
Affiliation(s)
- Yue Xin
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Bernardo T. Lopes
- School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - JunJie Wang
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
- The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - Jie Wu
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - ManMan Zhu
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - MuChen Jiang
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - YuanYuan Miao
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - HuiNi Lin
- STU-CUHKJoint Shantou International Eye Center, Shantou, China
| | - Si Cao
- Wuhan Puren Hospital, Wuhan, China
| | - XiaoBo Zheng
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
- The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - Ashkan Eliasy
- School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - ShiHao Chen
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
- The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
- *Correspondence: ShiHao Chen, ; YuFeng Ye, ; FangJun Bao,
| | - QinMei Wang
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
- The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - YuFeng Ye
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
- *Correspondence: ShiHao Chen, ; YuFeng Ye, ; FangJun Bao,
| | - FangJun Bao
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
- The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
- *Correspondence: ShiHao Chen, ; YuFeng Ye, ; FangJun Bao,
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| |
Collapse
|
27
|
Liu Y, Liu Y, Wu M, Zou R, Mao S, Cong P, Hou M, Jin H, Zhao Y, Bao Y. Adipose-derived mesenchymal stem cell-loaded β-chitin nanofiber hydrogel promote wound healing in rats. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:12. [PMID: 35050422 PMCID: PMC8776676 DOI: 10.1007/s10856-021-06630-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 11/28/2021] [Indexed: 05/14/2023]
Abstract
Because of stem cells are limited by the low efficiency of their cell homing and survival in vivo, cell delivery systems and scaffolds have attracted a great deal of attention for stem cells' successful clinical practice. β-chitin nanofibers (β-ChNF) were prepared from squid pens in this study. Fourier transform infrared spectroscopy, X-ray diffraction and scanning electron microscopy proved that β-ChNFs with the diameter of 5 to 10 nm were prepared. β-ChNF dispersion became gelled upon the addition of cell culture medium. Cell culture experiments showed that β-ChNFs exhibited negligible cytotoxicity towards ADSCs and L929 cells, and it was found that more exosomes were secreted by the globular ADSCs grown in the β-ChNF hydrogel. The vivo experiments of rats showed that the ADSCs-loaded β-ChNF hydrogel could directly cover the wound surface and significantly accelerate the wound healing and promote the generation of epithelization, granulation tissue and collagen. In addition, the ADSCs-loaded β-ChNF hydrogel clearly regulated the expressions of VEGFR, α-SMA, collagen I and collagen III. Finally, we showed that ADSCs-loaded β-ChNF hydrogel activated the TGFβ/smad signaling. The neutralization of TGFβ markedly reduced Smad phosphorylation and the expressions of TIMP1, VEGFR and α-SMA. Taken together, these findings suggest that ADSCs-loaded β-ChNF hydrogel promises for treating wounds that are challenge to heal via conventional methods. Graphical abstract.
Collapse
Affiliation(s)
- Ying Liu
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, 130117, China
- Emergency Medicine Department of General Hospital of Northern Theater Command, Laboratory of Rescue Center of Severe Wound and Trauma PLA, Shenyang, 110016, China
| | - Yunen Liu
- Emergency Medicine Department of General Hospital of Northern Theater Command, Laboratory of Rescue Center of Severe Wound and Trauma PLA, Shenyang, 110016, China
| | - Mi Wu
- Jihua Laboratory, Foshan, 528200, China
| | - Rufei Zou
- Jihua Laboratory, Foshan, 528200, China
| | - Shun Mao
- Emergency Medicine Department of General Hospital of Northern Theater Command, Laboratory of Rescue Center of Severe Wound and Trauma PLA, Shenyang, 110016, China
| | - Peifang Cong
- Emergency Medicine Department of General Hospital of Northern Theater Command, Laboratory of Rescue Center of Severe Wound and Trauma PLA, Shenyang, 110016, China
| | - Mingxiao Hou
- Emergency Medicine Department of General Hospital of Northern Theater Command, Laboratory of Rescue Center of Severe Wound and Trauma PLA, Shenyang, 110016, China
| | - Hongxu Jin
- Emergency Medicine Department of General Hospital of Northern Theater Command, Laboratory of Rescue Center of Severe Wound and Trauma PLA, Shenyang, 110016, China.
| | - Yan Zhao
- Jihua Laboratory, Foshan, 528200, China.
| | - Yongli Bao
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, 130117, China.
| |
Collapse
|
28
|
Bao F, Chen W, Zheng X, Miao Y, Zhu M, Akiti S, Li Y, Weng Z, Wang J, Zhang P, Chen S, Elsheikh A. Changes in Corneal Biomechanical Properties in PRK Followed by Two Accelerated CXL Energy Doses in Rabbit Eyes. J Refract Surg 2021; 37:853-860. [PMID: 34914559 DOI: 10.3928/1081597x-20210830-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether photorefractive keratectomy (PRK) combined with the two commonly delivered energy doses in accelerated corneal cross-linking (A-CXL) could help the cornea maintain its preoperative stiffness level. METHODS A total of 72 corneas of 36 healthy white Japanese rabbits were randomly divided into four equal groups. The groups included an untreated control group and three that had undergone PRK. After tissue ablation, one of the latter three groups (PRK group) was left untreated, whereas the other two were exposed to riboflavin (0.22% concentration by volume) and ultraviolet-A (370 nm) with the same irradiation (30 mW/cm2) but different CXL energy doses of 1.8 J/cm2 (PXL group) and 2.7 J/cm2 (PXH group). Dynamic Scheimpflug analyzer (Corvis ST; Oculus Optikgeräte GmbH) measurements of stiffness parameter at first applanation (SP-A1), Stress-Strain Index (SSI), and other dynamic corneal response parameters were taken 3 days preoperatively and 1 month postoperatively. Subsequently, ex vivo inflation testing was performed and the tangent modulus of each specimen was estimated using an inverse analysis process. RESULTS In comparison to the control group, the tangent modulus at a stress of 10 kPa decreased by 8.9% in the PRK group and increased by 10.6% and 22.4% in the PXL and PXH groups, respectively. SP-A1 decreased postoperatively in the PRK group (P < .05), indicating an overall stiffness reduction of -7.4, -3.5, and -5.3 mm Hg/mm in PRK, PXL, and PXH groups, respectively. The material stiffness parameter SSI remained almost unchanged in the PRK group (P = .989), increased slightly in the PXL group (8.3%, P = .077), and increased significantly in the PXH group (11.1%) (P < .05). CONCLUSIONS Biomechanical deterioration following PRK was significant and could not be fully compensated for by ACXL with either 1.8 or 2.7 J/cm2 doses. The increased value of corneal overall stiffness was higher in A-CXL with 2.7 J/cm2 energy than with 1.8 J/cm2 energy. [J Refract Surg. 2021;37(12):853-860.].
Collapse
|
29
|
Understanding Drivers of Ocular Fibrosis: Current and Future Therapeutic Perspectives. Int J Mol Sci 2021; 22:ijms222111748. [PMID: 34769176 PMCID: PMC8584003 DOI: 10.3390/ijms222111748] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 01/10/2023] Open
Abstract
Ocular fibrosis leads to severe visual impairment and blindness worldwide, being a major area of unmet need in ophthalmology and medicine. To date, the only available treatments are antimetabolite drugs that have significant potentially blinding side effects, such as tissue damage and infection. There is thus an urgent need to identify novel targets to prevent/treat scarring and postsurgical fibrosis in the eye. In this review, the latest progress in biological mechanisms underlying ocular fibrosis are discussed. We also summarize the current knowledge on preclinical studies based on viral and non-viral gene therapy, as well as chemical inhibitors, for targeting TGFβ or downstream effectors in fibrotic disorders of the eye. Moreover, the role of angiogenetic and biomechanical factors in ocular fibrosis is discussed, focusing on related preclinical treatment approaches. Moreover, we describe available evidence on clinical studies investigating the use of therapies targeting TGFβ-dependent pathways, angiogenetic factors, and biomechanical factors, alone or in combination with other strategies, in ocular tissue fibrosis. Finally, the recent progress in cell-based therapies for treating fibrotic eye disorders is discussed. The increasing knowledge of these disorders in the eye and the promising results from testing of novel targeted therapies could offer viable perspectives for translation into clinical use.
Collapse
|
30
|
Fukuto A, Kim S, Kang J, Gates BL, Chang MW, Pinkerton KE, Van Winkle LS, Kiuchi Y, Murphy CJ, Leonard BC, Thomasy SM. Metal Oxide Engineered Nanomaterials Modulate Rabbit Corneal Fibroblast to Myofibroblast Transformation. Transl Vis Sci Technol 2021; 10:23. [PMID: 34661622 PMCID: PMC8525860 DOI: 10.1167/tvst.10.12.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Corneal keratocyte-fibroblast-myofibroblast (KFM) transformation plays a critical role in corneal stromal wound healing. However, the impact of engineered nanomaterials (ENMs), found in an increasing number of commercial products, on this process is poorly studied. This study investigates the effects of metal oxide ENMs on KFM transformation in vitro and in vivo. Methods Cell viability of rabbit corneal fibroblasts (RCFs) was tested following treatment with 11 metal oxide ENMs at concentrations of 0.5 to 250 µg/ml for 24 hours. Messenger RNA (mRNA) and protein expression of αSMA, a marker of myofibroblast transformation, were measured using RCFs after exposure to 11 metal oxide ENMs at a concentration that did not affect cell viability, in media containing either 0 or 10 ng/ml of TGF-β1. Additionally, the effect of topical Fe2O3 nanoparticles (NPs) (50 ng/ml) on corneal stromal wound healing following phototherapeutic keratectomy (PTK) was determined. Results V2O5, Fe2O3, CuO, and ZnO ENMs were found to significantly reduce cell viability as compared to vehicle control and the other seven metal oxide ENMs tested. V2O5 nanoflakes significantly reduced mRNA and protein αSMA concentrations in the presence of TGF-β1. Fe2O3 NPs significantly increased αSMA mRNA expression in the presence of TGF-β1 but did not alter αSMA protein expression. Topically applied Fe2O3 NPs in an in vivo rabbit corneal stromal wound healing model did not delay healing. Conclusions Fe2O3 NPs promote corneal myofibroblast induction in vitro but do not impair corneal stromal wound healing in vivo. Translational Relevance These experimental results can apply to human nanomedical research.
Collapse
Affiliation(s)
- Atsuhiko Fukuto
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.,Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Soohyun Kim
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Jennifer Kang
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Brooke L Gates
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Maggie W Chang
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Kent E Pinkerton
- Center for Health and the Environment, University of California-Davis, Davis, CA, USA.,Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Laura S Van Winkle
- Center for Health and the Environment, University of California-Davis, Davis, CA, USA.,Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Christopher J Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.,Department of Ophthalmology & Vision Science, School of Medicine, University of California-Davis, Davis, CA, USA
| | - Brian C Leonard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.,Department of Ophthalmology & Vision Science, School of Medicine, University of California-Davis, Davis, CA, USA
| |
Collapse
|
31
|
Kim S, Gates BL, Chang M, Pinkerton KE, Van Winkle L, Murphy CJ, Leonard BC, Demokritou P, Thomasy SM. Transcorneal delivery of topically applied silver nanoparticles does not delay epithelial wound healing. NANOIMPACT 2021; 24:100352. [PMID: 35559825 DOI: 10.1016/j.impact.2021.100352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 06/15/2023]
Abstract
Silver nanoparticles (AgNPs) are a common antimicrobial additive for a variety of applications, including wound care. However, AgNPs often undergo dissolution resulting in release of silver ions, with subsequent toxicity to mammalian cells. The cornea is a primary exposure site to topically administered AgNPs in and around the eye but their impact on corneal wound healing is understudied. Thus, the purpose of this study was to determine in vitro toxicity of AgNPs on corneal epithelial cells and fibroblasts as well as their effects on corneal epithelial wound healing utilizing an in vivo rabbit model. Non-coated 20 nm sized AgNP (AgNP-20) as well as 1% and 10% silver silica NPs (AgSiO2NPs) were tested at concentrations ranging from 0.05-250 μg/mL. Immortalized human corneal epithelial (hTCEpi) cells and primary rabbit corneal fibroblasts (RCFs) were incubated for 24 h with AgNPs and cell viability was tested. Additionally, a round wound healing assay was performed to determine hTCEpi cell migration. Quantitative real-time PCR and western blot analysis was performed to determine α-smooth muscle actin (α-SMA, a myofibroblast marker) mRNA and protein expression, respectively, in RCFs treated with 50 μg/mL of AgNPs. Corneal epithelial wound healing was evaluated with 1%-AgSiO2NPs (10 and 250 μg/mL) using an in vivo rabbit model. Rabbits were subsequently euthanized, and histologic sections of the enucleated globes were used to determine corneal penetration of 1%-AgSiO2NPs with autometallography and hyperspectral darkfield microscopy. Cell viability of both the hTCEpi cells and fibroblasts was significantly decreased by the three AgNPs in a dose dependent manner. Migration of hTCEpi cells was significantly inhibited by the three AgNPs. Alpha-SMA mRNA expression was significantly inhibited with three AgNPs, but only the 1%-AgSiO2NPs inhibited protein expression of α-SMA. In vivo epithelial wound closure did not significantly differ between groups treated with 10 or 250 μg/mL of 1%-AgSiO2NPs or vehicle control. The 1%-AgSiO2NPs penetrated throughout all corneal layers and into the anterior chamber in all treated eyes with no histopathological changes observed. In conclusion, the 1%-AgSiO2NPs are safe and have potential therapeutic applications through its efficacy of the corneal penetration and reduced scar formation during corneal wound healing.
Collapse
Affiliation(s)
- Soohyun Kim
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA
| | - Brooke L Gates
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA
| | - Maggie Chang
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA
| | - Kent E Pinkerton
- Center for Health and the Environment, University of California, Davis, CA 95616, USA
| | - Laura Van Winkle
- Center for Health and the Environment, University of California, Davis, CA 95616, USA; Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Christopher J Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA; Department of Ophthalmology and Vision Science, School of Medicine, University of California, Davis, CA 95616, USA
| | - Brian C Leonard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA
| | - Philip Demokritou
- Center for Nanotechnology and Nanotoxicology, HSPH-NIEHS Nanosafety Center, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington, Boston, MA 02115, USA
| | - Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA; Department of Ophthalmology and Vision Science, School of Medicine, University of California, Davis, CA 95616, USA.
| |
Collapse
|
32
|
Li S, Ding C, Guo Y, Zhang Y, Wang H, Sun X, Zhang J, Cui Z, Chen J. Mechanotransduction Regulates Reprogramming Enhancement in Adherent 3D Keratocyte Cultures. Front Bioeng Biotechnol 2021; 9:709488. [PMID: 34568299 PMCID: PMC8460903 DOI: 10.3389/fbioe.2021.709488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/27/2021] [Indexed: 11/18/2022] Open
Abstract
Suspended spheroid culture using ultralow attachment plates (ULAPs) is reported to effect corneal fibroblast reprogramming. Polydimethylsiloxane (PDMS), with hydrophobic and soft substrate properties, facilitates adherent spheroid formation that promotes cellular physical reprogramming into stem-like cells without using transcription factors. However, it is still unknown whether the biophysical properties of PDMS have the same effect on adult human corneal keratocyte reprogramming. Here, PDMS and essential 8 (E8) medium were utilized to culture keratocyte spheroids and fibroblast spheroids, and the reprogramming results were compared. We provide insights into the probable mechanisms of the PDMS effect on spheroids. qPCR analysis showed that the expression of some stem cell marker genes (OCT4, NANOG, SOX2, KLF4, CMYC, ABCG2 and PAX6) was significantly greater in keratocyte spheroids than in fibroblast spheroids. The endogenous level of stemness transcription factors (OCT4, NANOG, SOX2, KLF4 and CMYC) was higher in keratocytes than in fibroblasts. Immunofluorescence staining revealed Klf4, Nanog, Sox2, ABCG2 and Pax6 were positively stained in adherent 3D spheroids but weakly or negatively stained in adherent 2D cells. Furthermore, OCT4, NANOG, SOX2, KLF4, HNK1, ABCG2 and PAX6 gene expression was significantly higher in adherent 3D spheroids than in adherent 2D cells. Meanwhile, SOX2, ABCG2 and PAX6 were more upregulated in adherent 3D spheroids than in suspended 3D spheroids. The RNA-seq analysis suggested that regulation of the actin cytoskeleton, TGFβ/BMP and HIF-1 signaling pathways induced changes in mechanotransduction, the mesenchymal-to-epithelial transition and hypoxia, which might be responsible for the effect of PDMS on facilitating reprogramming. In conclusion, compared to corneal fibroblasts, keratocytes were more susceptible to reprogramming due to higher levels of endogenous stemness transcription factors. Spheroid culture of keratocytes using PDMS had a positive impact on promoting the expression of some stem cell markers. PDMS, as a substrate to form spheroids, was better able to promote reprogramming than ULAPs. These results indicated that the physiological cells and culture conditions herein enhance reprogramming. Therefore, adherent spheroid culture of keratocytes using PDMS is a promising strategy to more safely promote reprogramming, suggesting its potential application for developing clinical implants in tissue engineering and regenerative medicine.
Collapse
Affiliation(s)
- Shenyang Li
- Aier School of Ophthalmology, Central South University, Changsha, China
| | | | - Yonglong Guo
- Key Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, China
| | - Yanan Zhang
- Key Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, China
| | - Hao Wang
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Xihao Sun
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Jun Zhang
- Key Laboratory of Optoelectronic Information and Sensing Technologies of Guangdong Higher Educational Institutes, Jinan University, Guangzhou, China
| | - Zekai Cui
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier Eye Institute, Changsha, China
| | - Jiansu Chen
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier Eye Institute, Changsha, China.,Key Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, China
| |
Collapse
|
33
|
Khosravimelal S, Mobaraki M, Eftekhari S, Ahearne M, Seifalian AM, Gholipourmalekabadi M. Hydrogels as Emerging Materials for Cornea Wound Healing. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2006335. [PMID: 33887108 DOI: 10.1002/smll.202006335] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/15/2020] [Indexed: 06/12/2023]
Abstract
Hydrogel biomaterials have many favorable characteristics including tuneable mechanical behavior, cytocompatibility, optical properties suitable for regeneration and restoration of the damaged cornea tissue. The cornea is a tissue susceptible to various injuries and traumas with a complicated healing cascade, in which conserving its transparency and integrity is critical. Accordingly, the hydrogels' known properties along with the stimulation of nerve and cell regeneration make them ideal scaffold for corneal tissue engineering. Hydrogels have been used extensively in clinical applications for the repair and replacement of diseased organs. The development and optimizing of novel hydrogels to repair/replace corneal injuries have been the main focus of researches within the last decade. This research aims to critically review in vitro, preclinical, as well as clinical trial studies related to corneal wound healing using hydrogels in the past 10 years, as this is considered as an emerging technology for corneal treatment. Several unique modifications of hydrogels with smart behaviors have undergone early phase clinical trials and showed promising outcomes. Financially, this considers a multibillion dollars industry and with huge interest from medical devices as well as pharmaceutical industries with several products may emerge within the next five years.
Collapse
Affiliation(s)
- Sadjad Khosravimelal
- Department of Medical Biotechnology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, 1449614535, Iran
- Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran
| | - Mohammadmahdi Mobaraki
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, 1591634311, Iran
| | - Samane Eftekhari
- Department of Medical Biotechnology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, 1449614535, Iran
| | - Mark Ahearne
- Trinity Centre for Biomedical Engineering, School of Engineering, Trinity College Dublin, University of Dublin, Dublin, D02 R590, Republic of Ireland
| | - Alexander Marcus Seifalian
- Nanotechnology & Regenerative Medicine Commercialization Centre (NanoRegMed Ltd), London BioScience Innovation Centre, London, NW1 0NH, UK
| | - Mazaher Gholipourmalekabadi
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, 1449614535, Iran
- Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran
| |
Collapse
|
34
|
Domínguez-López A, Magaña-Guerrero FS, Buentello-Volante B, Bautista-Hernández LA, Reyes-Grajeda JP, Bautista-de Lucio VM, Garfias Y. Amniotic membrane conditioned medium (AMCM) reduces inflammatory response on human limbal myofibroblast, and the potential role of lumican. Mol Vis 2021; 27:370-383. [PMID: 34447239 PMCID: PMC8370574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/13/2021] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Viral infections such as herpetic keratitis (HSK) activate the innate immune response in the cornea triggering opacity and loss of vision. This condition is performed mainly by myofibroblasts that exacerbate secretion of inflammatory cytokines. Amniotic membrane transplantation (AMT) reduces ocular opacity and scarring inhibiting secretion of inflammatory cytokines and proliferation of myofibroblasts. We previously reported that the amniotic membrane (AM) favors an anti-inflammatory microenvironment inhibiting the secretion of inflammatory cytokines, expression of innate immune receptors, and translocation of nuclear NF-κB on human limbal myofibroblasts (HLMs). The aim of the present study was to determine whether the soluble factors of the AM decrease the immune response of HLMs stimulated with polyinosinic-polycytidylic acid sodium salt (poly I:C). METHODS The AM was incubated in Dulbecco's modified eagle medium (DMEM)/F12, and the supernatant was collected to obtain amniotic membrane conditioned medium (AMCM). HLMs were isolated from cadaveric sclera-corneal rims. HLMs were cultured in DMEM/F12 or AMCM and stimulated or not with poly I:C (10 µg/ml) for 12 h to analyze synthesis of CCL2, CCL5, CXCL10, MDA5, RIG-1, and TLR3 or for 2 h to analyze translocation of nuclear NF-kB, IRF3, and IRF7. The proteins contained on AMCM were analyzed by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and the acquired peptide ions were analyzed with the Mascot program using both National Center for Biotechnology Information (NCBI) and expressed sequence tag (EST) databases. RESULTS AMCM downregulated the mRNA levels of CCL2, CCL5, CXCL10, MDA5, RIG-1, and TLR3. In addition, AMCM decreased secretion of CCL2, CCL5, and CXCL10 and translocation of nuclear NF-κB. Interestingly, AMCM increased translocation of nuclear IRF3 and synthesis and secretion of type I IFN-β. We also identified small leucine-rich proteoglycan lumican in the AMCM. The administration of rh-lumican to poly I:C-stimulated HLMs reduced the mRNA levels of CCL2, CCL5, and CXCL10. CONCLUSIONS These results suggest that the AM can trigger an anti-inflammatory response on HLMs through soluble factors, and that lumican could play an important role in these effects.
Collapse
Affiliation(s)
- Alfredo Domínguez-López
- Research Unit, Institute of Ophthalmology Conde de Valenciana Foundation, Mexico City, Mexico,Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | | | | | | | | | - Yonathan Garfias
- Research Unit, Institute of Ophthalmology Conde de Valenciana Foundation, Mexico City, Mexico,Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
| |
Collapse
|
35
|
Yang Y, Wu Y, Zhou K, Wu D, Yao X, Heng BC, Zhou J, Liu H, Ouyang H. Interplay of Forces and the Immune Response for Functional Tendon Regeneration. Front Cell Dev Biol 2021; 9:657621. [PMID: 34150755 PMCID: PMC8213345 DOI: 10.3389/fcell.2021.657621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/26/2021] [Indexed: 01/11/2023] Open
Abstract
Tendon injury commonly occurs during sports activity, which may cause interruption or rapid decline in athletic career. Tensile strength, as one aspect of tendon biomechanical properties, is the main parameter of tendon function. Tendon injury will induce an immune response and cause the loss of tensile strength. Regulation of mechanical forces during tendon healing also changes immune response to improve regeneration. Here, the effects of internal/external forces and immune response on tendon regeneration are reviewed. The interaction between immune response and internal/external forces during tendon regeneration is critically examined and compared, in relation to other tissues. In conclusion, it is essential to maintain a fine balance between internal/external forces and immune response, to optimize tendon functional regeneration.
Collapse
Affiliation(s)
- Yuwei Yang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yicong Wu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Ke Zhou
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Dongmei Wu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xudong Yao
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Boon Chin Heng
- Central Laboratories, School of Stomatology, Peking University, Beijing, China
| | - Jing Zhou
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Hua Liu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Hongwei Ouyang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, China
| |
Collapse
|
36
|
Yemanyi F, Baidouri H, Burns AR, Raghunathan V. Dexamethasone and Glucocorticoid-Induced Matrix Temporally Modulate Key Integrins, Caveolins, Contractility, and Stiffness in Human Trabecular Meshwork Cells. Invest Ophthalmol Vis Sci 2021; 61:16. [PMID: 33170205 PMCID: PMC7686803 DOI: 10.1167/iovs.61.13.16] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose To determine the temporal effects of dexamethasone (DEX) and glucocorticoid-induced matrix (GIM) on integrins/integrin adhesomes, caveolins, cytoskeletal-related proteins, and stiffness in human trabecular meshwork (hTM) cells. Methods Primary hTM cells were plated on plastic dishes (TCP), treated with vehicle (Veh) or 100 nM DEX in 1% serum media for 1, 3, 5, and 7 day(s). Concurrently, hTM cells were also plated on vehicle control matrices (VehMs) and GIMs for similar time points; VehMs and GIMs had been generated from chronic cultures of Veh-/DEX-stimulated hTM cells and characterized biochemically. Subsets of cells prior to plating on TCP or VehMs / GIMs served as baseline. Protein expression of mechanoreceptors, cytoskeletal-related proteins, and elastic moduli of hTM cells were determined. Results Compared with Veh, DEX temporally overexpressed αV, β3, and β5 integrins from day 3 to day 7, and integrin linked kinase at day 7, in hTM cells. However, DEX decreased β1 integrin at day 1 and day 7, while increasing Cavin1 at day 7, in a time-independent manner. Further, DEX temporally upregulated α-smooth muscle actin(α-SMA) and RhoA at day 7 and day 5, respectively; while temporally downregulating Cdc42 at day 3 and day 7 in hTM cells. Conversely, GIM showed increased immunostaining of fibronectin extra-domain A and B isoforms. Compared with VehM, GIM temporally increased αV integrin, Cavin1, and RhoA from day 3 to day 7, at day 3 and day 7, and at day 5, respectively, in hTM cells. Further, GIM overexpressed α-SMA at day 3 and day 7, and stiffened hTM cells from day 1 to day 7, in a time-independent fashion. Conclusions Our data highlight crucial mechanoreceptors, integrin adhesomes, and actin-related proteins that may temporally sustain fibrotic phenotypes precipitated by DEX and/or GIM in hTM cells.
Collapse
Affiliation(s)
- Felix Yemanyi
- Department of Basic Sciences, University of Houston College of Optometry, Houston, Texas, United States
| | - Hasna Baidouri
- Department of Basic Sciences, University of Houston College of Optometry, Houston, Texas, United States
| | - Alan R Burns
- Department of Basic Sciences, University of Houston College of Optometry, Houston, Texas, United States
| | - VijayKrishna Raghunathan
- Department of Basic Sciences, University of Houston College of Optometry, Houston, Texas, United States.,Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, Texas, United States
| |
Collapse
|
37
|
Feldt J, Welss J, Schneider U, Paulsen F. Gold-based blood serum treatment promotes wound closure of corneal epithelial cell defects in primary in vitro experiments. Ann Anat 2021; 237:151745. [PMID: 33905809 DOI: 10.1016/j.aanat.2021.151745] [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: 03/24/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Wound healing disorders characterised by impaired or delayed reepithelialisation are a serious medical problem. In the present study, we show that gold-based blood serum therapy is a suitable therapeutic approach and shows a supportive effect in wound closure of human corneal epithelial cells (HCE) in primary in vitro experiments. METHODS For this purpose, blood from healthy individuals was incubated without (S.Ctrl) or with gold-microparticles (S.Therapy) for 24 h. Prior to human epithelial cell stimulation (HCE), the gold particles were removed and the serum was diluted in DMEM (10 % or 30 %). Both groups of serum were compared after injury. HCE were cultured and injured (corneal in vitro wound model) and then stimulated with S.Ctrl or S. THERAPY RESULTS Treatment with serum from a gold-based serum therapy (S.Therapy) shows a supportive effect on wound healing in HCE cells in vitro. In addition, gold therapy supports the secretion of important cytokines normally associated with ocular surface wound healing (IL-1β, IL-6, TNF-α and TGF-β) in HCE cells. CONCLUSIONS Therapy with gold-based blood serum significantly promotes the secretion and expression of cytokines and growth factors in HCE cells in vitro. Further preclinical experiments are necessary to demonstrate the influence of this therapy on HCE cells for possible clinical application on the human ocular surface and to prove its function also in poorly healing corneal lesions.
Collapse
Affiliation(s)
- Jessica Feldt
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany.
| | - Jessica Welss
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | | | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany; Sechenov University, Department of Operative Surgery and Topographic Anatomy, Moscow, Russia
| |
Collapse
|
38
|
Abstract
Numerous individuals suffer from impaired wound healing, such as chronic ulcers, severe burns and immune disorders, resulting in both public health and economic burdens. Skin is the first line of defense and the largest organ of the human body, however, an incomplete understanding of underlying cellular and molecular mechanisms of dermal repair leads to a lack of effective therapy for healing impaired wounds. There are strong clinical and social needs for improved therapeutic approaches to enhance endogenous tissue repair and regenerative capacity. The purpose of this review is to illuminate the cellular and molecular aspects of the healing process and highlight potential therapeutic strategies to accelerate translational research and the development of clinical therapies in dermal wounds.
Collapse
Affiliation(s)
- Fan Yang
- Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiangjun Bai
- Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiaojing Dai
- MD Anderson Cancer Center, The Advanced Technology Genomics Core, Houston, TX 77030, USA
| | - Yong Li
- Department of Orthopedic Surgery & Biomedical Engineering, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| |
Collapse
|
39
|
Chen F, Buickians D, Le P, Xia X, Montague-Alamin SQ, Blanco Varela IB, Mundy DC, Logan CM, Myung D. 3D Printable, Modified Trephine Designs for Consistent Anterior Lamellar Keratectomy Wounds in Rabbits. Curr Eye Res 2021; 46:1105-1114. [PMID: 33474996 DOI: 10.1080/02713683.2020.1868010] [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: 10/22/2022]
Abstract
PURPOSE Our goal is to develop a low-cost tool that can be used to create consistent, partial-thickness defects in rabbit and other large animals with minimal surgical training and that can facilitate pre-clinical testing of lamellar and in situ-forming biosynthetic matrix materials for corneal repair. MATERIALS & METHODS In this study, three modified trephines were designed to create deep corneal wound defects with consistent depth in large animals. The modified trephines incorporated either 3D-printed parts made from photopolymerizable resins, or custom-cut commercially available Teflon sheets. Wound defects were imaged with optical coherence tomography (OCT), and the depth was analyzed based on the OCT images. RESULTS The results revealed that an inner-stopper guard trephine had the best performance in creating consistent and precise wound defect depth compared to modified vacuum trephine and custom guard vacuum trephine. A 75% ± 10% cut of the cornea was achieved with the inner-stopper guard trephine. The wound defect depth by created by the inner-stopper guard trephine was independent of the corneal thickness or size of the globes. Although the cut depth of the inner-stopper guard trephine differed by the experience-level of its users, the consistency (standard deviation) of the depth was independent of experience. CONCLUSIONS Our studies provided three cost-efficient animal trephines that can create corneal wounds of consistent depth by lab researchers without extensive training in keratectomy.
Collapse
Affiliation(s)
- Fang Chen
- Ophthalmology, Stanford University School of Medicine, Stanford, California, USA.,VA Palo Alto Health Care System, Palo Alto, California, USA
| | - David Buickians
- Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
| | - Peter Le
- Ophthalmology, Stanford University School of Medicine, Stanford, California, USA.,VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Xin Xia
- Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
| | | | | | - David C Mundy
- Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
| | - Caitlin M Logan
- Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
| | - David Myung
- Ophthalmology, Stanford University School of Medicine, Stanford, California, USA.,VA Palo Alto Health Care System, Palo Alto, California, USA.,Chemical Engineering, Stanford University, Stanford, California, USA
| |
Collapse
|
40
|
Cen YJ, You DB, Wang W, Feng Y. Preliminary studies of constructing a tissue-engineered lamellar corneal graft by culturing mesenchymal stem cells onto decellularized corneal matrix. Int J Ophthalmol 2021; 14:10-18. [PMID: 33469478 DOI: 10.18240/ijo.2021.01.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/28/2020] [Indexed: 12/28/2022] Open
Abstract
AIM To construct a competent corneal lamellar substitute in order to alleviate the shortage of human corneal donor. METHODS Rabbit mesenchymal stem cells (MSCs) were isolated from bone marrow and identified by flow cytometric, osteogenic and adipogenic induction. Xenogenic decellularized corneal matrix (XDCM) was generated from dog corneas. MSCs were seeded and cultured on XDCM to construct the tissue-engineered cornea. Post-transplantation biocompatibility of engineered corneal graft were tested by animal experiment. Rabbits were divided into two groups then underwent lamellar keratoplasty (LK) with different corneal grafts: 1) XDCM group (n=5): XDCM; 2) XDCM-MSCs groups (n=4): tissue-engineered cornea made up with XDCM and MSCs. The ocular surface recovery procedure was observed while corneal transparency, neovascularization and epithelium defection were measured and compared. In vivo on focal exam was performed 3mo postoperatively. RESULTS Rabbit MSCs were isolated and identified. Flow cytometry demonstrated isolated cells were CD90 positive and CD34, CD45 negative. Osteogenic and adipogenic induction verified their multipotent abilities. MSC-XDCM grafts were constructed and observed. In vivo transplantation showed the neovascularization in XDCM-MSC group was much less than that in XDCM group postoperatively. Post-transplant 3-month confocal test showed less nerve regeneration and bigger cell-absent area in XDCM-MSC group. CONCLUSION This study present a novel corneal tissue-engineered graft that could reduce post-operatively neovascularization and remain transparency, meanwhile shows that co-transplantation of MSCs may help increase corneal transplantation successful rate and enlarge the source range of corneal substitute to overcome cornea donor shortage.
Collapse
Affiliation(s)
- Yu-Jie Cen
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - De-Bo You
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Wei Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| |
Collapse
|
41
|
Zhang Y, Ling Y, Zhang D, Wang M, Purslow C, Yang Y, Li C, Huang Z. Quantitative measurement of mechanical properties in wound healing processes in a corneal stroma model by using vibrational optical coherence elastography (OCE). BIOMEDICAL OPTICS EXPRESS 2021; 12:588-603. [PMID: 33659091 PMCID: PMC7899504 DOI: 10.1364/boe.404096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 05/11/2023]
Abstract
Corneal wound healing, caused by frequent traumatic injury to the cornea and increasing numbers of refractive surgeries, has become a vital clinical problem. In the cornea, wound healing is an extremely complicated process. However, little is known about how the biomechanical changes in wound healing response of the cornea. Collagen-based hydrogels incorporating corneal cells are suitable for replicating a three-dimensional (3D) equivalent of the cornea in-vitro. In this study, the mechanical properties of corneal stroma models were quantitatively monitored by a vibrational optical coherence elastography (OCE) system during continuous culture periods. Specifically, human corneal keratocytes were seeded at 5 × 105 cells/mL in the hydrogels with a collagen concentration of 3.0 mg/mL. The elastic modulus of the unwounded constructs increased from 2.950 ± 0.2 kPa to 11.0 ± 1.4 kPa, and the maximum thickness decreased from 1.034 ± 0.1 mm to 0.464 ± 0.09 mm during a 15-day culture period. Furthermore, a traumatic wound in the construct was introduced with a size of 500 µm. The elastic modulus of the neo-tissue in the wound area increased from 1.488 ± 0.4 kPa to 6.639 ± 0.3 kPa over 13 days. This study demonstrates that the vibrational OCE system is capable of quantitative monitoring the changes in mechanical properties of a corneal stroma wound model during continuous culture periods and improves our understanding on corneal wound healing processes.
Collapse
Affiliation(s)
- Yilong Zhang
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - Yuting Ling
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - Duo Zhang
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - Mingkai Wang
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - Christine Purslow
- Thea Pharmaceuticals Ltd, Keele University Science & Innovation Park, Innovation Way, Stoke-on-Trent, ST5 5NT, UK
| | - Ying Yang
- Guy Hilton Research Center, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, ST4 7QB, UK
| | - Chunhui Li
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - Zhihong Huang
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| |
Collapse
|
42
|
Raghunathan V, Edwards SG, Leonard BC, Kim S, Evashenk AT, Song Y, Rewinski E, Marangakis Price A, Hoehn A, Chang C, Reilly CM, Muppala S, Murphy CJ, Thomasy SM. Differential effects of Hsp90 inhibition on corneal cells in vitro and in vivo. Exp Eye Res 2020; 202:108362. [PMID: 33220237 DOI: 10.1016/j.exer.2020.108362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/30/2020] [Accepted: 11/13/2020] [Indexed: 10/23/2022]
Abstract
The transformation of quiescent keratocytes to activated fibroblasts and myofibroblasts (KFM transformation) largely depends on transforming growth factor beta (TGFβ) signaling. Initiation of the TGFβ signaling cascade results from binding of TGFβ to the labile type I TGFβ receptor (TGFβRI), which is stabilized by the 90 kDa heat shock protein (Hsp90). Since myofibroblast persistence within the corneal stroma can result in stromal haze and corneal fibrosis in patients undergoing keratorefractive therapy, modulation of TGFβ signaling through Hsp90 inhibition would represent a novel approach to prevent myofibroblast persistence. In vitro, rabbit corneal fibroblasts (RCFs) or stratified immortalized human corneal epithelial cells (hTCEpi) were treated with a Hsp90 inhibitor (17AAG) in the presence/absence of TGFβ1. RCFs were cultured either on tissue culture plastic, anisotropically patterned substrates, and hydrogels of varying stiffness. Cellular responses to both cytoactive and variable substrates were assessed by morphologic changes to the cells, and alterations in expression patterns of key keratocyte and myofibroblast proteins using PCR, Western blotting and immunocytochemistry. Transepithelial electrical resistance (TEER) measurements were performed to establish epithelial barrier integrity. In vivo, the corneas of New Zealand White rabbits were wounded by phototherapeutic keratectomy (PTK) and treated with 17AAG (3× or 6× daily) either immediately or 7 days after wounding for 28 days. Rabbits underwent clinical ophthalmic examinations, SPOTS scoring and advanced imaging on days 0, 1, 3, 7, 10, 14, 21 and 28. On day 28, rabbits were euthanized and histopathology/immunohistochemistry was performed. In vitro data demonstrated that 17AAG inhibited KFM transformation with the de-differentiation of spindle shaped myofibroblasts to dendritic keratocyte-like cells accompanied by significant upregulation of corneal crystallins and suppression of myofibroblast markers regardless of TGFβ1 treatment. RCFs cultured on soft hydrogels or patterned substrates exhibited elevated expression of α-smooth muscle actin (αSMA) in the presence of 17AAG. Treatment of hTCEpi cells disrupted zonula occludens 1 (ZO-1) adherens junction formation. In vivo, there were no differences detected in nearly all clinical parameters assessed between treatment groups. However, rabbits treated with 17AAG developed greater stromal haze formation compared with controls, irrespective of frequency of administration. Lastly, there was increased αSMA positive myofibroblasts in the stroma of 17AAG treated animals when compared with controls. Hsp90 inhibition promoted reversion of the myofibroblast to keratocyte phenotype, although this only occurred on rigid substrates. By contrast, in vivo Hsp90 inhibition was detrimental to corneal wound healing likely due to impairment in corneal epithelial closure and barrier function restoration. Collectively, our data demonstrated a strong interplay in vitro between biophysical cues and soluble signaling molecules in determining corneal stromal cell phenotype.
Collapse
Affiliation(s)
- VijayKrishna Raghunathan
- Department of Basic Sciences, United States; The Ocular Surface Institute, College of Optometry, University of Houston, Houston, TX, United States.
| | - Sydney Garrison Edwards
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Brian C Leonard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Soohyun Kim
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Alexander T Evashenk
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Yeonju Song
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Eva Rewinski
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Ariana Marangakis Price
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Alyssa Hoehn
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Connor Chang
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Christopher M Reilly
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Santoshi Muppala
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States
| | - Christopher J Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States; Department of Ophthalmology and Vision Science, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, United States; Department of Ophthalmology and Vision Science, School of Medicine, University of California, Davis, Davis, CA, United States.
| |
Collapse
|
43
|
Petroll WM, Varner VD, Schmidtke DW. Keratocyte mechanobiology. Exp Eye Res 2020; 200:108228. [PMID: 32919993 PMCID: PMC7655662 DOI: 10.1016/j.exer.2020.108228] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 01/22/2023]
Abstract
In vivo, corneal keratocytes reside within a complex 3D extracellular matrix (ECM) consisting of highly aligned collagen lamellae, growth factors, and other extracellular matrix components, and are subjected to various mechanical stimuli during developmental morphogenesis, fluctuations in intraocular pressure, and wound healing. The process by which keratocytes convert changes in mechanical stimuli (e.g. local topography, applied force, ECM stiffness) into biochemical signaling is known as mechanotransduction. Activation of the various mechanotransductive pathways can produce changes in cell migration, proliferation, and differentiation. Here we review how corneal keratocytes respond to and integrate different biochemical and biophysical factors. We first highlight how growth factors and other cytokines regulate the activity of Rho GTPases, cytoskeletal remodeling, and ultimately the mechanical phenotype of keratocytes. We then discuss how changes in the mechanical properties of the ECM have been shown to regulate keratocyte behavior in sophisticated 2D and 3D experimental models of the corneal microenvironment. Finally, we discuss how ECM topography and protein composition can modulate cell phenotypes, and review the different methods of fabricating in vitro mimics of corneal ECM topography, novel approaches for examining topographical effects in vivo, and the impact of different ECM glycoproteins and proteoglycans on keratocyte behavior.
Collapse
Affiliation(s)
- W Matthew Petroll
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Victor D Varner
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - David W Schmidtke
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| |
Collapse
|
44
|
Kamil S, Mohan RR. Corneal stromal wound healing: Major regulators and therapeutic targets. Ocul Surf 2020; 19:290-306. [PMID: 33127599 DOI: 10.1016/j.jtos.2020.10.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/16/2020] [Accepted: 10/25/2020] [Indexed: 12/12/2022]
Abstract
Corneal stromal wound healing is a complex event that occurs to restore the transparency of an injured cornea. It involves immediate apoptosis of keratocytes followed by their activation, proliferation, migration, and trans-differentiation to myofibroblasts. Myofibroblasts contract to close the wound and secrete extracellular matrix and proteinases to remodel it. Released proteinases may degenerate the basement membrane allowing an influx of cytokines from overlying epithelium. Immune cells infiltrate the wound to clear cellular debris and prevent infections. Gradually basement membrane regenerates, myofibroblasts and immune cells disappear, abnormal matrix is resorbed, and transparency of the cornea is restored. Often this cascade deregulates and corneal opacity results. Factors that prevent corneal opacity after an injury have always intrigued the researchers. They hold clinical relevance as they can guide the outcomes of corneal surgeries. Studies in the past have shed light on the role of various factors in stromal healing. TGFβ (transforming growth factor-beta) signaling is the central player guiding stromal responses. Other major regulators include myofibroblasts, basement membrane, collagen fibrils, small leucine-rich proteoglycans, biophysical cues, proteins derived from extracellular matrix, and membrane channels. The knowledge about their roles helped to develop novel therapies to prevent corneal opacity. This article reviews the role of major regulators that determine the outcome of stromal healing. It also discusses emerging therapies that modulate the role of these regulators to prevent stromal opacity.
Collapse
Affiliation(s)
- Sabeeh Kamil
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; One-Health Vision Research Program, Department of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Rajiv R Mohan
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; One-Health Vision Research Program, Department of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA; Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA.
| |
Collapse
|
45
|
Maruri DP, Miron-Mendoza M, Kivanany PB, Hack JM, Schmidtke DW, Petroll WM, Varner VD. ECM Stiffness Controls the Activation and Contractility of Corneal Keratocytes in Response to TGF-β1. Biophys J 2020; 119:1865-1877. [PMID: 33080219 DOI: 10.1016/j.bpj.2020.08.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/31/2020] [Accepted: 08/31/2020] [Indexed: 12/19/2022] Open
Abstract
After surgery or traumatic injury, corneal wound healing can cause a scarring response that stiffens the tissue and impairs ocular function. This fibrosis is caused in part by the activation of corneal keratocytes from a native mechanically quiescent state to an activated myofibroblastic state. This transformation is tied to signaling downstream of transforming growth factor-β1 (TGF-β1). Here, to better understand how biochemical and biophysical cues interact to regulate keratocyte activation and contractility, we cultured primary rabbit corneal keratocytes on flexible substrata of varying stiffness in the presence (or absence) of TGF-β1. Time-lapse fluorescence microscopy was used to assess changes in keratocyte morphology, as well as to quantify the dynamic traction stresses exerted by cells under different experimental conditions. In other experiments, keratocytes were fixed after 5 days of culture and stained for markers of both contractility and myofibroblastic activation. Treatment with TGF-β1 elicited distinct phenotypes on substrata of different stiffnesses. Cells on soft (1 kPa) gels formed fewer stress fibers and retained a more dendritic morphology, indicative of a quiescent keratocyte phenotype. Keratocytes cultured on stiff (10 kPa) gels or collagen-coated glass coverslips, however, had broad morphologies, formed abundant stress fibers, exhibited greater levels of α-smooth muscle actin (α-SMA) expression, and exerted larger traction forces. Confocal images of phospho-myosin light chain (pMLC) immunofluorescence, moreover, revealed stiffness-dependent differences in the subcellular distribution of actomyosin contractility, with pMLC localized at the tips of thin cellular processes in mechanically quiescent cells. Importantly, keratocytes cultured in the absence of TGF-β1 showed no stiffness-dependent differences in α-SMA immunofluorescence, suggesting that a stiff microenvironment alone is insufficient to induce myofibroblastic activation. Taken together, these data suggest that changes in ECM stiffness can modulate the morphology, cytoskeletal organization, and subcellular pattern of force generation in corneal keratocytes treated with TGF-β1.
Collapse
Affiliation(s)
- Daniel P Maruri
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas
| | - Miguel Miron-Mendoza
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Pouriska B Kivanany
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joshua M Hack
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas
| | - David W Schmidtke
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - W Matthew Petroll
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Victor D Varner
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
| |
Collapse
|
46
|
Giannikaki S, Escanilla N, Sturgess K, Lowe RC. A modified technique of keratoleptynsis ("letter-box") for treatment of canine corneal edema associated with endothelial dysfunction. Vet Ophthalmol 2020; 23:930-942. [PMID: 32893460 DOI: 10.1111/vop.12823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/01/2020] [Accepted: 08/11/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe a modified keratoleptynsis procedure, as a method of preserving central corneal function, and evaluate the outcome in vision, reduction of corneal thickness and treatment of epithelial corneal ulcers in cases with endothelial cell dysfunction. METHODS Forty-four dogs (72 eyes) were affected by progressive corneal edema, with or without ulcerative keratitis. All patients were treated with a dorsal and ventral superficial keratectomy followed by conjunctival flaps, maintaining a clear central cornea. Corneal thickness measurements were obtained via ultrasound biomicroscopy. RESULTS All eyes showed resolution of ocular discomfort postoperatively, with a median time to resolution of 35 days. Two years post-surgery, vision had been lost in 2 of 29 eyes (7%). From the initial population, 23 dogs (39 eyes) had follow-up evaluations of corneal thickness. The mean central corneal thickness was 1359 ± 251 μm prior to surgery. Thickening of the central cornea was observed one week after surgery to 1559 ± 263 μm. Decreased corneal thickness was reported, at 1 month, 4 months, 10 months and 2 years postoperatively (1285 ± 267 μm, 1102 ± 150 μm, 1121 ± 288 μm, 1193 ± 283 μm, respectively). All eyes showed a similar trend of increasing and then decreasing corneal thickness. CONCLUSIONS This surgical technique provided statistically significant reduction in central corneal thickness and sustained relief of ocular pain. Reduction in corneal thickness appeared to be maintained 2 years post-surgery, and all patients remained comfortable. Superficial corneal pigmentation and fibrosis resulted in vision loss in two eyes.
Collapse
|
47
|
Liu T, Shen M, Li H, Zhang Y, Mu B, Zhao X, Wang Y. Changes and quantitative characterization of hyper-viscoelastic biomechanical properties for young corneal stroma after standard corneal cross-linking treatment with different ultraviolet-A energies. Acta Biomater 2020; 113:438-451. [PMID: 32525050 DOI: 10.1016/j.actbio.2020.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 12/27/2022]
Abstract
Corneal collagen cross-linking (CXL) treatment can restore vision in patients suffering from keratoconus and corneal injury, by improving the mechanical properties of the cornea. The correlation between ultraviolet-A (UVA) irradiant energies of standard CXL (SCXL) and corneal visco-hyperelastic mechanical behavior remains unknown. In this study, SCXL with four different UVA irradiant energy doses (0-5.4 J/cm2) were administered as part of quantitative treatments of corneal stromal lenticules extracted from young myopic patients via small incision lenticule extraction (SMILE) corneal refractive surgery. Double-strip samples with symmetric geometries were cut simultaneously for SCXL treatment and non-treated control. First, 40 pairs of strips were loaded to failure to assess the mechanical parameters of the material. Then, another 40 pairs were tested using a special uniaxial tensile test including quasi-static loading-unloading, instantaneous loading, and stress relaxation, to determine the visco-hyperelastic mechanical behavior. Upon combining the collagen fibril crimping constitutive model with the quasi-linear viscoelastic model, it was observed that with increasing UVA energy dose, the corneal strength and hyperelastic stiffness were significantly enhanced, while the maximum stretch and viscosity of the cornea were significantly reduced. Considering the quantitative analysis of SCXL and the rehabilitation prediction of keratoconus treatment, the results clarify the biomechanical behavior of human corneal stroma in SCXL clinical surgery. STATEMENT OF SIGNIFICANCE: This study quantitatively analyzes the improvement in the biomechanical properties of young central corneal stroma, due to SCXL treatment with different energies. Furthermore, the correlation between the hyper-viscoelastic mechanical parameters and UVA irradiant energy doses of SCXL are clarified. The contribution of this study fills the knowledge gap of the CXL on corneal biomechanics. It can not only clarify this mechanism better but also assist with guiding SCXL surgery for individualized patient corneas.
Collapse
Affiliation(s)
- Taiwei Liu
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, Tianjin 300350 China; Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Min Shen
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, Tianjin 300350 China.
| | - Hongxun Li
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Yan Zhang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Bokun Mu
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Xinheng Zhao
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Yan Wang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| |
Collapse
|
48
|
Gefen A, Creehan S, Black J. Critical biomechanical and clinical insights concerning tissue protection when positioning patients in the operating room: A scoping review. Int Wound J 2020; 17:1405-1423. [PMID: 32496025 DOI: 10.1111/iwj.13408] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
An optimal position of the patient during operation may require a compromise between the best position for surgical access and the position a patient and his or her tissues can tolerate without sustaining injury. This scoping review analysed the existing, contemporary evidence regarding surgical positioning-related tissue damage risks, from both biomechanical and clinical perspectives, focusing on the challenges in preventing tissue damage in the constraining operating room environment, which does not allow repositioning and limits the use of dynamic or thick and soft support surfaces. Deep and multidisciplinary aetiological understanding is required for effective prevention of intraoperatively acquired tissue damage, primarily including pressure ulcers (injuries) and neural injuries. Lack of such understanding typically leads to misconceptions and increased risk to patients. This article therefore provides a comprehensive aetiological description concerning the types of potential tissue damage, vulnerable anatomical locations, the risk factors specific to the operative setting (eg, the effects of anaesthetics and instruments), the complex interactions between the tissue damage risk and the pathophysiology of the surgery itself (eg, the inflammatory response to the surgical incisions), risk assessments for surgical patients and their limitations, and available (including emerging) technologies for positioning. The present multidisciplinary and integrated approach, which holistically joins the bioengineering and clinical perspectives, is unique to this work and has not been taken before. Close collaboration between bioengineers and clinicians, such as demonstrated here, is required to revisit the design of operating tables, support surfaces for surgery, surgical instruments for patient stabilisation, and for surgical access. Each type of equipment and its combined use should be evaluated and improved where needed with regard to the two major threats to tissue health in the operative setting: pressure ulcers and neural damage.
Collapse
Affiliation(s)
- Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Sue Creehan
- Wound/Ostomy Program Team, VCU Health System, Richmond, Virginia, USA
| | - Joyce Black
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
| |
Collapse
|
49
|
Dhamodaran K, Baidouri H, Sandoval L, Raghunathan V. Wnt Activation After Inhibition Restores Trabecular Meshwork Cells Toward a Normal Phenotype. Invest Ophthalmol Vis Sci 2020; 61:30. [PMID: 32539133 PMCID: PMC7415288 DOI: 10.1167/iovs.61.6.30] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
Purpose Wnt is a spatiotemporally regulated signaling pathway whose inhibition is associated with glaucoma, elevated intraocular pressure (IOP), and cell stiffening. Whether such changes are permanent or may be reversed is unclear. Here, we determine if activation of Wnt pathway after inhibition reverses the pathologic phenotype. Methods Primary human trabecular meshwork (hTM) cells from nonglaucomatous donors were cultured for 12 days in the absence or presence of Wnt modulators: (i) LGK974 (Porcn inhibitor, 10 µM); (ii) LY2090314 (pGSK3β inhibitor, 250 nM); or (iii) 9 days of LGK974 followed by 3 days of LY2090314. Wnt modulation were determined by Western blotting and extracellular matrix (ECM) related genes were evaluated by quantitative PCR. Cytoskeletal morphology was determined by immunofluorescence and cell stiffness by atomic force microscopy. Results Wnt activation was confirmed by downregulation of pGSK3β (0.3-fold; P < 0.01), overexpression of AXIN2 (6.7-fold; P < 0.001), and LEF1 (3.8-fold; P < 0.001). Wnt inhibition resulted in dramatic changes in F-actin, which were resolved with subsequent Wnt activation. Concurrently, cell stiffness that was elevated with Wnt inhibition (11.86 kPa; P < 0.01) decreased with subsequent Wnt activation (4.195 kPa; P < 0.01) accompanied by significant overexpression of phosphorylated YAP (1.8-fold; P < 0.001) and TAZ (1.4-fold; P < 0.001). Additionally, Wnt activation after inhibition significantly repressed ECM genes (SPARC and CTGF, P < 0.01), cross-linking genes (LOX and TGM2, P < 0.05), inhibitors of matrix metalloproteinases (TIMP1 and PAI1, P < 0.001), and overexpressed MMP 1/9/14 (P < 0.01). Conclusions These data strongly demonstrate that, in normal hTM cells, activation of the Wnt pathway reverses the pathological phenotype caused by Wnt inhibition and may thus be a viable therapeutic for lowering IOP.
Collapse
Affiliation(s)
- Kamesh Dhamodaran
- Department of Basic Sciences, College of Optometry, University of Houston, Houston, Texas, United States
| | - Hasna Baidouri
- Department of Basic Sciences, College of Optometry, University of Houston, Houston, Texas, United States
| | - Lyndsey Sandoval
- Department of Basic Sciences, College of Optometry, University of Houston, Houston, Texas, United States
| | - VijayKrishna Raghunathan
- Department of Basic Sciences, College of Optometry, University of Houston, Houston, Texas, United States
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| |
Collapse
|
50
|
Kim S, Jalilian I, Thomasy SM, Bowman MAW, Raghunathan VK, Song Y, Reinhart-King CA, Murphy CJ. Intrastromal Injection of Hyaluronidase Alters the Structural and Biomechanical Properties of the Corneal Stroma. Transl Vis Sci Technol 2020; 9:21. [PMID: 32821518 PMCID: PMC7409307 DOI: 10.1167/tvst.9.6.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/05/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose Glycosaminoglycans (GAGs) are important components of the corneal stroma, and their spatiotemporal arrangement regulates the organization of collagen fibrils and maintains corneal transparency. This study was undertaken to determine the consequences of hyaluronidase (HAse) injected into the corneal stroma on stromal stiffness and ultrastructure. Methods Equal volumes of HAse or balanced salt solution (vehicle) were injected intrastromally into the corneas of New Zealand white rabbits. Ophthalmic examination and multimodal imaging techniques, including Fourier-domain optical coherence tomography and in vivo confocal microscopy (IVCM), were performed at multiple time points to evaluate the impact of HAse treatment in vivo. Atomic force microscopy and transmission electron microscopy (TEM) were used to measure corneal stiffness and collagen's interfibrillar spacing, respectively. Results Central corneal thickness progressively decreased after HAse injection, reaching its lowest value at day 7, and then returned to normal by day 42. The HAse did not impact the corneal endothelium but transiently altered keratocyte morphology at days 1 and 7, as measured by IVCM. HAse-injected corneas became stiffer by day 1 postinjection, were stiffest at day 7, and returned to preinjection values by day 90. Changes in stromal stiffness correlated with decreased interfibrillar spacing as measured by TEM. Conclusions Degradation of GAGs by HAse decreases the corneal thickness and increases stromal stiffness through increased packing of the collagen fibrils in a time-dependent manner. Translational Relevance Intrastromal HAse injection appears relatively safe in the normal cornea, but its impact on corneal biomechanics and structure under pathologic conditions requires further study.
Collapse
Affiliation(s)
- Soohyun Kim
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Iman Jalilian
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA.,Department of Ophthalmology & Vision Science, School of Medicine, University of California Davis, Davis, CA, USA
| | - Morgan A W Bowman
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Vijay Krishna Raghunathan
- Department of Basic Science, College of Optometry, University of Houston, Houston, TX, USA.,Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, TX, USA
| | - Yeonju Song
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Cynthia A Reinhart-King
- Department of Biomedical Engineering, School of Engineering, Vanderbilt University, Nashville, TN, USA
| | - Christopher J Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA.,Department of Ophthalmology & Vision Science, School of Medicine, University of California Davis, Davis, CA, USA
| |
Collapse
|