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Utheim OA, Pasovic L, Raeder S, Eidet JR, Fostad IG, Sehic A, Roald B, de la Paz MF, Lyberg T, Dartt DA, Utheim TP. Effects of explant size on epithelial outgrowth, thickness, stratification, ultrastructure and phenotype of cultured limbal epithelial cells. PLoS One 2019; 14:e0212524. [PMID: 30861002 PMCID: PMC6413940 DOI: 10.1371/journal.pone.0212524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/04/2019] [Indexed: 01/16/2023] Open
Abstract
Purpose Transplantation of limbal stem cells is a promising therapy for limbal stem cell deficiency. Limbal cells can be harvested from either a healthy part of the patient’s eye or the eye of a donor. Small explants are less likely to inflict injury to the donor site. We investigated the effects of limbal explant size on multiple characteristics known to be important for transplant function. Methods Human limbal epithelial cells were expanded from large versus small explants (3 versus 1 mm of the corneal circumference) for 3 weeks and characterized by light microscopy, immunohistochemistry, and transmission electron microscopy. Epithelial thickness, stratification, outgrowth, ultrastructure and phenotype were assessed. Results Epithelial thickness and stratification were similar between the groups. Outgrowth size correlated positively with explant size (r = 0.37; P = 0.01), whereas fold growth correlated negatively with explant size (r = –0.55; P < 0.0001). Percentage of cells expressing the limbal epithelial cell marker K19 was higher in cells derived from large explants (99.1±1.2%) compared to cells derived from small explants (93.2±13.6%, P = 0.024). The percentage of cells expressing ABCG2, integrin β1, p63, and p63α that are markers suggestive of an immature phenotype; Keratin 3, Connexin 43, and E-Cadherin that are markers of differentiation; and Ki67 and PCNA that indicate cell proliferation were equal in both groups. Desmosome and hemidesmosome densities were equal between the groups. Conclusion For donor- and culture conditions used in the present study, large explants are preferable to small in terms of outgrowth area. As regards limbal epithelial cell thickness, stratification, mechanical strength, and the attainment of a predominantly immature phenotype, both large and small explants are sufficient.
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Affiliation(s)
- O. A. Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Norwegian Dry Eye Clinic, Oslo, Norway
- * E-mail:
| | - L. Pasovic
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - S. Raeder
- Norwegian Dry Eye Clinic, Oslo, Norway
| | - J. R. Eidet
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - I. G. Fostad
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - A. Sehic
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Maxillofacial surgery, Oslo University Hospital, Oslo, Norway
| | - B. Roald
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - M. F. de la Paz
- Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - T. Lyberg
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - D. A. Dartt
- Schepens Eye Research Institute/Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, United States of America
| | - T. P. Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Norwegian Dry Eye Clinic, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Department of Maxillofacial surgery, Oslo University Hospital, Oslo, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Ophthalmology, Soerlandet Hospital Arendal, Arendal, Norway
- Department of Ophthalmology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of Southeast Norway, Kongsberg, Norway
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2
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Yao Q, Hu Y, Yu F, Zhang W, Fu Y. A novel application of electrospun silk fibroin/poly(l-lactic acid-co-ε-caprolactone) scaffolds for conjunctiva reconstruction. RSC Adv 2018; 8:18372-18380. [PMID: 35541105 PMCID: PMC9080522 DOI: 10.1039/c7ra13551c] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/08/2018] [Indexed: 11/21/2022] Open
Abstract
Electrospun hybrid nanofibers prepared using combinations of natural and synthetic polymers have been widely investigated in tissue engineering. In this study, silk fibroin (SF) and poly(l-lactic acid-co-ε-caprolactone) (PLCL) hybrid scaffolds were successfully prepared by electrospinning. Scanning electron micrographs (SEM) showed that SF/PLCL scaffolds were composed of defect-free nanofibers with a smooth and homogeneous fiber morphology. Water contact angle measurements demonstrated that the scaffolds were hydrophilic. To assess the cell affinity of SF/PLCL scaffolds, rabbit conjunctival epithelial cells (rCjECs) were cultured on the electrospun scaffolds. Scanning electron micrographs and in vitro proliferation assays showed that the cells adhered and proliferated well on the scaffolds. The quantitative polymerase chain reaction (qPCR) results showed excellent expression of CjEC genes, with reduced expression of inflammatory mediators. Hematoxylin and eosin (H&E) staining showed that the engineered conjunctiva constructed with SF/PLCL scaffolds consisted of 2–4 layers of epithelium. Furthermore, SF/PLCL scaffolds transplanted subcutaneously exhibited excellent biocompatibility. Therefore, SF/PLCL scaffolds may find biomedical applications in conjunctival reconstruction in the near future. We present a promising scaffold with favorable mechanical and biological properties for conjunctival regeneration.![]()
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Affiliation(s)
- Qinke Yao
- Department of Ophthalmology
- Ninth People’s Hospital
- Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Yang Hu
- Department of Ophthalmology
- Ninth People’s Hospital
- Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Fei Yu
- Department of Ophthalmology
- Ninth People’s Hospital
- Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Weijie Zhang
- Department of Ophthalmology
- Ninth People’s Hospital
- Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
| | - Yao Fu
- Department of Ophthalmology
- Ninth People’s Hospital
- Shanghai Jiao Tong University School of Medicine
- Shanghai 200011
- China
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3
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Yao Q, Zhang W, Hu Y, Chen J, Shao C, Fan X, Fu Y. Electrospun collagen/poly(L-lactic acid-co-ε-caprolactone) scaffolds for conjunctival tissue engineering. Exp Ther Med 2017; 14:4141-4147. [PMID: 29104630 PMCID: PMC5658689 DOI: 10.3892/etm.2017.5073] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 03/24/2017] [Indexed: 11/06/2022] Open
Abstract
Conjunctival injuries are general but intractable ocular surface diseases, the sequelae of which are particularly challenging to treat. A promising therapy for conjunctival injuries is to employ biodegradable scaffolds to deliver conjunctival epithelial cells for repairing damaged or diseased conjunctiva. In the present study, an ultrathin porous nanofibrous scaffold was fabricated by using collagen and poly(L-lactic acid-co-ε-caprolactone) (PLCL) and displayed a thickness of 20 µm, with a high porosity and an average fiber diameter of 248.83±26.44 nm. Conjunctival epithelial cells seeded on the scaffolds proliferated well and had a high cell viability. Reverse-transcription quantitative PCR showed the expression of conjunctival epithelial cell-specific genes; in addition, there was no significant difference in the inflammatory gene expression between cells grown on collagen/PLCL scaffolds and tricalcium phosphate scaffolds. After co-culture for 2 weeks in vitro, epithelial cell stratification was observed using hematoxylin and eosin staining, exhibiting three to four epithelial-cell layers. In conclusion, these results suggested that collagen/PLCL scaffolds have potential application for repairing conjunctival epithelial coloboma.
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Affiliation(s)
- Qinke Yao
- Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P.R. China
| | - Weijie Zhang
- Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P.R. China
| | - Yang Hu
- Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P.R. China
| | - Junzhao Chen
- Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P.R. China
| | - Chunyi Shao
- Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P.R. China
| | - Xianqun Fan
- Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P.R. China
| | - Yao Fu
- Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P.R. China
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4
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Kasbekar S, Kaye SB, Williams RL, Stewart RMK, Leow-Dyke S, Rooney P. Development of decellularized conjunctiva as a substrate for the ex vivo expansion of conjunctival epithelium. J Tissue Eng Regen Med 2017; 12:e973-e982. [PMID: 28112872 DOI: 10.1002/term.2419] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 01/09/2017] [Accepted: 01/16/2017] [Indexed: 12/12/2022]
Abstract
This study was performed to develop a method to decellularize human conjunctiva and to characterize the tissue in terms of its deoxyribose nucleic acid (DNA) content, tensile strength, collagen denaturation, basement membrane, extracellular matrix components and its potential to support conjunctival epithelial growth. Human conjunctival tissues were subjected to a decellularization process involving hypotonic detergent and nuclease buffers. Variations in sodium dodecyl sulfate concentration (0.05-0.5%, w/v) were tested to determine the appropriate concentration of detergent buffer. DNA quantification, collagen denaturation, cytotoxicity and tensile strength were investigated. Human conjunctival cell growth by explant culture on the decellularized tissue substrate was assessed after 28 days in culture. Samples were fixed and paraffin embedded for immunohistochemistry including conjunctival epithelial cell markers and extracellular matrix proteins. Conjunctival tissue from 20 eyes of 10 donors (age range 65-92 years) was used. Decellularization of human conjunctiva was achieved to 99% or greater DNA removal (p < 0.001) with absence of nuclear staining. This was reproducible at the lowest concentration of sodium dodecyl sulfate (0.05% w/v). No collagen denaturation (p = 0.74) and no difference in tensile strength parameters was demonstrated following decellularization. No significant difference was noted in the immunolocalization of collagen IV, laminin and fibronectin, or in the appearance of periodic acid-Schiff-stained basement membranes following decellularization. The decellularized tissue did not exhibit any cytotoxicity and explant culture resulted in the growth of stratified conjunctival epithelium. Allogeneic decellularized human conjunctiva can be successfully decellularized using the described protocol. It represents a novel substrate to support the expansion of conjunctival epithelium for ocular surface cellular replacement therapies. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shivani Kasbekar
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Stephen B Kaye
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Rachel L Williams
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Rosalind M K Stewart
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Daulby Street, Liverpool, UK
| | - Sophie Leow-Dyke
- National Health Service Blood and Transplant Tissue Services, Speke, Liverpool, UK
| | - Paul Rooney
- National Health Service Blood and Transplant Tissue Services, Speke, Liverpool, UK
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5
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Islam R, Eidet JR, Badian RA, Lippestad M, Messelt E, Griffith M, Dartt DA, Utheim TP. Tissue Harvesting Site and Culture Medium Affect Attachment, Growth, and Phenotype of Ex Vivo Expanded Oral Mucosal Epithelial Cells. Sci Rep 2017; 7:674. [PMID: 28386069 PMCID: PMC5428414 DOI: 10.1038/s41598-017-00417-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/23/2017] [Indexed: 11/18/2022] Open
Abstract
Transplantation of cultured oral mucosal epithelial cells (OMECs) is a promising treatment strategy for limbal stem cell deficiency. In order to improve the culture method, we investigated the effects of four culture media and tissue harvesting sites on explant attachment, growth, and phenotype of OMECs cultured from Sprague-Dawley rats. Neither choice of media or harvesting site impacted the ability of the explants to attach to the culture well. Dulbecco’s modified Eagle’s medium/Ham’s F12 (DMEM) and Roswell Park Memorial Institute 1640 medium (RPMI) supported the largest cellular outgrowth. Fold outgrowth was superior from LL explants compared to explants from the buccal mucosa (BM), HP, and transition zone of the lower lip (TZ) after six-day culture. Putative stem cell markers were detected in cultures grown in DMEM and RPMI. In DMEM, cells from TZ showed higher colony-forming efficiency than LL, BM, and HP. In contrast to RPMI, DMEM both expressed the putative stem cell marker Bmi-1 and yielded cell colonies. Our data suggest that OMECs from LL and TZ cultured in DMEM give rise to undifferentiated cells with high growth capacity, and hence are the most promising for treatment of limbal stem cell deficiency.
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Affiliation(s)
- Rakibul Islam
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA. .,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway. .,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
| | - Jon Roger Eidet
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Reza A Badian
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Faculty of Visual Sciences, University College of Southeast Norway, Kongsberg, Norway.,Department of Ophthalmology, Innlandet Hospital Trust, Elverum, Norway
| | - Marit Lippestad
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Edward Messelt
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - May Griffith
- Integrative Regenerative Medicine (IGEN) Centre, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Darlene A Dartt
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tor Paaske Utheim
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.,Department of Ophthalmology, Innlandet Hospital Trust, Elverum, Norway
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6
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Quan Y, Zhang X, Xu S, Li K, Zhu F, Li Q, Cai X, Lu R. Tcf7l2 localization of putative stem/progenitor cells in mouse conjunctiva. Am J Physiol Cell Physiol 2016; 311:C246-54. [PMID: 27281479 DOI: 10.1152/ajpcell.00014.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 06/02/2016] [Indexed: 12/23/2022]
Abstract
Conjunctival integrity and preservation is indispensable for vision. The self-renewing capacity of conjunctival cells controls conjunctival homeostasis and regeneration; however, the source of conjunctival self-renewal and the underlying mechanism is currently unclear. Here, we characterize the biochemical phenotype and proliferative potential of conjunctival epithelial cells in adult mouse by detecting proliferation-related signatures and conducting clonal analysis. Further, we show that transcription factor 7-like 2 (T-cell-specific transcription factor 4), a DNA binding protein expressed in multiple types of adult stem cells, is highly correlated with proliferative signatures in basal conjunctival epithelia. Clonal studies demonstrated that Transcription factor 7-like 2 (Tcf7l2) was coexpressed with p63α and proliferating cell nuclear antigen (PCNA) in propagative colonies. Furthermore, Tcf7l2 was actively transcribed concurrently with conjunctival epithelial proliferation in vitro. Collectively, we suggest that Tcf7l2 may be involved in maintenance of stem/progenitor cells properties of conjunctival epithelial stem/progenitor cells, and with the fornix as the optimal site to isolate highly proliferative conjunctival epithelial cells in adult mice.
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Affiliation(s)
- Yadan Quan
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China; and
| | - Xinchun Zhang
- Hospital of Stomatology, Guanghua College of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Siying Xu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China; and
| | - Kang Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China; and
| | - Feng Zhu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China; and
| | - Qian Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China; and
| | - Xianxian Cai
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China; and
| | - Rong Lu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China; and
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7
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Eidet JR, Dartt DA, Utheim TP. Concise Review: Comparison of Culture Membranes Used for Tissue Engineered Conjunctival Epithelial Equivalents. J Funct Biomater 2015; 6:1064-84. [PMID: 26690486 PMCID: PMC4695911 DOI: 10.3390/jfb6041064] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/02/2015] [Accepted: 12/07/2015] [Indexed: 02/06/2023] Open
Abstract
The conjunctival epithelium plays an important role in ensuring the optical clarity of the cornea by providing lubrication to maintain a smooth, refractive surface, by producing mucins critical for tear film stability and by protecting against mechanical stress and infectious agents. A large number of disorders can lead to scarring of the conjunctiva through chronic conjunctival inflammation. For controlling complications of conjunctival scarring, surgery can be considered. Surgical treatment of symblepharon includes removal of the scar tissue to reestablish the deep fornix. The surgical defect is then covered by the application of a tissue substitute. One obvious limiting factor when using autografts is the size of the defect to be covered, as the amount of healthy conjunctiva is scarce. These limitations have led scientists to develop tissue engineered conjunctival equivalents. A tissue engineered conjunctival epithelial equivalent needs to be easily manipulated surgically, not cause an inflammatory reaction and be biocompatible. This review summarizes the various substrates and membranes that have been used to culture conjunctival epithelial cells during the last three decades. Future avenues for developing tissue engineered conjunctiva are discussed.
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Affiliation(s)
- Jon Roger Eidet
- Department of Ophthalmology, Oslo University Hospital, Oslo 0424, Norway.
| | - Darlene A Dartt
- Schepens Eye Research Institute, Massachusetts Eye and Ear/Harvard Medical School, Boston, MA 02114, USA.
| | - Tor Paaske Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo 0424, Norway.
- Department of Oral Biology, University of Oslo, Oslo 0316, Norway.
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen 3004, Norway.
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8
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Bobba S, Chow S, Watson S, Di Girolamo N. Clinical outcomes of xeno-free expansion and transplantation of autologous ocular surface epithelial stem cells via contact lens delivery: a prospective case series. Stem Cell Res Ther 2015; 6:23. [PMID: 25889475 PMCID: PMC4396082 DOI: 10.1186/s13287-015-0009-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/10/2014] [Accepted: 02/17/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction Depletion of limbal stem cells leads to a debilitating condition known as limbal stem cell deficiency, characterised by impaired corneal wound healing and poor vision. The aim of this study was to determine whether delivering progenitor cells on a contact lens is a viable and effective alternative to current transplantation techniques, which are complicated by biological and xenogeneic materials. Methods Sixteen eyes of 16 patients who had total (n = 14) and partial (n = 2) limbal stem cell deficiency (chemical burns, five eyes; iatrogenic causes, four eyes; aniridia, three eyes; trachoma-induced, two eyes; contact lens over-wear, one eye; and cicatrising conjunctivitis, one eye) and who had failed prior therapy were recruited prospectively into the study. Autologous limbal (n = 7) or conjunctival epithelial (n = 9) biopsies were harvested from patients and placed on the concave surface of silicone hydrogel contact lenses. Cells were expanded in culture with autologous serum and transplanted onto the ocular surface. Results Restoration of a transparent avascular and clinically stable corneal epithelium was attained in 10 of 16 eyes (63%) at a median follow-up time of 2.5 years (range of 0.8 to 5.8 years). Although minor complications occurred in two eyes of two patients because of contact lens insertion or removal, these were not associated with long-term sequelae. Conclusions This is the first and largest study to evaluate the mid-term outcomes of autologous limbal/conjunctival stem cell transplantation via a US Food and Drug Administration-approved contact lens, demonstrating that delivery of ocular progenitor cells via this procedure offers a viable, effective, and xeno-free alternative to current transplantation methodologies. Trial registration Australian New Zealand Clinical Trials Registry ACTRN012607000211460. Registered 17 April 2007.
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Affiliation(s)
- Samantha Bobba
- School of Medical Sciences, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia. .,Faculty of Medicine, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
| | - Sharron Chow
- School of Medical Sciences, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
| | - Stephanie Watson
- Save Sight Institute, University of Sydney, 8 Macquarie Street, Sydney, 2000, Australia. .,Sydney Eye Hospital, 8 Macquarie Street, Sydney, 2000, Australia. .,Faculty of Medicine, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
| | - Nick Di Girolamo
- School of Medical Sciences, University of New South Wales, High Street, Kensington, Sydney, 2052, Australia.
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9
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Hodges RR, Dartt DA. Tear film mucins: front line defenders of the ocular surface; comparison with airway and gastrointestinal tract mucins. Exp Eye Res 2013; 117:62-78. [PMID: 23954166 DOI: 10.1016/j.exer.2013.07.027] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/07/2013] [Accepted: 07/24/2013] [Indexed: 01/09/2023]
Abstract
The ocular surface including the cornea and conjunctiva and its overlying tear film are the first tissues of the eye to interact with the external environment. The tear film is complex containing multiple layers secreted by different glands and tissues. Each layer contains specific molecules and proteins that not only maintain the health of the cells on the ocular surface by providing nourishment and removal of waste products but also protect these cells from environment. A major protective mechanism that the corneal and conjunctival cells have developed is secretion of the innermost layer of the tear film, the mucous layer. Both the cornea and conjunctiva express membrane spanning mucins, whereas the conjunctiva also produces soluble mucins. The mucins present in the tear film serve to maintain the hydration of the ocular surface and to provide lubrication and anti-adhesive properties between the cells of the ocular surface and conjunctiva during the blink. A third function is to contribute to the epithelial barrier to prevent pathogens from binding to the ocular surface. This review will focus on the different types of mucins produced by the corneal and conjunctival epithelia. Also included in this review will be a presentation of the structure of mucins, regulation of mucin production, role of mucins in ocular surface diseases, and the differences in mucin production by the ocular surface, airways and gastrointestinal tract.
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Affiliation(s)
- Robin R Hodges
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, USA
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10
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Ex-vivo ocular surface stem cell therapies: current techniques, applications, hurdles and future directions. Expert Rev Mol Med 2013; 15:e4. [DOI: 10.1017/erm.2013.5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Engineered tissue derived from ocular surface stem cells (SCs) are a cutting edge biotechnology for repair and restoration of severely damaged eyes as a result of ocular surface dysfunction because of SC failure. Ex-vivo SC expansion techniques have advanced significantly since the first patients were treated in the late 1990s. The techniques and clinical reports reviewed here highlight the evolution and successes of these techniques, while also revealing gaps in our understanding of ocular surface and SC biology that drives further research and development in this field. Although hurdles still remain before stem-cell-based therapies are more widely available for patients with devastating ocular surface disease, recent discoveries in the field of mesenchymal SCs and the potential of induced pluripotent SCs heralds a promising future for clinicians and our patients.
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11
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Fostad IG, Eidet JR, Shatos MA, Utheim TP, Utheim OA, Raeder S, Dartt DA. Biopsy harvesting site and distance from the explant affect conjunctival epithelial phenotype ex vivo. Exp Eye Res 2012; 104:15-25. [PMID: 23022405 DOI: 10.1016/j.exer.2012.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 08/28/2012] [Accepted: 09/17/2012] [Indexed: 12/11/2022]
Abstract
The purpose of the study was to investigate if the number of goblet cells expanded ex vivo from a conjunctival explant is affected by the biopsy harvesting site on the conjunctiva and the distance from the explant. Conjunctival explants from six regions: superior and inferior bulbus, fornix, and tarsus of male Sprague-Dawley rats were grown in RPMI 1640 with 10% fetal bovine serum on coverslips for eight days. Histochemical and immunofluorescent staining of goblet (CK-7/UEA-1/MUC5AC), stratified squamous, non-goblet (CK-4), proliferating (PCNA) and progenitor (ABCG2) cells were analyzed by epifluorescence and laser confocal microscopy. Outgrowth was measured with NIH ImageJ. For statistical analysis the Mann-Whitney test and Spearman's rank-order correlation test were used. Cultures from superior and inferior fornix contained the most goblet cells as indicated by the presence of CK-7+, UEA-1+ and MUC5AC+ cells. Superior and inferior forniceal cultures displayed 60.8% ± 9.2% and 64.7% ± 6.7% CK-7+ cells, respectively, compared to the superior tarsal (26.6% ± 8.4%; P < 0.05), superior bulbar (31.0% ± 4.0%; P < 0.05), inferior bulbar (38.5% ± 9.3%; P < 0.05) and inferior tarsal cultures (27.7% ± 8.3%; P < 0.05). While 28.4% ± 6.3% of CK-7+ goblet cells co-labeled with PCNA, only 7.4% ± 1.6% of UEA-1+ goblet cells did (P < 0.01). CK-7+ goblet cells were located at a lower concentration close to the explant (39.8% ± 3.1%) compared to near the leading edge (58.2% ± 4.5%; P < 0.05). Both markers for goblet cell secretory product (UEA-1 and MUC5AC), however, displayed the opposite pattern with a higher percentage of positive cells close to the explant than near the leading edge (P < 0.05). The percentage of CK-4+ cells was higher near the explant compared to near the leading edge (P < 0.01). The percentage of CK-7+ goblet cells in the cultures did not correlate with the outgrowth size (r(s) = -0.086; P = 0.435). The percentage of UEA-1+ goblet cells correlated negatively with outgrowth size (r(s) = -0.347; P < 0.01), whereas the percentage of CK-4+ cells correlated positively with the outgrowth size (r(s) = 0.473; P < 0.05). We conclude that forniceal explants yield the highest number of goblet cells ex vivo and thereby seem to be optimal for goblet cell transplantation. We also suggest that CK-7+/UEA-1- cells represent highly proliferative immature goblet cells. These cells could be important during conjunctival migration as they are mostly located close to the leading edge and their density does not decrease with increasing outgrowth size.
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Affiliation(s)
- I G Fostad
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, USA
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