A Contact Lens-Based Technique for Expansion and Transplantation of Autologous Epithelial Progenitors for Ocular Surface Reconstruction
A Contact Lens-Based Technique for Expansion and Transplantation of Autologous Epithelial Progenitors for Ocular Surface Reconstruction
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DOI：
10.1097/tp.0b013e3181a4bbf2
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发表时间：
2009-05-27
期刊：
影响因子：
6.2
通讯作者：
Watson, Stephanie L.
中科院分区：
文献类型：
--
作者：
Di Girolamo, Nick;Bosch, Martina;Watson, Stephanie L.
背景健康的角膜依赖于不同的干细胞（SC）群体，这些干细胞在整个生命过程中替代受损或老化的上皮。SC池的消耗或对龛的损害可导致称为角膜缘SC缺陷（LSCD）的致盲和疼痛状况。尽管目前用于重建患有LSCD的患者的眼表面的治疗策略是有希望的，但是它们通过在动物、人和合成产物的存在下转移自体或同种异体祖细胞而变得复杂。我们报告了一种独特的自体SC转移技术的安全性和有效性，该技术利用食品和药物管理局批准的接触透镜（CL）作为SC基板和载体，用于LSCD患者。纳入了3例因无虹膜（n=1）和复发性眼表黑色素瘤治疗后（n=2）而患有LSCD的患者。收获角膜缘（n=2）或结膜活检（n=1），并在自体血清存在下在治疗性CL上离体扩增祖细胞。将载有细胞的CL转移到患者的角膜表面，并记录临床结果（随访范围，8-13个月）。每例患者均恢复了稳定透明的角膜上皮。所有患者均无结膜或角膜血管化复发，症状评分显著改善。术后最佳矫正视力均提高。在自体血清存在下的眼表上皮的离体扩增和在软CL的帮助下的移植是能够实现眼表康复的有前途的新技术。
Background. A healthy cornea is reliant on a distinct population of stern cells (SC) that replace damaged or aging epithelium throughout life. Depletion of the SC pool or damage to the niche can result in a blinding and painful condition known as limbal-SC deficiency (LSCD). Although Current treatment strategies for reconstituting the ocular surface for patients suffering LSCD are promising, they are complicated by transferring autologous or allogeneic progenitors in the presence of animal, human, and synthetic products. We report on the safe and efficacy of a unique autologous SC transfer technique that utilizes an Food and Drug Administration-approved contact lens (CL) as the SC substrate and carrier for patients with LSCD.Methods. Three patients with LSCD due to aniridia (n=1) and posttreatment for recurrent ocular surface melanoma (n=2) were included. Limbal (n=2) or conjunctival biopsies (n=1) were harvested and progenitors expanded ex vivo on therapeutic CLs in the presence of autologous serum. Cell-laden CLs were transferred to the patient's corneal surface and clinical outcome measures were recorded (follow-up range, 8-13 months).Results. A stable transparent corneal epithelium was restored in each patient. There was no recurrence of conjunctivalization or corneal vascularization, and a significant improvement in symptom score Occurred in all patients. Best-corrected visual acuity was increased in all eyes after the procedure.Conclusion. Ex vivo expansion of ocular surface epithelium in the presence of autologous serum and transplantation with the aid of a soft CLs is a promising new technique capable of achieving Ocular surface rehabilitation.