Corneal epithelial cell bandage to treat persistent epithelial defect

角膜的愈合对维持角膜的完整性至关重要。在健康的眼睛中，在对眼表面的损伤之后，上皮缺损通过复杂的再上皮化过程来修复。在受损的情况下，愈合可能会延迟或停止，从而使下层基质容易受到进一步的创伤、浸润、感染、瘢痕形成和穿孔。持续性上皮缺损定义为标准治疗2周后未消退的缺损。存在混淆角膜上皮伤口愈合的风险因素，包括糖尿病性角膜病、角膜缘干细胞缺乏、干眼病、神经营养性角膜病和疱疹感染等。目前对持续性上皮缺损的治疗可包括润滑滴眼液、泪点阻塞以提供更润滑的环境、绷带隐形眼镜、血清、睑板缝合术或羊膜移植。标准治疗往往无效，会延长患者的不适感并降低视力。由于疾病的复杂性，患者每周必须接受多次检查，有些患者一年需要多达90次的检查。这对卫生系统的经济影响是巨大的。我们正在开发一种替代治疗方法，包括通过软性接触透镜将角膜上皮细胞直接转移到眼表。我们的“细胞绷带”将能够通过移植的细胞快速愈合伤口，并具有由治疗的接触透镜元件提供的保护免受眨眼时发生的剪切力的额外益处。我们已经证明了细胞绷带可以在体外愈合伤口的原理，但我们需要在实验室中使用人眼模型测试其有效性，并在整个动物模型中测试其安全性。如果细胞绷带提供了有利的结果，我们将继续与细胞疗法制造商合作开发产品，以确定适合患者使用的生产方法。

Corneal would healing is essential to maintain the integrity of the cornea. In a healthy eye, after an insult to the ocular surface, the epithelial defect is repaired by a complex re-epithelialisation process. Healing may be delayed or halted in compromised conditions leaving the underlying stroma vulnerable to further trauma, infiltrates, infection, scarring and perforation. A persistent epithelial defect is defined as a defect that is not resolved after 2 weeks of standard treatment. There are risk factors that confound corneal epithelial wound healing including diabetic keratopathy, limbal stem cell deficiency, dry eye disease, neurotrophic keratopathy and herpetic infection to name a few. The current treatments for persistent epithelial defect can include lubricating eye drops, punctal occlusion to provide a more lubricious environment, bandage contact lenses, serum, tarsorrhaphy or amniotic membrane transplant. Standard treatments tend to be ineffective, prolonging patient discomfort and diminished visual acuity. Due to the complex nature of the disease, patients must be examined multiple times a week, with some patients requiring up to 90 visits a year. The economic impact of this on health systems is substantial. We are developing an alternative treatment that involves transfer of corneal epithelial cells to the ocular surface directly via a soft contact lens. Our 'cell bandage' will enable rapid healing of the wound by the transplanted cells with the additional benefit provided by the contact lens element of the therapy of the protection from shearing forces that occur when blinking. We have proof of principle that the cell bandage functions to heal wounds in vitro but we need to test its effectiveness in a model using human eyes in the lab and its safety in a whole animal model. If the cell bandage provides favourable results we will continue to develop the product working with cell therapy manufacturers to determine a production method suitable for use in patients.