Cornea and ocular surface treatment.
In addition to being a protective shield, the cornea represents two thirds of the eye's refractive power. Corneal pathology can affect one or all of the corneal layers, producing corneal opacity. Although full corneal thickness keratoplasty has been the standard procedure, the ideal strategy would be to replace only the damaged layer. Current difficulties in corneal transplantation, mainly immune rejection and shortage of organ supply, place more emphasis on the development of artificial corneas. Bioengineered corneas range from prosthetic devices that solely address the replacement of the corneal function, to tissue-engineered hydrogels that allow regeneration of the tissue. Recently, major advances in the biology of corneal stem cells have been achieved. However, the therapeutic use of these stem cell types has the disadvantage of needing an intact stem cell compartment, which is usually damaged. In addition, long ex vivo culture is needed to generate enough cell numbers for transplantation. In the near future, combination of advanced biomaterials with cells from abundant outer sources will allow advances in the field. For the former, magnetically aligned collagen is one of the most promising ones. For the latter, different cell types will be optimal: 1) for epithelial replacement: oral mucosal epithelium, ear epidermis, or bone marrow- mesenchymal stem cells, 2) for stromal regeneration: adipose-derived stem cells and 3) for endothelial replacement, the possibility of in vitro directed differentiation of adipose-derived stem cells towards endothelial cells provides an exciting new approach.
De Miguel
Maria P
MP
Cell Engineering Laboratory, La Paz Hospital IdiPAZ, Maternity Building, Paseo Castellana 261, Madrid 28046 Spain. mariapdemiguel@gmail.com
Alio
Jorge L
JL
Arnalich-Montiel
Francisco
F
Fuentes-Julian
Sherezade
S
de Benito-Llopis
Laura
L
Amparo
Francisco
F
Bataille
Laurent
L
D000273:Adipose Tissue / Q000473:pathology*; D000818:Animals; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology; D003094:Collagen / Q000627:therapeutic use; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000473:pathology / Q000628:therapy*; D065306:Corneal Injuries; D048091:Guided Tissue Regeneration; D006801:Humans; D020100:Hydrogels / Q000627:therapeutic use; D059630:Mesenchymal Stem Cells / Q000378:metabolism* / Q000473:pathology; D019651:Plastic Surgery Procedures; D055153:Stem Cell Niche / Q000473:pathology*; D033581:Stem Cell Transplantation; D046509:Tissue Culture Techniques; D023822:Tissue Engineering
D020100:Hydrogels; D003094:Collagen