Department of Transplantation Immunology, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 14220, Prague 4, Czech Republic,
Stem Cell Rev Rep. 2013 Oct;9(5):609-19. doi: 10.1007/s12015-013-9449-0.
Ocular surface defects represent one of the most common causes of impaired vision or even blindness. For treatment, keratoplasty represents the first choice. However, if corneal defects are more extensive and associated with a limbal stem cell (LSC) deficiency, corneal transplantation is not a sufficient therapeutic procedure and only viable approach to treatment is the transplantation of LSCs. When the LSC deficiency is a bilateral disorder, autologous LSCs are not available. The use of allogeneic LSCs requires strong immunosuppression, which leads to side-effects, and the treatment is not always effective. The alternative and perspective approach to the treatment of severe ocular surface injuries and LSC deficiency is offered by the transplantation of autologous mesenchymal stem cells (MSCs). These cells can be obtained from the bone marrow or adipose tissue of the particular patient, grow well in vitro and can be transferred, using an appropriate scaffold, onto the damaged ocular surface. Here they exert beneficial effects by possible direct differentiation into corneal epithelial cells, by immunomodulatory effects and by the production of numerous trophic and growth factors. Recent experiments utilizing the therapeutic properties of MSCs in animal models with a mechanically or chemically injured ocular surface have yielded promising results and demonstrated significant corneal regeneration, improved corneal transparency and a rapid healing process associated with the restoration of vision. The use of autologous MSCs thus represents a promising therapeutic approach and offers hope for patients with severe ocular surface injuries and LSC deficiency.
眼表缺陷是导致视力受损甚至失明的最常见原因之一。对于治疗，角膜移植是首选。然而，如果角膜缺陷更广泛，并伴有角膜缘干细胞（LSC）缺乏，角膜移植不是一种充分的治疗程序，唯一可行的治疗方法是移植 LSCs。当 LSC 缺乏是双侧疾病时，自体 LSCs 不可用。使用同种异体 LSCs 需要强烈的免疫抑制，这会导致副作用，并且治疗并不总是有效。对于严重眼表损伤和 LSC 缺乏的治疗，自体间充质干细胞（MSCs）的移植提供了一种替代和有前景的方法。这些细胞可以从特定患者的骨髓或脂肪组织中获得，在体外生长良好，并可以使用适当的支架转移到受损的眼表上。在这里，它们通过可能直接分化为角膜上皮细胞、免疫调节作用以及产生多种营养和生长因子来发挥有益作用。最近在机械或化学损伤眼表的动物模型中利用 MSCs 的治疗特性进行的实验取得了可喜的结果，证明了显著的角膜再生、改善的角膜透明度和与视力恢复相关的快速愈合过程。因此，自体 MSCs 的使用代表了一种有前途的治疗方法，为患有严重眼表损伤和 LSC 缺乏的患者带来了希望。
