Mimura Tatsuya, Yokoo Seiichi, Yamagami Satoru
Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo 116-8567, Japan.
Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
J Funct Biomater. 2012 Oct 17;3(4):726-44. doi: 10.3390/jfb3040726.
Human corneal endothelial cells (HCECs) do not replicate after wounding. Therefore, corneal endothelial deficiency can result in irreversible corneal edema. Descemet stripping automated endothelial keratoplasty (DSAEK) allows selective replacement of the diseased corneal endothelium. However, DSAEK requires a donor cornea and the worldwide shortage of corneas limits its application. This review presents current knowledge on the tissue engineering of corneal endothelium using cultured HCECs. We also provide our recent work on tissue engineering for DSAEK grafts using cultured HCECs. We reconstructed DSAEK grafts by seeding cultured DiI-labelled HCECs on collagen sheets. Then HCEC sheets were transplanted onto the posterior stroma after descemetorhexis in the DSAEK group. Severe stromal edema was detected in the control group, but not in the DSAEK group throughout the observation period. Fluorescein microscopy one month after surgery showed numerous DiI-labelled cells on the posterior corneal surface in the DSAEK group. Frozen sections showed a monolayer of DiI-labelled cells on Descemet's membrane. These findings indicate that cultured adult HCECs, transplanted with DSAEK surgery, maintain corneal transparency after transplantation and suggest the feasibility of performing DSAEK with HCECs to treat endothelial dysfunction.
人角膜内皮细胞（HCECs）受伤后不会复制。因此，角膜内皮细胞缺乏可导致不可逆的角膜水肿。后弹力层剥除自动角膜内皮移植术（DSAEK）可选择性替换病变的角膜内皮。然而，DSAEK需要供体角膜，而全球角膜短缺限制了其应用。本综述介绍了利用培养的HCECs进行角膜内皮组织工程的现有知识。我们还提供了我们最近关于使用培养的HCECs进行DSAEK移植物组织工程的工作。我们通过将培养的DiI标记的HCECs接种在胶原片上来重建DSAEK移植物。然后在DSAEK组进行后弹力层撕除后，将HCEC片移植到后基质上。在整个观察期内，对照组检测到严重的基质水肿，而DSAEK组未检测到。术后1个月荧光素显微镜检查显示DSAEK组角膜后表面有大量DiI标记的细胞。冰冻切片显示后弹力膜上有单层DiI标记的细胞。这些发现表明，通过DSAEK手术移植的培养成年HCECs在移植后可维持角膜透明度，并提示用HCECs进行DSAEK治疗内皮功能障碍的可行性。
