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[角膜缘干细胞缺乏症的治疗。综述]

[Limbal stem cell deficiency management. A review].

作者信息

Kocaba V, Damour O, Auxenfans C, Burillon C

机构信息

Cornea Center of Excellence, Harvard Medical School, Schepens Eye Research Institute, 20, Staniford Street, Boston, 02114-MA, États-Unis; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, 243, Charles Street, Boston, 02114-MA, États-Unis; Banque de cornée de Lyon, pavillon I, hôpital Edouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France; Service d'ophtalmologie, pavillon C, hôpital Edouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France; Université Claude-Bernard Lyon-I, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France.

Banque de cornée de Lyon, pavillon I, hôpital Edouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France.

出版信息

J Fr Ophtalmol. 2016 Nov;39(9):791-803. doi: 10.1016/j.jfo.2016.08.001. Epub 2016 Oct 12.

Abstract

Limbal stem cell deficiency is predominantly caused by severe eye burns resulting in a decreased or a complete ablation of the regenerative potential of these stem cells. The inability to reconstruct the corneal epithelium further leads conjunctivalization of the gimbal-epithelial barrier. These abnormalities collectively result in the progressive opacification of the cornea responsible for blindness that is driven by chronic corneal ulceration and neovascularization. The underlying pathology of the cornea affects the homeostasis of the neighboring conjunctiva, eyelids, and tear film. Therefore, the ocular reconstruction to treat limbal stem cell deficiency is quite prolonged and involves a continued treatment plan. The management of limbal stem cell deficiency has undergone a multitude of changes over the past several decades. The understanding of limbal anatomy and physiology, as well as therapeutic advances in the stem cell field have propelled the development of new treatments offering new hope to severely disabled patients. Cultivated limbal epithelial and oral mucosal epithelial transplantations are therefore viable alternatives that could be utilized for the treatment of limbal stem cell deficiency.

摘要

角膜缘干细胞缺乏主要由严重的眼部烧伤引起,导致这些干细胞的再生潜能降低或完全丧失。无法重建角膜上皮会进一步导致角膜缘上皮屏障结膜化。这些异常共同导致角膜逐渐混浊,进而导致失明,这是由慢性角膜溃疡和新生血管形成所驱动的。角膜的潜在病理会影响邻近结膜、眼睑和泪膜的稳态。因此,治疗角膜缘干细胞缺乏的眼部重建过程相当漫长,且需要持续的治疗方案。在过去几十年里,角膜缘干细胞缺乏的治疗方法发生了诸多变化。对角膜缘解剖学和生理学的认识,以及干细胞领域的治疗进展推动了新治疗方法的发展,为严重残疾患者带来了新的希望。因此,培养的角膜缘上皮移植和口腔黏膜上皮移植是可用于治疗角膜缘干细胞缺乏的可行替代方法。

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