Yazdanpanah Ghasem, Jabbehdari Sayena, Djalilian Ali R
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.
Curr Opin Ophthalmol. 2017 Jul;28(4):348-354. doi: 10.1097/ICU.0000000000000378.
The aim of this review is to describe the underlying mechanisms of corneal epithelial homeostasis in addition to illustrating the vital role of the limbal epithelial stem cells (LESCs) and the limbal niche in epithelial regeneration and wound healing.
The shedded corneal epithelial cells are constantly replenished by the LESCs which give rise to epithelial cells that proliferate, differentiate, and migrate centripetally. While some recent studies have proposed that epithelial stem cells may also be present in the central cornea, the predominant location for the stem cells is the limbus. The limbal niche is the specialized microenvironment consisting of cells, extracellular matrix, and signaling molecules that are essential for the function of LESCs. Disturbances to limbal niche can result in LESC dysfunction; therefore, limbal stem cell deficiency should also be considered a limbal niche deficiency. Current and in-development therapeutic strategies are aimed at restoring the limbal niche, by medical and/or surgical treatments, administration of trophic factors, and cell based therapies.
The corneal epithelium is constantly replenished by LESCs that are housed within the limbal niche. The limbal niche is the primary determinant of the LESC function and novel therapeutic approaches should be focused on regeneration of this microenvironment.
本综述旨在描述角膜上皮稳态的潜在机制,同时阐明角膜缘上皮干细胞(LESCs)和角膜缘微环境在上皮再生和伤口愈合中的重要作用。
脱落的角膜上皮细胞不断由角膜缘上皮干细胞补充,这些干细胞产生的上皮细胞会增殖、分化并向心性迁移。虽然最近一些研究提出中央角膜也可能存在上皮干细胞,但干细胞的主要位置是角膜缘。角膜缘微环境是由细胞、细胞外基质和信号分子组成的特殊微环境,对角膜缘上皮干细胞的功能至关重要。角膜缘微环境的紊乱会导致角膜缘上皮干细胞功能障碍;因此,角膜缘干细胞缺乏也应被视为角膜缘微环境缺乏。目前和正在开发的治疗策略旨在通过药物和/或手术治疗、给予营养因子和基于细胞的疗法来恢复角膜缘微环境。
角膜上皮不断由位于角膜缘微环境中的角膜缘上皮干细胞补充。角膜缘微环境是角膜缘上皮干细胞功能的主要决定因素,新的治疗方法应专注于该微环境的再生。