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异体角膜缘干细胞在羊膜上扩增后移植治疗双侧角膜缘干细胞缺乏症的近期疗效分析。

Short-Term Results Analysis in the Allogenic Transplantation of Limbal Stem Cells Expanded on Amniotic Membrane in Patients with Bilateral Limbal Stem Cell Deficiency.

机构信息

Cornea and Refractive Surgery Department, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico.

Instituto Visión Láser, Aguascalientes, Mexico.

出版信息

J Ocul Pharmacol Ther. 2020 May;36(4):238-246. doi: 10.1089/jop.2019.0147. Epub 2020 Feb 20.

Abstract

The objective of this study was to describe the short-term results of allogenic transplantation of limbal stem cells expanded on amniotic membrane for the ocular surface reconstruction. Prospective nonrandomized, nonmasked study in a single ophthalmological center. Ten patients with bilateral total limbal stem cell deficiency (LSCD) were included. Expression and presence of ABCB5 and Δp63α in amniotic membrane-cultured limbal epithelial stem cells were analyzed, in relationship with clinical changes after allogenic transplantation. An objective evaluation was performed to determine corneal transparency and superficial vascularization. In a median follow-up time of 11.6 months, 7 patients (70%) were considered as failure compared with the preoperative status. ABCB5 and Δp63α are expressed in similar amount in the limbal epithelial cells expanded and transplanted in patients with bilateral LSCD. Transplantation of allogenic epithelial limbal cells expanded in amniotic membrane could be considered in patients with LSCD due to burns or congenital etiologies such as aniridia, but its benefit is limited for patients with immunologic diseases.

摘要

本研究旨在描述羊膜培养扩增同种异体角膜缘干细胞移植用于眼表重建的短期结果。 这是在一家眼科中心进行的前瞻性非随机、非盲法研究。纳入了 10 例双侧完全性角膜缘干细胞缺乏症(LSCD)患者。分析了羊膜培养扩增的角膜缘上皮干细胞中 ABCB5 和 Δp63α 的表达和存在情况,与同种异体移植后的临床变化相关。采用客观评估方法确定角膜透明度和浅层血管化情况。 在 11.6 个月的中位随访时间内,7 例患者(70%)与术前状态相比被认为是失败。在双侧 LSCD 患者中,扩增和移植的角膜缘上皮细胞中 ABCB5 和 Δp63α 的表达量相似。 由于烧伤或先天性疾病(如无虹膜)导致 LSCD 的患者可以考虑使用羊膜培养扩增同种异体上皮性角膜缘细胞移植,但对于免疫性疾病患者,其益处是有限的。

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