Giannaccare Giuseppe, Carnevali Adriano, Senni Carlotta, Logozzo Laura, Scorcia Vincenzo
Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Ophthalmology Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy.
Ophthalmol Ther. 2020 Jun;9(2):235-248. doi: 10.1007/s40123-020-00239-9. Epub 2020 Feb 27.
Several blood derivatives have been proposed for the treatment of various ocular diseases that affect either the anterior or the posterior segment of the eye. Blood sources may range from the patient's own peripheral blood (autologous) to donor tissues, mainly allogeneic peripheral blood and umbilical cord blood (UCB). The utilization of the latter permits the collection of a large amount of serum all at once, and is characterized by therapeutic feasibility in patients with a poor general condition or anemia and blood dyscrasia. Products derived from UCB have two potential uses. First, serum in the form of eye drops can be applied topically onto the ocular surface to efficiently treat anterior segment disorders such as dry eye syndrome or corneal epithelial defects with different etiologies. The rationale for and efficacy of this application derive from the high concentrations of biologically active components and growth factors in UCB, which can nourish the ocular surface. Second, UCB is a source of stem cells, which are used in the field of regenerative medicine because they differentiate into various mature cells, including corneal and retinal cells. Therefore, UCB-derived stem cells have been proposed as a replacement therapy for the treatment of retinal and optic nerve diseases, given that current standard treatments often fail. The present review explores the clinical results that have been obtained using UCB-derived products in the field of ophthalmology, as well as the current limitations of those products in this field. Furthermore, given the promising development of UCB-based therapies, possible future directions in this area are discussed.
几种血液衍生物已被提议用于治疗影响眼球前段或后段的各种眼部疾病。血液来源范围从患者自身的外周血(自体血)到供体组织,主要是异体外周血和脐带血(UCB)。使用后者可以一次性采集大量血清,其特点是对于一般状况较差、贫血或血液系统疾病患者具有治疗可行性。源自脐带血的产品有两种潜在用途。第一,眼药水形式的血清可局部应用于眼表,以有效治疗前段疾病,如干眼症或不同病因的角膜上皮缺损。这种应用的原理和疗效源于脐带血中高浓度的生物活性成分和生长因子,它们可以滋养眼表。第二,脐带血是干细胞的来源,由于它们可分化为各种成熟细胞,包括角膜和视网膜细胞,因此在再生医学领域得到应用。鉴于目前的标准治疗常常失败,因此已提议将源自脐带血的干细胞作为治疗视网膜和视神经疾病的替代疗法。本综述探讨了在眼科领域使用源自脐带血的产品所取得的临床结果,以及这些产品在该领域目前存在的局限性。此外,鉴于基于脐带血的疗法有前景的发展,还讨论了该领域未来可能的发展方向。