Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
University of Sao Paulo, Sao Paulo, Brazil.
Exp Eye Res. 2020 May;194:108002. doi: 10.1016/j.exer.2020.108002. Epub 2020 Mar 13.
Basement membranes are highly specialized extracellular matrices. More than providing scaffolds, basement membranes are recognized as dynamic and versatile structures that modulate cellular responses to regulate tissue development, function, and repair. Increasing evidence suggests that, in addition to providing structural support to adjacent cells, basement membranes serve as reservoirs and modulators of growth factors that direct and fine-tune cellular functions. Since the corneal stroma is avascular and has a relatively low keratocyte density, it's likely that the corneal BM is different in composition from the BMs in other tissues. BMs are composed of a diverse assemblage of extracellular molecules, some of which are likely specific to the tissue where they function; but in general they are composed of four primary components-collagens, laminins, heparan sulfate proteoglycans, and nidogens-in addition to other components such as thrombospondin-1, matrilin-2, and matrilin-4 and fibronectin. Severe injuries to the cornea, including infection, surgery, and trauma, may trigger the development of myofibroblasts and fibrosis in the normally transparent connective tissue stroma. Ultrastructural studies have demonstrated that defective epithelial basement membrane (EBM) regeneration after injury to the cornea underlies the development of myofibroblasts from both bone marrow- and keratocyte-derived precursor cells. Defective EBM permits epithelium-derived and tear-derived transforming growth factor beta (TGF-β), platelet-derived growth factor (PDGF), and possibly other modulators, to penetrate the stroma at sustained levels necessary to drive the development and persistence of vimentin + alpha-smooth muscle actin + desmin+ (V + A + D+) mature myofibroblasts. A recent discovery that has contributed to our understanding of haze development is that keratocytes and corneal fibroblasts produce critical EBM components, such as nidogen-1, nidogen-2 and perlecan, that are essential for complete regeneration of a normal EBM once laminin secreted by epithelial cells self-polymerizes into a nascent EBM. Mature myofibroblasts that become established in the anterior stroma are a barrier to keratocyte/corneal fibroblast contributions to the nascent EBM. These myofibroblasts, and the opacity they produce, often persist for months or years after the injury. Transparency is subsequently restored if the EBM is fully regenerated, myofibroblasts are deprived of TGF-β and undergo apoptosis, and keratocytes reoccupy the anterior stroma and reabsorb the disordered extracellular matrix.
基底膜是高度特化的细胞外基质。基底膜不仅提供支架,还被认为是一种动态和多功能的结构,可调节细胞对组织发育、功能和修复的反应。越来越多的证据表明,除了为相邻细胞提供结构支持外,基底膜还作为生长因子的储库和调节剂,指导和微调细胞功能。由于角膜基质是无血管的,且角膜基质细胞密度相对较低,因此角膜 BM 的组成可能与其他组织中的 BM 不同。BM 由多种细胞外分子组成,其中一些可能是其功能所在组织所特有的;但一般来说,它们由四种主要成分组成-胶原、层粘连蛋白、硫酸乙酰肝素蛋白聚糖和巢蛋白-以及其他成分,如血小板反应蛋白-1、基质蛋白-2 和基质蛋白-4 和纤维连接蛋白。角膜的严重损伤,包括感染、手术和创伤,可能会引发正常透明结缔组织基质中的成纤维细胞和纤维化的发展。超微结构研究表明,角膜损伤后上皮基底膜 (EBM) 的再生缺陷是骨髓源性和角膜基质细胞源性前体细胞成纤维细胞的发展的基础。EBM 的缺陷允许上皮衍生和泪液衍生的转化生长因子β (TGF-β)、血小板衍生生长因子 (PDGF) 和可能的其他调节剂,以持续穿透基质,达到驱动 vimentin+α-平滑肌肌动蛋白+desmin+(V+A+D+)成熟成纤维细胞发展和持续存在的水平。最近的一项发现有助于我们理解混浊发展,即角膜基质细胞和角膜成纤维细胞产生关键的 EBM 成分,如巢蛋白-1、巢蛋白-2 和 perlecan,这些成分对于上皮细胞分泌的层粘连蛋白自我聚合形成新生 EBM 后完全再生正常 EBM 是必不可少的。在前基质中形成的成熟成纤维细胞是角膜基质细胞/成纤维细胞对新生 EBM 贡献的障碍。这些成纤维细胞和它们产生的不透明性通常在损伤后持续数月或数年。如果 EBM 完全再生,成纤维细胞剥夺 TGF-β并凋亡,角膜基质细胞重新占据前基质并吸收紊乱的细胞外基质,透明度随后恢复。