Gouveia Ricardo M, Connon Che J
Biosciences Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Newcastle upon Tyne, UK.
Transl Vis Sci Technol. 2020 Nov 2;9(12):5. doi: 10.1167/tvst.9.12.5. eCollection 2020 Nov.
Ocular injuries caused by chemical and thermal burns are often unmanageable and frequently result in disfigurement, corneal haze/opacification, and vision loss. Currently, a considerable number of surgical and pharmacological approaches are available to treat such injuries at either an acute or a chronic stage. However, these existing interventions are mainly directed at (and limited to) suppressing corneal inflammation and neovascularization while promoting re-epithelialization. Reconstruction of the ocular surface represents a suitable but last-option recourse in cases where epithelial healing is severely impaired, such as due to limbal stem cell deficiency. In this concise review, we discuss how biomechanical modulation therapy (BMT) may represent a more effective approach to promoting the regeneration of ocular tissues affected by burn injuries via restoration of the limbal stem cell niche. Specifically, the scientific basis supporting this new therapeutic modality is described, along with our growing understanding of the role that tissue biomechanics plays in stem cell fate and function. The potential impact of BMT as a future treatment option for the management of injuries affecting tissue compliance is also further discussed.
化学和热烧伤引起的眼外伤通常难以处理,常导致毁容、角膜混浊/opacity以及视力丧失。目前,有相当多的手术和药理学方法可用于在急性或慢性阶段治疗此类损伤。然而,这些现有的干预措施主要针对(并限于)抑制角膜炎症和新生血管形成,同时促进上皮再形成。在诸如角膜缘干细胞缺乏等上皮愈合严重受损的情况下,眼表重建是一种合适但最后的选择。在这篇简要综述中,我们讨论生物力学调节疗法(BMT)如何可能代表一种更有效的方法,通过恢复角膜缘干细胞龛来促进受烧伤影响的眼组织再生。具体而言,描述了支持这种新治疗方式的科学依据,以及我们对组织生物力学在干细胞命运和功能中所起作用的日益深入的理解。还进一步讨论了BMT作为未来治疗影响组织顺应性损伤的潜在影响。