Amin Sohil, Jalilian Elmira, Katz Eitan, Frank Charlie, Yazdanpanah Ghasem, Guaiquil Victor H, Rosenblatt Mark I, Djalilian Ali R
Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA.
Richard and Loan Hill Department of Bioengineering, University of Illinois Chicago, Chicago, IL 60612, USA.
Vision (Basel). 2021 Sep 22;5(4):43. doi: 10.3390/vision5040043.
The protective function and transparency provided by the corneal epithelium are dependent on and maintained by the regenerative capacity of limbal epithelial stem cells (LESCs). These LESCs are supported by the limbal niche, a specialized microenvironment consisting of cellular and non-cellular components. Disruption of the limbal niche, primarily from injuries or inflammatory processes, can negatively impact the regenerative ability of LESCs. Limbal stem cell deficiency (LSCD) directly hampers the regenerative ability of the corneal epithelium and allows the conjunctival epithelium to invade the cornea, which results in severe visual impairment. Treatment involves restoring the LESC population and functionality; however, few clinically practiced therapies currently exist. This review outlines the current understanding of the limbal niche, its pathology and the emerging approaches targeted at restoring the limbal niche. Most emerging approaches are in developmental phases but show promise for treating LSCD and accelerating corneal regeneration. Specifically, we examine cell-based therapies, bio-active extracellular matrices and soluble factor therapies in considerable depth.
角膜上皮提供的保护功能和透明度依赖于角膜缘上皮干细胞（LESCs）的再生能力并由其维持。这些角膜缘上皮干细胞由角膜缘生态位支持，角膜缘生态位是一个由细胞和非细胞成分组成的特殊微环境。角膜缘生态位的破坏主要源于损伤或炎症过程，会对角膜缘上皮干细胞的再生能力产生负面影响。角膜缘干细胞缺乏症（LSCD）直接阻碍角膜上皮的再生能力，并使结膜上皮侵入角膜，从而导致严重的视力损害。治疗方法包括恢复角膜缘上皮干细胞群体及其功能；然而，目前临床实践中的治疗方法很少。本综述概述了目前对角膜缘生态位的认识、其病理学以及针对恢复角膜缘生态位的新兴方法。大多数新兴方法正处于研发阶段，但显示出治疗角膜缘干细胞缺乏症和加速角膜再生的前景。具体而言，我们深入研究了基于细胞的疗法、生物活性细胞外基质和可溶性因子疗法。
