Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro, Songpa-Gu, Seoul 05505, Republic of Korea.
Int J Mol Sci. 2023 Jun 30;24(13):10917. doi: 10.3390/ijms241310917.
The cornea, with its delicate structure, is vulnerable to damage from physical, chemical, and genetic factors. Corneal transplantation, including penetrating and lamellar keratoplasties, can restore the functions of the cornea in cases of severe damage. However, the process of corneal transplantation presents considerable obstacles, including a shortage of available donors, the risk of severe graft rejection, and potentially life-threatening complications. Over the past few decades, mesenchymal stem cell (MSC) therapy has become a novel alternative approach to corneal regeneration. Numerous studies have demonstrated the potential of MSCs to differentiate into different corneal cell types, such as keratocytes, epithelial cells, and endothelial cells. MSCs are considered a suitable candidate for corneal regeneration because of their promising therapeutic perspective and beneficial properties. MSCs compromise unique immunomodulation, anti-angiogenesis, and anti-inflammatory properties and secrete various growth factors, thus promoting corneal reconstruction. These effects in corneal engineering are mediated by MSCs differentiating into different lineages and paracrine action via exosomes. Early studies have proven the roles of MSC-derived exosomes in corneal regeneration by reducing inflammation, inhibiting neovascularization, and angiogenesis, and by promoting cell proliferation. This review highlights the contribution of MSCs and MSC-derived exosomes, their current usage status to overcome corneal disease, and their potential to restore different corneal layers as novel therapeutic agents. It also discusses feasible future possibilities, applications, challenges, and opportunities for future research in this field.
角膜结构精细，容易受到物理、化学和遗传因素的损害。角膜移植术，包括穿透性和板层角膜移植术，可以在严重损伤的情况下恢复角膜的功能。然而，角膜移植术存在许多障碍，包括供体短缺、严重排斥反应的风险以及潜在的危及生命的并发症。在过去的几十年中，间充质干细胞（MSC）疗法已成为角膜再生的一种新的替代方法。许多研究表明，MSC 具有分化为不同角膜细胞类型的潜力，如角膜细胞、上皮细胞和内皮细胞。MSC 因其有前途的治疗前景和有益特性被认为是角膜再生的合适候选者。MSC 具有独特的免疫调节、抗血管生成和抗炎特性，并分泌各种生长因子，从而促进角膜重建。MSC 通过分化为不同谱系和通过外泌体发挥旁分泌作用来介导这些在角膜工程中的效应。早期研究已经证明 MSC 衍生的外泌体在角膜再生中的作用，可减少炎症、抑制新生血管形成和血管生成，并促进细胞增殖。本综述强调了 MSC 和 MSC 衍生的外泌体的作用，及其在克服角膜疾病方面的当前应用现状，以及它们作为新型治疗剂恢复不同角膜层的潜力。还讨论了该领域未来研究的可行未来可能性、应用、挑战和机遇。
