Vita-Salute San Raffaele University, Milan, Italy; Eye Repair Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Holostem Terapie Avanzate S.r.l., Modena, Italy.
Prog Retin Eye Res. 2024 Sep;102:101275. doi: 10.1016/j.preteyeres.2024.101275. Epub 2024 May 24.
The cornea is an ideal testing field for cell therapies. Its highly ordered structure, where specific cell populations are sequestered in different layers, together with its accessibility, has allowed the development of the first stem cell-based therapy approved by the European Medicine Agency. Today, different techniques have been proposed for autologous and allogeneic limbal and non-limbal cell transplantation. Cell replacement has also been attempted in cases of endothelial cell decompensation as it occurs in Fuchs dystrophy: injection of cultivated allogeneic endothelial cells is now in advanced phases of clinical development. Recently, stromal substitutes have been developed with excellent integration capability and transparency. Finally, cell-derived products, such as exosomes obtained from different sources, have been investigated for the treatment of severe corneal diseases with encouraging results. Optimization of the success rate of cell therapies obviously requires high-quality cultured cells/products, but the role of the surrounding microenvironment is equally important to allow engraftment of transplanted cells, to preserve their functions and, ultimately, lead to restoration of tissue integrity and transparency of the cornea.
角膜是细胞治疗的理想试验场。其高度有序的结构，其中特定的细胞群体被隔离在不同的层中，加上其可及性，使得第一种基于干细胞的治疗方法获得了欧洲药品管理局的批准。如今，已经提出了用于同种异体和同种异体角膜缘和非角膜缘细胞移植的不同技术。在发生在 Fuchs 营养不良中的内皮细胞失代偿的情况下，也尝试了细胞替代：培养的同种异体内皮细胞的注射现在处于临床开发的高级阶段。最近，已经开发出具有出色整合能力和透明度的基质替代品。最后，细胞衍生产品，如来自不同来源的外泌体，已被用于治疗严重的角膜疾病，并取得了令人鼓舞的结果。细胞治疗成功率的优化显然需要高质量的培养细胞/产品，但周围微环境的作用同样重要，以允许移植细胞的植入，保持其功能，最终导致组织完整性和角膜透明度的恢复。
