Corneal epithelial stem cells in health and disease

Daniels, Julie T.; Harris, A. R.; Mason, Chris

doi:10.1007/s12015-006-0053-4

Cited by 40 publications

(22 citation statements)

References 60 publications

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“…More commonly LESCD occurs as a result of acquired factors including thermal or chemical injury, Stevens Johnson syndrome, contact lens wear and multiple surgeries (Clinch et al 1992;Holland 1996;Holland and Schwartz 1996;Gomes et al 2003) The outcome is persistent epithelial breakdown, superficial corneal vascularisation, chronic discomfort and impaired vision caused by the migration of neighbouring conjunctival epithelial cells and blood vessels onto the corneal surface (Huang and Tseng 1991;Puangsricharern and Tseng 1995; see also Daniels et al 2007). LESCD may be partial or total .…”

Section: Clinical Lescd: Causes and Proposed Treatmentsmentioning

confidence: 99%

Biological principals and clinical potentials of limbal epithelial stem cells

Notara¹,

Daniels²

2007

Cell Tissue Res

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In this review, we describe a population of adult stem cells that are currently being successfully used in the clinic to treat blinding ocular surface disease, namely limbal epithelial stem cells (LESC). The function and characteristics of LESC and the challenges faced in making use of their therapeutic potential will be examined. The cornea on the front surface of the eye provides our window on the world. The consistency and functionality of the outer-most corneal epithelium is essential for vision. A population of LESC are responsible for replenishing the epithelium throughout life by providing a constant supply of daughter cells that replace those constantly removed from the ocular surface during normal wear and tear and following injury. LESC deficiency results in corneal inflammation, opacification, vascularisation and severe discomfort. The transplantation of cultured LESC is one of only a few examples of the successful use of adult stem cell therapy in patients. The clinical precedence for the use of stem cell therapy and the ready accessibility of a transparent stem cell niche make the cornea a unique model for the study of adult stem cells in health and disease.

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Section: Clinical Lescd: Causes and Proposed Treatmentsmentioning

confidence: 99%

Biological principals and clinical potentials of limbal epithelial stem cells

Notara¹,

Daniels²

2007

Cell Tissue Res

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“…The serial sequelae resulting from limbal stem cell deficiency includes delayed epithelial healing or non-union, corneal erosion, conjunctive tissue and new vessel formation [21][22][23][24] . Pathological observation in this study showed that following the transplantation, the epithelial cells formed double-layer repairing, even producing the epithelial process.…”

Section: Discussionmentioning

confidence: 99%

“…Corneal alkaline burn is involved in complicated inflammation and immunological reaction, limbal stem cells of the cornea may be injured or loss due to alkaline burning, thus producing corneal opacity, inflammation, vascularization and severe complaints 1) .…”

Section: Introductionmentioning

confidence: 99%

Tissue-Engineered Corneal Epithelium Transplantation for Repair of Corneal Alkali Burn

Lü

Tang

et al. 2012

J. Hard Tissue Biology.

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The tissue-engineered corneal epithelium can be constructed with cultured limbal stem cells from the cornea of healthy rabbits cornea cultured in vitro, and its transplantation may promote the repair and healing of corneal alkaline burn. The aim of this study was to probe the effect and opportunity of treating corneal alkali burn with a tissue-engineered corneal epithelium transplantation. The tissue-engineered corneal epithelium was prepared in 37 rabbits with limbal stem cells cultured in vitro, for transplantation in a double eye corneal alkali burn model. Autologous or allogenic transplantation was performed at early time points (1, 3, 6, 9 days) or metaphase (14 days) following alkaline burning. 1 week following the burn, large corneal epithelial desquamation occurred, with 72% of the rabbits having epithelial desquamations or corneal ulcers at 2 weeks, continuing to 4 weeks post burn. Only 25% of the rabbits in the transplantation group had these effects 4 weeks post-treatment. Cell infiltration and vascularization of corneal stroma was observed in the metaphase transplantation group, not the early transplantation groups; Within 4 weeks, immunological rejection induced by allogenic transplantation was not greater than that of autologous transplantation. Cultivated autologous or allogenic tissue-engineered corneal epithelium transplantation restored ocular surface integrity, and the effect of early transplantation surpasses that of metaphase.

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“…Conventional corneal transplantation is unsuccessful in patients with severely damaged ocular surface with total LSCD, as the donor corneal graft only contains the differentiated cell population. Normal host stem cell population is necessary to maintain the reservoir of stem cells by replenishing the existing pool of cells [2,3,4]. Previous studies show tremendous success of limbal stem cell transplantation (LSCT) [5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Phenotypic Evaluation of Severely Damaged Ocular Surface after Reconstruction by Cultured Limbal Epithelial Cell Transplantation

Sharma

Tandon²,

Mohanty³

et al. 2013

Ophthalmic Res

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Objective: To report the clinical outcome of autologous cultured limbal epithelial cell transplantation (CLECT) followed by deep anterior lamellar keratoplasty (DALK) in paediatric eyes and to correlate the clinical outcome with the phenotype of rejuvenated corneal epithelium. Methods: Four patients with total limbal stem cell deficiency (LSCD) underwent autologous CLECT. Cultivated cell sheets were transplanted onto the damaged ocular surface followed by DALK surgery. Excised corneal buttons were subjected to histopathological analysis. Data recorded included age, sex, laterality, nature of injury, follow-up period, severity of stem cell deficiency, visual acuity, Schirmer's test and impression cytology. Results: At a mean follow-up period of 19.5 ± 7.4 (range 9-26) months after CLECT, all 4 eyes showed epithelialized and clinically stabilized ocular surface. Manual DALK was performed in all 4 eyes, with a mean follow-up of 9.75 ± 4.5 (range 5-15) months. All eyes exhibited smooth and clear corneal epithelium with improved visual acuity. Excised corneal buttons demonstrated organized corneal epithelial morphology and showed expression of cornea-specific CK3/12 marker. Conclusion: Restoration of severely damaged ocular surface following chemical injury by using 2-stage meticulous approaches offers a new modality for the treatment of severe LSCD. Transplantation of cultivated autologous limbal epithelial cell sheet followed by DALK surgery can efficiently restore the corneal phenotype with improved vision.

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Corneal epithelial stem cells in health and disease

Cited by 40 publications

References 60 publications

Biological principals and clinical potentials of limbal epithelial stem cells

Biological principals and clinical potentials of limbal epithelial stem cells

Tissue-Engineered Corneal Epithelium Transplantation for Repair of Corneal Alkali Burn

Phenotypic Evaluation of Severely Damaged Ocular Surface after Reconstruction by Cultured Limbal Epithelial Cell Transplantation

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