scholarly journals Limbal Stem Cell Transplantation: Clinical Results, Limits, and Perspectives

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Marta Sacchetti ◽  
Paolo Rama ◽  
Alice Bruscolini ◽  
Alessandro Lambiase
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Corneal Epithelium ◽  
Clinical Results ◽  
Limbal Stem Cells ◽  
Fellow Eye ◽  
Ocular Surface Reconstruction ◽  
Limbal Stem Cell Transplantation ◽  
Limbal Stem Cell

Limbal stem cell deficiency (LSCD) is a clinical condition characterized by damage of cornea limbal stem cells, which results in an impairment of corneal epithelium turnover and in an invasion of the cornea by the conjunctival epithelium. In these patients, the conjunctivalization of the cornea is associated with visual impairment and cornea transplantation has poor prognosis for recurrence of the conjunctivalization. Current treatments of LSCD are aimed at replacing the damaged corneal stem cells in order to restore a healthy corneal epithelium. The autotransplantation of limbal tissue from the healthy, fellow eye is effective in unilateral LSCD but leads to depauperation of the stem cell reservoir. In the last decades, novel techniques such as cultivated limbal epithelial transplantation (CLET) have been proposed in order to reduce the damage of the healthy fellow eye. Clinical and experimental evidence showed that CLET is effective in inducing long-term regeneration of a healthy corneal epithelium in patients with LSCD with a success rate of 70%–80%. Current limitations for the treatment of LSCD are represented by the lack of a marker able to unequivocally identify limbal stem cells and the treatment of total, bilateral LSCD which requires other sources of stem cells for ocular surface reconstruction.

scholarly journals Clinical Trials of Limbal Stem Cell Deficiency Treated with Oral Mucosal Epithelial Cells

2020 ◽  
Vol 21 (2) ◽  
pp. 411 ◽  
Author(s):  
Joan Oliva ◽  
Fawzia Bardag-Gorce ◽  
Yutaka Niihara
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Corneal Epithelium ◽  
Contact Lenses ◽  
Embryonic Stem ◽  
Epithelial Stem Cells ◽  
Physical Damage ◽  
Limbal Stem Cells ◽  
Cell Therapies ◽  
Limbal Stem Cell

The corneal surface is an essential organ necessary for vision, and its clarity must be maintained. The corneal epithelium is renewed by limbal stem cells, located in the limbus and in palisades of Vogt. Palisades of Vogt maintain the clearness of the corneal epithelium by blocking the growth of conjunctival epithelium and the invasion of blood vessels over the cornea. The limbal region can be damaged by chemical burns, physical damage (e.g., by contact lenses), congenital disease, chronic inflammation, or limbal surgeries. The degree of limbus damage is associated with the degree of limbal stem cells deficiency (partial or total). For a long time, the only treatment to restore vision was grafting part of the healthy cornea from the other eye of the patient or by transplanting a cornea from cadavers. The regenerative medicine and stem cell therapies have been applied to restore normal vision using different methodologies. The source of stem cells varies from embryonic stem cells, mesenchymal stem cells, to induced pluripotent stem cells. This review focuses on the use of oral mucosa epithelial stem cells and their use in engineering cell sheets to treat limbal stem cell deficient patients.

Autologous Cultivated Limbal Stem Cell Transplantation after Failed Previous Limbal Graft

2017 ◽  
Vol 27 (5) ◽  
pp. e137-e139
Author(s):  
Karl A. Knutsson ◽  
Stanislav Matuska ◽  
Paolo Rama
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Ocular Surface ◽  
Ex Vivo ◽  
Limbal Stem Cells ◽  
Limbal Stem Cell Transplantation ◽  
Limbal Stem Cell ◽  
Contralateral Eye

Purpose To describe a case of unilateral limbal stem cell deficiency (LSCD) with previously failed autologous graft, resolved by ocular surface reconstruction using cultured autologous limbal stem cells from the contralateral eye. Case Report A 35-year-old patient presented to our clinic with LSCD due to a unilateral alkali burn. The patient had received a previous limbal graft from the contralateral eye that had failed to impede corneal conjunctivalization. We decided to repeat limbal stem cell transplantation using an ex vivo cultivation procedure to reduce the risk of tissue harvesting on the healthy fellow eye. A small limbal biopsy (1.5 × 1.5 mm) near the previously excised limbus was performed. Stem cells were then isolated and cultured on fibrin and a 3T3 feeder cell layer using a standard protocol. Four months later, the cultivated cells on fibrin were grafted after pannus removal. In the subsequent months, the ocular surface stabilized and inflammation decreased. Two years later, the patient underwent large tectonic lamellar keratoplasty for severe corneal thinning involving the entire cornea, and 6 months later central penetrating keratoplasty and extracapsular cataract extraction with intraocular lens implantation and pupilloplasty was performed. Following reconstruction, the patient showed improved best-corrected vision from count fingers to 20/200 due to amblyopia, and the ocular surface was stable with a transparent corneal graft. Conclusions Ex vivo limbal stem cell transplantation is a valid technique for treating LSCD and can be utilized for treating patients who have had previous failed limbal grafts.

scholarly journals Limbal Stem Cell-Sparing Corneoscleroplasty with Peripheral Intralamellar Tuck: A New Surgical Technique for Keratoglobus

2017 ◽  
Vol 8 (1) ◽  
pp. 279-287
Author(s):  
Elias Jarade ◽  
Rafic Antonios ◽  
Sylvain el-Khoury
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Structural Integrity ◽  
Single Step ◽  
Limbal Stem Cells ◽  
Host Cornea ◽  
Limbal Stem Cell ◽  
The Right ◽  
New Surgical Technique

Purpose: To describe the technique of limbal stem cell-sparing corneoscleroplasty for the management of advanced keratoglobus. Methods: A patient with bilateral advanced keratoglobus, with best-corrected visual acuity of 20/400 in the right eye and 20/200 in the left eye, underwent limbal stem cell-sparing corneoscleroplasty of the right eye. Initially, a 360-degree limbal incision with 200-μm depth was created, followed by a sublimbal tunnel dissection into the sclera, in order to conserve stem cells. Next, a limbus-to-limbus lamellar keratectomy at 200-μm depth was performed. Meanwhile, a donor corneoscleral button with preserved endothelium of the central 8 mm was fashioned. Prior to suturing the donor corneoscleral graft using a modified suturing technique to cover its scleral component, a full-thickness trephination of 8-mm diameter was completed in the central host cornea. Results: Reepithelialization occurred within the first week. No episodes of rejection, intraocular pressure spikes, or epithelial breakdown were observed postoperatively. At the 6-month follow-up, the patient had 20/70 best-corrected vision and a smooth cornea with regular astigmatism on topography. Conclusion: Limbal stem cell-sparing corneoscleroplasty is a single-step technique for restoring the structural integrity of the cornea in advanced keratoglobus while preserving the host limbal stem cells.

Stem Cell-Like Characteristics of Corneal Epithelial Cells

2014 ◽  
Vol 998-999 ◽  
pp. 312-315
Author(s):  
Fan Wang ◽  
Bo Ren ◽  
Yi Ning Yan
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Epithelial Cells ◽  
Corneal Epithelium ◽  
Cell Activity ◽  
Stem Cell Marker ◽  
Corneal Tissue ◽  
Limbal Stem Cells ◽  
Corneal Epithelial Cells ◽  
Corneal Epithelial

Purpose: The adult corneal epithelium is maintained by a population of limbal stem cells (LSCs), transmembrane protein prominin, regarded as stem cell marker was investigated on mouse corneal tissue, to study weather contains CD133-expressing cells and their distribution. Methods: Enucleated mouse eyes were embedded in OCT and cryosections were performed for mmunohistochemical studies using the avidin-biotin-peroxidase complex (ABC) procedure. Meanwhile, dissected mouse corneas were analyzed by westernblot. Results: In the adult mouse, 13A4 immunoreactivity was detected at the apical side of superficial corneal epithelium, including the limbus region, but not by stroma and endothelium. 115 KDa protein was approved in corneal tissue by Westernblot. Conclusions: The stem cell activity does not occur along the limbus but presumably presented by small portion of corneal epithelial cells which may hold a similar properties of stem cells.

scholarly journals Limbal stem cell deficiency: etiology, pathogenesis, priniciples and prospects of surgical treatment

2019 ◽  
Vol 12 (1) ◽  
pp. 103-111
Author(s):  
A. S. Dubovikov ◽  
I. O. Gavrilyuk ◽  
A. N. Kulikov ◽  
S. V. Churashov ◽  
V. F. Chernysh ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Surgical Treatment ◽  
Ex Vivo ◽  
Epithelial Stem Cells ◽  
Limbal Stem Cells ◽  
History Of Development ◽  
History Of ◽  
Limbal Epithelial Stem Cells ◽  
Limbal Stem Cell

The review is focused on the modern view of the etiology and pathogenesis of limbal stem cells deficiency. The history of development of tissue and ex-vivo transplantation of limbal epithelial stem cells is presented. Certain promising directions of the treatment of patients with limbal stem cells deficiency are presented.

scholarly journals Hyaluronan-Based Hydrogel Scaffolds for Limbal Stem Cell Transplantation: A Review

Cells ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 245 ◽  
Author(s):  
Mazyar Yazdani ◽  
Aboulghassem Shahdadfar ◽  
Catherine Joan Jackson ◽  
Tor Paaske Utheim
Keyword(s):  
Extracellular Matrix ◽  
Stem Cell ◽  
Limbal Stem Cells ◽  
Receptor Proteins ◽  
Hydrogel Scaffolds ◽  
Cell Based Therapy ◽  
Limbal Stem Cell Transplantation ◽  
Limbal Stem Cell ◽  
Cell Niche ◽  
Synthesis And Degradation

Hyaluronan (HA), also termed hyaluronic acid or hyaluronate, is a major component of the extracellular matrix. This non-sulfated glycosaminoglycan plays a key role in cell proliferation, growth, survival, polarization, and differentiation. The diverse biological roles of HA are linked to the combination of HA’s physicochemical properties and HA-binding proteins. These unique characteristics have encouraged the application of HA-based hydrogel scaffolds for stem cell-based therapy, a successful method in the treatment of limbal stem cell deficiency (LSCD). This condition occurs following direct damage to limbal stem cells and/or changes in the limbal stem cell niche microenvironment due to intrinsic and extrinsic insults. This paper reviews the physical properties, synthesis, and degradation of HA. In addition, the interaction of HA with other extracellular matrix (ECM) components and receptor proteins are discussed. Finally, studies employing HA-based hydrogel scaffolds in the treatment of LSCD are reviewed.

AUTOLOGOUS FIBRIN-CULTURED LIMBAL STEM CELLS PERMANENTLY RESTORE THE CORNEAL SURFACE OF PATIENTS WITH TOTAL LIMBAL STEM CELL DEFICIENCY1

2001 ◽  
Vol 72 (9) ◽  
pp. 1478-1485 ◽  
Author(s):  
Paolo Rama ◽  
Stefano Bonini ◽  
Alessandro Lambiase ◽  
Osvaldo Golisano ◽  
Patrizia Paterna ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Limbal Stem Cells ◽  
Corneal Surface ◽  
Limbal Stem Cell
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