Abstract
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.
Highlights
A healthy cornea is essential for proper vision
Fetal bovine serum, bovine serum, and bovine pituitary extract (BPE) are usually introduced into the manufacturing process to ensure the growth of the cells during the culture period [65,86,87,126,127]
After the Creutzfeldt–Jakob epidemic, BPE was prohibited in cell manufacturing for cell therapy
Summary
A healthy cornea is essential for proper vision. This part of the eye must be kept clear to be fully functional. The endothelial cells control the pressure in the cornea by expressing Na+/K+ pumps, which regulate the osmotic pressure between the stroma and the anterior eye chamber [5]. The corneal epithelium is a first barrier of defense from any external incursion It is composed of a few layers of epithelial cells tightly connected by complex proteins (tight junction, desmosomes, and hemidesmosomes). Autologous grafts produce excellent results in treating the LSCD cornea because the risk of graft rejection from the transplant is reduced. This treatment has limitations: (1) this approach cannot be performed if the patient has bilateral LSCD, which is a challenging task for ophthalmologists [26]; (2) a risk exists of damaging the healthy cornea [14].
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