Abstract

Cornea is a clear outermost layer of the eye which enables transmission of light onto the retina. The transparent corneal epithelium is regenerated by limbal stem cells (LSCs), whose loss/dysfunction results in LSCs deficiency (LSCD). Ex vivo expansion of autologous LSCs obtained from patient's healthy eye followed by transplantation onto the LSCs damaged/deficient eye, has provided a successful treatment for unilateral LSCD. However, this is not applicable to patient with total bilateral LSCD, where LSCs are lost/damaged from both eyes. We investigated the potential of human induced pluripotent stem cell (hiPSC) to differentiate into corneal epithelial‐like cells as a source of autologous stem cell treatment for patients with total bilateral LSCD. Our study showed that combined addition of bone morphogenetic protein 4 (BMP4), all trans‐retinoic acid and epidermal growth factor for the first 9 days of differentiation followed by cell‐replating on collagen‐IV‐coated surfaces with a corneal‐specific‐epithelial cell media for an additional 11 days, resulted in step wise differentiation of human embryonic stem cells (hESC) to corneal epithelial progenitors and mature corneal epithelial‐like cells. We observed differences in the ability of hiPSC lines to undergo differentiation to corneal epithelial‐like cells which were dependent on the level of endogenous BMP signaling and could be restored via the activation of this signaling pathway by a specific transforming growth factor β inhibitor (SB431542). Together our data reveal a differential ability of hiPSC lines to generate corneal epithelial cells which is underlined by the activity of endogenous BMP signaling pathway. Stem Cells 2018;36:337–348

Highlights

  • Cornea is the transparent region at the front of the eye which enables transmission of light to the retina

  • Our study showed that combined addition of bone morphogenetic protein 4 (BMP4), all trans-retinoic acid and epidermal growth factor for the first 9 days of differentiation followed by cell-replating on collagen-IV-coated surfaces with a corneal-specific-epithelial cell media for an additional 11 days, resulted in step wise differentiation of human embryonic stem cells to corneal epithelial progenitors and mature corneal epithelial-like cells

  • One human embryonic stem cells (hESC) (H9) and two human induced pluripotent stem cell (hiPSC) (SB-Ad2 and SB-Ad3) lines were directed to differentiate to corneal epithelial-like cells using a two stage differentiation protocol which aimed at generating corneal epithelial progenitors and their further differentiation to mature corneal epithelial cells

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Summary

Introduction

Cornea is the transparent region at the front of the eye which enables transmission of light to the retina. Work done by our group and others have shown that the transplantation of ex vivo expanded autologous LSCs is able to reconstruct the corneal surface and to restore vision in patients with unilateral total LSCD [7,8,9]. This treatment is not applicable to a significant number of patients with total bilateral LSCD where patient’s both eyes are devoid of LSCs which are needed for the ex vivo expansion and subsequently used for transplantation. Notwithstanding, we showed that cultured oral epithelial cells retained a gene expression profile that was attributed to epithelial stem cells in general, but they did not acquire a typical limbal expression pattern after 10–14 days in culture [18], indicating that the transplanted cells did not fully transdifferentiate into corneal epithelium

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