Abstract
Ocular chemical burns are potentially blinding ocular injuries and require urgent management. Amniotic membrane (AM) transplantation is an effective surgical treatment, one of the reasons is because AM is a rich source of growth factors that can promote epithelialization and wound healing. However, growth factors will be gradually lost and insufficient after preparation process and long-time storage, leading to unsatisfactory therapeutic effects. Herein, we present a modified AM (AM-HEP) for the supplement and sustained release of growth factor by surface grafting heparin for treatment of ocular chemical burns. Heparin grafting rate and stability, microstructure, physical property, and sustained release of epithelial growth factor (EGF) of AM-HEP were characterized. Biocompatibility and ability to promote corneal epithelial cell growth and migration were evaluated and compared with a biological amnion, which is available on the market in vitro. The therapeutic effects of AM-HEP combined with EGF (AM-HEP@EGF) in vivo had been evaluated in a model of mouse corneal alkali burn. The results indicated that heparin was introduced into AM and maintain stability over 3 weeks at 37°C. The modification process of AM-HEP did not affect microstructure and physical property after comparing with non-modified AM. EGF could be combined quickly and effectively with AM-HEP; the sustained release could last for more than 14 days. AM-HEP@EGF could significantly promote corneal epithelial cell growth and migration, compared with non-modified AM and control group. Faster corneal epithelialization was observed with the transplantation of AM-HEP@EGF in vivo, compared with the untreated control group. The corneas in the AM-HEP@EGF group have less inflammation and were more transparent than those in the control group. The results from in vitro and in vivo experiments demonstrated that AM-HEP@EGF could significantly enhance the therapeutic effects. Taken together, AM-HEP@EGF is exhibited to be a potent clinical application in corneal alkali burns through accelerating corneal epithelial wound healing.
Highlights
Cornea is located on the outermost layer of the eye and is injured (Meek and Knupp, 2015)
Heparin content of Amniotic membrane (AM)-Heparin sodium salt (HEP) was much higher after chemical modification than that of AM, which was only soaked in heparin solution for the same time and non-modified AM (Figure 2C)
We have successfully prepared AM grafted with heparin, which can adsorb quickly, and sustained release epithelial growth factor (EGF) for treatment of ocular chemical burns
Summary
Cornea is located on the outermost layer of the eye and is injured (Meek and Knupp, 2015). As a temporary covering material, AM can promote corneal epithelialization and inhibit inflammation (Kobayashi et al, 2003; Liang et al, 2012; Sharma et al, 2015) To some extent, it alleviates the shortage of corneal donors and has become a usual biomaterial in ophthalmic surgery (Fan et al, 2016). The existing methods for preparing AM cannot balance storage time and activity Whether it is stored in a dry state or in a wet state, it is difficult to keep growth factors active for a long time in the same storage environment as AM. These may lead to unsatisfactory therapeutic effects
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