Corneal blindness is one of the most common causes of vision loss worldwide, affecting millions of people. To treat these patients, researchers have been examining different approaches to engineer corneal scaffolds suitable for transplantation. Scaffolds have been developed to replace part or all of the cornea depending on the patient requirements. Both acellular and cell-seeded scaffolds have been tested in animal models. Materials that have been under investigation for manufacturing scaffolds include collagen, silk fibroin, amniotic membrane, decellularized cornea, fibrin, chitosan, gelatin, agarose, alginate, and hyaluronic acid in addition to several synthetic polymers. Different combinations of materials, fiber crosslinking techniques, and incorporation of bioactive molecules have also been examined. Factors such as the physical properties, cytocompatibility, degradation behavior, and optical characteristics have to be considered when selecting a suitable scaffold material. Recent advancements in materials fabrication techniques such as bioprinting, electrospinning, and different collagen alignment techniques, allow scaffolds to be generated that more accurately mimic the structure of the corneal stroma. A number of scaffolds have commenced clinical trials to determine their suitability for corneal regeneration.

There has been a drive to develop new cell based therapies to treat corneal blindness, one of the most common causes of blindness worldwide. Mechanical and physical cues are known to regulate the behavior of many cell types, however studies examining these effects on corneal epithelial cells have been limited in number and their findings have not previously been amalgamated and contrasted. Here, we provide an overview of the different types of mechanical stimuli to which the corneal epithelium is exposed and the influence that these have on the cells. Shear stress from the tear film motion and blinking, extracellular matrix stiffness and external physical forces such as eye rubbing and contact lens wear are among some of the forms of mechanical stimuli that the epithelium experiences. In vivo and in vitro studies examining the mechanobiology on corneal epithelial cells under differing mechanical environments are explored. A greater understanding of the mechanobiology of the corneal epithelium has the potential to lead to improved tissue engineering and cell based therapies to repair and regenerate damaged cornea.

Many cell types are known to modulate their behaviour in response to changes in material stiffness; however, little is known about how stiffness affects corneal epithelial cells. This study aims to investigate the response of a corneal epithelial cell line to polydimethylsiloxane (PDMS) substrates with a range of Young's moduli from 10 to 1500 kPa. Cellular morphology, proliferation, differentiation and mechanobiology were examined. Cells grown on PDMS adopted the typical cobblestone morphology exhibited by the corneal epithelium. Proliferative markers pERK and Ki67 were higher in cells cultured on stiffer substrates compared with those on softer substrates. Material stiffness was also found to influence the cell phenotype with cells on stiffer substrates having higher cytokeratin 3 gene expression, a mature epithelial marker, while cells on softer substrates expressed more cytokeratin 14, a basal epithelial marker. Cells grown on softer substrates also displayed higher levels of focal adhesions and intermediate filaments compared with cells on stiff substrates. This research will aid in designing novel biomaterials for the culture and transplantation of corneal epithelial cells.

It is known that culture media composition can affect cell behavior, morphology, and gene expression. However, in the case of corneal epithelial cells, the combined role of calcium and glucose concentration in media has not previously been examined. In this study, a human immortalized corneal epithelial cell line was used to examine the effect of glucose and calcium concentrations on these cells. Cell metabolic activity, cell growth curve analysis, and relative gene and protein expression of proliferative marker extracellular related kinase (ERK) were used to study proliferation. Corneal epithelial stem cell marker NP63 and mature epithelial marker cytokeratin 3 (CK3) were analyzed by using reverse transcription polymerase chain reaction (RT-PCR) and immunocytochemistry. Focal adhesions were examined by using immunocytochemistry. Cells cultured in both low-glucose, high-calcium (LG-HC) media and high-glucose, low-calcium (HG-LC) media showed similar results in both RT-PCR and immunocytochemistry analysis. NP63 expression was significantly lower and CK3 expression was higher in these groups compared with cells cultured in commercial media. NP63 and CK3 expression was also analyzed by using immunocytochemistry, which confirmed these findings. The high-glucose, high-calcium-fed cells showed the lowest expression of all markers and no gene expression of CK3. This was deemed the most unsuitable media formulation for this cell line. Focal adhesion expression was the lowest in the high-calcium, high-glucose-fed cells, with the most even distribution of this among the commercial media group. Overall, this study showed that varying glucose and calcium concentrations can have significant effects on differentiation, proliferation, focal adhesions, and metabolic activity of this cell line. It seems that an LG-HC and HG-LC formulation were interchangeable with similar proliferative and differentiation effects.