Amniotic membrane transplantation to reconstruct the conjunctival surface in cases of chemical burn

Katircioğlu, Yasemin Arslan; Budak, Koray; Şalvarli, Sibel; Duman, Sunay

doi:10.1016/s0021-5155(03)00109-6

Cited by 10 publications

(7 citation statements)

References 6 publications

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“…Experimentally, AM has been shown to promote corneal epithelial wound healing (17), reduce scarring (4,46), suppress inflammation (25,36,41,42), and inhibit angiogenesis (16). Clinically, AM grafts have widely been used to treat ocular surface diseases including corneal ulcers (8,20), band keratopathy (1), symptomatic bullous keratopathy (39), pterygium (28,43), and chemical/thermal burns (15,31). In tissue engineering, AM has also proved useful as a scaffold to provide the basement membrane and mitogenic growth factors required for ex vivo expansion of limbal epithelial stem cells (51) and corneal endothelial cells (48).…”

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confidence: 99%

Amniotic membrane inhibits squamous metaplasia of human conjunctival epithelium

Tan

Qiu

et al. 2011

American Journal of Physiology-Cell Physiology

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Squamous metaplasia is a common pathological process that occurs in the ocular surface epithelium. At present, there is no effective treatment for this abnormality. In the current study, we established an ex vivo conjunctival squamous metaplasia model by culturing human conjunctival tissues at an air-liquid interface for durations of up to 12 days. We then investigated the effects of amniotic membrane (AM) on squamous metaplasia through coculture of conjunctival tissues with AM or AM extract. We found that metaplasia features such as hyperproliferation and abnormal epidermal differentiation of conjunctival epithelium could be inhibited by AM or its extract. In addition, existing squamous metaplasia of conjunctival epithelium could be reversed to a nearly normal phenotype by AM. The mechanism by which AM prevents squamous metaplasia may involve downregulation of p38 mitogen-activated protein kinase and Wnt signaling pathways, which were activated in conjunctival explants cultured with an airlift technique. In conclusion, AM can inhibit and reverse squamous metaplasia of conjunctival epithelium. This finding may shed new light on prevention and treatment of diseases that involve epithelial squamous metaplasia. conjunctiva; ocular surface diseases; SQUAMOUS METAPLASIA is defined as pathological transition of a nonkeratinized, stratified epithelium into a nonsecretory, keratinized epithelium (2,35,44). It is a commonly occurring pathological process in respiratory epithelium (21) and urothelium (27) and is also frequently present in ocular surface epithelia such as the cornea and conjunctiva. In the eye, squamous metaplasia can be a manifesting characteristic of a number of ocular surface diseases such as dry eye, Sjögren Syndrome, Stevens-Johnson Syndrome, mucous membrane pemphigoid, chemical/thermal burns, pterygium, pinguecula, and vitamin A deficiency (2,23,44). Along with limbal stem cell deficiency, squamous metaplasia is one of the two major types of ocular surface failure that can give rise to severe visual loss or blindness (27,40). At this point in time, there is no effective method for the treatment of squamous metaplasia. Recently, Li et al. (23) developed a model of squamous metaplasia by subjecting human limbal explant to an airlift culture condition. This in vitro model now provides us with the possibility of dissecting the mechanism of squamous metaplasia and exploring new treatment modalities.

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confidence: 99%

Amniotic membrane inhibits squamous metaplasia of human conjunctival epithelium

Tan

Qiu

et al. 2011

American Journal of Physiology-Cell Physiology

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“…A variety of surgical approaches have been attempted to achieve these goals, with variable results [6][7][8][9][10]16,19,20 (Table 1). Previously we have reported a high success rate of 85.2% by selectively deploying cicatrix lysis, amniotic membrane transplantation, intraoperative MMC, oral mucosa graft, conjunctival autograft, and anchoring sutures.…”

Section: The Surgical Goals Of Treating Symblepharon Arementioning

confidence: 99%

“…A variety of surgical approaches have been reported for the treatment of symblepharon. Tissue substitutes such as conjunctiva, 1,2 oral mucosa graft, [3][4][5] or amniotic membrane [6][7][8][9][10] were used for ocular surface reconstruction after symblepharon lysis. Anchoring sutures were also useful to secure the released conjunctiva deep into the fornix.…”

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confidence: 99%

“…10 Various materials have been evaluated to keep the potentially adhesive surfaces apart after surgery and to reduce recurrences such as symblepharon ring, 11 silicone sheet implant, 12,13 nylon foil-anchored polytetrafluoroetyhlene (Gore-Tex), 14 mitomycin C (MMC), 15,16 bevacizumab, 17 or postoperative application of b-irradiation. 18 Despite all these efforts, the recurrence rates remained highly variable from 6.2% to 40% [6][7][8][9][10]16,19,20 (Table 1).…”

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confidence: 99%

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Sealing of the Gap between the Conjunctiva and Tenon Capsule to Improve Symblepharon Surgery

Zhao

Yin

Cheng

et al. 2015

American Journal of Ophthalmology

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“…Where it has been used to treat symblepharon caused by non-inflammatory disease, such as after removal of tumours, pterygia, and the treatment of cryptophthalmos, the results have been encouraging Downloaded by: [7][8][9]. The results of AMT in the treatment of acute ocular burns have been encouraging in the treatment of less severe cases with some healthy peripheral conjunctival tissue, but poor for the treatment of severe burns [20,21].…”

Section: Guidelines For Choice Of Graft Materialsmentioning

confidence: 99%

Mucous Membrane Grafting

Henderson

Collin

2008

Developments in Ophthalmology

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The reformation and maintenance of a conjunctival fornix requires the addition of epithelial tissue, or a basement membrane which can be populated by healthy host epithelial cells. A healthy conjunctival or tarsal autograft, when available, is the ideal material. Oral mucosa does not contain goblet cells and therefore does not supplement the tear film: a full-thickness oral mucous membrane graft is the simplest graft to use if conjunctiva or tarsus is not available. Split-thickness mucosal grafts contract more, but are less bulky and pink than full-thickness grafts, and therefore should be used on the globe. Hard palate grafts are the thickest oral mucosal grafts and contract the least. Nasal mucosal grafts contain goblet cells that may contribute mucous to the tear film. This is maximised in turbinate mucosal grafts, which can relieve discomfort in extreme dry eye situations. Nasal septal cartilage contains fewer goblet cells, but adds rigidity. Amniotic membrane is thin and translucent-like conjunctiva, and possesses antiangiogenic, antiscarring and anti-inflammatory properties. It may become re-epithelialised with normal a conjunctival cell population and prevent postoperative cicatrisation, but requires the presence of healthy conjunctival stem cells to repopulate the graft, adequate lacrimal function to keep the graft moist, and a host site that is free from inflammation, otherwise it rapidly contracts. It can be combined with limbal transplantation and with an adjunctive antimetabolite.

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Amniotic membrane transplantation to reconstruct the conjunctival surface in cases of chemical burn

Cited by 10 publications

References 6 publications

Amniotic membrane inhibits squamous metaplasia of human conjunctival epithelium

Amniotic membrane inhibits squamous metaplasia of human conjunctival epithelium

Sealing of the Gap between the Conjunctiva and Tenon Capsule to Improve Symblepharon Surgery

Mucous Membrane Grafting

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