“…It is not yet clear how the tissue alterations are initiated and kept in progress. Favored but controversial [35,40] factors include the mutation of limbus stem cells [17,18,42], modification of stroma fibroblasts [3,5,6,7,22,27,29,30], and immunological and other processes in the matrix [3,12,23,37,45]. That the extracellular matrix can interact with the cells contacting it is an established biological fact [2,38].…”