Prospective Clinical Trial of Corneal Reconstruction With Biomaterial-Free Cultured Oral Mucosal Epithelial Cell Sheets

Kim, Yu Jeong; Lee, Hyun Ju; Ryu, Jin Suk; Kim, Yun Hee; Jeon, Sanggeun; Oh, Joo Youn; Choung, Ho Kyung; Khwarg, Sang In; Wee, Won Ryang; Kim, Mee Kum

doi:10.1097/ico.0000000000001409

Cited by 34 publications

(45 citation statements)

References 30 publications

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“…Surgical treatment of LSCD had been offered at 66 eye centers in 23 countries in Europe, Asia, North America, and South America (Table 1). Of the 131 studies, 5 were uncontrolled clinical trials, 18,42,62,113,158 29 were prospective studies, 3,13,17,28,35,47,48,64,72,73,75,76,81,97,100,103,104,109,112,114,121,125,129,130,136,137,144,146,157 and 73 were retrospective studies. 1,2,5,7e12,14e16,20,24e26,31,32,39e41, 43,45,46,49,51e54,57,60,61,63,65,70,71, 77,78,83e91,95,98,99,106,108,116,118e120,122,123,126e128,131e135,139e142,147, 150,153,154 In the remaining 24 studies 6,29,37,38, 44,50,55,56,59,74,80,88,96,105,107,117,…”

Section: Resultsmentioning

confidence: 99%

Diagnostic criteria for limbal stem cell deficiency before surgical intervention—A systematic literature review and analysis

Chauhan

Deng

2020

Survey of Ophthalmology

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Keywords: limbal stem cell deficiency limbal stem cells diagnosis impression cytology in vivo laser scanning confocal microscopy imaging a b s t r a c t An accurate diagnosis of limbal stem cell deficiency (LSCD) is the premise of an appropriate treatment; however, there is no consensus about the diagnostic criteria for LSCD. We performed a systematic literature search of the peer-reviewed articles on PubMed, Medline, and Ovid to investigate how LSCD was diagnosed before surgical intervention. The methods used to diagnose LSCD included clinical presentation, impression cytology, and in vivo confocal microscopy. Among 131 eligible studies (4054 eyes), 26 studies (459 eyes, 11.3%) did not mention the diagnostic criteria. In the remaining 105 studies, the diagnosis of LSCD was made on the basis of clinical examination alone in 2398 eyes (62.9%), and additional diagnostic tests were used in 1047 (25.8%) eyes. Impression cytology was used in 981 eyes (24.2%), in vivo confocal microscopy was used in 29 eyes (0.7%), and both impression cytology and in vivo confocal microscopy were used in 37 eyes (0.9%). Our findings suggest that only a small portion of patients underwent a diagnostic test to confirm the diagnosis of LSCD. Treating physicians should be aware of the limitations of clinical examination in diagnosing LSCD and perform a diagnostic test whenever possible before surgical intervention. ª ScienceDirect journal h om epa ge: www.elsev ie r.com/locate/surv ophthal 0039-6257/$ e see front matter ª 2019 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.survophthal.2019.06.008 s u r v e y o f o p h t h a l m o l o g y 6 5 ( 2 0 2 0 ) 3 2 e4 0 r e f e r e n c e s

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Section: Resultsmentioning

confidence: 99%

Diagnostic criteria for limbal stem cell deficiency before surgical intervention—A systematic literature review and analysis

Chauhan

Deng

2020

Survey of Ophthalmology

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“…Similarly, following COMET/CAOMECS, patients received antibiotics and anti-inflammatory agents [topical or general corticosteroids, or Cyclosporine (37)], in order to keep inflammation to the minimum, and artificial tears (13,14,(35)(36)(37)(38)(40)(41)(42)(43). In some studies, autologous serum drops were used also (41,42,47).…”

Section: Post-operative Considerationsmentioning

confidence: 99%

Clinical Outcomes From Cultivated Allogenic Stem Cells vs. Oral Mucosa Epithelial Transplants in Total Bilateral Stem Cells Deficiency

Samoilă

Gocan

2020

Front. Med.

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Total bilateral limbal stem cell deficiency results from various pathologies, from burns (either chemical or physical) to Sjogren Syndrome, aniridia or ocular cicatricial pemphigoid. After the loss of stem cells, normal corneal epithelium is replaced by a more opaque and vascularized conjunctival epithelium, causing loss of vision. After 1997, cultivation techniques for limbal stem cells became possible. In parallel, cultivation techniques for oral mucosa epithelial cells were also available. The aim of our review was to summarize the clinical outcomes following allogenic cultured limbal stem cell transplant (allogenic CLET), and on the other hand, oral mucosa derived epithelium transplant (cultivated oral mucosa epithelial transplant-COMET or cultivated autologous oral mucosal epithelial cell sheet-CAOMECS), in the case of total bilateral limbal stem cell loss. Thirty studies matching the inclusion criteria were found. The clinical improvement in both methods was reported similar, with percentages higher than 50% of the treated cases. However, the comparison between studies was difficult to achieve due to the lack of a universal and objective grading tool for assessing post-operative results. The definition of clinical improvement was problematic, because success was defined differently, depending on the study. Moreover, some of the studies followed both autologous and allogenic CLET, but described the results together, for both procedures, and therefore it was impossible to analyze them separately. COMET presented some advantages compared to CLET. By using autologous cells, there was no risk of immune activation and no immunosuppression was needed. COMET, however, might be associated with increased risk of persistent epithelial defects and graft failure, compared with allogenic CLET.

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“…Cell sheet engineering involves many disciplines including medicine, biology, engineering, and pharmacy [2,3], because the noninvasive cell sheet can be engrafted to the desired transplantation site without suturing the cell sheet. Preclinical and Clinical studies have been conducted by cell sheet transplantation for the regeneration of cornea [4], bone [5], tendon [6], myocardium [7] and peridontium [8]. Transplanted cell sheets can replace injured tissue and compensate impaired function when implanted in the ectopic region.…”

Section: Introductionmentioning

confidence: 99%

Construction of Sandwich-like cell sheets with natural electrospun gelatin/chitosan nanofibrous delivered plasmid VEGF for accelerated wound healing

Zhu

Liao

Zhang

et al. 2020

Preprint

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Background Development of natural biodegradable electrospun nanofibrous with appropriate physical properties and biocompatibility is highly desirable to support multi-layer cell sheets construction for wound healing. Results We developed a series of electrospun gelatin/chitosan nanofibrous with different gelatin/chitosan ratios and controlled pore sizes, and impregnated plasmid VEGF into membrane, which as supporting membrane to construct sandwich-like adipose-derived stem cells (ADSCs) cell sheets with a simple and effective technique for accelerated wound healing. We found that the physical properties of the electrospun nanofibrous including water retention, stiffness, strength, elasticity and degradation could be tailored by changing the proportion of gelatin/chitosan. We further observed that the optimized electrospun nanofibrous with the optimal ratio of gelatin to chitosan (7:3) which were soft and elastic could most effectively support cell adhesion, proliferation and migration into the whole nanofibrous membranes. Nanofibrous delivered plasmid VEGF facilitating multi-layer ADSC cell sheets formation and promoting regeneration of cutaneous tissues within two weeks. Conclusions Such natural biodegradable and biocompatible electrospun gelatin/chitosan nanofibrous with plasmid have the potential to become fully cellularized and support sandwich-like ADSC cell sheets formation, which will make it suitable for widespread applications such as skin substitute or wound dressing.

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Prospective Clinical Trial of Corneal Reconstruction With Biomaterial-Free Cultured Oral Mucosal Epithelial Cell Sheets

Abstract: Transplanting biomaterial-free COMECs seems to be an efficient and safe procedure to reconstruct the ocular surface in patients who are completely limbal stem cell deficient without a full symblepharon.

Cited by 34 publications

References 30 publications

Diagnostic criteria for limbal stem cell deficiency before surgical intervention—A systematic literature review and analysis

Diagnostic criteria for limbal stem cell deficiency before surgical intervention—A systematic literature review and analysis

Clinical Outcomes From Cultivated Allogenic Stem Cells vs. Oral Mucosa Epithelial Transplants in Total Bilateral Stem Cells Deficiency

Construction of Sandwich-like cell sheets with natural electrospun gelatin/chitosan nanofibrous delivered plasmid VEGF for accelerated wound healing

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