Transplantation of cultivated autologous oral mucosal epithelial cells in patients with severe ocular surface disorders

Abstract

Background/aims: To determine outcomes of transplants of cultivated autologous oral epithelial cells in patients with severe ocular surface disorders. Methods: The eyes (n = 6) of four patients with Stevens-Johnson syndrome (three eyes) or chemical burns (three eyes) were studied. Autologous oral epithelial cells, grown for 2-3 weeks on a denuded amniotic membrane carrier in the presence of 3T3 fibroblasts, were air lifted. The resultant sheet was transplanted onto the damaged eye, and acceptance of the sheet by the corneal surface was confirmed 48 hours after surgery. The success of ocular surface reconstruction, graft survival, changes in visual acuity, and postoperative complications were assessed and the quality of the cultivated oral epithelial sheet was evaluated histologically. Results: At 48 hours after transplant, the entire corneal surface of all six eyes was free of epithelial defects indicating complete survival of the transplanted oral epithelium. Visual acuity was improved in all eyes. During follow up (mean 13.8 (SD 2.9) months), the corneal surface remained stable, although all eyes manifested mild peripheral neovascularisation. Conclusions: Autologous oral epithelial cells grown on denuded amniotic membrane can be transplanted to treat severe ocular surface disorders.

Transplantation of cultivated oral mucosal epithelial cells for severe corneal burn

“…The cell culture protocol was similar to that described by Nakamura et al, 10 but with some modifications in that: (1) A larger 6 Â 6 mm buccal mucosal tissue was harvested. (2) The tissue was treated with 100 ml of 1.2 IU dispase II in PBS at 371C for 1 h. Then the tissue was transferred to another 35 mm dish, and treated with 75 ml of 0.25% trypsin-EDTA solution at 371C.…”

“…[10][11][12][13][14] Autologous in origin, this technique avoids the need for long-term immunosuppression. In this study, we reported our results of using COMET for the management of acute and chronic corneal burn.…”

The differentiation and transdifferentiation of epithelial cells in vitro – is it a new strategy in regenerative biomedicine?

“…By eliminating the risk of graft-versus-host disease, the survivability and prospective lifespan is greatly improved [47], [50]. This approach could potentially be applied to other tissues, especially epithelia, as it could take advantage of their extraordinary plasticity, in order to allow for minimizing the impact associated with extraction of the source tissue and provide a graft that most closely resembles the original [43]. Advancements in methods of cell culture, could also allow to create stable populations of epithelial cells coming from the host, that could be easily banked in order for potential use in tissue engineering for the purposes of transplantology, tissue reconstruction and regeneration.…”

“…Their extraordinary plasticity, together with the ability to maintain a clonogenic population of steady size, for virtually unlimited amount of time, has suggested that therapies involving stem cells could be a potential cure for various, previously incurable diseases [6]. Pluripotent cells, could be potentially used to create almost any type of transplantable tissue, and in perspective organ without the possibility of rejection by host [43]. However, the source of cells for such therapy needed to be verified, before any potential clinical applications could be brought to life.…”

Concise Review: Limbal Epithelial Stem Cell Therapy: Controversies and Challenges

“…COMET has been shown to be successful in restoring the corneal surface with follow-up times of up to 35 months [36][37][38][39][40][41][42][43]. A summary of the reported studies in human patients to date is shown in Table 1.…”