Umbilical Cord Blood and Serum for the Treatment of Ocular Diseases: A Comprehensive Review

Abstract

Several blood derivatives have been proposed for the treatment of various ocular diseases that affect either the anterior or the posterior segment of the eye. Blood sources may range from the patient's own peripheral blood (autologous) to donor tissues, mainly allogeneic peripheral blood and umbilical cord blood (UCB). The utilization of the latter permits the collection of a large amount of serum all at once, and is characterized by therapeutic feasibility in patients with a poor general condition or anemia and blood dyscrasia. Products derived from UCB have two potential uses. First, serum in the form of eye drops can be applied topically onto the ocular surface to efficiently treat anterior segment disorders such as dry eye syndrome or corneal epithelial defects with different etiologies. The rationale for and efficacy of this application derive from the high concentrations of biologically active components and growth factors in UCB, which can nourish the ocular surface. Second, UCB is a source of stem cells, which are used in the field of regenerative medicine because they differentiate into various mature cells, including corneal and retinal cells. Therefore, UCB-derived stem cells have been proposed as a replacement therapy for the treatment of retinal and optic nerve diseases, given that current standard treatments often fail. The present review explores the clinical results that have been obtained using UCBderived products in the field of ophthalmology, as well as the current limitations of those products in this field. Furthermore, given the promising development of UCB-based therapies, possible future directions in this area are discussed.

Experimental Pharmacotherapy for Dry Eye Disease: A Review

“…Several blood derivatives can be used for the treatment of various ocular diseases including DED. 110 Blood sources can derive from autologous serum, allogenic peripheral blood and umbilical cord blood (UCB). Serum-based eye drops contain high concentration of growth factors, cell adhesion molecules and biochemical components that make them more similar to natural tears; they perform lubricating, antimicrobial, and anti-inflammatory functions.…”

“… 111 DED patients treated with serum-based eye drops experienced a fast epithelial healing rate, increased goblet cell density and a significant improvement in symptoms. 110 …”

“…UCB, whose main application is hematological stem cells transplantation for the treatment of hematological diseases, can also be used as a source of other cells, including mesenchymal stem cells (MSCs) for replacement therapy. 110 …”

Use of Acellular Umbilical Cord-Derived Tissues in Corneal and Ocular Surface Diseases

“…With minimal manipulation whole UCB can be rendered into a mononuclear cellular product rich in hematopoietic stem (HSCs) and progenitor cells (HPCs), mesenchymal stromal cells (MSCs), epithelial cells and endothelial progenitor cells (EPCs), potent mediators of repair for regenerative retinal or corneal medicine. With appropriate isolation an acellular product can also be extracted, which can be used as eye drops to be applied topically to treat ocular surface diseases such as dry eye syndrome or persistent corneal epithelial defects of multiple etiologies, when other conventional therapies have failed [ 6 , 7 ].…”

Current Status and Future Prospects of Perinatal Stem Cells

“…The co-expression of these different antigens with CD34 antigen defines different HSPC populations, from more primitive or early progenitors to late progenitors and cells at an early stage of differentiation [ 81 , 82 ]. Besides its clinical use in the treatment of hematological disorders, cord blood has been studied as a treatment for several other pathologies such as liver and brain injury, stroke, hearing loss, diabetes, heart attack, and vision loss in both human clinical trials and preclinical studies [ 83 , 84 , 85 , 86 , 87 , 88 ].…”