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Potentials and Limitations of Ex Vivo Expansion of Stem Cells of the Ocular Surface
1Meller D., 2Steuhl K. P.,
1Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde (Essen)
2Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde, Abt. für Erkrankungen des vorderen Augenabschnitts (Essen)
The ocular surface epithelium is composed of conjunctiva, limbus and cornea. These three compartments and an stable preocular tear film are crucial factors determining ocular surface health. Stem cells of the corneal epithelium are exclusively located at the limbus and are the ultimate source of regeneration of the entire corneal epithelium. However, stem cells of the conjunctiva are predominately enriched in the fornical conjunctiva. In a variety of ocular surface diseases limbal stem cell deficiency has been observed to be a characteristic feature. Therefore, renewal of the limbal stem cell population using different surgical techniques has been described as the only possible therapeutic strategy. Recent advancements in cell biology have enabled the development of new models of tissue engineering as a tool for tissue replacement. The preservation of the undifferentiated phenotype of stem cells during ex vivo expansion has been considered to be a crucial factor. Recent developments in tissue engineering have introduced as a potential biomatrix for corneal epithelial cells cryopreserved amniotic membrane or fibrin. Experimental data suggest that progenitor cells of the ocular surface are maintained and preserved during ex vivo expansion on amniotic membrane. The aim of this review is to summarize recently reported clinical and experimental studies showing new developments in tissue engineering for the reconstitution of the ocular surface epithelium.