Der Ophthalmologe

, Volume 109, Issue 9, pp 863–868

Oberflächenrekonstruktion bei Limbusstammzellinsuffizienz

Transplantation von Limbusgewebe – Kultivierungsverfahren
Leitthema

Zusammenfassung

Verschiedene Krankheitsbilder des okulären Oberflächenepithels werden durch den Verlust der kornealen Stammzellpopulation oder Dysfunktion der limbalen Stammzellnische verursacht. Neben den konventionellen Methoden der autologen oder allogenen Limbustransplantation haben die in den letzten Jahren erzielten Fortschritte im Tissue-Engineering die Kultur und Expansion von humanen limbalen Stamm- und Progenitorzellen (LSPZ) als neue Strategie zur Behandlung der limbalen Stammzellinsuffizienz ermöglicht. Aus wenigen LSPZ einer autologen Limbusbiopsie wird ein transplantationsfähiges Epithel gewonnen. Die autologe Transplantation dieses Limbusepithels führt in den überwiegenden Fällen zur Stabilisierung der Hornhautoberfläche. Alternative Methoden umfassen die Transplantation von autologem Fremdgewebe, wie z. B. Mundschleimhaut. In dieser Übersichtsarbeit sollen die Herausforderungen und kontroversen Punkte bezüglich der etablierten Kultivierungsverfahren von LSPZ, aber auch der von alternativen Stammzellquellen zur kornealen Oberflächenrekonstruktion dargestellt werden.

Schlüsselwörter

Limbusstammzellinsuffizienz Stammzelle Transplantation Ex-vivo-Expansion Amnionmembran 

Ocular surface reconstruction in limbal stem cell deficiency

Transplantation of cultivated limbal epithelium

Abstract

Various ocular surface diseases are caused by loss of corneal epithelial stem cells or dysfunction of the limbal stem cell niche. Besides conventional transplantation of autologous or allogenic limbal tissue, recent advances in tissue engineering have led to the development of new culture and expansion techniques of human limbal stem and progenitor cells (LSPC) as a new strategy to successfully treat limbal stem cell deficiency (LSCD). From a small autologous limbal biopsy with a limited amount of LSPC an epithelium ready for transplantation is achieved. Autologous grafting of cultured limbal epithelium led in most of the treated cases to a successful reconstruction of the corneal surface. Alternative methods which have recently been introduced to treat LSCD use other stem cell sources including the transplantation of oral mucosal epithelium. In this article the challenges and controversies associated with these stem cell culture techniques for ocular surface reconstruction are reviewed.

Keywords

Limbal stem cell deficiency Stem cells Transplantation Ex vivo expansion Amniotic membrane 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Klinik für Erkrankungen des vorderen Augenabschnitts, Zentrum für AugenheilkundeUniversität Duisburg-EssenEssenDeutschland

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