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Regenerative Medizin für das Hornhautepithel

Zelltherapie in Wissenschaft und Klinik

Regenerative medicine for the corneal epithelium

Cell therapy from bench to bedside

  • Leitthema
  • Published:
Die Ophthalmologie Aims and scope Submit manuscript

Zusammenfassung

Bei einer Verbrennung oder Verätzung der Augenoberfläche kann der Verlust von Limbusepithelstammzellen zu einer kompromittierten Selbsterneuerung des Hornhautepithels führen. Hierdurch kommt es zu einem dauerhaften Sehverlust. In diesen Situationen kann die Transplantation von kultivierten Limbusepithelzellen auf einer Amnionmembran oder einem Fibringel als Träger (Holoclar®, Holostem Terapie Avanzate s.r.l., Modena, Italien) zu einer Regeneration der Hornhautoberfläche beitragen. Die erforderlichen Zellen werden dem gesunden Partnerauge entnommen – sofern vorhanden. Alternative Zellquellen sind adulte Stammzellen aus anderen Körperregionen (Haarfollikel, Mundschleimhaut, mesenchymale Stromazellen) oder induzierte pluripotente Stammzellen (ursprünglich z. B. Hautfibroblasten). Das Umprogrammieren solcher Zellen kann unter Zuhilfenahme von Transkriptionsfaktoren erfolgen. Zusätzlich wird an biosynthetischen oder synthetischen Matrices gearbeitet, die nicht nur als Trägermaterial für die Transplantation dienen, sondern auch die Funktionen der Zellen (Selbsterneuerung, hornhautepitheltypischer Phänotyp) unterstützen sollen.

Abstract

In the case of thermal or caustic burns of the ocular surface, loss of limbal epithelial stem cells leads to compromised self-renewal of the corneal epithelium. This results in permanent loss of vision. In these situations, transplantation of cultured limbal epithelial cells on an amniotic membrane or fibrin gel as substrate (Holoclar®) can help to regenerate the corneal surface. The required cells are obtained from the healthy partner eye, if available. Adult stem cells from other parts of the body potentially serve as alternative cell sources: hair follicles, oral mucosa, mesenchymal stromal cells, or induced pluripotent stem cells (originally, e.g., skin fibroblasts). The reprogramming of such cells can be achieved with the help of transcription factors. In addition, work is being done on biosynthetic or synthetic matrices, which not only serve as substrate material for the transplantation but also support the functional properties of these cells (self-renewal, corneal epithelial-typical phenotype).

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Authors and Affiliations

  1. Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    Johannes Menzel-Severing, Kristina Spaniol & Gerd Geerling

  2. Translationszentrum Regenerative Therapien | TLZ-RT, Leitung In-vitro-Testsysteme, Fraunhofer-Institut für Silicatforschung ISC, Würzburg, Deutschland

    Florian Groeber-Becker

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Menzel-Severing, J., Spaniol, K., Groeber-Becker, F. et al. Regenerative Medizin für das Hornhautepithel. Ophthalmologie 119, 891–901 (2022). https://doi.org/10.1007/s00347-022-01674-8

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