生物工程活性角膜基质的研制及相容性研究

研究生物工程活性角膜的生物相容性，为进一步临床应用提供理论基础。猪角膜基质脱细胞并去除免疫源性物质形成网状半透明生物材料，将培养的角膜基质细胞与生物材料复合构建生物工程活性角膜基质。对复合物进行倒置显微镜和扫描电镜检测细胞附着情况及材料的细胞相容性；将活性角膜基质移植入新西兰兔角膜囊袋内．细胞用BrdU标记检测在体内移植过程中的存活及转归，不同时间观察角膜的生物相容性及改建情况。结果显示脱细胞基质材料的细胞相容性较好，细胞种植后可存活、黏附并增殖；移植区细胞可有BrdU阳性着色，4周后角膜开始透明，8周后角膜改建基本完成。     

角膜内不同部位植入壳聚糖-胶原复合膜的生物相容性

背景:角膜基质层间植入是评价材料角膜内生物相容性的理想模型,但将材料植入角膜基质层间的位置不同,可能会影响材料的降解以及角膜的代谢,最终影响到材料在角膜内生物相容性评价结果。目的:观察壳聚糖胶原复合膜(胶原含量为30%)植入兔角膜不同部位基质层的组织相容性。方法:制备厚度为20μm的壳聚糖胶原复合膜。将新西兰大白兔以抽签法随机分为两组:一组角膜周边基质层间植入壳聚糖胶原复合膜材料;另一组角膜中央基质层间植入壳聚糖胶原复合膜材料。裂隙灯显微镜观察材料植入后眼表及前房的反应、材料植入部位角膜和材料的相互反应及植入部位角膜透明性改变。6周后取角膜做组织切片,观察植入部位角膜组织和材料的组织学改变。结果与结论:角膜周边植入组的复合膜逐渐降解,最终完全降解,并对角膜结构无明显影响,显示了良好的角膜组织相容性;中央植入组复合膜植入早期眼表稳定,也显示了良好的生物相容性,但是2周过后伴随着材料的缓慢降解,材料周边变得不透明,伴随着炎症细胞浸润,最终在第34,42天分别有一只发生角膜溶解。结果说明薄的壳聚糖胶原复合膜材料透明性好、力学性能匹配,植入角膜周边基质层间后在短时间内能完全降解,适宜作为角膜修复材料,特别是作为角膜缘干细胞的载体可以用来修复角膜缘干细胞损伤引起的角膜疾病。     

壳聚糖-胶原角膜修复材料的制备及生物相容性

背景：将胶原和壳聚糖按一定比例制成复合膜后,能够降低壳聚糖的正电荷,改善壳聚糖的吸附力,促进细胞的黏附生长、迁移和增殖,增强壳聚糖的生物学性能,成为十分优良的生物材料。 目的：制备壳聚糖-胶原复合膜,观察其与角膜基质层的组织相容性。 方法：制作壳聚糖-胶原复合膜材料。将16只新西兰兔随机分为两组,实验组于右眼角膜基质袋内植入壳聚糖-胶原复合膜,对照组右眼角膜基质袋内植入壳聚糖膜。移植后进行裂隙灯显微镜、前节-光学相干断层成像及组织学观察。 结果与结论：①裂隙灯显微镜：移植后第8周,实验组膜片中央出现降解浸润,皱褶屈曲不明显;对照组膜片全部浸润,皱褶屈曲明显。②前节-光学相干断层成像：移植后第6周,实验组的复合膜边界模糊,密度与正常角膜组织很接近,角膜形态恢复正常。③组织学观察：移植后第8周,实验组膜片表层少量降解,降解材料与角膜基质融合,膜片周围角膜基质有少量炎性细胞浸润;对照组膜片表层降解程度大于实验组,降解物质与角膜基质交织融合,膜片周围角膜基质有较多炎性细胞浸润。表明壳聚糖-胶原复合膜具有可降解性和良好的组织相容性。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

羟基磷灰石表面修饰人工角膜钛支架的体内生物相容性

背景：纯钛人工角膜支架在临床应用中的并发症发生率较高,因此寻找一种生物相容性高的人工角膜支架材料一直是国内外研究的重点和热点。目的：观察羟基磷灰石表面修饰人工角膜钛支架的体内生物相容性。方法：取新西兰白兔27只,制作右眼角膜碱烧伤模型,造模后立即均分为3组,实验组右眼植入经过羟基磷灰石表面修饰的人工角膜钛支架,对照组右眼植入人工角膜钛支架,空白对照组右眼仅制备囊袋而不植入支架。术后2,4,16周取兔右眼角膜组织,进行病理组织学观察及扫描电镜观察。结果与结论：术后16周,3组间炎性细胞与纤维细胞数量比较差异均无显著性意义。随着时间的延长,实验组角膜组织逐渐增多,纤维组织逐渐增厚,细胞外基质附着逐渐增加,角膜组织贴附密集度、细胞外基质附着密集度及组织愈合度均优于对照组及空白对照组。表明羟基磷灰石表面修饰人工角膜钛支架具有良好的生物相容性,可有效促进角膜细胞增生,有利于角膜血管化。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

内皮祖细胞在膀胱细胞外基质上的生长及分化

背景：传统的组织工程膀胱支架材料本身无血管结构,植入体内后面临血管化不足的问题。 目的：观察内皮祖细胞与膀胱细胞外基质的生物相容性。 方法：分离培养兔内皮祖细胞,种植于兔膀胱细胞外基质上与其复合培养。将复合生长材料植入兔背部皮下检测其组织相容性。 结果与结论：兔内皮祖细胞能够在膀胱细胞外基质表面正常黏附、生长、增殖,细胞形态良好。内皮祖细胞-膀胱细胞外基质植入兔体内后1周时,可见材料周围炎症反应明显,粘连严重,出血较多;苏木精-伊红染色可见组织中较多炎性细胞浸润,胶原及弹性纤维排列松散。植入后8周时可见材料已降解成碎细丝状,与周围组织融合生长在一起,但质地略脆,易出血;苏木精-伊红染色可见组织中已无明显炎症细胞浸润反应,胶原及弹性纤维排列紧密并且有新生血管长入其中。结果表明内皮祖细胞与膀胱细胞外基质具有良好的相容性,复合培养物与体内组织具有良好的相容性。     

角膜体外重构异种生物载体材料植入性实验研究

目的：分析测定异种（猪）角膜基质组织免疫原性，观察其角膜层间植入后与受体角膜愈合情况，以评价该材料生物相容性，并在此载体上体外重构角膜内皮组织，探讨其作为角膜重建载体材料可行性。 方法： (1)将新鲜、脱水两种猪角膜基质植片分别植入F344大鼠角膜基质层间，术后12、90 d对外周血进行CD25和CD4/CD8双色免疫荧光标记，流式细胞仪测定分析。(2)猪角膜基质植入新西兰白兔角膜层间，定期临床观察植片愈合情况，并取受体兔角膜进行组织学观察。(3)将猫角膜内皮细胞接种于保留后弹力层的脱水猪角膜基质上，加入培养液培养7 d，组织学观察体外重构的角膜内皮组织形态结构。 结果： (1)测得新鲜组、脱水组大鼠外周血T淋巴细胞CD4＋CD25＋、CD8＋CD25＋双阳性表达率及CD4＋/CD8＋比值与同基因移植组、阴性对照组比较无显著差异（P>0.05）。(2)兔眼临床观察：全部植片存活，12只术眼未见有角膜水肿混浊、角膜新生血管、排斥反应发生，新鲜植片在2个月左右已透明，脱水植片在6个月后透明。兔角膜组织学观察：新鲜植片4个月时与兔角膜基质相融愈合，脱水植片经角膜细胞再分布、胶原纤维改建重塑于8个月后与兔角膜基质相融愈合，两组植片愈合过程中未见有淋巴细胞浸润及新生血管生成。(3)体外重构的内皮组织形态结构与正常内皮层相似。 结论： 异种（猪）角膜基质免疫原性低，具有良好的生物相容性，是目前较为理想的角膜体外重构载体材料。     

脱细胞猪小肠黏膜下层的组织相容性

目的:研究脱细胞猪小肠黏膜下层(small intestinal submucosa,SIS)的组织相容性。方法:酶消化联合去垢剂制备脱细胞猪SIS。将其植入SD大鼠脊柱旁肌肉内,组织学检测植入后不同时间(1、2和4周)样品周围组织反应。另取乳胶植入,做为阳性对照。结果:经脱细胞处理后,猪SIS仅存纤维结构,未见细胞残留。植入后1周,脱细胞SIS形态完整,可见宿主细胞(成纤维细胞和炎性细胞)长入。2周时,可见脱细胞SIS断裂。至4周时,脱细胞SIS降解,新生细胞外基质形成,并可见毛细血管样结构。随植入时间的延长,炎性细胞逐渐减少。在不同时间点,乳胶均可完整取出,未见宿主细胞长入,其周围形成纤维囊。结论:提示脱细胞猪SIS具有良好的组织相容性。     

脱细胞猪角膜基质的基底膜在修复兔角膜损伤中的作用

目的 探讨脱细胞角膜基质支架材料表面保存基底膜样结构对修复角膜损伤的必要性. 方法 将采用反复冻融及酶消化法制备的脱细胞猪角膜基质,移植到兔角膜损伤模型上,通过大体及组织学分别观察材料表面基底膜结构的有无对修复兔角膜基质损伤的影响. 结果 脱细胞猪角膜基质材料表面有基底膜的实验组（n=8）兔角膜损伤全部修复,无穿孔,支架材料与受体角膜整合.材料表面无基底膜的对照组（n=8）中,有6例植入的支架材料溶解,兔角膜穿孔.两组结果比较差异有显著统计学意义. 结论 脱细胞角膜基质支架材料表面具有基底膜样结构,有利于形成正常角膜上皮屏障,从而防止了生物材料的过快降解,有利于材料与宿主基质的整合和改建.     

异种脱细胞真皮替代睑板材料重建眼睑的可行性

背景：眼睑后层重建是眼睑重建的重点和难点,其中睑板替代物更是研究的焦点。异种脱细胞真皮作为一种新型的组织工程材料,在国内外烧伤整形领域,正得到广泛的研究和应用。 目的：观察异种(猪)脱细胞真皮植入兔眼睑后的组织相容性极其组织病理学变化。 方法：剥取健康小白猪全层皮肤20 cm×20 cm,制备异种(猪)脱细胞真皮基质。同时制备兔睑板全层缺损模型并植入脱细胞真皮基质,观察大体情况,并分别于第1,2,3周取移植交界处眼睑组织光镜下观察组织学的改变。 结果与结论：大体观察未见明显排斥反应及眼睑的变形;光镜下1周时可见局部炎症细胞浸润,2周时炎症细胞减少,3周时正常纤维组织长入,逐渐分割代替植入的胶原纤维,炎症反应消失。提示异种脱细胞真皮免疫原性低,并可引导新生胶原的生长,是一种良好的睑板替代物。     

羟基磷灰石表面修饰人工角膜钛支架的生物相容性:电镜观察

背景:人工角膜是双眼角膜盲患者复明的希望,提高人工角膜材料的生物相容性使人工角膜与宿主角膜达到生物愈合是目前人工角膜的研究方向。目的:扫描电子显微镜观察经羟基磷灰石表面修饰能否增加人工角膜纯钛支架的生物相容性。方法:采用酸碱两步预处理法在人工角膜钛支架表面快速沉积羟基磷灰石涂层。将第4～6代兔角膜基质成纤维细胞直接接种于羟基磷灰石修饰的钛支架、纯钛支架及玻璃表面,3,24,48,72h后,扫描电子显微镜观察材料表面的细胞黏附,伸展及增殖情况;将18只正常新西兰白兔随机分为2组,于右眼角膜基质层内分别植入羟基磷灰石修饰的钛支架、纯钛支架,术后6,12周取出人工角膜支架,扫描电子显微镜观察材料表面角膜组织贴附生长状态。结果与结论:体外实验显示,细胞接种3h和24h后,细胞扩展面积及细胞张力丝长度:羟基磷灰石修饰的钛支架玻璃纯钛表面,羟基磷灰石修饰的钛支架表面的活细胞数多于其他材料表面(P0.05)。72h后,羟基磷灰石修饰的钛支架表面完全被胶原覆盖。体内实验显示,扫描电子显微镜观察羟基磷灰石修饰的钛支架表面细胞外基质生长良好,与羟基磷灰石贴附紧密。而纯钛支架仅为角膜组织简单包裹。说明人工角膜纯钛支架经羟基磷灰石表面修饰后,其生物相容性增加。     

Using acellular porcine limbal stroma for rabbit limbal stem cell microenvironment reconstruction

To investigate the feasibility of using acellular porcine limbal stroma for limbal stem cell microenvironment reconstruction. Limbal reconstruction was performed in rabbit partial limbal defect models. Rabbits were randomly divided into four groups: acellular porcine limbal stroma, de-epithelized rabbit limbal autograft stroma, de-epithelized porcine limbal stroma and acellular porcine corneal stroma transplantation groups. In both the acellular porcine limbal stroma and de-epithelized rabbit limbal autograft stroma groups, cornea transparency and epithelium integrity were sustained and graft rejection was not observed. The basal epithelial cells of the grafts showed the K3+/P63+/Ki67+ phenotype at postoperative month 1, but it returned to K3-/P63+/Ki67+(phenotype characteristic of limbal epithelium) by postoperative months 3 and 6. In the de-epithelized porcine limbal stroma group, acute and serious immune rejection occurred by postoperative days 8-10. The basal epithelial cells of the grafts showed the K3+/P63+/Ki67+ phenotype at postoperative month 1. In the acellular porcine corneal stroma group, there were some new vessel invasion into the peripheral cornea and mild corneal opacity. The basal epithelial cells of the grafts showed the K3+/P63+/Ki67+ phenotype at postoperative months 1, 3, and 6. In conclusion, acellular porcine limbal stroma possessed very low immunogenicity, retained a good original limbal ECM microenvironment, and thus the reconstructed rabbit limbal microenvironment maintained limbal epithelial stem cell stemness and proliferation.     

Tissue engineering of nearly transparent corneal stroma

We determined whether a polyglycolic acid (PGA) scaffold bearing an adherent corneal stromal cell insert could be integrated into the ultrastructure of rabbit corneal stroma without compromising tissue transparency. Stromal cells were isolated from 10 newborn rabbits and expanded by tissue culture. After reaching confluence, the cells were harvested and mixed with nonwoven PGA fibers to form cell-scaffold constructs. After 1 week of culturing, they were implanted into the corneal stroma of female rabbit recipients. Green fluorescent protein (GFP) expression in transplanted corneal stromal cells was monitored at the protein level to determine cellular origin in the reconstructed stroma. Eight weeks after implantation, transmission electron microscopy and histological evaluation were performed on stromal tissue. Insertion of PGA scaffold alone served as a sham control. After stromal implantation, implants gradually became transparent over an 8-week period. During this time stromal histology was gradually restored, as collagen fibril organization approached that of their normal counterpart. GFP-labeled corneal stromal cells were preponderant in the regions bearing inserted scaffolds, suggesting that they were derived from the implants rather than from neighboring corneal stromal cells. No reconstructed stroma developed in regions where naked PGA was implanted instead. We conclude that intrastromal implantation of PGA fiber scaffold implants bearing corneal stromal cells is a useful procedure for corneal stromal tissue reconstruction because, over an 8-week period, the implants become progressively more transparent. Marked losses of translucence during this period combined with restoration of ultrastructure indicate that the implants provide the functions needed for deturgescing initially swollen stroma.     

Tissue engineering of corneal stromal layer with dermal fibroblasts: phenotypic and functional switch of differentiated cells in cornea

Previously, we successfully engineered a corneal stromal layer using corneal stromal cells. However, the limited source and proliferation potential of corneal stromal cells has driven us to search for alternative cell sources for corneal stroma engineering. Based on the idea that the tissue-specific environment may alter cell fate, we proposed that dermal fibroblasts could switch their phenotype to that of corneal stromal cells in the corneal environment. Thus, dermal fibroblasts were harvested from newborn rabbits, seeded on biodegradable polyglycolic acid (PGA) scaffolds, cultured in vitro for 1 week, and then implanted into adult rabbit corneas. After 8 weeks of implantation, nearly transparent corneal stroma was formed, with a histological structure similar to that of its native counterpart. The existence of cells that had been retrovirally labeled with green fluorescence protein (GFP) demonstrated the survival of implanted cells. In addition, all GFP-positive cells that survived expressed keratocan, a specific marker for corneal stromal cells, and formed fine collagen fibrils with a highly organized pattern similar to that of native stroma. However, neither dermal fibroblast-PGA construct pre-incubated in vitro for 3 weeks nor chondrocyte-PGA construct could form transparent stroma. The results demonstrated that neonatal dermal fibroblasts could switch their phenotype in the new tissue environment under restricted conditions. The functional restoration of corneal transparency using dermal fibroblasts suggests that they could be an alternative cell source for corneal stroma engineering.     

干燥脱水保存鸵鸟脱细胞角膜基质载体材料的细胞毒性

背景：陕西省眼科研究所通过前期研究发现鸵鸟角膜具有开发成为人角膜材料替代品的优势。 目的：判断鸵鸟角膜基质支架材料对细胞的潜在毒性作用。 方法：采用细胞培养方法,将干燥脱水法保存的鸵鸟脱细胞角膜基质载体支架制备成浸提液与L-929细胞共同培养,采用MTT比色法评价其作用1,2,3 d,对细胞生长和增殖的影响。 结果与结论：干燥脱水法保存的鸵鸟脱细胞角膜基质载体支架浸提液组培养1,3,5 d,对实验细胞毒性反应级别均为1级。参照《中华人民共和国国家标准GB/T16886.5-2003》进行细胞毒性试验,供试品组见少量细胞呈圆形,疏松贴壁,无胞浆内颗粒,偶见细胞溶解。结合MTT法分析结果表明,采用干燥脱水法保存鸵鸟脱细胞角膜基质载体材料,细胞毒性为1级,为合格材料。     

脱细胞猪角膜基质支架的制备及其生物相容性

BACKGROUND: Studies have found that a variety of biological materials can be used for preparing corneal stroma scaffolds that have good biocompatibility, but research on preparation and biocompatibility of the acellular porcine corneal stroma scaffold is little. OBJECTIVE: To explore the preparation and biocompatibility of the acellular porcine corneal stroma scaffold. METHODS: Acellular porcine corneal stroma scaffold and its extract were prepared. Well-grown human corneal stromal cells were selected and cultured in the extract of acellular porcine corneal stroma scaffold (experimental group) or in the complete medium (control group), respectively. After 1, 2 and 3 days of culture, the proliferation ability of human corneal stromal cells was detected by MTT assay. In the meanwhile, human corneal cells were directly seeded onto the acellular porcine corneal stroma scaffold, and then the cell growth on the scaffold was detected using immunochemical method. RESULTS AND CONCLUSION: The number of human corneal stromal cells was in a rise with time in the two groups, and absorbance values had no significant difference between two groups at different time points of culture. Human corneal stromal cells grew well on the scaffold, and were positive for cell integrin β1, vimentin, aldehyde dehydrogenase 3A1, as well as CD34, CDK2 and K-Ras. These results show that the acellular porcine corneal stroma scaffold has no cytotoxicity, and has good biocompatibility.     

The three-dimensional microanatomy of the rabbit and human cornea. A chemical and mechanical microdissection-SEM approach

The three-dimensional (3D) microanatomy of the cornea is the major determinant of its optical and mechanical properties. Scanning electron microscopy (SEM) is the most commonly used method to obtain information on the overall 3D microanatomy of organs. However, SEM has not been successful in revealing the 3D microanatomy of the cornea, because the interior of the cornea is too compact to be explored by the electron beam. In this study, the 3D organisation of the cells and extracellular materials of human and rabbit corneas was examined after exposure by HCl and NaOH digestion, and by microdissection by the adhesive tape method. In the cornea of both species, all epithelial cells exhibited microplicae regardless of their location. This raises doubts about the tear film-holding role assigned to the microplicae of the superficial cells. Human and rabbit corneas differed in the collagen fibre patterns of the epithelial basement membranes. The 3D organisation of the stromal lamellae was similar in both species. In humans and rabbits, the keratocytes showed similar 3D features. However, the surface of human keratocytes located near Descemet's membrane exhibited small fenestrations that were not present in the rabbit keratocytes. The pattern of keratocyte innervation by the stromal neural plexus and 3D keratocyte microanatomy confirms that keratocytes form a large intercommunicating network within the corneal stroma. Two morphologically discrete subpopulations of keratocytes located at different stromal levels were identified in both human and rabbit corneas, suggesting that keratocytes are not functionally homogeneous. In addition, the density of the stromal neural plexus appeared to be greater in rabbits than in humans. Clear differences between human and rabbit corneas were observed in the collagen arrangement in Descemet's membrane, which may reflect their different biomechanical requirements.     

Corneal reinforcement using an acellular dermal matrix for an analysis of biocompatibility, mechanical properties, and transparency

The aim of this study was to analyze the viability of using an acellular dermal matrix (ADM) as a reinforcement material for peripheral corneal thinning disease. The complete removal of cell components was confirmed by hematoxylin and eosin (H&E) and 4',6-diamidino-2-phenylindole (DAPI) staining. Transmission electron microscopy determined that the stromal structure was well preserved. Uniaxial tests revealed that the ADM had strong mechanical properties. After being implanted into rabbit cornea the ADM showed no sign of rejection and even achieved good transparency 24weeks post-surgery. H&E staining demonstrated that keratocytes grew in the ADM and the ADM-cornea interface became blurry. Picrosirius red staining revealed great changes of collagen in the ADM. Uniaxial testing of the reinforced cornea showed better mechanical strength than the normal rabbit cornea, but this did not exhibit statistical significance. These results suggest that ADM is a worthy candidate for future exploration as a reinforcement material for peripheral corneal thinning problems.