组织工程角膜三维构建的实验研究

目的以人胚胎干细胞（hESC）诱导细胞为种子细胞,以脱细胞猪角膜基质（APCM）为支架三维构建生物工程角膜,以期用于穿透性角膜移植,解决角膜供体极度匮乏的难题。方法实验研究。无菌条件下将新鲜猪角膜组织置于0.5% SDS溶液中4 ℃脱细胞 24 h,获取APCM。将hESCs与人角膜基质细胞通过Transwell共培养5 d,获取眼周间充质干细胞（POMPs）,再于人晶状体上皮细胞源性条件培养基继续培养14 d获取角膜内皮样细胞并进行鉴定和筛选纯化。将纯化后扩增的角膜内皮样细胞接种于APCM构建角膜内皮植片,并移植入角膜内皮功能失代偿动物模型进行泵功能评估;采用人角膜缘干细胞（LSCs）来源的条件培养基培养hESCs 12 d,诱导其分化人角膜上皮样细胞并筛选鉴定,将其与APCM构建的角膜上皮植片移植于LSC失代偿动物模型的角膜缘,观察其眼表修复能力。结果诱导的人角膜内皮样细胞表达内皮细胞相关标记物vimentin、N-cadherin、Na+/K+ATP酶和ZO-1。构建的角膜内皮植片能够促使角膜内皮功能失代偿动物的角膜逐渐恢复透明。构建的角膜上皮细胞植片具有4～5层细胞复层结构,类似于正常角膜上皮,且能够一定程度上修复LSC失代偿动物模型眼表。结论采用hESCs诱导分化来源的细胞与APCM构建的人角膜内皮植片和人角膜上皮植片具有类似于正常角膜的功能,为全层生物角膜的构建提供了良好的实验和理论基础,具有良好的临床应用前景。     

培养的兔羊膜上皮细胞构建角膜表层移植片的研究

目的应用培养的兔羊膜上皮细胞（AECs）体外构建复层上皮细胞-角膜基质移植材料,探讨利用AECs重建角膜表层的可行性。方法取妊娠晚期新西兰大白兔（27～28孕周）的羊膜,制成AECs单细胞悬液,用含血清和表皮生长因子（EGF）的DMEM／F12培养液培养、传代,利用免疫组织化学单克隆抗体AE1／AE3、AE5检测培养的AECs中细胞角蛋白ck3／12的表达;将体外培养的2～3代兔AECs种植在新鲜兔角膜基质上,利用气-液界面培养法使之复层化,体外构建复层上皮细胞-角膜基质移植材料,进行光学显微镜和扫描电镜观察,并进行免疫组织化学测定。结果体外培养的兔AECs呈现单克隆抗体AE1／AE3、AE5表达阳性,AECs在新鲜兔角膜基质上能形成形态类似于正常角膜上皮细胞的3～5层复层结构,且复层化后的上皮细胞单克隆抗体AE5表达阳性。结论应用培养的AECs能成功构建类似角膜表层的复层上皮细胞-角膜基质移植材料,AECs可能成为重建角膜表层的一种新的细胞来源。     

人角膜及角膜缘上皮细胞分化标记的检测

目的检测分化标记在人角膜及角膜缘上皮细胞的表达,以了解角膜及角膜缘细胞分化状态,旨在发现新的角膜上皮干细胞的阴性标记。方法获取人角膜及角膜缘组织,对冰冻切片及整个角膜组织行免疫荧光染色检测分化标记钙粘连素E、角蛋白3(CK3)、角蛋白12(CK12)、缝隙连接蛋白43、巢蛋白(nestin)和包壳蛋白(involucrin)的表达,经荧光显微镜及激光扫描共焦电镜观察,并行半定量RT-PCR以检测其相关分化标记基因的表达。结果分化标记CK3、CK12、缝隙连接蛋白43、巢蛋白和包壳蛋白在角膜和角膜缘上皮的表层细胞表达,角膜缘基底细胞不表达。激光扫描共焦电镜观察及RT-PCR结果显示角膜缘基底上皮细胞不表达细胞CK3、连接蛋白43和巢蛋白,而角膜上皮细胞则明显表达。结论角膜及角膜缘表层上皮较为成熟分化,而角膜缘基底细胞具有未分化细胞的特征,很可能是干细胞的部位。     

人骨髓间充质干细胞分化为上皮样细胞的初步研究

目的 应用猪板层角膜做载体将人骨髓间充质干细胞(human bone marrow mesenchymal stem cells,hMSC)跨胚层诱导为上皮样细胞,甚至角膜上皮样细胞,初步探讨hMSC作为构建组织工程角膜种子细胞的可行性.方法 实验研究.用密度梯度离心培养技术结合贴壁培养法分离纯化hMSC并传代,对体外培养的hMSC进行免疫表型鉴定.将传代后的hMSC接种于去上皮的猪角膜基质片前弹力层表面培养诱导分化,免疫荧光检测角膜上皮细胞标志物角蛋白12(CK12)以及角膜缘干细胞标记物ABCG2和CK19的表达.运用体外培养的方法使种植在前弹力层表面的细胞复层化.待细胞融合形成单层后,置入插入式培养皿中进行气液界面培养.培养4周后进行HE染色及免疫组织化学检测,光镜下观察其复层情况.结果 获得的hMSC可以在体外培养扩增,表现出很强的增殖潜能.流式细胞仪示:培养的hMSC CD45阳性率为0.06%,CD34为0.41%,CD44为86.43%,CD29为85.72%,CD105为90.72%.诱导4周后部分细胞表达CK12和CK19,不表达ABCG2.运用气液界面培养法进行体外复层的结果显示可以形成1～2层的上皮样细胞,并很可能为角膜上皮样细胞.结论 在本实验的诱导条件下,hMSC可以分化为上皮样细胞,并很可能为角膜上皮样细胞,hMSC有可能作为组织工程技术角膜上皮重建的种子细胞的选择.     

羊膜培养兔角膜缘上皮细胞及自体移植--角膜缘干细胞缺损的治疗

目的　探讨以人羊膜为载体培养兔角膜缘上皮细胞及其自体移植治疗全角膜缘干细胞缺损。方法　在8只兔右眼用正庚醇脱上皮和角膜缘环切的方法构建全角膜缘干细胞缺损模型2月。其中6只兔为实验组,活体取左眼角膜缘浅层小块,置羊膜上常规和气_液培养42天后进行自体移植治疗右眼角膜缘干细胞缺损;2只兔为对照组,直接用解冻无细胞人羊膜移植治疗右眼角膜缘干细胞缺损。进行细胞和术眼活体观察、组织学观察和电镜观察。结果　角膜缘上皮细胞在羊膜上生长良好,形成复层,细胞间的联结结构存在,细胞与羊膜组织粘附牢固。实验组移植手术后角膜迅速上皮化,恢复角膜表面光滑和透明,组织学观察和电镜观察呈现生理角膜上皮层的结构特点。但眼睑闭合不全可导致手术失败。对照组术后出现角膜缘干细胞缺损导致的角膜病变。结论　以羊膜为载体培养角膜缘上皮细胞后自体移植可有效地治疗角膜缘干细胞缺损导致的角膜病变。     

人角膜基质细胞诱导人骨髓间充质干细胞分化为角膜上皮细胞的初步研究

目的 探讨人骨髓间充质干细胞（MSC）体外分化为角膜上皮细胞的可行性.方法 实验研究.分别取第3代人MSC和自行培养的第3代人角膜基质细胞共同培养1周,实验组在Transwell共培养体系中培养,对照组不放置Transwell小室培养.1周后,观察实验组和对照组中人MSC光镜特征、间接免疫细胞化学染色和电镜结构,对被诱导分化的细胞进行综合鉴别.结果 第3代人MSC和人角膜基质细胞在体外培养条件下均能够较快贴壁生长.两种细胞共同培养1周后,可见部分细胞形态上呈上皮细胞特征,单克隆抗体AE1染色呈阳性,电镜下可见微绒毛、桥粒和张力丝等典型上皮细胞结构特征.结论 体外培养的人MSC在人角膜基质细胞的诱导下可能会分化为人角膜上皮样细胞.     

胚胎干细胞向角膜上皮细胞诱导分化的研究进展

胚胎干细胞（ESCs）是一种具有多向分化潜能的细胞,在一定条件诱导下能分化为骨细胞、软骨细胞、肌细胞、血管内皮细胞和神经细胞,在眼表的修复和重建方面具有广阔的应用前景.目前,大量研究已证实,ESCs可以被定向诱导分化为角膜上皮样细胞,并且对眼表损伤的修复也有重要作用.ESCs作为组织工程角膜的种子细胞仍存在一些问题需要解决,如定向分化机制不明确、细胞大量扩增可能存在致瘤问题等.就ESCs向角膜上皮细胞分化的研究进展进行综述.     

慢病毒介导EGFP基因修饰的人羊膜上皮细胞重建角膜表层的实验研究

背景研究发现人羊膜上皮细胞（AECs）具有干细胞的某些特性,已有学者用其进行眼表重建,其可能是角膜表层重建的一种新型种子细胞。目的探讨经慢病毒载体（pLenti6／V5一DEST）介导增强型绿色荧光蛋白（EGFP）基因修饰的人AECs作为组织工程化角膜表层一种新的细胞来源的应用价值。方法利用慢病毒载体携带标记基因EGFP转染人AECs,荧光显微镜下观察转染基因的瞬时表达,倒置显微镜下观察转染细胞的生长形态,用流式细胞仪检测转染细胞中EGFP的阳性表达率,然后应用EGFP基因修饰的人AECs构建复层上皮细胞一角膜基质移植材料。手术切除兔眼的全部角膜缘组织制备角膜缘干细胞缺损动物模型,随机分为2组,实验组兔眼移植EGFP基因修饰的人AECs构建的复层上皮细胞一角膜基质移植材料,对照组兔眼移植无上皮细胞的角膜基质移植材料,每天裂隙灯下观察2组兔眼角膜的混浊、结膜上皮化和新生血管化情况。1个月后处死动物摘除眼球,荧光显微镜下观察角膜植片中EGFP的表达,用免疫组织化学法检测其细胞角蛋白8（CK8）、CKl8和CKl2的表达,以鉴定移植细胞分化为角膜样的上皮细胞。结果大多数转染细胞筛选出的抗性克隆以及培养的克隆细胞与正常体外培养的人AECs形态相似,流式细胞仪检测显示瞬时转染48h的人AECs中EGFP阳性表达率最高,为61．50％,与12、24、96h转染组15．24％、38．27％、39．10％比较差异均有统计学意义（P〈0．05）,与72h转染组的58．36％比较差异无统计学意义（P〉0．05）。实验组10只兔眼中有6只眼角膜恢复透明,组织片在荧光显微镜下观察能发出绿色荧光,免疫组织化学结果显示CK8、CKl8、CKl2表达均为细胞质棕色染色,细胞核蓝染。对照组兔眼角膜均混浊、水肿,荧光显微镜下未见荧光,且部分角膜组织有CK8、CKl8表达,无CKl2表达。结论EGFP基因修饰的人AECs构建的复层上皮细胞一角膜基质移植材料能较好地重建角膜缘干细胞缺乏的兔眼角膜表层,可能是组织工程角膜表层一种新的细胞来源。慢病毒载体是一种安全有效的基因转移工具。     

大鼠角膜缘上皮细胞培养与同体移植的实验研究

目的：观察以明胶为载体培养的角膜缘上皮细胞移植治疗角膜缘干细胞缺乏症的疗效。 方法：大鼠角膜缘上皮细胞在铺有明胶载体的细胞培养板上进行培养5d后,角膜上皮细胞移植术前24h用3H胸腺嘧啶核苷标记培养的角膜缘上皮细胞,培养标记的角膜缘上皮细胞对角膜缘干细胞缺乏的大鼠动物模型行角膜缘上皮细胞同体移植术,对移植术后角膜进行观察、病理学检查及同位素检测。 结果：大鼠角膜缘上皮细胞可以在明胶载体上培养、增殖、分化为密集角膜上皮细胞层;角膜缘上皮细胞移植术后角膜上皮完整、基质细胞浸润减轻、新生血管减少。病理学检查角膜缘及周边部上皮细胞为多层结构,角膜新生血管消失及基质中炎性细胞浸润减轻。角膜缘上皮细胞移植术后4wk受眼角膜仍可测到3H胸腺嘧啶核苷。 结论：角膜缘上皮细胞移植治疗角膜缘干细胞缺乏症可恢复角膜缘干细胞缺乏病变角膜上皮结构的完整性,减少角膜新生血管的形成,维持角膜缘干细胞的屏障功能,为角膜移值提供更好的条件。     

体外重建角膜上皮组织的实验研究

利用体外培养重建同基因角膜上皮组织的新方法，为角膜化学伤后重建角膜表面提供理想的角膜上皮移植片。方法以同种或异种脱水保存的浅层角膜基质片作为载体，通过体外培养自体缘上皮细胞，并使其在体外形成复层角膜上皮组织。     

角膜缘干细胞的研究

角膜缘干细胞是位于角膜缘基底上皮层底的一类特殊类型的上皮细胞,随着细胞培养技术的发展,角膜缘干细胞体外培养后移植用于治疗由于角膜缘干细胞缺乏或者功能不全引起的眼表疾病成为研究的热点。本文就其解剖学定位、生物学特性、组织工程化角膜的基础性研究及其临床应用做一综述。     

The Preliminary Experimental Study of Induced Differentiation of Embryonic Stem Cells into Corneal Epithelial Cells

Purpose: To study preliminarily induced differentiation of embryonic stem cells into corneal epithelial cells in vitro.Methods: Murine embryonic stem cells were co-cultured with Rabbit limbal corneal epithelial cells in Transwell system to induce differentiation. Mophological and immunohistochemical examination were implemented.Results: The induced cells from embryonic stem cells have an epithelial appearance. The cells formed a network and were confluent into film gradually after being co-cultured with rabbit limbal corneal epithelial cells for 24 ~ 96 hours. The cells ranged mosaic structure and localized together with clear rim. Most of the cells showed polygonal appearance. Transmission electron microscope showed lots of microvilli on the surface of induced cells and tight junctions between them. These epithelial-like cells expressed the corneal epithelial cell specific marker cytokeratin3/cytokeratin12. Conclusion: The potential mechanism of the differentiation of murine embryonic stem cel     

以干燥脱水法保存的异种角膜基质为载体构建人工生物角膜上皮组织

目的:观察以干燥脱水法保存的鸵鸟角膜基质为载体构建人工生物角膜上皮组织的生物学特性。方法:采用组织块培养法获得新西兰大白兔角膜缘干细胞,经胰蛋白酶消化法获得细胞,种植于干燥脱水法保存的鸵鸟角膜板层基质上,采用气液界面培养法进行培养,通过倒置显微镜、透射电子显微镜、荧光显微镜观察其形态学、生长特点,超微结构及免疫学特征。结果:在干燥脱水法保存的鸵鸟角膜基质上种植兔角膜缘干细胞,接种72h后,细胞形成单层,移置气液交界面后继续培养7～10d,逐渐形成复层。经光镜、透射电镜、及免疫学检测显示其具有角膜上皮组织的生物学特性。结论:兔角膜缘干细胞能够在干燥脱水法保存的鸵鸟角膜基质载体上生长,并可形成复层,基本具有正常角膜上皮细胞的形态、超微结构和生物学特性。     

培养角膜缘上皮细胞深低温保存后异体移植实验研究

目的深低温保存培养的角膜缘上皮细胞,复苏后进行异体移植实验,为临床应用提供实验依据。方法将浅层角膜基质载体上培养的角膜缘上皮细胞深低温保存,同时制作兔角膜缘干细胞损伤模型,分别用新鲜培养的角膜缘上皮细胞和冷冻复苏后培养的细胞及角膜基质进行异体移植实验。结果角膜缘上皮细胞能成功地培养于载体上,将培养细胞保存于-196℃的液氮罐中二月,可见深低温保存前后细胞的形态结构及生物学特性无显著差异。异体移植实验显示：新鲜培养的细胞及深低温保存后的细胞异体移植后,模型兔角膜表面逐渐正常上皮化,而角膜基质组异体移植后,角膜表面仍结膜化并可见大量新生血管生长,各项检测结果与培养细胞组相比差异显著（P〈0．05）。结论以浅层角膜基质为载体培养的角膜缘上皮细胞深低温保存后仍具有上皮细胞特性并具有高增殖能力,可用以进行异体移植治疗角膜缘干细胞缺陷的角膜病。     

培养角膜干细胞羊膜片移植治疗角膜缘功能障碍

目的：临床观察培养的角膜干细胞羊膜移植片治疗角膜缘功能障碍的效果。方法：人角膜缘干细胞原代培养后接种生长于羊膜上,临床选择角膜缘烧伤后（碱烧伤、酸烧伤、其他化学烧伤等）,角膜新生血管的患者进行干细胞羊膜片移植,术后观察角膜上皮、组织浸润和新生血管情况。结果：术后患者自觉症状轻,视力有一定提高,角膜缘移植片紧密贴附,角膜上皮完整,轻度基质炎性浸润,浅层新生血管减少,深层新生血管充盈减轻,睑球粘连得到     

角膜缘干细胞研究新进展

位于角膜最外层的角膜上皮细胞,正常损耗或创伤后,由角膜缘干细胞不断自我更新补充。当损伤等致角膜缘干细胞缺乏时,则会导致角膜溃疡、新生血管、混浊等角膜病变而影响视力。目前治疗这些角膜疾病的重要方式之一为移植体外培养的角膜缘干细胞。本文将从角膜缘干细胞的定位、体外培养、新细胞来源等方面进行综述。     

Corneal epithelial stem cells at the limbus: looking at some old problems from a new angle

Corneal epithelium is traditionally thought to be a self-sufficient, self-renewing tissue implying that its stem cells are located in its basal cell layer. Recent studies indicate however that corneal epithelial stem cells reside in the basal layer of peripheral cornea in the limbal zone, and that corneal and conjunctival epithelia represent distinct cell lineages. These ideas are supported by the unique limbal/corneal expression pattern of the K3 keratin marker for corneal-type differentiation; the restriction of the slow-cycling (label-retaining) cells in the limbus; the distinct keratin expression patterns of corneal and conjunctival epithelial cells even when they are provided with identical in vivo and in vitro growth environments; and the limbal cells' superior ability as compared with central corneal epithelial cells in undergoing in vitro proliferation and in reconstituting in vivo an intact corneal epithelium. The realization that corneal epithelial stem cells reside in the limbal zone provides explanations for several paradoxical properties of corneal epithelium including its 'mature-looking' basal cells, the preponderance of tumor formation in the limbal zone, and the centripetal cellular migration. The limbal stem cell concept has led to a better understanding of the strategies of corneal epithelial repair, to a new classification of various anterior surface epithelial diseases, to the use of limbal stem cells for the reconstruction of corneal epithelium damaged or lost as a consequence of trauma or disease ('limbal stem cell transplantation'), and to the rejection of the traditional notion of 'conjunctival transdifferentiation'. The fact that corneal epithelial stem cells reside outside of the cornea proper suggests that studying corneal epithelium per se without taking into account its limbal zone will yield partial pictures. Future studies need to address the signals that constitute the limbal stem cell niche, the mechanism by which amniotic membrane facilitates limbal stem cell transplantation and ex vivo expansion, and the lineage flexibility of limbal stem cells.     

Stromal niche controls the plasticity of limbal and corneal epithelial differentiation in a rabbit model of recombined tissue

PURPOSE: The adult rabbit limbal basal epithelium contains corneal epithelial stem cells, which have been characterized by a negative expression of keratin-3 (K3) and a lower expression of connexin 43 (Cx43). This study was conducted to determine whether the limbal stroma dictates the plasticity of limbal and corneal epithelial differentiation. METHODS: Viable epithelial sheets of the central cornea and the pigmented limbus were isolated from Dutch belted rabbits by incubation of 50 mg/mL of dispase II in supplemental hormonal epithelial medium (SHEM) for 18 hours at 4 degrees C. The cleavage plane was studied by immunostaining with antibodies against K3, Cx43, integrin beta1, and collagen IV. Viability of single cells derived from these sheets was assessed by a live-dead assay. Such limbal (L) and corneal (K) epithelial sheets were recombined with either limbal (Ls) or corneal (Ks) stroma, and cultured in SHEM for 10 days before lifting to the air-fluid interface for 1 week. The resultant epithelial phenotype was determined by histology and immunostaining to K3 and Cx43, and apoptosis was investigated by Hoechst and TUNEL nuclear staining. RESULTS: Viability of isolated limbal and corneal epithelial sheets was determined to be 91.1% +/- 2.9%. The basal epithelium of isolated limbal epithelial sheets was positive for integrin beta1, negative for K3, but weakly positive for Cx43, and still retained patches of collagen IV. All recombinants showed stratified epithelia, with intraepithelial cysts with desquamated debris noted only in K/Ks, and epithelial outgrowth onto the insert filter from L/Ls. As expected, expression of K3 was negative in the basal layer of L/Ls, but positive in that of K/Ks. Expression of K3 was sporadically positive in the basal layer of L/Ks but largely negative in that of K/Ls. Expression of Cx43 was uniformly expressed in the basal layer of the K/Ks, but weak in that of L/Ls, K/Ls, and L/Ks. A higher apoptosis index was only noted in intraepithelial cysts of K/Ks. CONCLUSIONS: These results strongly indicate that the limbal stroma modulates epithelial differentiation, proliferation and apoptosis in the direction favoring stemness, whereas the corneal stroma promotes differentiation. Further investigation into elements constituting such a niche should help unveil the secrecy whereby stemness is controlled.     

Induction of epithelial progenitors in vitro from mouse embryonic stem cells and application for reconstruction of damaged cornea in mice

PURPOSE: Severe ocular surface diseases and injuries cause loss of the corneal limbal epithelium, leading to re-epithelialization by bulbar conjunctival cells, resulting in vascularization of the cornea, conjunctival scarring, and loss of visual acuity. In this study, the optimal culture condition for induction of differentiation of epithelial progenitor cells from embryonic stem (ES) cells was determined for use in transplantation to damaged cornea in mice. METHODS: Mouse ES cells were cultured on Petri dishes coated with several extracellular matrix proteins, and the markers for epithelial cells were analyzed with RT-PCR and Western blot analysis. The optimal condition for induction of epithelial progenitor cells was determined, and the progenitors were transplanted onto mouse eyes with corneal epithelia that had been damaged by exposure to n-heptanol. RESULTS: Epithelial progenitors were successfully induced by culturing mouse ES cells on type IV collagen for 8 days. These progenitors expressed keratin (K)12, which is specific to corneal epithelial cells, and cell surface CD44 and E-cadherin, both of which are essential in corneal epithelial wound healing. Complete re-epithelialization of the corneal surface occurred within 24 hours after transplantation. The resultant corneal epithelial cells expressed markers of the grafted cells, and no teratomata were observed during the follow-up period. CONCLUSIONS: Epithelial progenitors were successfully induced in vitro from ES cells and were applicable as grafts for treating corneal epithelial injury. ES cells may become an unlimited donor source of corneal epithelial cells for corneal transplantation and may restore useful vision in patients with a deficiency of limbal epithelial cells. This is an important first trial toward assessing the use of ES cells to reconstruct corneal epithelial cells.