Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26197361
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Prog+Retin+Eye+Res
2015 ; 49
(ä): 17-45
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Progress in corneal wound healing
#MMPMID26197361
Ljubimov AV
; Saghizadeh M
Prog Retin Eye Res
2015[Nov]; 49
(ä): 17-45
PMID26197361
show ga
Corneal wound healing is a complex process involving cell death, migration,
proliferation, differentiation, and extracellular matrix remodeling. Many
similarities are observed in the healing processes of corneal epithelial, stromal
and endothelial cells, as well as cell-specific differences. Corneal epithelial
healing largely depends on limbal stem cells and remodeling of the basement
membrane. During stromal healing, keratocytes get transformed to motile and
contractile myofibroblasts largely due to activation of transforming growth
factor-? (TGF-?) system. Endothelial cells heal mostly by migration and
spreading, with cell proliferation playing a secondary role. In the last decade,
many aspects of wound healing process in different parts of the cornea have been
elucidated, and some new therapeutic approaches have emerged. The concept of
limbal stem cells received rigorous experimental corroboration, with new markers
uncovered and new treatment options including gene and microRNA therapy tested in
experimental systems. Transplantation of limbal stem cell-enriched cultures for
efficient re-epithelialization in stem cell deficiency and corneal injuries has
become reality in clinical setting. Mediators and course of events during stromal
healing have been detailed, and new treatment regimens including gene (decorin)
and stem cell therapy for excessive healing have been designed. This is a very
important advance given the popularity of various refractive surgeries entailing
stromal wound healing. Successful surgical ways of replacing the diseased
endothelium have been clinically tested, and new approaches to accelerate
endothelial healing and suppress endothelial-mesenchymal transformation have been
proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to
activate TGF-? inhibitor SMAD7. Promising new technologies with potential for
corneal wound healing manipulation including microRNA, induced pluripotent stem
cells to generate corneal epithelium, and nanocarriers for corneal drug delivery
are discussed. Attention is also paid to problems in wound healing understanding
and treatment, such as lack of specific epithelial stem cell markers, reliable
identification of stem cells, efficient prevention of haze and stromal scar
formation, lack of data on wound regulating microRNAs in keratocytes and
endothelial cells, as well as virtual lack of targeted systems for drug and gene
delivery to select corneal cells.
free
free
free
