A Bioengineering-Regenerative Medicine Approach for Ocular Surface Reconstruction Using a Functionalized Native Cornea-Derived Bio-Scaffold

Limbal stem cell deficiency (LSCD) is characterized by the loss of limbal epithelial stem cells (LESCs) which compromises corneal transparency, leading to blindness. It cannot be treated with pharmacological or corneal transplantation interventions, instead a specialized stem cell (SC) therapy is needed to restore eye health and sight. Herein, a native cornea-derived biomaterial, a by-product of a laser refractive surgical procedure called small incision lenticule extraction is identified as a new cell delivery matrix. Culture conditions are optimized to facilitate LESC attachment, expansion and stratification, and their identity is immunophenotyped. Using electron microscopy, bio-constructs display stratification, similar to the architectural and cellular organization of a native mammalian cornea with formation of a basement membrane and an orderly array of collagen fibrils. Neuronal growth and depleted CD45+/CD14+ leukocytes on lenticules are also shown, suggesting that in transplantation experiments, they will re-innervate and not trigger a host-mediated immune response. Finally, human lenticules are geometrically customized to successfully fit them over a LSCD murine cornea ex vivo, during which they maintain curvature. The authors are poised to conduced similar studies in live mice using these and other carriers currently used in the clinic to compare SC therapy outcomes. A slice of normal cornea, extracted following a laser refractive surgical procedure called small incision lenticule extraction, is salvaged from the medical waste, and repurposed to entice limbal epithelial stem cell attachment, proliferation, and stratification. The goal now is to determine whether this bioengineering approach can be developed into a new cornea regenerating, sight-restoring therapy for patients with limbal stem cell deficiency.image