[Conjunctival reconstruction-State of the art of regenerative treatment forms beyond the limbus].
Bindehautrekonstruktion – Status quo regenerativer Therapieformen jenseits des Limbus.
Amniotic membrane
Conjunctival replacement tissue
Decellularized tissues
Goblet cell growth
Mucous membrane
Journal
Die Ophthalmologie
ISSN: 2731-7218
Titre abrégé: Ophthalmologie
Pays: Germany
ID NLM: 9918402288106676
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
accepted:
25
05
2022
pubmed:
5
8
2022
medline:
8
9
2022
entrez:
4
8
2022
Statut:
ppublish
Résumé
The demands on conjunctival replacement tissues are high: they need to be elastic, clinically compatible, surgically feasible and support goblet cell growth. This article provides an overview of currently applied conjunctival replacement tissues and those under investigation. Current publications on clinically applied conjunctival replacement tissues and substrates which are the subject of scientific research and those already tested in animal models are presented and discussed. Replacement tissues in clinical use are autologous and allogenic conjunctiva, nasal and oral mucous membranes, amniotic membrane and decellularized tissues. Autologous conjunctiva shows good results but is not suitable for large defects due to limited availability. In these cases autologous nasal and oral mucous membranes can be used; however, success is limited in cases of autoimmune diseases. Amniotic membranes are frequently applied clinically but goblet cell growth is limited. Different decellularized tissues are used clinically and goblet cell growth was found in vivo. Robust comparative studies are not yet available. Biological matrices such as fibrin, collagen, elastin, gelatin or hyaluronate and synthetic tissues from the group of polyesters are being investigated in the laboratory and in animal models. These studies show good epithelialization and goblet cell growth in vivo. Transplantation of conjunctiva, nasal and oral mucous membranes and amniotic membranes show satisfactory clinical results but exhibit individual weaknesses. Further studies in animal models and clinical settings are required to further evaluate the benefits of other matrices, such as cell-free tissues or other biological and synthetic matrices. HINTERGRUND: Die Ansprüche an ein Bindehautersatzgewebe sind hoch: Es muss elastisch, klinisch verträglich sowie chirurgisch handhabbar sein und das Becherzellwachstum unterstützen. Diese Arbeit gibt einen Überblick über aktuell verwendete und in der Forschung untersuchte Bindehautersatzgewebe. Es erfolgen eine Darstellung und Diskussion aktueller Publikationen zum klinischen Bindehautersatz und zu Geweben, die sich in der wissenschaftlichen Erforschung befinden und bereits im Tiermodell getestet wurden. Ersatzgewebe in der klinischen Anwendung sind autologe oder allogene Bindehaut, Nasen- oder Mundschleimhaut, Amnionmembran und dezellularisierte Gewebe. Hierbei zeigt autologe Bindehaut sehr gute Ergebnisse, ist aber aufgrund der limitierten Verfügbarkeit nicht für große Defekte geeignet. Hier kann autologe Nasen- und Mundschleimhaut angewendet werden. Allerdings sind die Erfolgsraten bei Autoimmunerkrankungen reduziert. Amnionmembran wird klinisch vielfach eingesetzt, hat aber den Nachteil, dass keine vitalen Zellen transplantiert werden und dass das Becherzellwachstum eingeschränkt ist. Des Weiteren werden dezellularisierte Gewebe klinisch angewendet, und in vivo war Becherzellwachstum nachweisbar. Aussagekräftige vergleichende Studien für den Bindehautersatz fehlen allerdings. Biologische Matrices wie Fibrin, Kollagen, Elastin, Gelatine oder Hyaluronat und synthetische Gewebe aus der Gruppe der Polyester werden im Labor und im Tiermodell untersucht. Studien zeigen eine gute Epithelialisierung und Becherzellbesiedlung in vivo. Die Bindehaut‑, Nasen‑/Mundschleimhaut- und Amnionmembrantransplantation zeigen klinisch befriedigende Ergebnisse, haben aber individuelle Nachteile. Es bedarf weiterer Untersuchungen im Tiermodell und in der Klinik, um andere Matrices wie zellfreie Gewebe oder weitere biologische und synthetische Matrices genauer zu evaluieren.
Sections du résumé
BACKGROUND
BACKGROUND
The demands on conjunctival replacement tissues are high: they need to be elastic, clinically compatible, surgically feasible and support goblet cell growth.
OBJECTIVE
OBJECTIVE
This article provides an overview of currently applied conjunctival replacement tissues and those under investigation.
METHOD
METHODS
Current publications on clinically applied conjunctival replacement tissues and substrates which are the subject of scientific research and those already tested in animal models are presented and discussed.
RESULTS
RESULTS
Replacement tissues in clinical use are autologous and allogenic conjunctiva, nasal and oral mucous membranes, amniotic membrane and decellularized tissues. Autologous conjunctiva shows good results but is not suitable for large defects due to limited availability. In these cases autologous nasal and oral mucous membranes can be used; however, success is limited in cases of autoimmune diseases. Amniotic membranes are frequently applied clinically but goblet cell growth is limited. Different decellularized tissues are used clinically and goblet cell growth was found in vivo. Robust comparative studies are not yet available. Biological matrices such as fibrin, collagen, elastin, gelatin or hyaluronate and synthetic tissues from the group of polyesters are being investigated in the laboratory and in animal models. These studies show good epithelialization and goblet cell growth in vivo.
CONCLUSION
CONCLUSIONS
Transplantation of conjunctiva, nasal and oral mucous membranes and amniotic membranes show satisfactory clinical results but exhibit individual weaknesses. Further studies in animal models and clinical settings are required to further evaluate the benefits of other matrices, such as cell-free tissues or other biological and synthetic matrices.
ZUSAMMENFASSUNG
UNASSIGNED
HINTERGRUND: Die Ansprüche an ein Bindehautersatzgewebe sind hoch: Es muss elastisch, klinisch verträglich sowie chirurgisch handhabbar sein und das Becherzellwachstum unterstützen.
FRAGESTELLUNG
UNASSIGNED
Diese Arbeit gibt einen Überblick über aktuell verwendete und in der Forschung untersuchte Bindehautersatzgewebe.
METHODE
METHODS
Es erfolgen eine Darstellung und Diskussion aktueller Publikationen zum klinischen Bindehautersatz und zu Geweben, die sich in der wissenschaftlichen Erforschung befinden und bereits im Tiermodell getestet wurden.
ERGEBNISSE
UNASSIGNED
Ersatzgewebe in der klinischen Anwendung sind autologe oder allogene Bindehaut, Nasen- oder Mundschleimhaut, Amnionmembran und dezellularisierte Gewebe. Hierbei zeigt autologe Bindehaut sehr gute Ergebnisse, ist aber aufgrund der limitierten Verfügbarkeit nicht für große Defekte geeignet. Hier kann autologe Nasen- und Mundschleimhaut angewendet werden. Allerdings sind die Erfolgsraten bei Autoimmunerkrankungen reduziert. Amnionmembran wird klinisch vielfach eingesetzt, hat aber den Nachteil, dass keine vitalen Zellen transplantiert werden und dass das Becherzellwachstum eingeschränkt ist. Des Weiteren werden dezellularisierte Gewebe klinisch angewendet, und in vivo war Becherzellwachstum nachweisbar. Aussagekräftige vergleichende Studien für den Bindehautersatz fehlen allerdings. Biologische Matrices wie Fibrin, Kollagen, Elastin, Gelatine oder Hyaluronat und synthetische Gewebe aus der Gruppe der Polyester werden im Labor und im Tiermodell untersucht. Studien zeigen eine gute Epithelialisierung und Becherzellbesiedlung in vivo.
SCHLUSSFOLGERUNG
UNASSIGNED
Die Bindehaut‑, Nasen‑/Mundschleimhaut- und Amnionmembrantransplantation zeigen klinisch befriedigende Ergebnisse, haben aber individuelle Nachteile. Es bedarf weiterer Untersuchungen im Tiermodell und in der Klinik, um andere Matrices wie zellfreie Gewebe oder weitere biologische und synthetische Matrices genauer zu evaluieren.
Autres résumés
Type: Publisher
(ger)
HINTERGRUND: Die Ansprüche an ein Bindehautersatzgewebe sind hoch: Es muss elastisch, klinisch verträglich sowie chirurgisch handhabbar sein und das Becherzellwachstum unterstützen.
Identifiants
pubmed: 35925338
doi: 10.1007/s00347-022-01673-9
pii: 10.1007/s00347-022-01673-9
doi:
Substances chimiques
Gelatin
9000-70-8
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
902-909Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
Références
Makuloluwa AK, Hamill KJ, Rauz S, Bosworth L, Haneef A, Romano V, Williams RL, Dartt DA, Kaye SB (2021) Biological tissues and components, and synthetic substrates for conjunctival cell transplantation. Ocul Surf. https://doi.org/10.1016/j.jtos.2021.06.003
doi: 10.1016/j.jtos.2021.06.003
pubmed: 34119712
Macdonald EA, Maurice DM (1991) The kinetics of tear fluid under the lower lid. Exp Eye Res 53:421–425
pubmed: 1936179
doi: 10.1016/0014-4835(91)90158-B
Yaici R, Roth M, Juergens L, Geerling G et al (2022) On the current care situation and treatment of ocular mucous membrane pemphigoid in Germany. Klin Monatsbl Augenheilkd 239:1–7
Schrader S, Notara M, Beaconsfield M, Tuft SJ, Daniels JT, Geerling G (2009) Tissue engineering for conjunctival reconstruction: established methods and future outlooks. Curr Eye Res 34:913–924
pubmed: 19958107
doi: 10.3109/02713680903198045
Tan D (1999) Conjunctival grafting for ocular surface disease. Curr Opin Ophthalmol 10:277–281
pubmed: 10621536
doi: 10.1097/00055735-199908000-00010
Kwitko S, Marinho D, Barcaro S, Bocaccio F, Rymer S, Fernandes S, Neumann J (1995) Allograft conjunctival transplantation for bilateral ocular surface disorders. Ophthalmology 102:1020–1025
pubmed: 9121746
doi: 10.1016/S0161-6420(95)30918-9
Kuckelkorn R, Schrage N, Redbrake C, Kottek A, Reim M (1996) Autologous transplantation of nasal mucosa after severe chemical and thermal eye burns. Acta Ophthalmol Scand 74:442–448
pubmed: 8950391
doi: 10.1111/j.1600-0420.1996.tb00596.x
Wenkel H, Rummelt V, Naumann GOH (2000) Long term results after autologous nasal mucosal transplantation in severe mucus deficiency syndromes. Br J Ophthalmol 84:279–284
pubmed: 10684838
pmcid: 1723415
doi: 10.1136/bjo.84.3.279
Borrelli M, Geerling G, Spaniol K, Witt J (2020) Eye socket regeneration and reconstruction. Curr Eye Res 45(12):1627
pubmed: 32664765
doi: 10.1080/02713683.2020.1775258
Geerling G, Raus P, Murube J (2008) Minor salivary gland transplantation. Dev Ophthalmol 41:243–254
pubmed: 18453773
doi: 10.1159/000131093
Sant’ Anna AE, Hazarbassanov RM, de Freitas D, Gomes JÁ (2012) Minor salivary glands and labial mucous membrane graft in the treatment of severe symblepharon and dry eye in patients with Stevens-Johnson syndrome. Br J Ophthalmol 96:234–239
pubmed: 21527414
doi: 10.1136/bjo.2010.199901
Grixti A, Malhotra R (2018) Oral mucosa grafting in periorbital reconstruction. Orbit 37:411–428
pubmed: 29405795
doi: 10.1080/01676830.2018.1435693
Weinberg DA, Tham V, Hardin N, Antley C, Cohen AJ, Hunt K, Glasgow BJ, Baylis HI, Shorr N, Goldberg RA (2007) Eyelid mucous membrane grafts: a histologic study of hard palate, nasal turbinate, and buccal mucosal grafts. Adv Ophthalmic Plast Reconstr Surg 23:211–216
doi: 10.1097/IOP.0b013e318050d2d1
Walkden A (2020) Amniotic membrane transplantation in ophthalmology: an updated perspective. Clin Ophthalmol 14:2057–2072
pubmed: 32801614
pmcid: 7383023
doi: 10.2147/OPTH.S208008
Meller D, Pauklin M, Thomasen H, Westekemper H, Steuhl K‑P (2011) Amniotic membrane transplantation in the human eye. Dtsch Arztebl Int 108:243
pubmed: 21547164
pmcid: 3087122
de Rotth A (1940) Plastic repair of conjunctival defects with fetal membranes. Arch Ophthalmol 23:522–525
doi: 10.1001/archopht.1940.00860130586006
Satake Y, Higa K, Tsubota K, Shimazaki J (2011) Long-term outcome of cultivated oral mucosal epithelial sheet transplantation in treatment of total limbal stem cell deficiency. Ophthalmology 118:1524–1530
pubmed: 21571372
doi: 10.1016/j.ophtha.2011.01.039
Cabral JV, Jackson CJ, Utheim TP, Jirsova K (2020) Ex vivo cultivated oral mucosal epithelial cell transplantation for limbal stem cell deficiency: a review. Stem Cell Res Ther 11:1–13
doi: 10.1186/s13287-020-01783-8
Gopakumar V, Agarwal S, Srinivasan B, Krishnakumar S, Krishnan UM, Iyer G (2019) Clinical outcome of autologous cultivated oral mucosal epithelial transplantation in ocular surface reconstruction. Cornea 38:1273–1279
pubmed: 31356413
doi: 10.1097/ICO.0000000000002082
Ti S‑E, Tseng SCG (2002) Management of primary and recurrent pterygium using amniotic membrane transplantation. Curr Opin Ophthalmol 13:204–212
pubmed: 12165701
doi: 10.1097/00055735-200208000-00003
Clearfield E, Hawkins BS, Kuo IC (2017) Conjunctival autograft versus amniotic membrane transplantation for treatment of pterygium: findings from a Cochrane systematic review. Am J Ophthalmol 182:8–17
pubmed: 28734814
pmcid: 5610642
doi: 10.1016/j.ajo.2017.07.004
Malhotra C, Jain AK (2014) Human amniotic membrane transplantation: different modalities of its use in ophthalmology. World J Transplant 4:111
pubmed: 25032100
pmcid: 4094946
doi: 10.5500/wjt.v4.i2.111
Park SJ, Kim Y, Jang SY (2018) The application of an acellular dermal allograft (AlloDerm) for patients with insufficient conjunctiva during evisceration and implantation surgery. Eye (Lond) 32:136–141
doi: 10.1038/eye.2017.161
Shorr N, Perry JD, Goldberg RA, Hoenig J, Shorr J (2000) The safety and applications of acellular human dermal allograft in ophthalmic plastic and reconstructive surgery: a preliminary report. Adv Ophthalmic Plast Reconstr Surg 16:223–230
doi: 10.1097/00002341-200005000-00010
Chen X, Yuan F (2018) Ologen implantation versus conjunctival autograft transplantation for treatment of pterygium. J Ophthalmol 2018:1617520
pubmed: 30254754
pmcid: 6142751
Chan-Ho C, Sang-Bumm L (2015) Biodegradable collagen matrix (Ologen (TM)) implant and conjunctival autograft for scleral necrosis after pterygium excision: two case reports. BMC Ophthalmol 15:140
doi: 10.1186/s12886-015-0130-z
Rosentreter A, Lappas A, Widder RA, Alnawaiseh M, Dietlein TS (2018) Conjunctival repair after glaucoma drainage device exposure using collagen-glycosaminoglycane matrices. BMC Ophthalmol 18:1–5
doi: 10.1186/s12886-018-0721-6
Barmettler A, Heo M (2018) A prospective, randomized comparison of lower eyelid retraction repair with autologous auricular cartilage, bovine acellular dermal matrix (surgimend), and porcine acellular dermal matrix (enduragen) spacer grafts. Adv Ophthalmic Plast Reconstr Surg 34:266–273
doi: 10.1097/IOP.0000000000000946
Teo L, Woo YJ, Kim DK, Kim CY, Yoon JS (2017) Surgical outcomes of porcine acellular dermis graft in anophthalmic socket: comparison with oral mucosa graft. Korean J Ophthalmol 31:9–15
pubmed: 28243018
pmcid: 5327181
doi: 10.3341/kjo.2017.31.1.9
Witt J, Mertsch S, Borrelli M, Dietrich J, Geerling G, Schrader S, Spaniol K (2018) Decellularised conjunctiva for ocular surface reconstruction. Acta Biomater 67:259–269
pubmed: 29225150
doi: 10.1016/j.actbio.2017.11.054
Witt J, Dietrich J, Mertsch S, Schrader S, Spaniol K, Geerling G (2020) Decellularized porcine conjunctiva as an alternative substrate for tissue-engineered epithelialized conjunctiva. Ocul Surf 18:901–911
pubmed: 32860970
doi: 10.1016/j.jtos.2020.08.009
Zhao L, Jia Y, Zhao C, Li H, Wang F, Dong M, Liu T, Zhang S, Zhou Q, Shi W (2020) Ocular surface repair using decellularized porcine conjunctiva. Acta Biomater 101:344–356
pubmed: 31706041
doi: 10.1016/j.actbio.2019.11.006
Yang C, Hillas PJ, Báez JA, Nokelainen M, Balan J, Tang J, Spiro R, Polarek JW (2004) The application of recombinant human collagen in tissue engineering. BioDrugs 18:103–119
pubmed: 15046526
doi: 10.2165/00063030-200418020-00004
Witt J, Borrelli M, Mertsch S, Geerling G, Spaniol K, Schrader S (2019) Evaluation of plastic-compressed collagen for conjunctival repair in a rabbit model. Tissue Eng Part A 25:1084–1095
pubmed: 30501562
doi: 10.1089/ten.tea.2018.0190
Merrett K, Fagerholm P, McLaughlin CR, Dravida S, Lagali N, Shinozaki N, Watsky MA, Munger R, Kato Y, Li F, Marmo CJ, Griffith M (2008) Tissue-engineered recombinant human collagen-based corneal substitutes for implantation: performance of type I versus type III collagen. Invest Ophthalmol Vis Sci 49:3887–3894
pubmed: 18515574
doi: 10.1167/iovs.07-1348
Schrader S, Witt J, Geerling G (2018) Plastic compressed collagen transplantation—a new option for corneal surface reconstruction. Acta Ophthalmol 96:e757–e758
pubmed: 29193821
doi: 10.1111/aos.13649
García-Posadas L, Soriano-Romaní L, López-García A, Diebold Y (2017) An engineered human conjunctival-like tissue to study ocular surface inflammatory diseases. PLoS ONE 12:e171099
pubmed: 28248962
pmcid: 5331958
doi: 10.1371/journal.pone.0171099
Safinaz MK, Norzana AG, Hairul Nizam MH, Ropilah AR, Faridah HA, Chua KH, Ruszymah BH, Jemaima CH (2014) The use of autologous fibrin as a scaffold for cultivating autologous conjunctiva in the treatment of conjunctival defect. Cell Tissue Bank 15:619–626
pubmed: 24633432
doi: 10.1007/s10561-014-9436-y
Dehghani S, Rasoulianboroujeni M, Ghasemi H, Keshel SH, Nozarian Z, Hashemian MN, Zarei-Ghanavati M, Latifi G, Ghaffari R, Cui Z, Ye H, Tayebi L (2018) 3D-printed membrane as an alternative to amniotic membrane for ocular surface/conjunctival defect reconstruction: an in vitro & in vivo study. Biomaterials 174:95–112
pubmed: 29793112
doi: 10.1016/j.biomaterials.2018.05.013
Manavitehrani I, Fathi A, Badr H, Daly S, Negahi Shirazi A, Dehghani F (2016) Biomedical applications of biodegradable polyesters. Polymers (Basel) 8:E20
doi: 10.3390/polym8010020
Homaeigohar S, Boccaccini AR (2021) Nature-derived and synthetic additives to poly(ɛ-caprolactone) nanofibrous systems for biomedicine; an updated overview. Front Chem 9:809676
pubmed: 35127651
doi: 10.3389/fchem.2021.809676
Espinoza SM, Patil HI, San Martin Martinez E, Casañas Pimentel R, Ige PP (2020) Poly-ε-caprolactone (PCL), a promising polymer for pharmaceutical and biomedical applications: focus on nanomedicine in cancer. Int J Polym Mater Polym Biomater 69:85–126
doi: 10.1080/00914037.2018.1539990
Shin YJ, Lee HI, Kim MK, Wee WR, Lee JH, Koh JH, Lee HJ, Lee JL, Min BM, Sohn YS, Kim HY (2007) Biocompatibility of nanocomposites used for artificial conjunctiva: in vivo experiments. Curr Eye Res 32:1–10
pubmed: 17364729
doi: 10.1080/02713680601077061
Ang LP, Cheng ZY, Beuerman RW, Teoh SH, Zhu X, Tan DT (2006) The development of a serum-free derived bioengineered conjunctival epithelial equivalent using an ultrathin poly(epsilon-caprolactone) membrane substrate. Invest Ophthalmol Vis Sci 47:105–112
pubmed: 16384951
doi: 10.1167/iovs.05-0512
Fu J, Sun F, Liu W, Liu Y, Gedam M, Hu Q, Fridley C, Quigley HA, Hanes J, Pitha I (2016) Subconjunctival delivery of dorzolamide-loaded poly(ether-anhydride) microparticles produces sustained lowering of intraocular pressure in rabbits. Mol Pharm 13:2987–2995
pubmed: 27336794
pmcid: 5088785
doi: 10.1021/acs.molpharmaceut.6b00343
Tahara K, Karasawa K, Onodera R, Takeuchi H (2017) Feasibility of drug delivery to the eye’s posterior segment by topical instillation of PLGA nanoparticles. Asian J Pharm Sci 12:394–399
pubmed: 32104351
pmcid: 7032217
doi: 10.1016/j.ajps.2017.03.002
Lee SY, Oh JH, Kim JC, Kim YH, Kim SH, Choi JW (2003) In vivo conjunctival reconstruction using modified PLGA grafts for decreased scar formation and contraction. Biomaterials 24:5049–5059
pubmed: 14559019
doi: 10.1016/S0142-9612(03)00411-3
ClinicalTrials.gov (2021) Ahmed valve implantation coated with poly lactic -co-glycolic acid (PLGA) saturated with mitomycin‑C in the management of adult onset glaucoma in Sturge Weber syndrome. https://clinicaltrials.gov/ct2/show/NCT04735601?term=PLGA+AND+conjunctiva&draw=2&rank=1 . Zugegriffen: 23. Apr. 2022