Bottom-Up Strategy for Harvesting Limbal Stem Cell Sheet and its Transplantation in LSCD Patients
Fatemeh SanieJahromi1 , Masoomeh Eghtedari1 *, Mahmood Nejabat1 , Ramin Salouti1 , Hossein Jamali1 , Shahram Bamdad1 , Mohammad Hassan Jalalpour1 , Amir Khosravi1
- Department of Ophthalmology, school of medicine, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract: Limbal Stem Cell Deficiency (LSCD) results in vision challenges due to damaged Limbal Stem Cells (LSCs). This study introduces a novel "bottom-up" approach using polytetrafluoroethylene (PTFE) membranes for harvesting LSC sheets.
Methods: Limbal biopsies from patients, their relatives, or cadaver corneas were utilized to culture LSCs. Once reaching the desired confluence, LSCs were transferred to PTFE scaffolds using the cell air-drying technique and a bottom-up cell transfer approach. Before transplantation, LSCs were characterized, and viability was evaluated. Eight patients with treatment-resistant eye conditions underwent non-randomized PTFE-cell transplants. Post-surgery assessments included visual acuity and corneal health.
Results: Immunocytochemical tests confirmed marker expression and microscopic images vividly displayed the sustained LSC structure on the PTFE scaffold. MTT tests provided compelling evidence for the safety of PTFE. In the one-month follow-up, visual acuity either improved or remained stable, accompanied by a noteworthy reduction in lubricating drop usage. No immediate severe complications were noted. After six months, satisfaction was reported by one patient with the transplantation outcomes. However, two patients did not attend their six-month follow-up, and the remaining patients experienced a return to their original vision state.
Conclusion: Patient satisfaction, assessed in a moderately high number, showcased short-term quality-of-life improvements. PTFE-cell transplantation demonstrated safety, with no reported adverse effects in the six-month follow-up. This method exhibits promising potential for corneal transplantation, effectively addressing previous tissue engineering challenges. Further research into membrane enrichment with growth factors is recommended for enhanced long-term therapeutic effects.
