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 Post subject: AS-derived cultivated corneal epithelial transplant
PostPosted: Wed Nov 01, 2006 1:29 am 
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Ophthalmology. 2006 Oct;113(10):1765-72.
Epub 2006 Aug 14.

Transplantation of autologous serum-derived cultivated corneal epithelial equivalents for the treatment of severe ocular surface disease.

Nakamura T, Inatomi T, Sotozono C, Ang LP, Koizumi N, Yokoi N, Kinoshita S.

Department of Ophthalmology, Kyoto Prefectural University of Medicine, Graduate School of Medicine, Kyoto, Japan.

PURPOSE: To evaluate the use of autologous serum (AS)-derived cultivated corneal epithelial transplantation for the treatment of severe ocular surface disease.

DESIGN: Retrospective noncomparative case series.

PARTICIPANTS: Nine eyes from 9 patients with total limbal stem cell deficiency were studied. These consisted of 2 eyes with Stevens-Johnson syndrome, 1 with chemical injury, 1 with ocular cicatricial pemphigoid, 1 with Salzmann corneal dystrophy, 1 with aniridia, 1 with graft-versus-host disease, and 2 with idiopathic ocular surface disease.

METHODS: Autologous serum obtained from patients was used for cultivating corneal epithelial cells on an amniotic membrane substrate. These AS-derived corneal epithelial equivalents were compared with those derived from fetal bovine serum (FBS)-supplemented medium. At the time of surgery, complete removal of the corneal pannus and conjunctiva up to 3 mm from the limbus was performed. Allogeneic (7 cases) and autologous (2 cases) AS-derived cultivated corneal epithelial equivalents were transplanted onto the ocular surface. Postoperative follow-up included serial slit-lamp examinations with fluorescein staining, as well as photographic documentation.

MAIN OUTCOME MEASURES: Ocular surface reconstruction with corneal epithelialization, graft integrity, visual acuity, and postoperative complications.

RESULTS: The corneal epithelial sheets cultivated in AS- and FBS-supplemented media were morphologically similar, and demonstrated the normal expression of tissue-specific keratins and junctional specialization assembly proteins. After transplantation, complete corneal epithelialization was achieved within 2 to 5 days. All eyes demonstrated an improvement in visual acuity by > or =2 lines. During the follow-up period of 14.6+/-4.36 months, the corneal surface of all patients remained stable and transparent, without significant complications.

CONCLUSIONS: Transplantation of AS-derived cultivated corneal epithelial equivalents was shown to be a feasible method of treating patients with severe ocular surface disease. The use of AS is of clinical importance in the development of autologous xenobiotic-free bioengineered ocular surface equivalents for clinical transplantation.

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"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato


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PostPosted: Wed Nov 01, 2006 2:54 am 
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http://www.osnsupersite.com/view.asp?rID=18954

OSN SuperSite Top Story 10/30/2006

Autologous serum-derived epithelial cells may be effective transplant source

Corneal epithelial cells cultivated in autologous serum may be an effective transplant source for treating patients with severe ocular surface disease, a case series suggests.

Takahiro Nakamura, MD, PhD, and colleagues at Kyoto Prefectural University of Medicine, Japan, retrospectively reviewed the outcomes of corneal epithelial cell transplantation in nine eyes of nine patients with total limbal stem cell deficiencies. In all cases, the researchers used autologous serum to cultivate corneal epithelial cells on an amniotic membrane substrate. They then compared these autologous serum-derived "corneal epithelial equivalents" with cells derived from a medium supplemented with fetal bovine serum.

Surgeons completely removed the corneal pannus and conjunctiva up to 3 mm from the limbus in all cases before transplanting the cultivated cells. Seven eyes received allogeneic and two eyes received autologous cultivated equivalent cells, according to the study.

"The corneal epithelial sheets cultivated in [autologous serum]- and [fetal bovine serum]-supplemented media were morphologically similar, and demonstrated the normal expression of tissue-specific keratins and junctional specialization assembly proteins," the authors said.

Patients achieved complete corneal epithelialization within 2 to 5 days postop, and visual acuity in all eyes improved by at least two lines. In addition, the corneal surfaces of all eyes remained transparent, stable and without significant complications at a mean follow-up of 14.6 months, according to the study.

Autologous serum is important for developing autologous xenobiotic-free bioengineered ocular surface transplant sources, the authors said.

The study is published in the October issue of Ophthalmology.

_________________
Broken Eyes

"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato


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