Mesenchymal stromal cells for ocular surface repair

ABSTRACT

Introduction: Cornea is a transparent, robust tissue that comprises highly organized cells. Disruption of this specialized tissue can lead to scarring and subsequent blindness, making corneal damage a considerable challenge worldwide. At present, the available medical treatments are unable to address the wide range of corneal diseases. Mesenchymal stem cells (MSCs) have increasingly been investigated for their regenerative effect on ocular surface injury due to their unique ability for growth factor production, anti-inflammatory activity, immunomodulatory capacity and differentiation into multiple cell lineages.

Areas covered: Within this review, we explore the pathogenesis of corneal disorders in response to injury and disease, and the potential for MSCs to modulate this process as a treatment. Through the review of over 25 animal studies, we investigate the common mechanisms of action by which MSCs have their effect and discuss their potential for treating and/or preventing corneal deterioration.

Expert opinion: Depending on the environmental cues, MSCs can exert a potent effect on corneal wound healing through reducing opacity and vascularization, whilst promoting re-epithelialization. Whilst their mechanism is multifactorial, it seems clear that the anti-inflammatory/immunomodulatory factors they produce in response to damage are key to their control of cellular milieu and improving healing outcomes.

KEYWORDS:

• Cornea
• mesenchymal stromal/stem cells
• cell therapy
• growth factors
• anti-inflammatory
• immunomodulatory

Article highlights

• Mesenchymal stem cells (MSCs) present vast potential in corneal wound healing.

• MSCs’ mechanism of action is multifactorial.

• MSC-therapy showed safety and enhanced wound healing ability in corneal wound healing in many in vivo animal models and clinical trials.

• MSCs’ production of paracrine factors directs the hosts cellular mechanism of regulating inflammation and immune cells infiltration, whilst allowing healing of the corneal tissue.

This box summarizes key points contained in the article.

Declaration of interest

S Swioklo is an employee of Atelerix Ltd. with no financial interest or conflicts related to this review to declare. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This work has been supported by research funding from the Biotechnology and Biological Sciences Research Council (BB/K011111/1).