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The mysterious power lurking at the edge of the eye: Why are corneal stem cells so important?
At the edge of the eyes, there is a powerful biological force hidden. Corneal stem cells, as important cells for maintaining eye health, are essential for the normal functioning of the eye. These stem cells are located at the junction of the cornea and sclera, the edge of the eye, and play a central role in the process of regenerating ocular epithelial tissue.
Corneal stem cells can not only continue to proliferate, but also repair damaged corneal epithelium to maintain the integrity of vision.
Corneal stem cells have many characteristics, such as high proliferation potential, clonality, and the ability to reconstruct the entire corneal epithelium. This makes them guardians of corneal health. Whenever an eye injury causes cell loss, these stem cells quickly replace the lost cells, maintaining clear vision.
However, damage to corneal stem cells may lead to corneal lesions, which can be caused by congenital diseases or external factors such as chemical burns or infection. When damage occurs, the eye's regenerative mechanisms may be threatened, leading to a loss of corneal stem cells.
When corneal stem cells are missing, symptoms that may occur include blurred vision, eye discomfort, and severe light sensitivity.
Management of these dilemmas must first reduce trauma or chemical insults to the eye and control inflammation to promote a healthy corneal environment. In the initial treatment, the use of preservative-free artificial tears, topical steroids, and autologous eye drops can all provide some relief to patients.
But when these methods are not enough to improve the condition, surgery becomes the main treatment option. The type of surgery varies and depends on the patient's specific circumstances. Some patients with corneal stem cell deficiency can undergo serial conjunctival epithelial resection to remove diseased tissue growing on the cornea. This can be a temporary measure until further surgery is possible.
Another treatment option is conjunctival corneal autotransplantation, which involves transplanting corneal stem cells from the healthy eye, but this also carries some risks to the healthy eye.
In contrast, Keystone Keratoplasty (KLAL) uses corneas donated by deceased individuals to perform corneal transplants. This approach could provide more donor options; however, most biologic transplants fail within five years. Recent innovative technologies, such as simple corneal epithelial transplantation (SLET) and cultured corneal epithelial transplantation (CLET), have shown more promising therapeutic directions. These technologies offer new hope to patients, especially those with damaged eyes.
CLET's technology not only avoids the risk of transplanting a healthy eye, but also may provide an opportunity for re-transplantation after the initial transplantation fails.
In 2015, the European Commission approved for the first time the use of autologous CLET for patients with severe corneal stem cell deficiency with ocular burns. This marks a major breakthrough in the clinical development of stem cell therapy and will change the fate of many patients. Furthermore, using the p63 transcription factor as a biomarker of stem cell potency ensures the exact number of cells required for clinical success.
Overall, corneal stem cells are not only the cornerstone of eye self-repair, but also the key to the health of the entire visual system. However, with the development of therapies and in-depth research, will the potential of these stem cells be fully released again?
