Original articleEx Vivo Expansion and Transplantation of Limbal Epithelial Stem Cells
Section snippets
Patients
Ten eyes of 10 patients with corneal LESC deficiency were treated. Ethical approval was obtained from the institutional Medical Research Ethics Committee, and informed consent was obtained from all patients before treatment. A diagnosis of LESC deficiency was based on characteristic clinical changes confirmed by the presence of conjunctival epithelial cells on the cornea on impression cytology. The clinical signs included some or all of the following changes: loss of corneal epithelial
Clinical Outcome
There were 3 serious adverse clinical events. Patient 5 developed a presumed microbial keratitis that resolved after treatment with topical ceftazidime 5% without evident toxicity to the graft. In patient 8, the graft detached and was lost on the first postoperative day. Patient 3 developed tremor, hypertension, and increased serum creatinine at 8 weeks after treatment. This was attributed to her treatment with oral cyclosporine, which was therefore stopped. Shortly thereafter, her tremor
Discussion
This study reports the detailed clinical, impression cytologic, and confocal microscopic results of the use of ex vivo LESCs cultured in compliance with GMP standards without the use of a 3T3 fibroblast feeder layer. The majority of previous studies of LESC transplantation have used a mouse-derived 3T3 feeder layer in the culture protocol.1, 2, 3, 5, 6, 7, 10, 13, 14 The discovery that human embryonic stem cells cultured on such a feeder layer begin to express animal glycoproteins on their
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2022, American Journal of OphthalmologyCitation Excerpt :Of note, the cohorts that used vision as an outcome measure included the patients that received penetrating or lamellar keratoplasty after CLEC to aid further in visual rehabilitation.32,34,37,42,47,74,94 The success of CLEC was related to the cause of LSCD in that chemical injuries were more likely to be successfully treated than inflammatory conditions, especially if there was active inflammation at the time of surgery.32,34,37,42,47,74,94,97 Multiple other benefits of CLEC have been described in these studies.
A systematic review of cellular therapies for the treatment of limbal stem cell deficiency affecting one or both eyes
2021, Ocular SurfaceCitation Excerpt :An investigation of the effect of the length of follow-up was not possible as most studies did not report the follow-up time point. Although six [41,43,47,49,50,52] of the 15 [17,41–44,46–54,56] studies that transplanted EVLAL reported no graft rejection (as reported by the study authors), four studies reported graft rejection [17,42,51,56], and one study [46] reported that immune rejection may have occurred although there were no obvious signs. In three of the studies [17,42,51] reporting graft rejection, the number of patients receiving EVLAL were ten or fewer.
Manuscript no. 2008-225.
Financial Disclosure(s): No author has a proprietary interest in this work, and there is no conflict of interest for any author.
Supported by the National Institutes of Health Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology. Funding was received in the form of a Clinical Research Training Fellowship awarded (AJS) by the UK Medical Research Council and from The Special Trustees of Moorfields Eye Hospital (AJS and JTD) and The Eranda Foundation (GAS). Funding for the Rostock adaptor and HRT-II used to perform in vivo confocal microscopy was provided by Moorfields Eye Hospital Special Trustees.