Mesenchymal stem cells (MSCs) possess regenerative, anti-inflammatory, and immunomodulatory qualities that have demonstrated encouraging potential for treating a range of ocular surface disorders. MSCsprovide novel therapeutic options for the ocular surface, which includes the cornea, conjunctiva, and related structures including the limbus. The ocular surface is susceptible to disease, damage, and degeneration.
MSCs‘ Principal Uses on the Ocular Surface
1. Corneal Ulcers and Injuries:
• Trauma, infections, or chemical burns to the cornea can cause permanent deformities, scarring, and vision loss. It has been demonstrated that MSCsaid in corneal epithelial regeneration and repair. By releasing bioactive chemicals (cytokines, growth factors) that promote cell proliferation and lessen scarring, they improve tissue repair.
• Moreover, MSCs lessen corneal inflammation, hastening healing and halting additional tissue deterioration.
2. Limbal Stem Cell Deficiency (LSCD)
• Usually brought on by burns, trauma, or illnesses such as Stevens-Johnson syndrome, limbal stem cells are responsible for maintaining and regenerating the corneal epithelium. When these stem cells are depleted or malfunctioning, LSCD arises. This results in corneal subjunctivization, corneal scarring, and loss of eyesight.
• MSCs may contribute to the restoration of the corneal surface by helping to replenish the limbal region with functional stem cells or by giving the remaining stem cells nutritional support. This can be accomplished with topical treatment, subconjunctival injection, or tissue-engineered MSC grafts.
3. Dry Eye Disease (DED)
• DED is a complex condition marked by inflammation and tear film and ocular surface dysfunction. MSCs have been investigated as a therapeutic for lowering inflammation and encouraging the healing of the ocular surface due to their anti-inflammatory properties.
• Through immune response modulation and tissue regeneration, MSC therapy has been demonstrated in multiple animal models to enhance tear production, decrease indications of dry eye, and restore normal ocular surface health.
4. Burns caused by chemicals or heat
• The corneal epithelium and deeper stromal layers can sustain significant damage from chemical and thermal assaults to the eye, leading to inflammation, neovascularization, and scarring. MSCs provide assistance through regulating the inflammatory response, encouraging epithelial repair, and averting excessive scarring (fibrosis).
• Through the restoration of the ocular surface architecture, MSC-based therapies have been investigated for their potential to enhance visual outcomes in patients suffering from severe ocularburns.
5. Pterygium
• Pterygium is the development of fibrovascular tissue onto the cornea from the conjunctiva, frequently as a result of inflammation or prolonged UV exposure. After surgical removal, recurrence is frequently observed. By regulating the inflammatory response following surgery and minimizing the creation of scar tissue, MSCs have the potential to lower the recurrence rate.
6. Fibrosis and Scarring of the Conjunctiva
• Ocular cicatricial pemphigoid and post-surgical scarring from glaucoma surgery, for example, can cause conjunctival fibrosis, which impairs the normal function of the ocular surface. Because MSCs block the development of fibroblasts into myofibroblasts, the cells responsible for scarring, they have antifibrotic capabilities that may help prevent the production of excessive scar tissue.
• To stop or lessen fibrosis, MSCs can be injected subconjunctival into the afflicted areas or used in tissue-engineered constructions.
7. Inflammation of the Ocular Surface
• The anti-inflammatory qualities of MSCs are particularly helpful in the treatment of autoimmune diseases (such Sjogren’s syndrome) and chronic inflammatory illnesses of the ocular surface, such as keratitis and allergic conjunctivitis.
• By lowering the invasion of inflammatory cells and the release of pro-inflammatory cytokines, MSCscan regulate the local immune response and help shield the ocular surface from further harm.
Modes of Delivery
• Topical Application: MSCs are a non-invasive treatment option for problems including dry eye or minor corneal injury. They can be applied as eye drops that contain MSC-derived exosomes or secretes, the therapeutic components secreted by MSCs.
• Subconjunctival Injection: This approach is helpful for treating more serious disorders like chemical burns or conjunctival scarring because it places MSCs close to the site of injury or disease, enabling targeted delivery and direct interaction with injured tissue.
• Tissue-Engineered Grafts: To replace injured ocular surface tissue, MSCs can be added to hydrogels or bioengineered scaffolds. This technique is very helpful for disorders like corneal ulcers or LSCD.
• Exosome Therapy: In order to reduce the hazards involved with live cell transplantation, MSC-derived exosomes—which carry the therapeutic chemicals released by MSCs—are being investigated as a cell-free therapy. Exosomes have demonstrated promise in accelerating wound healing and lowering eye surface inflammation.
In conclusion, MSCs show a great deal of promise to cure a variety of ocular surface conditions by encouraging regeneration, lowering inflammation, and averting fibrosis. MSC-based treatments have the potential to be a significant instrument in ophthalmology for maintaining and restoring eyesight as research progresses.