A Framework for Human Corneal Endothelial Cell Culture and Preliminary Wound Model Experiments with a New Cell Tracking Approach.

Cell injection therapy is emerging as an alternative to treat corneal endothelial dysfunction (CED) and to avoid corneal scarring due to bullous keratopathy. However, establishing a standardized culture procedure that provides appropriate cell yield while retaining functional features remains a challenge. Here, we describe a detailed framework obtained from in vitro culture of human corneal endothelial cells (HCECs) and comparative in vivo experimental models for CED treatment with a new cell tracking approach. Two digestion methods were compared regarding HCEC morphology and adhesion. The effect of Y-27632 (ROCKi) supplementation on final cell yield was also assessed. Cell adhesion efficacy with two cell delivery systems (superparamagnetic embedding and cell suspension) was evaluated in an ex vivo human cornea model and in an in vivo rabbit CED model. The injection of supplemented culture medium or balanced salt solution (BSS) was used for the positive and negative controls, respectively. HCEC isolation with collagenase resulted in better morphology and adhesion of cultured HCEC when compared to EDTA. Y-27632 supplementation resulted in a 2.6-fold increase in final cell yield compared to the control. Ex vivo and in vivo adhesion with both cell delivery systems was confirmed by cell tracker fluorescence detection. Corneal edema and opacity improved in both animal groups treated with cultured HCEC. The corneas in the control groups remained opaque. Both HCEC delivery systems seemed comparable as treatments for CED and for the prevention of corneal scarring.

Analysis of different conditioned media secreted by limbal progenitor cells in the modulation of corneal healing.

Ex vivo cultivation and transplantation of limbal epithelial cells has been reported as an alternative source for ocular surface reconstruction. However, until now, the functional improvement of these patients is limited due to the low survival rate of the transplanted cells. Consequently, the clinical benefits of this therapeutic strategy are only temporary and can assign them to paracrine effects associated with the transplanted cells. With this background in mind, we aimed to analyze the effect of different conditioned media containing growth factors secreted by limbal progenitor cells on corneal epithelial healing, both in vitro and in vivo. Limbal tissue was used to obtain different conditioned media (CM). For the in vitro assay, corneal epithelial cells were treated with CM and the epithelial migration was analyzed. Growth factors in the CM were identified with ELISA and multiplex. For the in vivo assay in rats, total limbal stem cell deficiency (LSCD) was induced with an abrasive injury to the ocular surface, and the animals were treated with different CM. Clinical and histological analyses were performed. In the in vitro assay, treatment with limbal fibroblast (LF CM) was more effective compared to the other CM, and analysis revealed high concentrations of keratinocyte growth factor (KGF) and hepatocyte growth factor (HGF). In the in vivo assay, animals treated with LF CM showed epithelial defect improvement, maintenance of thickness, and decreased opacity and neovascularization. This treatment also allowed better ocular surface tissue organization when compared to the other treatments. The in vitro and in vivo experiments showed better outcomes in the corneal wound healing for the LF CM treatment. The high concentrations of KGF and HGF, linked to epithelial cell migration and proliferation, may correlate to the best results found in this treatment.

Amniotic membrane as a biological scaffold for dental pulp stem cell transplantation in ocular surface reconstruction / Membrana amniótica como substrato biológico para o transplante de células-tronco da polpa do dente de leite na reconstrução da superfície ocular

ABSTRACT Purpose: To evaluate the ability of human immature dental pulp stem cells, which are mesenchymal stem cells of neural crest origin, to differentiate into the corneal epithelium for purposes of corneal transplantation and tissue engineering when cultured on de-epithelized amniotic membranes. Methods: We compared the immunophenotypes (ABCG2, K3/12, and vimentin) of cells grown on amniotic membranes or plastic surfaces under serum-free conditions or in culture media containing serum or serum replacement components. Results: Immature dental pulp stem cells grown on amniotic membranes under basal conditions are able to maintain their undifferentiated state. Our data also suggest that the culture medium used in the present work can modulate the expression of immature dental pulp stem cell markers, thus inducing epithelial differentiation of these cells in vitro. Conclusions: Our results suggest that the amniotic membrane is a good choice for the growth and transplantation of mesenchymal stem cells, particularly immature dental pulp stem cells, in clinical ocular surface reconstruction.

RESUMO Objetivos: Avaliar a capacidade das células-tronco imaturas da polpa do dente de leite que são células-tronco mesenquimais de origem da crista neural, de se diferenciarem no epitélio corneano para fins de transplante de córnea e engenharia de tecidos quando cultivadas em membrana amnióticas desepitelizadas. Métodos: Foram comparamos so imunofenótipo (ABCG2, CK3/12 e vimentina) de células cultivadas em membranas amnióticas ou em superfícies plásticas sob condições livres de soro ou em meios de cultura contendo soro ou componentes de substituição de soro. Resultados: Células-tronco imaturas da polpa do dente de leite cultivadas sobre membrana amniótica em condições basais são capazes de manter seu estado indiferenciado. Nossos dados também sugerem que o meio de cultura utilizado no presente trabalho pode modular a expressão de marcadores de células-tronco imaturas da polpa do dente de leite, induzindo a diferenciação epitelial destas células in vitro. Conclusão: Nossos resultados sugerem que a membrana amniótica é uma boa escolha para o crescimento e transplante de células-tronco mesenquimais, particularmente as células-tronco imaturas da polpa do dente de leite, na reconstrução da superfície ocular.

Biological modulation of corneal epithelial wound healing / Modulação biológica do processo de cicatrização epitelial da córnea

ABSTRACT The transparency and maintenance of corneal epithelial integrity are essential for its optical properties and, to preserve these characteristics, the epithelium undergoes continuous renewal. This renewal depends on the control of cell proliferation and differentiation mediated by mitogenic factors responsible for increasing mitoses and stimulating cellular migration. Cell-cell communication plays a pivotal role in epithelial healing process, and several cytokines and growth factors are involved in this process. Understanding the cross-talk and paracrine effects of these cytokines and growth factors released can help in the search for new therapeutic strategies to treat ocular surface diseases.

RESUMO A transparência e a manutenção da integridade epitelial da córnea são essenciais para suas propriedades ópticas e, para preservar tais características, o epitélio sofre renovação contínua. Essa renovação depende do controle da proliferação e diferenciação celular mediadas por fatores mitogênicos responsáveis pelo aumento das mitoses e estímulo à migração celular. A comunicação célula-célula desempenha um papel fundamental no processo de cicatrização epitelial, e várias citocinas e fatores de crescimento estão envolvidos neste processo. Compreender os efeitos cruzados e paracrinos dessas citocinas e fatores de crescimento liberados pode ajudar na busca de novas estratégias terapêuticas para o tratamento de doenças da superfície ocular.

Amniotic membrane as a biological scaffold for dental pulp stem cell transplantation in ocular surface reconstruction.

PURPOSE: To evaluate the ability of human immature dental pulp stem cells, which are mesenchymal stem cells of neural crest origin, to differentiate into the corneal epithelium for purposes of corneal transplantation and tissue engineering when cultured on de-epithelized amniotic membranes. METHODS: We compared the immunophenotypes (ABCG2, K3/12, and vimentin) of cells grown on amniotic membranes or plastic surfaces under serum-free conditions or in culture media containing serum or serum replacement components. RESULTS: Immature dental pulp stem cells grown on amniotic membranes under basal conditions are able to maintain their undifferentiated state. Our data also suggest that the culture medium used in the present work can modulate the expression of immature dental pulp stem cell markers, thus inducing epithelial differentiation of these cells in vitro. CONCLUSIONS: Our results suggest that the amniotic membrane is a good choice for the growth and transplantation of mesenchymal stem cells, particularly immature dental pulp stem cells, in clinical ocular surface reconstruction.

Biological modulation of corneal epithelial wound healing.

The transparency and maintenance of corneal epithelial integrity are essential for its optical properties and, to preserve these characteristics, the epithelium undergoes continuous renewal. This renewal depends on the control of cell proliferation and differentiation mediated by mitogenic factors responsible for increasing mitoses and stimulating cellular migration. Cell-cell communication plays a pivotal role in epithelial healing process, and several cytokines and growth factors are involved in this process. Understanding the cross-talk and paracrine effects of these cytokines and growth factors released can help in the search for new therapeutic strategies to treat ocular surface diseases.

Amniotic membrane as a biological scaffold for dental pulp stem cell transplantation in ocular surface reconstruction

Purpose: To evaluate the ability of human immature dental pulp stem cells, which are mesenchymal stem cells of neural crest origin, to differentiate into the corneal epithelium for purposes of corneal transplantation and tissue engineering when cultured on de-epithelized amniotic membranes. Methods: We compared the immunophenotypes (ABCG2, K3/12, and vimentin) of cells grown on amniotic membranes or plastic surfaces under serum-free conditions or in culture media containing serum or serum replacement components. Results: Immature dental pulp stem cells grown on amniotic membranes under basal conditions are able to maintain their undifferentiated state. Our data also suggest that the culture medium used in the present work can modulate the expression of immature dental pulp stem cell markers, thus inducing epithelial differentiation of these cells in vitro. Conclusions: Our results suggest that the amniotic membrane is a good choice for the growth and transplantation of mesenchymal stem cells, particularly immature dental pulp stem cells, in clinical ocular surface reconstruction.

Amniotic membrane as a biological scaffold for dental pulp stem cell transplantation in ocular surface reconstruction

Purpose: To evaluate the ability of human immature dental pulp stem cells, which are mesenchymal stem cells of neural crest origin, to differentiate into the corneal epithelium for purposes of corneal transplantation and tissue engineering when cultured on de-epithelized amniotic membranes. Methods: We compared the immunophenotypes (ABCG2, K3/12, and vimentin) of cells grown on amniotic membranes or plastic surfaces under serum-free conditions or in culture media containing serum or serum replacement components. Results: Immature dental pulp stem cells grown on amniotic membranes under basal conditions are able to maintain their undifferentiated state. Our data also suggest that the culture medium used in the present work can modulate the expression of immature dental pulp stem cell markers, thus inducing epithelial differentiation of these cells in vitro. Conclusions: Our results suggest that the amniotic membrane is a good choice for the growth and transplantation of mesenchymal stem cells, particularly immature dental pulp stem cells, in clinical ocular surface reconstruction.

ARPE-19 cell uptake of small and ultrasmall superparamagnetic iron oxide.

PURPOSE: To investigate the cytotoxicity, cellular intake and magnetic field interaction of three superparamagnetic iron oxide (SPIO) and one ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles on ARPE-19 cells. METHODS: Two FDA-approved SPIO nanoparticles (Endorem and Lumirem), one commercial SPIO(FluidMag-L) and one FDA-approved USPIO (Feraheme) were tested. Nanoparticle suspensions were diluted and prepared in high- (1000 Fe-ug/ml) and low- (100 Fe-ug/ml) dose suspensions. ARPE-19 cells were incubated in four 24-well plates and the medium changed every other day until cells attained 80% confluence. Nanoparticle cytotoxicity was evaluated using the XTT cytotoxicity assay. Cellular attraction was tested after digestion of the cells in collagenase A (1 mg/ml) overnight. A 3500 Gauss neodymium magnet was used to attract cells to the well walls. ARPE-19 cell ultrastructure was evaluated by transmission electron microscopy (TEM) to determine the specific locations of nanoparticles within the cell membranes. RESULTS: Cytotoxicity assessment by the XTT assay revealed that ARPE-19 cells that were exposed to either concentration of Endorem, FLuidMag-L, Feraheme non-conjugated with protamine and heparin or Lumirem demonstrated no statistically significant toxicity. Cells exposed to Feraheme when conjugated with protamine and heparin presented severe toxicity in both concentrations. When a magnetic field was applied, all nanoparticle-containing samples, except Feraheme non-conjugated form, were promptly attracted. TEM and prussian blue staining examination revealed that Feraheme alone was not initially capable of cellular uptake. This issue was solved by conjugating Feraheme with protamine and heparin (although cytotoxicity was found on those samples). Endorem, FLuidMag-L, Feraheme conjugated form were found within the cytoplasm of ARPE-19 cells. CONCLUSIONS: Ferahame when conjugated with protamine and heparin was cytotoxic at the higher and lower doses, as revealed by the XTT assay. Endorem and FluidMag-L were not toxic at the studied concentrations. Feraheme non-conjugated solutions and Lumirem solutions provided were harmless but were not internalized by ARPE-19 cells. All the studied nanoparticles were attracted to the magnetic field except Feraheme in the non-conjugated form.

Comparison of culture media for ex vivo cultivation of limbal epithelial progenitor cells.

PURPOSE: To compare the effectiveness of three culture media for growth, proliferation, differentiation, and viability of ex vivo cultured limbal epithelial progenitor cells. METHODS: Limbal epithelial progenitor cell cultures were established from ten human corneal rims and grew on plastic wells in three culture media: supplemental hormonal epithelial medium (SHEM), keratinocyte serum-free medium (KSFM), and Epilife. The performance of culturing limbal epithelial progenitor cells in each medium was evaluated according to the following parameters: growth area of epithelial migration; immunocytochemistry for adenosine 5'-triphosphate-binding cassette member 2 (ABCG2), p63, Ki67, cytokeratin 3 (CK3), and vimentin (VMT) and real-time reverse transcription polymerase chain reaction (RT-PCR) for CK3, ABCG2, and p63, and cell viability using Hoechst staining. RESULTS: Limbal epithelial progenitor cells cultivated in SHEM showed a tendency to faster migration, compared to KSFM and Epilife. Immunocytochemical analysis showed that proliferated cells in the SHEM had lower expression for markers related to progenitor epithelial cells (ABCG2) and putative progenitor cells (p63), and a higher percentage of positive cells for differentiated epithelium (CK3) when compared to KSFM and Epilife. In PCR analysis, ABCG2 expression was statistically higher for Epilife compared to SHEM. Expression of p63 was statistically higher for Epilife compared to SHEM and KSFM. However, CK3 expression was statistically lower for KSFM compared to SHEM. CONCLUSIONS: Based on our findings, we concluded that cells cultured in KSFM and Epilife media presented a higher percentage of limbal epithelial progenitor cells, compared to SHEM.

Comparison between different biomaterial scaffolds for limbal-derived stem cells growth and enrichment.

PURPOSE/AIM: Corneal epithelial stem cells have been used for the treatment of total limbal deficiency with corneal conjunctivalization and decreased vision secondary to a variety of ocular surface diseases. We set to compare the ability of different extracellular components in promoting growth and migration of these cells. MATERIALS AND METHODS: Growth parameters were evaluated, including cell migration and proliferation (by wound healing) and mRNA gene expression (by quantitative RT-PCR). RESULTS: The growth of corneal epithelial cells plated onto different matrix has shown that all treatments were efficient in supporting exponential growth, with a small increase in the puramatrix and collagen I groups when compared with fibrin treatment, which displayed the best doubling time rate and saturation density. The mRNA relative levels for c-myc, a proliferation marker, were considerably higher in the fibrin-coated group. In a smaller extent, the same could be observed for the puramatrix and collagen I groups. The same pattern could be observed for ß-1 and α-6-integrin mRNA relative levels. The levels of CD71 mRNA, a LESC negative marker, were decreased in all groups, with a greater decrease in the fibrin group. We also found that the relative mRNA levels of the efflux pump ABCG2 and ΔNp63 transcripts were significantly higher in the fibrin group but not for collagen and puramatrix groups. Moreover, a diminished capacity of wound repair was observed for the uncoated control while the coated biomaterial groups were able to restore the cell-covered surface at some extent. CONCLUSION: All components tested were effective in promoting growth of corneal epithelial cells and maintenance of stem cell putative markers when compared with the uncoated surface group. Fibrin was far superior than collagen I and puramatrix in promoting survival, growth and migration of these cells.

[Comparison between amniotic membrane with and without epithelium as a support for human limbal epithelial cells cultured ex vivo]. / Comparação entre membrana amniótica com e sem epitélio como substrato para cultura de células epiteliais do limbo ex vivo.

PURPOSE: To evaluate the efficacy and ultrastructural aspects of human limbal epithelial cells cultured on amniotic membrane (AM) with and without epithelium. METHODS: Limbal epithelial cell cultures were established from cadaveric cor neo-scleral rim explants derived from 6 different donors. The explants from each donor were placed under 3 different groups: on human preserved AM with epithelium (Group 1), AM deepithelialized with trypsin (Group 2) and control (Group 3). The epithelial cell migration was evaluated under phase contrast microscopy. After 15 days, the amniotic membrane with cells cultures were removed and submitted to scanning and transmission electron microscopy to check for epithelial migration and adhesion. RESULTS: All epithelial cell cultures from the controls grew over the botton of the culture plate wells until reaching confluence. Epithelial cultures grew over all but one denuded amniotic membrane. In the group amniotic membrane with epithelium, epithelial cell growing was observed only in 1 well. CONCLUSIONS: Using this model, denuded amniotic membrane appeared to be the best substrate for epithelial cell migration and adhesion comparing to amniotic membrane with epithelium. Removal of amniotic membrane epithelial seems to be an important step for establishing limbal epithelial cell culture on amniotic membrane.

Comparação entre membrana amniótica com e sem epitélio como substrato para cultura de células epiteliais do limbo ex vivo / Comparison between amniotic membrane with and without epithelium as a support for human limbal epithelial cells cultured ex vivo

OBJETIVO: Avaliar a eficácia e aspecto estrutural de células límbicas epiteliais humanas cultivadas sobre membrana amniótica (MA) com e sem epitélio. MÉTODOS: As culturas límbicas foram obtidas a partir de rima corneoescleral remanescentes de transplantes de córnea de 6 diferentes doadores. Cada explante foi cultivado em três diferentes grupos: MA desepitelizada por tripsina (Grupo 1), MA com epitélio íntegro (Grupo 2) e controle (Grupo 3). A migração epitelial foi avaliada por microscopia de contraste de fase. Após 15 dias, as células cultivadas sobre MA foram submetidas à microscopia eletrônica para avaliar migração e adesão epitelial. RESULTADOS: Todas as células do grupo controle cresceram até atingir confluência. Somente uma das culturas em membrana amniótica desepitelizada não apresentou crescimento epitelial. O crescimento de células epiteliais sobre membrana amniótica epitelizada foi observada em apenas uma cultura. CONCLUSÃO: Baseando-se nestes achados, o uso de membrana amniótica desepitelizada aparenta ser o melhor substrato para migração e adesão epitelial comparando com membrana amniótica epitelizada. Remover o epitélio da membrana amniótica demonstra ser um importante passo para estabelecer culturas de células sobre membrana amniótica.

PURPOSE: To evaluate the efficacy and ultrastructural aspects of human limbal epithelial cells cultured on amniotic membrane (AM) with and without epithelium. METHODS: Limbal epithelial cell cultures were established from cadaveric cor neo-scleral rim explants derived from 6 different donors. The explants from each donor were placed under 3 different groups: on human preserved AM with epithelium (Group 1), AM deepithelialized with trypsin (Group 2) and control (Group 3). The epithelial cell migration was evaluated under phase contrast microscopy. After 15 days, the amniotic membrane with cells cultures were removed and submitted to scanning and transmission electron microscopy to check for epithelial migration and adhesion. RESULTS: All epithelial cell cultures from the controls grew over the botton of the culture plate wells until reaching confluence. Epithelial cultures grew over all but one denuded amniotic membrane. In the group amniotic membrane with epithelium, epithelial cell growing was observed only in 1 well. CONCLUSIONS: Using this model, denuded amniotic membrane appeared to be the best substrate for epithelial cell migration and adhesion comparing to amniotic membrane with epithelium. Removal of amniotic membrane epithelial seems to be an important step for establishing limbal epithelial cell culture on amniotic membrane.