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Klin Monbl Augenheilkd 2009; 226(7): 541-545
DOI: 10.1055/s-0028-1109472
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Stammzelltherapie bei Korneadefekten

Stem Cell Therapy for Corneal DefectsA. Schilimow1 , B. Wiechens1
  • 1Klinik für Augenheilkunde, Klinikum Region Hannover, Klinikum Nordstadt
Further Information

Publication History

Eingegangen: 1.2.2009

Angenommen: 28.4.2009

Publication Date:
30 July 2009 (online)

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Zusammenfassung

Hintergrund: Der Heilungsprozess kornealer Defekte setzt funktionsfähige Limbusstammzellen voraus. Deren Verlust führt zur sekundären Wundheilungsstörung. Die Stammzellforschung eröffnet neue Therapiemöglichkeiten. Material und Methoden: Selektive Medline Recherche in der amerikanischen National Library of Medicine. Ergebnisse: Die autologe Limbusstammzelltransplantation ist derzeit die Therapie der Wahl. Eine andere klinisch erprobte Möglichkeit ist die Transplantation einer Amnionmembran, die zuvor mit Limbusstammzellen besiedelt wurde. Tierexperimentell sind auch knochenmarkisolierte mesenchymale oder epidermale Stammzellen zur Besiedlung verwendet worden. Fettisolierte mesenchymale Stammzellen können ebenfalls die Regenerationsfähigkeit der Kornea unterstützen. Überdies ist die Membrantransplantation, die aus Epithelzellen der Mundschleimhaut in vitro gezüchtet wurde, klinisch erprobt. Diskussion und Schlussfolgerungen: Beidseitige Limbusstammzellinsuffizienz ist der limitierende Faktor einer autologen Limbusstammzelltransplantation. Allogen transplantierte Limbusstammzellen müssen vor Destruktion durch Immunsuppression geschützt werden. Epithelzellen, epidermale Stammzellen, knochenmark- oder fettisolierte mesenchymale Stammzellen fördern die Regeneration der Kornea und scheinen für die Therapie der Korneadefekte geeignet zu sein. Die mesenchymalen Stammzellen bieten zum anderen den Vorteil einer entzündungshemmenden Wirkung, inhibieren in vitro die Proliferation allogener T-Zellen und führen nach allogener und xenogener Transplantation zu keiner Abstoßungsreaktion.

Abstract

Background: The healing process of corneal defects requires functioning limbus stem cells. Their loss will lead to secondary wound healing problems. Stem cell research offers new treatment options. Material and Methods: A Medline search of the U. S. National Library of Medicine was carried out. Results: The autologous limbus stem cell transplantation is currently the treatment of choice. Amniotic membrane transplantation, previously settled with limbus stem cells, is a clinically proven method. In animal experiments bone marrow-derived mesenchymal stem cells or epidermal stem cells can be used to improve healing of corneal defects. Adipose-derived stem cells may support the regenerative ability of the cornea as well. Moreover, membrane transplantation of epithelial cells from the buccal mucosa cultivated in vitro was clinically tested. Discussion and Conclusions: Limbus stem cell failure of both eye is the limiting factor for autologous limbus stem cell transplantation. Epithelial cells, epidermal stem cells, bone marrow- or adipose-derived mesenchymal stem cells promote the regeneration of the cornea and have become established for the treatment of corneal defects. Additionally, mesenchymal stem cells offer the advantage of immunosuppressive and anti-inflammatory effects.

Schlüsselwörter

Kornea - Trauma - Stammzelle

Key words

cornea - trauma - stem cells

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Prof. Dr. Burkhard Wiechens

Klinik für Augenheilkunde, Klinikum Region Hannover, Klinikum Nordstadt

Haltenhoffstr. 41

30167 Hannover

Phone: ++ 49/5 11/9 70 12 13

Fax: ++ 49/5 11/9 70 16 43

Email: burkhard.wiechens@krh.eu

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