The cornea is an ideal testing field for cell therapies. Its highly ordered structure, where specific cell populations are sequestered in different layers, together with its accessibility, has allowed the development of the first stem cell-based therapy approved by the European Medicine Agency. Today, different techniques have been proposed for autologous and allogeneic limbal and non-limbal cell transplantation. Cell replacement has also been attempted in cases of endothelial cell decompensation as it occurs in Fuchs dystrophy: injection of cultivated allogeneic endothelial cells is now in advanced phases of clinical development. Recently, stromal substitutes have been developed with excellent integration capability and transparency. Finally, cell-derived products, such as exosomes obtained from different sources, have been investigated for the treatment of severe corneal diseases with encouraging results. Optimization of the success rate of cell therapies obviously requires high-quality cultured cells/products, but the role of the surrounding microenvironment is equally important to allow engraftment of transplanted cells, to preserve their functions and, ultimately, lead to restoration of tissue integrity and transparency of the cornea.

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角膜细胞疗法：微环境的新兴作用


角膜是细胞疗法的理想试验场。其高度有序的结构，其中特定的细胞群被隔离在不同的层中，再加上其可访问性，使得欧洲药物管理局批准的第一个基于干细胞的疗法得以开发。如今，已经提出了不同的自体和同种异体角膜缘和非角膜缘细胞移植技术。还尝试了细胞替代治疗内皮细胞失代偿的情况，如福克斯营养不良中发生的情况：注射培养的同种异体内皮细胞目前正处于临床开发的后期阶段。最近，基质替代品已开发出来，具有优异的集成能力和透明度。最后，细胞衍生产品，例如从不同来源获得的外泌体，已被研究用于治疗严重的角膜疾病，并取得了令人鼓舞的结果。细胞疗法成功率的优化显然需要高质量的培养细胞/产品，但周围微环境的作用对于移植细胞的植入、保留其功能并最终恢复组织完整性和功能同样重要。角膜的透明度。