Keratocyte progenitor cell transplantation: A novel therapeutic strategy for corneal disease

Keratocytes are specialised cells that produce and maintain corneal stromal matrix and play a key role in corneal wound healing. Abnormal functioning of these cells is likely to play a central role in corneal disorders, such as keratoconus, which in many cases leads to corneal blindness if untreated. The genetic basis of keratoconus is poorly understood but it is likely that apoptosis pathways are involved. The current paper proposes a novel hypothesis for the treatment and prevention of corneal blindness in disorders such as keratoconus as an alternative to the gold standard treatment of penetrating or partial thickness keratoplasty. The proposed hypothesis involves the isolation, purification and transplantation of keratocyte progenitor cells (KPC), with introduction into stroma via femtosecond laser channels in diseased corneal stroma using a carrier medium. The success of this approach will depend upon the viability, migration, and cell division of introduced KPC and production of normal stromal matrix. Results from previous studies suggest that cellular transplantation is possible and may lead to healthy stromal matrix production and remission of a disease phenotype in patients affected with disorders such as keratoconus. If the current hypothesis proves to be correct, it may offer an alternative to invasive keratoplasty for treatment of corneal disorders such as keratoconus that cause significant morbidity for millions of people worldwide.