Decellularized porcine conjunctiva as an alternative substrate for tissue-engineered epithelialized conjunctiva

Area of Science:

• Ophthalmology
• Tissue Engineering
• Regenerative Medicine

Background:

• Severe conjunctival scarring impairs vision and requires conjunctival reconstruction.
• Effective conjunctival substitutes are crucial for successful visual rehabilitation.

Purpose of the Study:

• To develop and investigate a re-epithelialized conjunctival substitute using porcine decellularized conjunctiva (PDC).
• To evaluate the potential of PDC seeded with human conjunctival epithelial cells (PDC + HCEC) or human conjunctival explants (PDC + HCEx).

Main Methods:

• PDC was re-epithelialized with either PDC + HCEC or PDC + HCEx.
• Histology and immunohistochemistry assessed epithelial thickness, proliferation, apoptosis, goblet cells, and progenitor cells.
• The superior construct (PDC + HCEx) was transplanted into rabbit conjunctival defects for in vivo evaluation.

Main Results:

• PDC + HCEx demonstrated significantly thicker epithelium and higher expression of progenitor cell markers compared to PDC + HCEC.
• PDC + HCEx constructs were rich in goblet cells (MUC5AC positive) and maintained epithelial integrity in vivo.
• Transplanted PDC + HCEx preserved progenitor cell properties and showed goblet cell numbers comparable to native conjunctiva.

Conclusions:

• Directly culturing human conjunctival explants on PDC (PDC + HCEx) generates a stable, stratified, and goblet cell-rich construct.
• This PDC + HCEx substitute offers a promising alternative for patients with extensive conjunctival stem and goblet cell loss.
• The developed construct supports visual rehabilitation in cases of severe conjunctival scarring.