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首页> 外文期刊>Current Eye Research >Development of Causative Treatment Strategies for Lacrimal Gland Insufficiency by Tissue Engineering and Cell Therapy. Part 1: Regeneration of Lacrimal Gland Tissue: Can We Stimulate Lacrimal Gland Renewal In Vivo?
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Development of Causative Treatment Strategies for Lacrimal Gland Insufficiency by Tissue Engineering and Cell Therapy. Part 1: Regeneration of Lacrimal Gland Tissue: Can We Stimulate Lacrimal Gland Renewal In Vivo?

机译：通过组织工程和细胞治疗发展泪腺功能不全的病因治疗策略。第1部分：泪腺组织的再生：我们可以刺激体内的泪腺更新吗？

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摘要

Severe dry eye syndrome (DES) is a complex disease that is commonly caused by inflammatory and degenerative changes in the lacrimal gland, and can result in severe pain and disruption to visual acuity. In healthy subjects, the ocular surface is continually lubricated by the tear film that ensures that the ocular surface remains moist and free of debris, enabling normal vision. The lacrimal fluid, mid-layer of the tear film, is mainly produced by the lacrimal gland and if this is dysfunctional for any reason, severe DES can develop. Currently, only palliative treatments for DES exist that aim to either replace or retain tears and/or minimize inflammation. A curative approach that aims to trigger the regeneration of existing lacrimal gland tissue in situ may, therefore, be very beneficial to DES patients. This article reviews the different approaches that have been explored toward lacrimal gland regeneration. Progress to date in vitro, in vivo, and in man is described with a focus on clinical feasibility and efficacy. Promising candidates for drug-dependent treatment of DES are growth factors and cytokines, such as hepatocyte growth factor (HGF) and tumor necrosis factor -stimulated gene 6 protein (TSG-6). Only a few studies have evaluated gene therapy for lacrimal gland deficiencies, but with promising results. However gene therapy carries a variety of risks regarding carcinogenesis and therefore a treatment in the near future using this approach seems to be unlikely. Cell therapies utilizing mesenchymal stem cells (MSCs) seem to be more applicable than those using human amniotic membrane (hAM) epithelial cells or induced pluripotent stem (iPS) cells, since MSCs combine the favorable traits of both (multipotency, capability to stimulate regeneration immunomodulatory and non-immunogenic properties).
机译：严重的干眼症候群（DES）是一种复杂的疾病，通常由泪腺的炎症和退行性变化引起，并可能导致严重的疼痛和视力障碍。在健康受试者中，眼泪膜会持续润滑眼表，以确保眼表保持湿润且无碎屑，从而实现正常视力。泪液，泪膜的中间层，主要是由泪腺产生的，如果由于某种原因而功能失调，则会形成严重的DES。当前，仅存在针对DES的姑息治疗，其旨在替代或保留眼泪和/或使炎症最小化。因此，旨在触发现有泪腺组织原位再生的治疗方法可能对DES患者非常有益。本文介绍了探索泪腺再生的不同方法。迄今为止，在体外，体内和人体中的进展都以临床可行性和功效为重点进行了描述。生长因子和细胞因子，例如肝细胞生长因子（HGF）和肿瘤坏死因子刺激的基因6蛋白（TSG-6），有望成为DES药物依赖性治疗的候选药物。只有很少的研究评估了泪腺缺乏症的基因治疗，但结果令人满意。然而，基因疗法在致癌性方面存在多种风险，因此在不久的将来使用这种方法进行治疗似乎不太可能。使用间充质干细胞（MSC）的细胞疗法似乎比使用人羊膜（hAM）上皮细胞或诱导性多能干（iPS）细胞的细胞疗法更适用，因为MSC结合了两者的良好特性（多能性，刺激再生免疫调节能力和非免疫原性特性）。

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