Cell-Based Approach to Tissue Engineering

In recent years the focus of cell-based tissue engineering has been on the corneal epithelial tissue engineering, possibly because it is the most superficial layer and easily accessible. Many attempts have been made at generating a sheet of epithelial cells that is readily transplantable without the need of sutures (Yamato and Okano 2004; Nishida et al. 2004). After transplantation, the cell sheet should attach to the remaining native ECM in recipient eye. Cell sheets can be grown from a small biopsy of healthy epithelial tissue containing limbal epithelial stem cells, and this ex vivo expansion is an enormous advantage over the transplantation of large pieces of limbus from a healthy to a diseased eye, reducing the risk to the healthy donor. The use of laboratory-expanded limbal epithelial cells was proposed by Lindberg and coworkers in 1993 and first performed on patients by Pellegrini and collaborators in 1997 (Lindberg et al. 1993; Pellegrini et al. 1997). Since the first cultivated limbal epithelial transplantations (CLET), a lot of research has been done and more recently a number of clinical trials have been published focussing on the use of in vitro expanded LESC (Tsai et al. 2000; Koizumi et al. 2001; Grueterich et al. 2002; Shortt et al. 2007b).

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