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Neue Möglichkeiten der Augenoberflächenrekonstruktion

Membranen aus Kollagen und biokompatiblen Elastomernanofasern

New possibilities for ocular surface reconstruction

Collagen membranes and biocompatible elastomer nanofibers

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Zusammenfassung

Hintergrund

Im Zuge der technischen Verbesserungen im Bereich des Tissue Engineering erarbeiten diverse Arbeitsgruppen Alternativen zu konventionellen Methoden der Oberflächenrekonstruktion der Hornhaut. Dieses Bestreben entspringt der Not, dass die Amnionmembran als etablierte Biomatrix für die Oberflächenrekonstruktion wenig standardisiert hergestellt wird, hohen strukturellen Variationen unterliegt und nicht überall verfügbar ist.

Fragestellung

Es erfolgt eine Darlegung neuer Ansätze zur Rekonstruktion der Augenoberfläche mittels Membranen aus Kollagenen und aus bioverträglichen Polymeren.

Material und Methoden

Basierend auf einer Literaturrecherche wird ein Überblick über wesentliche Untersuchungsergebnisse zu kollagenen Biomatrizes an der Hornhautoberfläche gegeben. Zusätzlich werden eigene Erfahrungen mit neuartigen Biomatrizes für die Anwendung im Bereich der Hornhaut dargestellt.

Ergebnisse

Laborexperimentelle Arbeiten bestätigen den vorgestellten Materialien eine hohe Bioverträglichkeit und lassen ihre direkte Anwendung an der Hornhautoberfläche bei nicht heilenden Oberflächendefekten oder aber ihre Verwendung als Träger epithelialer Stammzellen für die Transplantation auf die Hornhaut auch am Menschen als vielversprechend erscheinen. Klinische Anwendungen biosynthetischer Biomatrizes im Bereich der Hornhaut sind jedoch im Klinikalltag bislang nicht etabliert, und auch klinische Studien gibt es nur vereinzelt.

Schlussfolgerung

Obgleich sich ein Großteil der vorgestellten Materialien im Wesentlichen in laborexperimentellen Stadien befindet, ist eine Translation in die Klinik denkbar und von hohem therapeutischem Interesse.

Abstract

Background

Amniotic membranes have been used for many years for reconstruction of the ocular surface. Despite having anti-inflammatory and antiangiogenic properties as well as being suitable as a carrier for corneal epithelial cells, amniotic membranes also have some limitations for use at the human cornea: availability is limited, there are major interindividual variations in structure and growth factor content and are not free from the risk of disease transmission. Progress in tissue engineering has been made aiming at the development and improvement of alternative biomaterials.

Objectives

This article presents new approaches for reconstruction of the corneal surface with collagen-based biomaterials and polymers.

Material and methods

Electronic databases were searched for articles which evaluated collagenous biomaterials for use at the corneal surface. In addition the authors’ own experiences with novel biomaterials are described.

Results

In vitro evaluation of the described biomaterials suggested a high biocompatibility with corneal epithelial cells in cell cultures. In vivo experiments with these materials in animal corneas demonstrated a certain variability in degradation and remodeling. Although some materials showed promising experimental results none of these are established in the clinical routine and only few clinical studies have so far been conducted with collagen-based biomaterials.

Conclusion

Although the majority of the described biomaterials are currently still in the experimental stage, a transfer into the clinical routine is conceivable and of great therapeutic interest.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Fuchsluger, S. Salehi, C. Petsch und B. Bachmann geben an, dass kein Interessenkonflikt besteht. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Augenklinik, Universitätsklinikum Erlangen, Erlangen, Deutschland

    T. Fuchsluger, C. Petsch &  B. Bachmann

  2. Augenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

    T. Fuchsluger & S. Salehi

  3. Zentrum für Augenheilkunde, Universitätsklinikum Köln, Kerpenerstr. 62, 50924, Köln, Deutschland

    B. Bachmann

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  1. T. Fuchsluger
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  2. S. Salehi
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  3. C. Petsch
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  4. B. Bachmann
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Correspondence to B. Bachmann.

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Fuchsluger, T., Salehi, S., Petsch, C. et al. Neue Möglichkeiten der Augenoberflächenrekonstruktion. Ophthalmologe 111, 1019–1026 (2014). https://doi.org/10.1007/s00347-013-3010-z

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