Tonti E, Manco GA, Spadea L, Zeppieri M. Focus on limbal stem cell deficiency and limbal cell transplantation. World J Transplant 2023; 13(6): 321-330 [PMID: 38174150 DOI: 10.5500/wjt.v13.i6.321]
Corresponding Author of This Article
Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, No. 15 p.le S. Maria della Misericordia, Udine 33100, Italy. markzeppieri@hotmail.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Dec 18, 2023; 13(6): 321-330 Published online Dec 18, 2023. doi: 10.5500/wjt.v13.i6.321
Focus on limbal stem cell deficiency and limbal cell transplantation
Emanuele Tonti, Gregorio Antonio Manco, Leopoldo Spadea, Marco Zeppieri
Emanuele Tonti, Gregorio Antonio Manco, Leopoldo Spadea, Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Author contributions: Tonti E wrote the outline, did the research, wrote the paper, and provided the final approval of the version of the article; Manco GA assisted in the editing and making critical revisions of the manuscript; Spadea L assisted in the writing, editing, and making critical revisions of the manuscript; Zeppieri M assisted in the conception and design of the study, and writing, outline, and final approval of the version of the article to be published and completed the English and scientific editing (a native English speaker).
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior authors or other coauthors who contributed their efforts to this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, No. 15 p.le S. Maria della Misericordia, Udine 33100, Italy. markzeppieri@hotmail.com
Received: September 19, 2023 Peer-review started: September 19, 2023 First decision: October 9, 2023 Revised: October 10, 2023 Accepted: November 2, 2023 Article in press: November 2, 2023 Published online: December 18, 2023 Processing time: 89 Days and 20.7 Hours
Abstract
Limbal stem cell deficiency (LSCD) causes severe vision impairment and can lead to blindness, representing one of the most challenging ocular surface disorders. Stem cell deficiency can be congenital or, more often, acquired. The categorization of ocular surface transplantation techniques is crucial to achieving treatment homogeneity and quality of care, according to the anatomic source of the tissue being transplanted, genetic source, autologous or allogenic transplantation (to reflect histocompatibility in the latter group), and cell culture and tissue engineering techniques. The aim of this minireview is to provide a summary of the management of LSCD, from clinical characteristics and therapeutic outcomes to the development of novel therapeutic approaches. The manuscript also briefly summarizes recent findings in the current literature and outlines the future challenges to overcome in the management of the major types of ocular surface failure.
Core Tip: Limbal cell transplantation has been developed for the management of limbal stem cell (LSC) deficiency, to improve this condition and related complications, ameliorating visual acuity and quality of life of affected patients. Some of the limitations include the lack of specific markers and standardized methods to identify LSCs, as well as the need to standardize the choice of therapeutic options which have diversified over the years and have evolved in terms of technology, efficacy, and safety. This clinical update review is to enable clinicians with the best evidence and current recommendations for managing their patients within the most advanced limbal cell transplant techniques.
