以兔子為模型評估去細胞豬角膜支架進行全層角膜置換手術的可行性

Abstract

眼科疾病是臨床上常見的疾病之一，常見的狀況有：「結膜炎、角膜潰傷、青光眼、飛蚊症等疾病。」內皮層細胞主要負責角膜排水的工作，能讓角膜維持透明度，使光線能順利穿過角膜進到眼球內，但最惱人的是一旦傷及角膜內皮層後，角膜無法自行再生，患者會出現水腫、角膜混濁不透光、視線模糊不清的徵兆，持續惡化之後病人逐漸喪失角膜所具有的功能，造成失明。失明後則需要接受角膜捐贈者捐贈角膜，病人進行全層角膜移植後才能重見光明，但並非每位病人都能如此幸運獲得新的角膜，現今角膜捐贈狀況可以使用供不應求來形容，因此許多研究希望能透過組織工程的方式，能在透過體外培養一片具有功能的眼角膜結構，加速病人進行角膜移植的速度。 此研究亦希望能透過體外培養，培養出具功能性的角膜。研究內使用去細胞之豬角膜為支架，選擇豬角膜原因為結構較接近人類角膜的結構，透過培養之細胞，將細胞種於去細胞支架上進行共培養，並且觀察細胞貼附狀況、所選的支架不利於對於角膜上皮、內皮細胞貼附。 成功將細胞種於支架後，將此支架進行全層角膜移植手術，移植至紐西蘭大白兔眼球上，透過長時間觀察，希望內皮細胞能使不透明的去細胞角膜支架轉變成透明的角膜組織，取代原先以混濁、不透光的角膜組織。

Disease of eyes is the most common illness clinically. There are some symptoms in common such as pink eyes, corneal ulcer, eye floaters and glaucoma. The corneal endothelium is a single layer on the inner of cornea. It has an important function which maintains the transparency of cornea. And if the corneal endothelial cells injury, it will not recover or regenerate again. Due to this factor, the cornea of patient will become edema and opacity until the patient go blind. Cornea transplant is a familiar therapy clinically, but this method is restricted to the amount of corneal donators. Therefore, there are limiting patients will complete this procedure. Nowadays, a lot of researchers want to prepare a tissue like cornea to substitute for not functioning cornea in order to boost the proportion of cornea transplant. The study also focuses on how to organize a functional tissue ex vivo. Acellular porcine cornea matrix is selected to be a scaffold, because the structure of acellular porcine cornea matrix is pretty approach to human cornea. It cultures with corneal endothelial cells and corneal epithelial cells. Moreover, it would be observed the circumstance which is friendly for cornea endothelial cells and epithelial cells attachment. And then, this scaffold was applied to carry on penetrating keratoplasty (PK) on New Zealand White; NZW. The study hopes that APCM scaffold can conduct pump function to maintain corneal transparency.