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Regenerated patient corneas. a In vivo confocal images of the regenerated cornea from Patient 1 at 24 months post-operation, showing the regenerated epithelium, regenerating nerve (arrowhead) and stroma. The unoperated endothelium remains intact. b Changes in corneal touch sensitivity before and after RHCIII-MPC implantation as measured by Cochet-Bonnet aesthesiometry. The average pressure required to elicit a blink response from corneas before surgery, after implantation, and in comparison to the normal, healthy corneas. Touch sensitivity is inversely related to the pressure needed to elicit a blink response from the patients. Note: *p < 0.05 compared to unoperated contralateral eyes (Kruskal-Wallis test with Dunn's correction for multiple comparisons) 

Regenerated patient corneas. a In vivo confocal images of the regenerated cornea from Patient 1 at 24 months post-operation, showing the regenerated epithelium, regenerating nerve (arrowhead) and stroma. The unoperated endothelium remains intact. b Changes in corneal touch sensitivity before and after RHCIII-MPC implantation as measured by Cochet-Bonnet aesthesiometry. The average pressure required to elicit a blink response from corneas before surgery, after implantation, and in comparison to the normal, healthy corneas. Touch sensitivity is inversely related to the pressure needed to elicit a blink response from the patients. Note: *p < 0.05 compared to unoperated contralateral eyes (Kruskal-Wallis test with Dunn's correction for multiple comparisons) 

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The severe worldwide shortage of donor organs, and severe pathologies placing patients at high risk for rejecting conventional cornea transplantation, have left many corneal blind patients untreated. Following successful pre-clinical evaluation in mini-pigs, we tested a biomaterials-enabled pro-regeneration strategy to restore corneal integrity in...

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... Patients 1-3, who had an ulcer or severe scarring due to infections, the implants were well-tolerated and stably incorpo- rated. They remained relatively clear and edema-free (Fig. 2). Patient 1's vision improved from near blindness (light perception) to 1.3 LogMAR at 2 weeks post-operation, to 0.7 LogMAR at three months and 0.52 LogMAR at eight months post-operation (moderate vision loss). Her vision remained stable over the 24 months follow-up period (Table 2A). In vivo confocal microscopical examination showed that she had fully regenerated epithelium and stroma, and her endothelium remains healthy (Fig. 3). A few corneal nerves were visible (Fig. 3). At 1-week post- operation, Patient 2's vision had improved from 1.6 to 1.1 LogMAR. Complete epithelial coverage of the implant occurred over 12 weeks (Table 2A). The implant remained clear, free of edema and neovascularization. BCVA improved to 0.1 LogMAR (normal vision) by 6 months post-operation and remained stable over a follow-up period of 35 months. Ultrasound biomicroscopy and optical coherence tomography confirmed the preservation of the cornea curvature in Patients 1 and 2 that was restored by implantation ( Supplementary Fig. 2). The vision of Patient 3 improved from 1.6 to 1.0 LogMAR at one-month post-operation (Table 2A). Unfortunately, he developed fungal keratitis at six weeks post-operation. Although this was deemed unrelated, as pathology findings showed the implant was untouched by ...
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... Patients 1-3, who had an ulcer or severe scarring due to infections, the implants were well-tolerated and stably incorpo- rated. They remained relatively clear and edema-free (Fig. 2). Patient 1's vision improved from near blindness (light perception) to 1.3 LogMAR at 2 weeks post-operation, to 0.7 LogMAR at three months and 0.52 LogMAR at eight months post-operation (moderate vision loss). Her vision remained stable over the 24 months follow-up period (Table 2A). In vivo confocal microscopical examination showed that she had fully regenerated epithelium and stroma, and her endothelium remains healthy (Fig. 3). A few corneal nerves were visible (Fig. 3). At 1-week post- operation, Patient 2's vision had improved from 1.6 to 1.1 LogMAR. Complete epithelial coverage of the implant occurred over 12 weeks (Table 2A). The implant remained clear, free of edema and neovascularization. BCVA improved to 0.1 LogMAR (normal vision) by 6 months post-operation and remained stable over a follow-up period of 35 months. Ultrasound biomicroscopy and optical coherence tomography confirmed the preservation of the cornea curvature in Patients 1 and 2 that was restored by implantation ( Supplementary Fig. 2). The vision of Patient 3 improved from 1.6 to 1.0 LogMAR at one-month post-operation (Table 2A). Unfortunately, he developed fungal keratitis at six weeks post-operation. Although this was deemed unrelated, as pathology findings showed the implant was untouched by ...
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... surgery, all acute phase patients had reduced touch sensitivity from slight to the total absence of response (Fig. 3b). After surgery, sensitivity in all patients was restored close to levels observed in their healthy contralateral corneas, including the individual with degenerative neurotrophic keratitis (Patient 5). Kruskal-Wallis test showed a significant difference between DISCUSSION RHCIII-MPC implants have been evaluated in a range of animal models including mice, 28 rabbits 18 and mini-pigs. 20 The mouse implantation model is a rejection model and only provides information on implant performance relative to allografting. 28 Rabbits have been used extensively in the pre-clinical testing of new corneal implants. For example, in a well-established alkali burn model that simulates severe pathology, 29 we were able to show that the addition of the inflammation suppressing MPC to RHCIII biosynthetic corneas resulted in the implants remaining stably incorporated and clear. 18 In contrast, burned corneas grafted with RHCIII only, like allografts, were vascularized. 18 However, rabbit corneas differ from human corneas in that they are thinner, have no Bowman's membrane and their endothelial cells proliferate readily. 30,31 The pig cornea is structurally and mechanically closer to the human cornea, 5,32 in that it possesses a Bowman's membrane and an endothelium with minimal pro- liferative ...

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... Corneal damage is a common cause of visual impairment. The usage of biomaterials for corneal repair can effectively reduce patient costs as the process is cheaper than the transplantation process, which suffers from a severe donor shortage [261,262]. The selection of hemostatic materials for the treatment of corneal injury should take into account the following relevant properties: 1) excellent biocompatibility and biodegradability; 2) high transparency; 3) mechanical stability and support; 4) high adhesion to tissue; 5) ability to promote endogenous tissue regeneration; and 6) stable physicochemical properties and ease of application. ...
Article
Bleeding caused by trauma or surgery is a serious health problem, and uncontrollable bleeding can result in death. Therefore, developing safe, effective, and convenient hemostatic materials is important. Active hemostatic agents currently used to investigate the field of hemostasis are divided into four broad categories: natural polymers, synthetic polymers, inorganic materials, and metal-containing materials. Hemostatic materials are prepared in various forms for wound care applications based on the active ingredients used. These materials include nanofibers, gels, sponges, and nanoparticles. Hemostatic materials find their applications in the field of wound care, and they are also used for hemostasis during malignant tumor surgery. Prompt and effective hemostasis can reduce the possibility of the spread of tumor cells with blood. This review discusses the outcomes of current research conducted in the field and the problems persisting in the field of developing hemostatic materials. The review also presents a platform for the further development of hemostatic materials. Bleeding caused by trauma or surgery is a serious health problem, and uncontrollable bleeding can result in death. Therefore, developing safe, effective, and convenient hemostatic materials is important. Active hemostatic agents currently used to investigate the field of hemostasis are divided into four broad categories: natural polymers, synthetic polymers, inorganic materials, and metal-containing materials. Hemostatic materials are prepared in various forms for wound care applications based on the active ingredients used. These materials include nanofibers, gels, sponges, and nanoparticles. Hemostatic materials find their applications in the field of wound care, and they are also used for hemostasis during malignant tumor surgery. Prompt and effective hemostasis can reduce the possibility of the spread of tumor cells with blood. This review discusses the outcomes of current research conducted in the field and the problems persisting in the field of developing hemostatic materials. The review also presents a platform for the further development of hemostatic materials.
... Annually, more than 1.5 million recent patients are presented with corneal blindness [28]. Because of the high cost and lack of the donors, corneal transplantations used as the treatment of only less than 5% of cases [18]. ...
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Background: The X-rays and the visible light are the main source of ultraviolet radiation (UVR). About 90% of ultraviolet B (UVB) is absorbed by the cornea which may promote corneal inflammation, oedema and damage of its epithelial layer. Bone marrow mesenchymal stem cells (BM-MSCs) have been demonstrated to ameliorate the injured corneal tissue and accelerate its wound healing. This study aimed to compare the healing effect of intravenous (IV) versus subconjunctival (SC) BM-MSCs on the rats’ corneas subjected to UVB-irradiation. Materials and methods: Ten rats were used as donors for BM-MSCs and the other 40 were allocated into four equal groups: group I (control group), group II (ultraviolet-irradiated group), group III (ultraviolet-irradiated + IV BM-MSCs-treated group) and group IV (ultraviolet-irradiated +SC BM-MSCs-treated group). Rats of all groups were euthanized after 3 weeks and the corneal specimens were processed for histopathological, immunohistochemical and electron microscopy assessment. Results: Ultraviolet-irradiated group showed remarkable thinning of epithelial thickness, wide partial epithelial separation, and desquamation. Neovascularisation of the disorganised stroma and disrupted Descemet’s membrane were observed. The superficial and basal epithelial cells appeared irregular and separated by wide intercellular spaces and inflammatory cells. Immunohistochemical examination showed a significant decrease in proliferating cell nuclear antigen immunoreaction. In contrast, minimal changes were observed in rats treated with BM-MSCs with more improvement associated with the subconjunctival administration compared to IV route. Conclusions: Local SC injection of BM-MSCs has an amazing regenerative efficacy on the corneal injury compared to the systemic IV route. (Folia Morphol 2022; 81, 4: 900–916)
... However, as with all transplants, the donor sources are highly restricted, with less than 5% of patients undergoing corneal transplantation [363]. Consequently, the replacement of diseased corneas with synthetic ones has been actively studied as an alternative to conventional corneal tissue transplantation [364][365][366]. Decellularized cryomilled corneal powder has been used for corneal repair and regeneration [367,368]. ...
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In view of their low immunogenicity, biomimetic internal environment, tissue- and organ-like physicochemical properties, and functionalization potential, decellularized extracellular matrix (dECM) materials attract considerable attention and are widely used in tissue engineering. This review describes the composition of extracellular matrices and their role in stem-cell differentiation, discusses the advantages and disadvantages of existing decellularization techniques, and presents methods for the functionalization and characterization of decellularized scaffolds. In addition, we discuss progress in the use of dECMs for cartilage, skin, nerve, and muscle repair and the transplantation or regeneration of different whole organs (e.g., kidneys, liver, uterus, lungs, and heart), summarize the shortcomings of using dECMs for tissue and organ repair after refunctionalization, and examine the corresponding future prospects. Thus, the present review helps to further systematize the application of functionalized dECMs in tissue/organ transplantation and keep researchers up to date on recent progress in dECM usage.
... A summary of recent clinical and preclinical studies of corneal bioengineering technologies is given in Supplementary Table 4. Most clinical studies, while having achieved significant advances in biomaterial properties, have addressed relatively rare causes of corneal blindness such as chemical burns 54,55 , infections [55][56][57][58] , ulcers 59 or high-risk cases 54,55 with the goal to stabilize the condition and avoid blindness, but not to optimize vision. Only two clinical studies to date have addressed keratoconus, a condition that impairs millions globally, aiming to provide vision gains comparable to standard PK or DALK. ...
... A summary of recent clinical and preclinical studies of corneal bioengineering technologies is given in Supplementary Table 4. Most clinical studies, while having achieved significant advances in biomaterial properties, have addressed relatively rare causes of corneal blindness such as chemical burns 54,55 , infections [55][56][57][58] , ulcers 59 or high-risk cases 54,55 with the goal to stabilize the condition and avoid blindness, but not to optimize vision. Only two clinical studies to date have addressed keratoconus, a condition that impairs millions globally, aiming to provide vision gains comparable to standard PK or DALK. ...
... A summary of recent clinical and preclinical studies of corneal bioengineering technologies is given in Supplementary Table 4. Most clinical studies, while having achieved significant advances in biomaterial properties, have addressed relatively rare causes of corneal blindness such as chemical burns 54,55 , infections [55][56][57][58] , ulcers 59 or high-risk cases 54,55 with the goal to stabilize the condition and avoid blindness, but not to optimize vision. Only two clinical studies to date have addressed keratoconus, a condition that impairs millions globally, aiming to provide vision gains comparable to standard PK or DALK. ...
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Visual impairment from corneal stromal disease affects millions worldwide. We describe a cell-free engineered corneal tissue, bioengineered porcine construct, double crosslinked (BPCDX) and a minimally invasive surgical method for its implantation. In a pilot feasibility study in India and Iran (clinicaltrials.gov no. NCT04653922), we implanted BPCDX in 20 advanced keratoconus subjects to reshape the native corneal stroma without removing existing tissue or using sutures. During 24 months of follow-up, no adverse event was observed. We document improvements in corneal thickness (mean increase of 209 ± 18 µm in India, 285 ± 99 µm in Iran), maximum keratometry (mean decrease of 13.9 ± 7.9 D in India and 11.2 ± 8.9 D in Iran) and visual acuity (to a mean contact-lens-corrected acuity of 20/26 in India and spectacle-corrected acuity of 20/58 in Iran). Fourteen of 14 initially blind subjects had a final mean best-corrected vision (spectacle or contact lens) of 20/36 and restored tolerance to contact lens wear. This work demonstrates restoration of vision using an approach that is potentially equally effective, safer, simpler and more broadly available than donor cornea transplantation.
... Combining the biopolymers (Co and silk fibroin) and modifying them with an EDC cross linker ascended T d up 90 C to 100 C. The cross linker can stabilise chains and amplify peptide fibres by bonding the functional groups in Co and silk fibroin. 36 Recombinant human Co type III/2-methacryloyloxyethyl phosphorylcholine (RHCIII-MPC) implants showed denaturation temperature of about 51 C, lower than that of the human cornea at 65 C, 37,38 while the fish-based Co membranes with cross linker showed denaturation temperature higher than RHCIII-MPC implants and comparable to the human cornea. ...
... Our results showed that membranes with silk fibroin of less than 10% have a water content of more than 80%, similar to corneal tissue. 38,50 In solution, silk fibroin has amorphous metastable conformations such as random coil and α-helix 62 which may be converted into stable crystallised sheets under certain conditions. pH change, shear force, methanol treatment (dehydrating solvent), cross linkers, or thermal treatment are examples of such conditions. ...
Article
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Natural biomaterials are crucial in ocular tissue engineering because they allow cells to proliferate, differentiate, and stratify while maintaining the typical epithelial phenotype. In this study, membranes as dressings were formed from silk fibroin and collagen (Co) extracted from fish skin and then modified with carbodiimide chemical cross linker in different concentrations. The samples were evaluated by different analyses such as structural, physical (optical, swelling, denaturation temperature, degradation), mechanical, and biological (viability, cell adhesion, immunocytochemistry) assays. The results showed that all membranes have excellent transparency, especially with higher silk fibroin content. Increasing the cross linker concentration and the ratio of silk fibroin to Co increased the denaturation temperature and mechanical strength and, conversely, reduced the degradation rate and cell adhesion. The samples did not show a significant difference in toxicity with increasing cross linker and silk fibroin ratio. In general, samples with a low silk fibroin ratio combined with cross linker can provide desirable properties as a membrane for corneal wound healing.
... For use in patients with severe pathologies that put them at high risk of rejecting conventional donor transplantation, RHCIII implants incorporating a synthetic lipid polymer, 2methacryloyloxyethyl phosphorylcholine (MPC) that suppresses inflammation, were successfully tested in high-risk patients with ulcerated and badly scarred corneas (Hackett et al., 2011;Islam et al., 2013Islam et al., , 2015Kakinoki et al., 2014). In these firstin-human clinical studies, the implants were manufactured aseptically under Class 100 or ISO 5 conditions and stored in phosphate-buffered saline (0.1 M) containing 1% chloroform (C-PBS) to maintain sterility (Fagerholm et al., 2010(Fagerholm et al., , 2014Islam et al., 2018). This storage solution required an extensive washing procedure to remove the chloroform before surgery, after which they were further washed in antibiotics before use to ensure their sterility. ...
Article
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Sterilization of biodegradable, collagen-based implants is challenging as irradiation sterilization methods can alter their mechanical properties. Electron beam (EB) irradiation is a terminal sterilization method that has been used for biologically-derived implants. Here, recombinant human collagen type III-phosphorylcholine (RHCIII-MPC) hydrogels were irradiated with EB doses of 17, 19, or 21 kGy and their subsequent biocompatibility and ability to promote regeneration in rabbit corneas was evaluated. Unirradiated hydrogels stored in 1% chloroform in phosphate-buffered saline (C-PBS) were the controls. There were no significant differences between irradiated and non-irradiated samples in optical or physical properties (tensile strength, modulus, elasticity), or the ability to support cell growth. However, irradiated implants were more sensitive to high levels of collagenase than unirradiated controls and the C-PBS implants had increased cell growth compared to EB and controls at 72 h. Corneal implants e-beamed at 17 kGy or e-beamed and subsequently frozen (EB-F) to increase shelf-life showed no adverse biological effects of the irradiation. EB, EB-F, and C-PBS implanted corneas all rapidly re-epithelialized but showed mild neovascularization that resolved over 6 months. The regenerated neo-corneas were transparent at 6 months post-operation. In vivo confocal microscopy confirmed normal morphology for the epithelium, stroma, sub-basal nerves and unoperated endothelium. Histology showed that all the regenerated corneas were morphologically similar to the normal. Immunohistochemistry indicated the presence of a differentiated corneal epithelium and functional tear film. In conclusion, the e-beamed corneal implants performed as well as non-irradiated control implants, resulting in fully regenerated neo-corneas with new nerves and without blood vessels or inflammation that may impede vision or corneal function. Therefore, a complete validation study to establish EB irradiation as an effective means for corneal implant sterilization prior to clinical application is necessary as a next step.
... At 4 years follow-up, the corneas were well integrated into the host tissue. Interpenetrating polymer-based CACs have also been evaluated in a human pilot study 14 , and in a clinical trial 15 and showed the capacity to stabilize corneas and improve vision in aggressive disease condition. Although CACs are highly biocompatible, their mechanical properties do not permit suturing of the implant and require overlying sutures for transplantation 13 . ...
... The relative fold change of HAdV-D37 DNA is depicted in Fig. 7a. The analysis through immunofluorescence assay also revealed a reduction in HAdV-D37 in the Coll 15 -PyKC 1 group compared to the control Coll 15 . Notably, fluorescence was less in the construct Coll 15 -PyKC 1 , followed by Coll 15 -PyKC 2 at 48 hpi (Fig. 7b). ...
... To fill the gap between supply and demand, much research has focused on developing an artificial cornea. Toward this end, CACs have been transplanted into humans 13,15 , in most cases they consisted of collagen crosslinked with EDC and NHS. Carbodiimide-based chemical crosslinkers, such as EDC-based methods are considered a standard strategy with low cytotoxicity, but the mechanical strength of crosslinked collagen is less than satisfactory. ...
Article
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Development of an artificial cornea can potentially fulfil the demand of donor corneas for transplantation as the number of donors is far less than needed to treat corneal blindness. Collagen-based artificial corneas stand out as a regenerative option, having promising clinical outcomes. Collagen crosslinked with chemical crosslinkers which modify the parent functional groups of collagen. However, crosslinkers are usually cytotoxic, so crosslinkers need to be removed from implants completely before application in humans. In addition, crosslinked products are mechanically weak and susceptible to enzymatic degradation. We developed a crosslinker free supramolecular gelation strategy using pyrene conjugated dipeptide amphiphile (PyKC) consisting of lysine and cysteine; in which collagen molecules are intertwined inside the PyKC network without any functional group modification of the collagen. The newly developed collagen implants (Coll-PyKC) are optically transparent and can effectively block UV light, are mechanically and enzymatically stable, and can be sutured. The Coll-PyKC implants support the growth and function of all corneal cells, trigger anti-inflammatory differentiation while suppressing the pro-inflammatory differentiation of human monocytes. Coll-PyKC implants can restrict human adenovirus propagation. Therefore, this crosslinker-free strategy can be used for the repair, healing, and regeneration of the cornea, and potentially other damaged organs of the body.
... Similarly, the patients who had medium and long duration of diagnosis were reducing the high risk of blindness of glaucoma patients. is finding was consistent with another study (French and Margo, 2010) [36][37][38]. e result shown that, medium and long duration of diagnosis were reducing the hazard of death or blindness. Glaucoma pain should be reported to an eye specialist on a regular basis so that the condition can be detected and treated before a longterm visual loss occurs. ...
Article
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Background: Glaucoma is one of the most frequent vision-threatening eye diseases. It is frequently associated with excessive intraocular pressure (IOP), which can cause vision loss and damaged optic nerves. The main objective of this study was to model time to blindness of glaucoma patients by using appropriate statistical models. Study Design. A Retrospective Community-Based Longitudinal Study design was applied. Materials and Procedures. The data were obtained from Ophthalmology Department of JUSH from the period of January 2016 to August 2020. The glaucoma patient's information was extracted from the patient card and 321 samples were included in the study. To discover the factors that affect time to blindness of glaucoma patients', researchers used the Accelerated Failure Time (AFT) model. Results: 81.3 percent of the 321 glaucoma patients were blind. Unilaterally and bilaterally blinded female and male glaucoma patients were 24.92 and 56.38%, respectively. After glaucoma disease was confirmed, the median time to the blindness of both eyes and one eye was 12 months. The multivariable log-logistic accelerated failure-time model fits the glaucoma patient's time to blind dataset well. The result showed that the chance of blindness of glaucoma patients who have absolute stage of glaucoma, medium duration of diagnosis, long duration of diagnosis, and IOP greater than 21 mmHg were high with parameters (ϕ = 2.425, p value = 0.049, 95% CI [2.249, 2.601]), (ϕ = 1.505, p value = 0.001, 95% CI [0.228, 0.589]), (ϕ = 3.037, p value = 0.001, 95% C.I [2.850, 3.22]) and (ϕ 0.851, p value = 0.034, 95% C.I [0.702, 0.999]), respectively. Conclusion: The multivariable log-logistic accelerated failure time model evaluates the prognostic factors of time to blindness of glaucoma patients. Under this finding, duration of diagnosis, IOP, and stage of glaucoma were a key determinant factors of time to blindness of glaucoma patients'. Finally, the log-logistic accelerated failure-time model was the best-fitted parametric model based on AIC and BIC values.
... This may indicate that our protocol to decellularize GI tissues and prepare ECM hydrogels can exclude contamination of SEM and IEM hydrogels from pathogens in the GI tissues. Given that the endotoxin level acceptable for implantable medical devices is 0.5 EU/ml in the guideline of the Food and Drug Administration (FDA) 23 , our decellularized GI tissue-derived ECM hydrogels would be able to serve biomaterials with clinical feasibility. Next, we checked the immunogenicity of decellularized GI tissue-derived ECM hydrogels. ...
Article
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Matrigel, a mouse tumor extracellular matrix protein mixture, is an indispensable component of most organoid tissue culture. However, it has limited the utility of organoids for drug development and regenerative medicine due to its tumor-derived origin, batch-to-batch variation, high cost, and safety issues. Here, we demonstrate that gastrointestinal tissue-derived extracellular matrix hydrogels are suitable substitutes for Matrigel in gastrointestinal organoid culture. We found that the development and function of gastric or intestinal organoids grown in tissue extracellular matrix hydrogels are comparable or often superior to those in Matrigel. In addition, gastrointestinal extracellular matrix hydrogels enabled long-term subculture and transplantation of organoids by providing gastrointestinal tissue-mimetic microenvironments. Tissue-specific and age-related extracellular matrix profiles that affect organoid development were also elucidated through proteomic analysis. Together, our results suggest that extracellular matrix hydrogels derived from decellularized gastrointestinal tissues are effective alternatives to the current gold standard, Matrigel, and produce organoids suitable for gastrointestinal disease modeling, drug development, and tissue regeneration. The culture of gastrointestinal organoids relies on Matrigel that has several drawbacks for clinical application. Here, the authors report the feasibility of gastrointestinal tissue-mimetic matrices as effective alternatives to Matrigel for organoid culture and transplantation.
... Globally, corneal blindness is estimated to affect approximately 23 million people, with an estimated 1.5 million new cases per year [1,2]. Corneal wounds and perforations can arise from infections, traumatic injuries, surgical procedures (e.g., cataract surgery), autoimmune diseases (e.g., ulcerative keratitis) or degenerative disorders [3,4]. ...
Article
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The current treatments for the management of corneal and scleral perforations include sutures and adhesives. While sutures are invasive, induce astigmatism and carry a risk of infection, cyanoacrylate glues are toxic, proinflammatory and form an opaque and rough surface that precludes vision. Consequently, the clinical need for a fast curing and strong tissue adhesive with minimised cytotoxicity and host inflammation remains unmet. In this paper, we engineer a gelatine methacryloyl (GelMA) adhesive that can be crosslinked in situ within 2 min using UV or visible light and a riboflavin (RF)/sodium persulfate (SPS) system. Optical coherence tomography (OCT) images demonstrated that the flowable GelMA adhesive could completely fill corneal wounds and restore the ocular curvature by forming a smooth contour on the ocular surface. Further, ex vivo studies in porcine eyes showed that GelMA bioadhesives exhibited burst pressures that were comparable to cyanoacrylates (49 ± 9 kPa), with the hydrogels exhibiting a transmittance (90%), water content (85%) and storage modulus (5 kPa) similar to the human cornea. Finally, using human dermal fibroblasts, we showed that our GelMA adhesive was non-toxic and could effectively support cell adhesion and proliferation. Taken together, the adhesive’s performance, injectability and ease of administration, together with gelatin’s availability and cost-effectiveness, make it a potential stromal filler or sealant for corneal and conjunctival applications.