Conjunctival reconstruction is an integral component of ocular surface restoration. Decellularised tissues are frequently used clinically for tissue engineering. This study identifies porcine decellularised conjunctiva (PDC) and human decellularised conjunctiva (HDC) as promising substitutes for conjunctival reconstruction. PDC and HDC were nearly DNA-free, structurally intact and showed no cytotoxic effects in vitro, which was confirmed by DNA quantification, histology, transmission electron microscopy, collagen quantification and cytotoxicity assay. Comparing the biomechanical properties to amniotic membrane (AM), the most frequently applied matrix for ocular surface reconstruction today, the decellularised conjunctiva was more extensible and elastic but exhibited less tensile strength. The in vivo application in a rabbit model proofed significantly enhanced transplant stability and less suture losses comparing PDC and HDC to AM while none of the matrices induced considerable inflammation. Ten days after implantation, all PDC, 4 of 6 HDC but none of the AM transplants were completely integrated into the recipient conjunctiva with a partially multi-layered epithelium. Altogether, decellularised conjunctivas of porcine and human origin were superior to AM for conjunctival reconstruction after xenogeneic application in vivo.

Statement of Significance

Conjunctival integrity is essential for a healthy ocular surface and clear vision. Its reconstruction is required in case of immunological diseases, after trauma, chemical or thermal burns or surgery involving the conjunctiva. Due to limitations of currently used substitute tissues such as amniotic membrane, there is a need for the development of new matrices for conjunctival reconstruction. Decellularised tissues are frequently applied clinically for tissue engineering. The present study identifies porcine and human decellularised conjunctiva as biocompatible and well tolerated scaffolds with superior integration into the recipient conjunctiva compared to amniotic membrane. Decellularised conjunctiva depicts a promising substitute for conjunctival reconstruction in ophthalmology.

中文翻译：

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脱细胞结膜用于眼表重建

结膜重建是眼表修复不可或缺的组成部分。脱细胞的组织在临床上经常用于组织工程。这项研究确定猪脱细胞结膜（PDC）和人脱细胞结膜（HDC）是结膜重建的有希望的替代品。PDC和HDC几乎不含DNA，在结构上完整，在体外没有细胞毒性作用，这已通过DNA定量，组织学，透射电镜，胶原蛋白定量和细胞毒性测定得到了证实。将生物力学性能与羊膜（AM）（当今眼表重建最常用的基质）进行比较，脱细胞的结膜更易伸长和富有弹性，但拉伸强度却更低。这与PDC和HDC与AM相比，在兔模型中的体内应用已证明能显着提高移植物的稳定性，并减少缝合线的损失，而没有一种基质能引起明显的炎症。植入后第10天，所有PDC，6个HDC中的4个，但没有AM移植完全与部分多层上皮完全整合到受体结膜中。在体内异种应用后，猪和人源性脱细胞结膜在结膜重建方面均优于AM 。

重要声明

结膜完整性对于健康的眼表和清晰的视力至关重要。如果是免疫系统疾病，创伤，化学或热灼伤或涉及结膜的手术后，需要对其进行重建。由于当前使用的替代组织如羊膜的局限性，需要开发用于结膜重建的新基质。去细胞的组织通常在临床上用于组织工程。本研究确定猪和人脱细胞结膜为生物相容性和耐受性良好的支架，与羊膜相比，其与受体结膜的整合性更高。脱细胞结膜描绘了眼科结膜重建的有希望的替代品。