In the cornea, repair cells are derived from the resident keratocytes of the corneal stroma.
3 4 5 The phenotypic transition from keratocyte to repair cell in corneal wounds is similar to the change that occurs when keratocytes are isolated from the normal stroma, placed in cell culture, and exposed to serum.
2 6 7 8 9 The transition is characterized by (1) a change in cell shape from dendritic to spindle-shaped associated with reorganization of the actin cytoskeleton to form stress fibers,
7 (2) induction of α5-integrin expression and its heterodimerization with β1-integrin to form the fibronectin receptor,
7 10 (3) deposition of a repair-type extracellular matrix (ECM) through induced expression of new molecule such as fibronectin and SPARC,
7 11 and (4) competence to activate an IL-1α autocrine feedback loop essential for the control of collagenase expression and subsequent repair tissue remodeling.
12 13 14 Cells in culture with these characteristics are called fibroblasts and, as just stated, they are similar to the fibroblastic cells present in corneal repair tissue in vivo. In cornea, the repair transition is also associated with loss of specific keratocyte markers, including secreted keratan sulfate proteoglycans (KSPGs) such as prostaglandin D synthase,
8 15 and the intracellular corneal crystallins, which in the rabbit are the metabolic enzymes transketolase (TKT) and aldehyde dehydrogenase class 1A1 (ALDH1A1).
16 Loss of the latter proteins is particularly significant, as they are thought to help confer transparency to corneal stromal cells. Under the influence of cytokines of the TGF-β family, a subset of repair fibroblasts may also begin to express a new gene product, α-smooth muscle actin (α-sm actin).
10 17 Cells expressing α-sm actin are often called myofibroblasts. Expression of α-sm actin is often also associated with a larger cell size and increased organization of filamentous actin into stress fibers. These molecular characteristics contribute to cell contractility, facilitating wound contraction.
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