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T. Inatomi, T. Nakamura, N. Koizumi, C. Sotozono, S. Kinoshita; Phenotypic Analysis of Cultivated Oral Mucosal Epithelium Transplanted on a Human Cornea. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6176.
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© ARVO (1962-2015); The Authors (2016-present)
To report the characterization of transplanted cultivated oral mucosal epithelium on a human cornea following ocular surface reconstruction for severe ocular surface disorders.
An autologous cultivated oral mucosal epithelial sheets were generated on amniotic membrane. The sheets were then transplanted on the corneal surface for ocular surface reconstruction. Corneal buttons covered with the transplanted oral mucosal epithelium were excised from 4 cases, 5 to 11 months later at the time of penetrating keratoplasty or reoperation. Specimens were analyzed immunohistochemically using antibody against mucins including MUC1, MUC2, MUC4, MUC5AC, and MUC16. Keratin expression patterns were also evaluated using antibody against keratins K1, K3, K12, and K13. In addition to examination by slit-lamp microscopy, an in vivo confocal microscope was used to examine the cellular morphology of survived oral mucosal epithelium.
The transplanted oral mucosal epithelium was recognized by the different fluorescein staining pattern from that of the corneal epithelium by slit-lamp examination. Peripheral neovascular invasions were induced in most of the cases. Ectopically survived oral mucosal epithelium on the cornea expressed neither MUC16 nor MUC5AC that is the same expression pattern with in vivo oral mucosal epithelium. However, the cultivated oral mucosal epithelial cells faintly expressed MUC16 in the in vitro environment. These cells also expressed K3 and K13, but not K12, the same as with in vivo oral mucosal epithelium, yet different from corneal and conjunctival epithelium. In vivo confocal microscopic analysis revealed well-organized stratified epithelium containing the proper cell density of basal cells and flattened apical cells. No goblet cells or nerve regeneration was observed.
The phenotype of mucin and keratin expression patterns of surviving transplanted oral mucosal epithelium on the cornea was the same as in vivo oral mucosal epithelium, suggesting that cultivated oral mucosal epithelium does not transdifferentiate into corneal epithelium after transplantation onto the human ocular surface.
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