Abstract
Purpose: :
The healing of eyes that were chemically burned is often slow and can be halted by many complications. To improve the healing, numerous agents were studied in animals in the 70’s and 80’s. Based on these studies, some cocktail of medications were tried on humans and showed some benefits. However, this was reported without assessing the individual properties of each agent on the healing process. To clarify this situation, we investigated the effect on reepithelialization of some of the agents used clinically.
Methods: :
An in vitro study using tissue–engineered human corneas, produced by cell culture, was designed. Corneas were reconstructed by stacking together sheets of fibroblasts and seeding them with epithelial cells that proliferated and then differentiated at the air–liquid interface. These reconstructed corneas were then wounded with a 6–mm punch biopsy, placed on a reconstructed stroma to allow epithelial migration and treated twice a day with drops of different pharmacologic agents. On the 3rd day, photographs were taken from which the wound size and the reepithelialized surface were measured.
Results: :
Wounds that received no drop (controls that were left dry) or that were treated with PBS (phosphate buffer saline) reepithelialized to a comparable extent. Citrate 10% reduced and acetylcysteine 10% severely inhibited the reepithelialization compared to the control. Treatment with ascorbate 10% on wounded corneas, that were cultured without the regular dosage of ascorbate in the medium, resulted in inhibition of the reepithelialization process compared to its own control. Treating wounds with either human serum or plasma stimulated the reepithelialization compared to the control.
Conclusions: :
We show that this tissue–engineered wound–model of corneas composed of human cells is well adapted to study the effect of drugs on healing. We studied the effect on reepithelialization of pharmacologic agents used to treat chemical burn. Considering the inhibitor impact on reepithelialization of citrate, acetylcysteine and ascorbate, we suggest to limit their use to severe chemical burns.
Keywords: wound healing • cornea: epithelium • pharmacology