基质再生剂促进角膜上皮损伤愈合的研究进展

Research progress of matrix regenerating agents in promoting corneal epithelial wound healing

角膜上皮急性损伤通常在48小时内愈合,而持续性角膜上皮缺损和慢性角膜溃疡常常难以治愈。角膜上皮的愈合很大程度上取决于细胞外基质(extracellular matrix,ECM)的重塑。硫酸乙酰肝素(heparin sulfate,HS)是ECM的重要成分,可与细胞外基质蛋白、生长因子和细胞因子特异结合,从而保护它们免受蛋白质酶解,促进组织愈合。近年来应用HS模拟聚合物组成的基质再生剂(regenerating agents,RGTA)促进角膜上皮损伤愈合已经逐步应用于临床。RGTA是能够完全抵抗乙酰肝素酶降解的纯生物工程聚合物,可替代受损组织中被酶解的HS重建ECM稳态。临床研究显示RGTA可有效治疗难治性角膜溃疡,是一种有前途的新方法。

Corneal epithelial defects usually heal within 48 hours.However,It is difficult to cure persistent corneal epithelial defect and chronic corneal ulcer with traditional therapy.The healing of corneal epithelium depends largely on the remodeling of extracellular matrix(ECM).Heparin sulfate(HS)is an important component of the ECM.It can specifically bind to matrix proteins,growth factors and cytokines,thus protecting them from proteolysis and facilitating tissue healing.In recent years,matrix regenerating agents(RGTA)consisting of heparan sulfate mimetic polymers has been gradually applied on clinical practice to promote corneal epithelial wound healing.RGTA is a pure bioengineering polymer that can completely resist the degradation of heparanase.It can replace the enzymatically hydrolyzed HS in damaged tissues,so as to reconstruct the stable environment in ECM.Clinical studies show that RGTA can effectively treat refractory corneal ulcer and is a promising new method.