眼表稳态失衡与组织重建策略

Ocular surface homeostasis imbalance and tissue reconstruction strategies

[背景]眼表位于眼球的最外层,是一个精细且复杂的系统,包括角膜、结膜以及相关的眼睑和泪腺,在维持人类视觉功能方面起着至关重要的作用.随着眼表组织器官培养技术在眼科领域的快速发展,研究人员能够更全面地探索其在不同生理和病理状态下的复杂特性.[进展]环境污染、干燥应激等因素会对眼表组织构成威胁,导致稳态失衡和损伤.近几十年来针对环境污染对眼表组织影响的研究不断涌现,与此同时,眼表重建技术不断发展,如组织工程角膜、小分子化学药物应用,以及先进的眼表药物递送系统等.本文系统地梳理了眼表组织器官培养技术的最新进展、环境污染和干燥应激下眼表细胞的功能紊乱,以及多样化的眼表重建策略.[展望]未来持续深入研究眼表系统的稳态维持机制和疾病发生机制,探索更多有效的治疗方法和药物递送策略,将为眼科医生、研究人员及决策者提供更深入的参考和启示,推动眼表组织健康与治疗的进一步发展.

[Background]The ocular surface is a morpho-functional unit comprising the major lacrimal glands,cornea,conjunctiva,tear film,immune cells and nerve fibers.These components work together to maintain homeostasis,which is essential for proper visual function.They form the first line of defense against environmental insults and are vital for the health and functionality of the eye.With the rapid development of ocular surface organ culture techniques in ophthalmology,researchers can now explore the complex characteristics of these tissues under various physiological and pathological states more deeply and comprehensively.Environmental pollution,such as exposure to particulate matter and chemicals,along with dry stress caused by reduced tear production or increased evaporation,poses significant threats to ocular surface tissues.These factors can lead to homeostasis imbalance,inflammation,and tissue damage,ultimately impairing visual function.Understanding these impacts is crucial for developing effective prevention and treatment strategies.[Progress]Despite numerous studies on the impact of environmental pollution on ocular surface tissues in recent decades,a comprehensive understanding of the damage mechanisms remains elusive.Research has shown that pollutants,such as particulate matter,chemicals,and allergens,can induce oxidative stress,inflammation,and cellular apoptosis in ocular surface cells.These pollutants can disrupt the tear film,cause damage to the epithelial cells,and impair the overall integrity of the ocular surface,leading to conditions such as dry eye syndrome and conjunctivitis.Additionally,dry stress,often exacerbated by environmental factors such as low humidity,high wind,and excessive screen time,can lead to similar detrimental effects.Dry stress reduces tear production and increases tear evaporation,resulting in tear film instability.This instability can cause microdamage to corneal and conjunctival epithelial cells,triggering inflammatory responses and further compromising ocular surface health.The combined impact of environmental pollutants and dry stress can lead to chronic inflammation,compromised barrier function,and progressive tissue damage.To address these challenges,ocular surface tissue reconstruction techniques are continuously evolving.Tissue-engineered corneas have shown promise in restoring vision and ocular surface integrity,providing a viable solution for patients suffering from severe corneal damage.Small molecule pharmaceuticals are being developed to target specific pathways involved in inflammation and tissue repair,offering precise and effective treatment options.Advanced ocular surface drug delivery systems,utilizing nanotechnology and smart materials,aim to enhance drug bioavailability and therapeutic efficacy by ensuring targeted and sustained release of medications.These advancements represent significant strides in ocular surface reconstruction,offering new treatment avenues and improving patient outcomes.Continuous development in this field enhances our understanding of ocular surface disorders and paves the way for innovative therapeutic strategies that promise to improve the quality of life for affected patients.[Perspective]This review systematically summarizes the latest advancements in ocular surface organ culture techniques,the functional disorders of ocular surface cells under environmental pollution and dry stress,and the diversified strategies for ocular surface tissue reconstruction.Future research should focus on elucidating the molecular mechanisms underlying environmental and dry stress-induced damage to ocular surface tissues to identify novel therapeutic targets.Optimizing tissue-engineered corneas to enhance their integration and functionality in the host environment,and developing more efficient and safe drug delivery systems to improve treatment outcomes and patient compliance,are crucial.Long-term studies assessing the safety and efficacy of new treatments and their impact on the quality of life for patients are essential.Interdisciplinary collaboration among ophthalmologists,environmental scientists,and material scientists is vital in addressing the complex challenges in this field.Future trends may include a focus on personalized medicine,advances in regenerative medicine such as stem cell therapy and gene editing,and sustainable,eco-friendly approaches to ocular surface treatments.Enhanced funding and resources for research,increased public awareness and education about the impact of environmental factors on ocular health,and strengthened regulatory support for new treatments will also be important.By advancing our understanding and treatment of ocular surface disorders,we can significantly improve ocular health and protect human visual function amid increasing environmental challenges.