Use of Acellular Umbilical Cord-Derived Tissues in Corneal and Ocular Surface Diseases
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
Neobiosis, LLC, UF Innovate Biotechnology Institute, 12085 Research Drive, Alachua, FL 32615, USA
Authors to whom correspondence should be addressed.
Academic Editors: Jeffrey N. Weiss and Steven Levy
Medicines 2021, 8(2), 12; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8020012
Received: 23 December 2020 / Revised: 28 January 2021 / Accepted: 29 January 2021 / Published: 9 February 2021
(This article belongs to the Special Issue Stem Cells in Eye Research and Ophthalmology—Current Advances and Future Directions)
Blood derived products have become a valuable source of tissue for the treatment of ocular surface diseases that are refractory to conventional treatments. These can be obtained from autologous or allogeneic sources (patient’s own blood or from healthy adult donors/umbilical cord blood, respectively). Allogeneic cord blood demonstrates practical advantages over alternatives and these advantages will be discussed herein. Umbilical cord blood (UCB) can be divided, generally speaking, into two distinct products: first, mononuclear cells, which can be used in regenerative ophthalmology, and second, the plasma/serum (an acellular fraction), which may be used in the form of eyedrops administered directly to the damaged ocular surface. The rationale for using umbilical cord serum (UCS) to treat ocular surface diseases such as severe dry eye syndrome (DES), persistent epithelial defects (PED), recurrent epithelial erosions, ocular chemical burns, graft versus host disease (GVHD), among others, is the considerably high concentration of growth factors and cytokines, mimicking the natural healing properties of human tears. Allogeneic serum also offers the opportunity for therapeutic treatment to patients who, due to poor heath, cannot provide autologous serum. The mechanism of action involves the stimulation of endogenous cellular proliferation, differentiation and maturation, which is highly efficient in promoting and enhancing corneal epithelial healing where other therapies have previously failed.