背景:在角膜碱烧伤治疗中,传统治疗方法存在多种局限,尤其在控制炎症、预防新生血管形成和抑制角膜瘢痕化方面表现不佳.天然材料、合成材料或复合材料为治疗提供了多元化的选择,然而生物材料促进角膜碱烧伤修复的相关机制尚未形成系统深入的认识.目的:对目前生物材料促进角膜碱烧伤修复的国内外研究进行梳理,综述生物材料修复角膜碱烧伤的机制及其应用途径.方法:第一作者以"角膜,碱烧伤,羊膜,透明质酸,胶原,壳聚糖,高分子材料""Amniotic membrane,Hyaluronic acid,Collagen,Chitosan,Polymer,Cornea,Alkali burn"为关键词在PubMed、Web of Science、中国知网和万方文献数据库内检索,根据纳入标准和排除标准,最终纳入符合要求的76篇文献进行综述.结果与结论:①在角膜碱烧伤修复领域,羊膜、透明质酸、胶原、壳聚糖和可降解高分子材料等生物材料被广泛研究和应用,这些生物材料各有其特点和优缺点,在不同方面都有所突出.②首先,羊膜因含丰富的生物活性因子而被认为是最有前景的生物材料之一,其生物相容性良好,并且能够调节角膜炎症反应,但是存在供体短缺和易感染疾病的问题.③透明质酸具有良好的保湿性和生物相容性,并且能够提高角膜细胞的生存率和增加角膜透明度.④胶原具有良好的生物相容性和支架结构,能够促进角膜细胞的黏附和增殖,促进角膜组织结构的重建.⑤壳聚糖具有良好的生物相容性和可降解性,可作为载体用于药物递送和细胞移植.⑥可降解高分子材料具有较好的降解可控性,可为角膜碱烧伤的修复提供良好的支持和递送平台,但其稳定性和生物相容性仍需进一步研究.⑦综合来看,目前还没有一种生物材料能够完全解决角膜碱烧伤的修复问题,每种生物材料都有其特定的适用场景和局限性.⑧未来的研究方向应该是通过进一步改进生物材料的性能和结构,探索更有效的组合应用方式,以及深入了解生物材料与角膜组织的相互作用机制,以提高角膜碱烧伤的治疗效果和患者的生活质量.
Action mechanisms and application pathways of biomaterials in promoting corneal alkali burn repair
BACKGROUND:Traditional treatments for corneal alkali burns are limited,especially in controlling inflammation,preventing neovascularization,and inhibiting corneal scarring.Natural,synthetic,or composite materials provide a wide range of treatment options.However,the mechanism by which biomaterials promote corneal alkali burn repair has not yet been systematically understood.OBJECTIVE:To summarize the current research on biomaterials in promoting corneal alkali burn repair in and outside China,and review the mechanism and application of biomaterials in repairing corneal alkali burn.METHODS:The first author searched"cornea,alkali burn,amniotic membrane,hyaluronic acid,collagen,chitosan,polymer materials"as Chinese keywords and"amniotic membrane,hyaluronic acid,collagen,chitosan,polymer,cornea,alkali burn"as English keywords in PubMed,Web of Science,CNKI,and WanFang databases.According to inclusion and exclusion criteria,76 eligible articles were finally included for review.RESULTS AND CONCLUSION:(1)In the field of corneal alkali burn repair,biomaterials such as amniotic membrane,hyaluronic acid,collagen,chitosan,and degradable polymer materials have been widely studied and applied.Each of these biomaterials has its own characteristics,advantages,and disadvantages,and stands out in different aspects.(2)First and foremost,amniotic membranes are considered one of the most promising biomaterials due to their abundance of bioactive factors.They are biocompatible and can regulate the corneal inflammatory response.However,there are issues with donor shortages and susceptibility to infectious diseases.(3)Hyaluronic acid has good moisturizing properties and biocompatibility,and is able to improve the survival rate of corneal cells and increase corneal transparency.(4)The good biocompatibility and scaffold structure of collagen enable the promotion of corneal cell adhesion and proliferation,as well as the reconstruction of corneal tissue structure.(5)Chitosan is recognized for its good biocompatibility and degradability,making it suitable as a carrier for drug delivery and cell transplantation.(6)Degradable polymer materials have good controllability over degradation and can provide a good support and delivery platform for the repair of corneal alkali burns,but further research is needed on their stability and biocompatibility.(7)Overall,there is currently no single biomaterial that can completely address the repair problem of corneal alkali burns,and each biomaterial has its own specific application scenarios and limitations.(8)Future research directions should focus on further improving the properties and structure of biomaterials,exploring more effective combination applications,and deeply understanding the interaction mechanism between biomaterials and corneal tissue,in order to enhance the therapeutic effect of corneal alkali burns and the quality of life of patients.