BACKGROUND:Keratitis,chemical injury,trauma,and other diseases often lead to irreparable damage to the corneal tissue,which can cause scars and finally vision loss.Corneal transplantation is the only way for treatment,but is of limit use by the deficiency of donors.Moreover,biosynthetic implants are expensive and complex.Silk fibroin and chitosan are common materials for tissue engineering and have been widely used as bio-scaffold materials.However,the technology applied in corneal repair is still in infant stage.OBJECTIVE:To systemically analyze the literature regarding the application of silk fibroin/chitosan scaffold materials in corneal repair,and to offer new directions and theoretical support for further studies on corneal repair.METHODS:A computer-based search of CNKI,WanFang and PubMed was performed for relevant articles with the keywords of "silk fibroin,chitosan,cornea,keratoprosthesis,scaffold".Then,we traced the development progress of silk fibroin/chitosan scaffolds in corneal repair and summarized its current applications and prospects.RESULTS AND CONCLUSION:In total,178 articles were preliminarily retrieved,and finally,52 eligible articles were reviewed.(1) The silk fibroin/chitosan scaffold for corneal repair has low cytotoxicity and good biocompatibility.(2) This kind of scaffold supplies proper pericellular environmental for corneal cells that is good for hydroelectrolyte exchange.(3) The presence of ABCG2 protein implies that the scaffold offers possibilities of limbal stem cell proliferation.(4) Increasing animal model tests have shown that the scaffold can barely cause an inflammatory reaction of corneal cells,which is highy important to remain the vitreousness of corneal tissues.(5) Because of the deficiency of corneal donors,searching for new artificial materials for corneal repair is the developing direction of corneal transplantation.Silk fibroin chitosan scaffold has huge potential in this area,and it deserves more researches for clinical use in the future.%背景:角膜炎、化学伤、创伤和其他疾病往往导致角膜组织不可逆的损伤,留下纤维瘢痕进而最终导致视力下降甚至视力丧失.角膜移植是唯一的治疗途径,但供体的缺乏限制了其应用,此外其他替代材料制备复杂且价格昂贵.丝素蛋白和壳聚糖是组织工程领域常用的材料,制备成生物支架的技术已日趋成熟,得到了广泛应用,但在角膜修复领域尚处于起步阶段.目的:系统分析丝素蛋白/壳聚糖支架材料应用于角膜修复领域的相关文献,为进一步研究和促进其修复角膜时的临床应用提出新方向和理论支持.方法:以“丝素蛋白,壳聚糖,角膜,角膜修复材料”为中文关键词,以“silk fibroin,chitosan,cornea,keratoprosthesis,scaffold”为英文关键词检索CNKI,万方以及PubMed数据库有关角膜修复材料的相关文献,追踪以丝素蛋白/壳聚糖作为修复材料在角膜组织工程领域的发展过程,并分析其应用现状及前景.结果与结论:初步检索178篇文献,最终纳入52篇符合标准的文献进行综述.①丝素蛋白/壳聚糖支架作为缺损角膜的修复体,细胞毒性低,生物相容性良好;②丝素蛋白/壳聚糖支架为角膜细胞提供了适宜的细胞外环境,有利于角膜细胞的水电解质交换;③ABCG2蛋白的检出,提示支架为角膜缘干细胞的增殖提供了可能;④大量的动物模型实验表明该支架几乎不会引起角膜细胞的炎症反应,这对于维持角膜组织的透明性有重要意义;⑤由于供体角膜的缺乏,寻找新型的人工材料修复损伤角膜是角膜移植领域的发展方向,而丝素蛋白壳/聚糖支架具有巨大的潜力,值得深入研究.
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