Ex vivo expansion of limbal epithelial stem cells: amniotic membrane serving as a stem cell niche

Surv Ophthalmol. 2003 Nov-Dec;48(6):631-46. doi: 10.1016/j.survophthal.2003.08.003.


Identification, maintenance, and expansion of stem cells for subsequent transplantation has become a new strategy for treating many diseases in most medical subspecialties. The stem cells of the corneal epithelium are located in the limbal basal layer and are the ultimate source for constant corneal epithelial renewal. Like those in other tissues, limbal stem cells are supported by a unique stromal microenvironment called the stem cell niche, which consists of certain extracellular matrix components, cell membrane-associated molecules, and cytokine dialogues. Destructive loss of limbal stem cells or dysfunction of their stromal environment renders many corneas with a clinical entity called limbal stem cell deficiency, which is characterized by variable extents of conjunctival ingrowth depending on the severity of limbal damage. A new strategy of treating limbal stem cell deficiency is to transplant a bio-engineered graft by expanding limbal epithelial stem cells ex vivo on amniotic membrane. This review summarizes the published literature data collectively explaining how amniotic membrane is an ideal biological substrate that can help maintain and support the expansion of limbal epithelial stem cells.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Amnion*
  • Biomarkers / analysis
  • Cell Culture Techniques / methods
  • Cell Differentiation
  • Cell Division
  • Corneal Diseases / surgery
  • Epithelial Cells / cytology*
  • Epithelial Cells / physiology
  • Humans
  • Limbus Corneae / cytology*
  • Stem Cell Transplantation
  • Stem Cells / cytology*
  • Stem Cells / physiology


  • Biomarkers