生物材料促进角膜碱烧伤修复的作用机制和应用途径

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.