Regenerative medicine in ocular diseases has shown major advances over
the last few years. The most critical progress has been achieved for diseases of the
cornea and retina, for which the transplantation of local and differentiated stem cells
(SC) is being studied. The treatment of the cornea is aimed at restoring corneal clarity
after severe injuries and diseases. Corneal blindness is the fourth leading cause of
visual impairment worldwide, and access to corneal transplantation surgery, the main
treatment for corneal blindness, is difficult given the shortage of tissue donors. For this
reason, the development of alternative therapies using SC is of special interest. The
corneal endothelium (CE) is the innermost layer of the cornea, and it is in contact with
the aqueous humor. It consists of a monolayer of polygonal cells which maintains an
optimal hydration state and clarity in the cornea through an active ATP-Na/K pump.
This tissue possesses limited mitotic ability. Therefore, when major injury occurs, it
can only be treated with a corneal graft. Recent advances have shown potential in
harvesting corneal endothelial cells (CECs) in order to obtain enough quantities to
perform a transplant. However, these strategies are still limited by the need for tissue
donors, as well as by the long time lapses required to proliferate the CECs. SC isolated
from different sources, including adipose tissue and dental pulp, are being investigated
in regenerative medicine given their potential to differentiate into other cell lines. For
use in CE restoration, a broad analysis must be performed, taking into account CE
embryological pathways, current reports in SC differentiation into ocular tissues, and
recently available bioinformatic tools, which can be used for differentiation assays.
This review encompasses the present knowledge of CE development and
embryological molecular signaling, recent reports in SC differentiation into CE, and the
available bioinformatic tools used to direct in vitro SC differentiation.
Keywords: Bioinformatics, Bone marrow stem cell, Cornea, Corneal
endothelium, Dental pulp stem cell, Differentiation, Embryogenesis, Embryonic
stem cell, Growth factors, Induced pluripotent cells, Mesenchymal stem cell.
