Background: Corneal ulcers are a serious vision frightening emergency. Even with accurate treatment, patients may suffer
complications as perforation, scarring, cataracts, glaucoma, synechiae, and even loss of vision. Stem cells-based treatment is
considered as a promising approach in corneal ulcer treatment. Now a days, alternative stem cell conditioned medium (CM)
and exosomes (EXs) -based treatment for corneal ulcers are feasible approaches..
Aim: To compare the possible ameliorating effects of stem cells conditioned medium (CM) versus their derived exosomes
(EXs) in corneal ulcer healing.
Materials and Methods: 40 rats were randomly allocated into five groups; the control, corneal ulcer, CM-treated, EXs-treated
and recovery groups; corneas were obtained for biochemical assessment of TNFα, VEGF, MDA and GSH levels and for
histological structure . Corneal damage was assessed by histopathological scoring and immunohistochemical staining.
Results: Corneal ulcer group revealed a significant increase in TNFα, VEGF and MDA levels and also revealed significant
decrease in the GSH level. Histological assessment revealed structural alteration indicating severs corneal damage. Moreover
a significant increase in P53 expression. Interestingly, CM and EXs administration significantly decreased TNFα, VEGF and
MDA levels and increased GSH level. Additionally, there was obvious improvement in histological structure of corneas, and
significant decrease in P53 expression.
Conclusion: To the best of our knowledge, this is the first study to investigate CM versus EXs in treatment of corneal ulcer.
Both EXs and CM ameliorate the healing of corneal ulcers with having a superior amelioration effect to EXs. The superior
effect of EXs could be attributed to their properties as anti-apoptotic, anti-inflammatory, and anti-oxidative.