Biotechnological application of microvesicle-enriched plasma fraction for corneal regeneration in Fuchs' endothelial dystrophy

BACKGROUND: Fuchs’ endothelial corneal dystrophy (FECD) is a primary disease of the corneal endothelium, characterized by structural modifications of the Descemet’s membrane (DM), including focal excrescences known as guttae, which ultimately lead to edema. In this study, we evaluated the therapeutic potential of microvesicle-enriched plasma fraction for treating FECD and tested their effects on corneal thickening, curvature, and other FECD-like damages in rabbits.METHODS: A total of eight rabbits (16 corneas) were divided into three distinct groups: the negative control group, the positive control group, grouping eyes that underwent FECD induction with deep intrastromal injection of collagenase II, and the treated group, consisting of eyes subjected to FECD induction followed, after seven days, by a daily treatment with microvesicle-enriched plasma fraction for an additional 7 days.RESULTS: Pachymetric and keratometric measurements of the rabbit eyes showed that the deep intrastromal injection of collagenase II induced a significant increase in corneal thickness, while treatment with microvesicle-enriched plasma fraction restored the corneal thickness reaching control group stage. This finding was supported the histopathological examination of corneal sections showing that microvesicle-enriched plasma fraction reduced some FECD-like histological damage by eliminating cysts and reducing the thickening of the DM.CONCLUSIONS: Together, these data offer valuable insights into the role of microvesicle-enriched plasma fraction in corneal regeneration and the repair of histological damage in the rabbit model of FECD, emphasizing their potential as a novel biotechnological application of plasma-derived microvesicles for degenerative corneal diseases, such as FECD.