CN107007879A - A kind of active artificial cornea and preparation method thereof - Google Patents
A kind of active artificial cornea and preparation method thereof Download PDFInfo
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- CN107007879A CN107007879A CN201710149500.5A CN201710149500A CN107007879A CN 107007879 A CN107007879 A CN 107007879A CN 201710149500 A CN201710149500 A CN 201710149500A CN 107007879 A CN107007879 A CN 107007879A
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- artificial cornea
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Abstract
Description
技术领域technical field
本发明涉及眼科医疗器械用品,尤其涉及一种活性人工角膜及其制备方法。The invention relates to an ophthalmic medical device, in particular to an active artificial cornea and a preparation method thereof.
背景技术Background technique
角膜疾病是目前全球主要致盲性眼病,占眼科致盲性眼病的第二位。我国有角膜病患者3237万人,已经致盲患者已达400多万人,且随着创伤、化学伤、感染等患者增多,致盲群体每年以10多万增加。治疗角膜疾病的最佳方法是角膜移植,在这些患者当中,绝大多数人可以通过角膜移植重见光明。但由于供体角膜材料来源的严重紧缺,每年能够进行角膜移植的患者仅为5000人左右,只占到实际需要手术病例的2%,远远无法满足病患需要。Corneal disease is currently the main blinding eye disease in the world, accounting for the second place in ophthalmology blinding eye disease. There are 32.37 million patients with corneal diseases in my country, and more than 4 million patients have been blinded. With the increase of trauma, chemical injury, infection and other patients, the number of blind patients is increasing by more than 100,000 every year. The best way to treat corneal diseases is corneal transplantation. Among these patients, the vast majority of people can regain their sight through corneal transplantation. However, due to the serious shortage of donor corneal materials, only about 5,000 patients can undergo corneal transplantation each year, accounting for only 2% of the cases that actually require surgery, which is far from meeting the needs of patients.
角膜疾病不仅使患者丧失劳动能力,降低生活质量,造成身体与精神上的损害,也对家庭造成严重的损失和经济负担,对社会也造成极大不利影响。因此,角膜替代物---人工角膜成为治疗此类疾病有效、可行的手术途径,寻求理想的人工角膜一直是众多患者的梦想,也是科技工作者的努力方向。Corneal diseases not only make patients lose their ability to work, reduce the quality of life, cause physical and mental damage, but also cause serious losses and economic burdens to families, and have a great adverse impact on society. Therefore, the corneal substitute---artificial cornea has become an effective and feasible surgical approach to treat such diseases. Seeking an ideal artificial cornea has always been the dream of many patients, and it is also the direction of efforts of scientific and technological workers.
人工角膜是用异质成形材料制成的一种特殊屈光装置,通过手术植入患眼,取代混浊病变的角膜组织,从而达到保持眼球完整、去除感染病灶、恢复角膜透明、获得视觉功能等目的。The artificial cornea is a special refractive device made of heterogeneous materials. It is surgically implanted into the affected eye to replace the cloudy and diseased corneal tissue, so as to maintain the integrity of the eyeball, remove infection lesions, restore corneal transparency, and obtain visual functions, etc. Purpose.
目前临床上获得应用的人工角膜都是国外产品,具体包括Boston人工角膜、Pintcueei人工角膜、Osteo-Odonto人工角膜、Alphacor人工角膜,以及Strampelli人工角膜等。尚未有获得广泛临床应用的我国自主的人工角膜产品。这些国外产品的特点如下:(1)Boston人工角膜(Dohlman型)需要安装在一新鲜的供体角膜植片上,即还是需要供体的角膜才能完成治疗;患者在术后需配戴软性角膜接触镜片,以防眼部泪液蒸发以及减少人工角膜的凹陷,从而减少供体角膜支架坏死和融解的可能性;人工角膜纤维渗出膜形成、青光眼、持续性上皮缺损、无菌性玻璃体炎、眼内炎及视网膜脱离是Boston人工角膜术后最常见的并发症,其中,人工角膜纤维渗出膜形成的发病率更高达24~65%。而且,部分患者术后还会发生结膜瓣漏水、角膜前基质变薄溶解等并发症,甚至导致人工角膜排出。(2)俄罗斯产MICOF人工角膜应用于眼部化学伤有一定疗效,但存在手术方法较复杂、并发症较多等问题;(3)以Chirila Pros人工角膜为基础进行自主研发改良型聚羟乙基丙烯酸甲酯-聚甲基丙烯酸甲酯一体化人工角膜,目前尚处在动物试验阶段。At present, the artificial corneas that have been clinically applied are all foreign products, including Boston artificial corneas, Pintcueei artificial corneas, Osteo-Odonto artificial corneas, Alphacor artificial corneas, and Strampelli artificial corneas. There is no independent artificial cornea product in my country that has been widely used clinically. The characteristics of these foreign products are as follows: (1) Boston artificial cornea (Dohlman type) needs to be installed on a fresh donor cornea graft, that is, the donor cornea is still needed to complete the treatment; the patient needs to wear a soft cornea after the operation Contact lenses to prevent tear evaporation from the eye and reduce depression of the artificial cornea, thereby reducing the possibility of donor corneal stent necrosis and melting; artificial corneal fibrous exudate membrane formation, glaucoma, persistent epithelial defects, aseptic vitritis, Endophthalmitis and retinal detachment are the most common complications after Boston artificial cornea, and the incidence rate of artificial corneal fibrous exudate membrane is as high as 24-65%. Moreover, in some patients postoperatively, complications such as leakage of the conjunctival flap, thinning and dissolution of the anterior corneal stroma, and even the discharge of the artificial cornea may occur. (2) The MICOF artificial cornea produced in Russia has a certain effect on chemical injury of the eye, but there are problems such as complicated surgical methods and many complications; (3) self-developed improved polyethylene glycol based on the Chirila Pros artificial cornea The methyl acrylate-polymethyl methacrylate integrated artificial cornea is still in the stage of animal testing.
从目前应用的结果来看,无论是Boston、Osteo或Alphacor人工角膜,其人工材料与机体的生物相容性、手术过程的复杂性、术后的长期疗效、术后各种并发症的防治、术后最佳视功能的维持等都尚待提高,这些问题是角膜盲患者复明的最大障碍,亦是患者术后视力的最大威胁,也极大地限制了人工角膜的进一步发展及广泛应用。随着社会经济的迅速发展,人们对健康的关注度也越来越高,医疗器械的发展必须与现代科技相结合,跟上时代发展的步伐,才能满足人们日益增长的对治疗效果的需求。Judging from the results of current applications, whether it is Boston, Osteo or Alphacor artificial cornea, the biocompatibility between the artificial material and the body, the complexity of the operation process, the long-term curative effect after operation, the prevention and treatment of various postoperative complications, The maintenance of optimal postoperative visual function still needs to be improved. These problems are the biggest obstacle to the vision recovery of corneal blind patients, and also the biggest threat to the postoperative visual acuity of patients. They also greatly limit the further development and wide application of artificial corneas. With the rapid development of social economy, people pay more and more attention to health. The development of medical equipment must be combined with modern technology to keep pace with the development of the times in order to meet people's growing demand for therapeutic effects.
目前,在人工角膜方面,中国知识产权局授权了发明专利18项,公开发明专利22项,例如:CN1141067C公开了一种用溶胀聚合粒子滤出法制备人工角膜的方法,通过标准筛筛取成孔剂,将生物相容性聚合物用四氢呋喃溶解制成饱和溶液,再与成孔剂搅拌混合后灌注于环形模具中制得的中空圆柱半成品,再将引发剂、交联剂、生物相容性聚合物单体的混合液倒入半成品中进行反应,然后把已成型的人工角膜毛坯切割、打磨与离子水浸泡,得到人工角膜。At present, in terms of artificial cornea, the China Intellectual Property Office has authorized 18 invention patents and 22 public invention patents. Pore agent, the biocompatible polymer is dissolved in tetrahydrofuran to make a saturated solution, then mixed with the pore forming agent and then poured into the hollow cylindrical semi-finished product made in the ring mold, and then the initiator, crosslinking agent, biocompatible Pour the mixture of permanent polymer monomers into the semi-finished product for reaction, and then cut, polish and soak the artificial cornea blank to obtain the artificial cornea.
CN1128096C公开了一种生物诱导型活性人工角膜的制备方法,具体包括将壳聚糖溶于酸溶液,将胶原和透明质酸溶于水;将壳聚糖酸溶液与胶原和透明质酸的水溶液在室温下搅拌;得到的混合液中加入碳二亚胺交联剂、成纤维细胞生长因子,表皮细胞生长因子和细胞转化生长因子,再充分混合半小时;将得到的混合液注入预制的角膜模具中,注满角膜模具后将其放入烘箱内烘干后取出得角膜制品;用清水浸泡清洗烘干后所得的角膜制品以去除残留杂质,并使其在水中放置,制得了生物诱导型活性人工角膜。CN1128096C discloses a preparation method of biologically induced active artificial cornea, which specifically comprises dissolving chitosan in an acid solution, dissolving collagen and hyaluronic acid in water; dissolving chitosan acid solution and an aqueous solution of collagen and hyaluronic acid Stir at room temperature; add carbodiimide cross-linking agent, fibroblast growth factor, epidermal growth factor and cell transforming growth factor to the obtained mixture, and mix thoroughly for half an hour; inject the obtained mixture into the prefabricated cornea In the mold, fill the corneal mold, put it in an oven and dry it, and then take it out to obtain a corneal product; soak the corneal product obtained after washing and drying to remove residual impurities, and place it in water to obtain a biologically induced Active artificial cornea.
CN100340309C公开了一种生物诱导型活性人工角膜,组分包括壳聚糖0.5%~3%、胶原0.5%~3%、透明质酸0.1%~0.5%、水93.5%~98.8%,为助于刺激自体生长因子富集速度,在材料上整合角膜生长因子。CN100340309C discloses a biologically induced active artificial cornea, the components include chitosan 0.5% to 3%, collagen 0.5% to 3%, hyaluronic acid 0.1% to 0.5%, water 93.5% to 98.8%, in order to help Stimulate the enrichment speed of autologous growth factor, and integrate corneal growth factor on the material.
CN102920532B公开了一种人工角膜,包括支架和镜柱,支架沿一球面延展,中心处设有孔状的由医用甲基丙烯酸甲酯制成的支架座,内壁设置有内螺纹;镜柱的径向截面为圆形;包括依次连接且共轴设置的导入段、螺纹段和外露段;螺纹段的周面带有与所述内螺纹配合的外螺纹,支架与所述镜柱配合时,凸面的凸出方向与所述支架的凸出方向一致。CN102920532B discloses a kind of artificial cornea, comprises bracket and mirror column, and bracket extends along a spherical surface, and the center is provided with the bracket seat made of medical methyl methacrylate hole-like, and internal thread is arranged on inner wall; The diameter of mirror column The cross-section is circular; it includes a lead-in section, a threaded section and an exposed section that are sequentially connected and arranged coaxially; the peripheral surface of the threaded section has an external thread that cooperates with the internal thread, and when the bracket is matched with the mirror column, the convex surface The protruding direction of the bracket is consistent with the protruding direction of the bracket.
CN104368046B公开了一种纤维增强型载药水凝胶人工角膜裙边支架及其制备方法,裙边支架由亲水性水凝胶、纤维和可生物降解载药微球组成,纤维的含量为6~10%、可生物降解载药微球的含量为8~15%、亲水性水凝胶的含量为75~86%,纤维无序地分布在亲水性水凝胶中。CN104368046B discloses a fiber-reinforced drug-loaded hydrogel artificial corneal skirt bracket and a preparation method thereof. The skirt bracket is composed of hydrophilic hydrogel, fibers and biodegradable drug-loaded microspheres, and the fiber content is 6-6 10%, the content of the biodegradable drug-loaded microspheres is 8-15%, the content of the hydrophilic hydrogel is 75-86%, and the fibers are randomly distributed in the hydrophilic hydrogel.
CN 1314461C公开了一种生物活性人工角膜,包括光学中心和周边支架,周边支架是由生物活性钙盐、高分子聚乙烯醇、溶剂制备,先将聚乙烯醇溶于溶剂,加入生物活性钙盐混合均匀得混合溶液后加入致孔剂得混合物,将混合物置于模具成型为中空圆柱体周边支架,在周边支架内腔中成形光学中心后将其在去离子水中除去残留的溶剂、致孔剂和其它杂质。CN 1314461C discloses a bioactive artificial cornea, which includes an optical center and a peripheral frame. The peripheral frame is prepared from bioactive calcium salt, macromolecular polyvinyl alcohol and a solvent. Firstly, the polyvinyl alcohol is dissolved in the solvent, and the bioactive calcium salt is added Mix evenly to obtain a mixed solution, add a porogen to the mixture, place the mixture in a mold to form a hollow cylinder peripheral bracket, form an optical center in the inner cavity of the peripheral bracket, and remove the residual solvent and porogen in deionized water and other impurities.
CN100484497C公开了一种具有生物活性的人工角膜的制备方法,以动物角膜基质为材料,采用酶消化、反复冻融、洗涤、Co-60辐照、复合促进角膜细胞生长或/和阻止局部病变发展的功能组分的步骤制备获得人工角膜。CN100484497C discloses a preparation method of a biologically active artificial cornea, using animal corneal stroma as material, adopting enzyme digestion, repeated freezing and thawing, washing, Co-60 irradiation, and compounding to promote the growth of corneal cells or/and prevent the development of local lesions The artificial cornea is prepared through the steps of functional components.
CN101380486B提供了一种活性再生人工角膜移植物及其制备方法,组成成分包括壳聚糖、胶原、硫酸软骨素、聚乙二醇、聚乙烯醇和、三蒸水,还包括适量角膜细胞生长因子、纤维连接蛋白和层粘连蛋白。将壳聚糖、胶原和硫酸软骨分别溶于盐酸、醋酸和水,然后按比例将各组分在室温下搅拌混匀后注入模具中烘干,再用水浸泡清洗烘干后获得人工角膜制品。CN101380486B provides a kind of active regenerative artificial corneal graft and its preparation method, the composition comprises chitosan, collagen, chondroitin sulfate, polyethylene glycol, polyvinyl alcohol and, triple distilled water, also includes appropriate amount of corneal cell growth factor, Fibronectin and laminin. Dissolving chitosan, collagen and sulfated cartilage in hydrochloric acid, acetic acid and water respectively, stirring and mixing the components in proportion at room temperature, pouring them into molds for drying, soaking in water, cleaning and drying to obtain artificial corneal products.
CN101843923B公开了一种利用新鲜羊膜制备组织工程人工角膜内皮载体支架的方法,先采用硫酸妥布霉素液对新鲜羊膜进行浸泡消毒,经胰蛋白酶-EDTA消化液倒置消化后,用细胞刮刀轻刮羊膜上皮面以全部去除残留上皮细胞,获得去上皮层羊膜,平铺在培养板孔中牢固干贴后,用去上皮层羊膜专用包被液进行包被处理,吸出包被液晾干后即可作为组织工程人工角膜内皮的载体支架使用。CN101843923B discloses a method for preparing a tissue-engineered artificial corneal endothelial carrier support using fresh amniotic membrane. First, the fresh amniotic membrane is soaked and sterilized in tobramycin sulfate solution, and after being inverted and digested by trypsin-EDTA digestion solution, lightly scraped with a cell scraper The epithelial surface of the amniotic membrane is completely removed from the residual epithelial cells to obtain the amniotic membrane without the epithelial layer. It can be used as a carrier scaffold for tissue engineering artificial corneal endothelium.
CN102580147B公开了一种具有抗菌活性的人工角膜,包括多孔周边支架部与光学中心部,支架部包括具有抗菌性的壳聚糖衍生物、聚乙烯醇、纳米磷酸盐,光学中心部包括聚乙烯醇水凝胶、聚甲基丙烯酸羟乙酯水凝胶。CN102580147B discloses an artificial cornea with antibacterial activity, comprising a porous peripheral stent and an optical center, the stent includes antibacterial chitosan derivatives, polyvinyl alcohol, and nano-phosphate, and the optical center includes polyvinyl alcohol Hydrogel, polyhydroxyethyl methacrylate hydrogel.
CN102755204B公开了一种新型组装式人工角膜,包括中央光学部分和固定支架部分,光学部分包括球盖体和柱形透明体,球盖体的上表面为球面,下表面与透明体的上表面连接,支架部分的中部设有通孔,通孔侧壁上设有固定环;透明体通过通孔贯穿固定支架部分。CN102755204B discloses a novel assembled artificial cornea, which includes a central optical part and a fixed support part. The optical part includes a spherical cover and a cylindrical transparent body. The upper surface of the spherical cover is a spherical surface, and the lower surface is connected to the upper surface of the transparent body. , the middle part of the support part is provided with a through hole, and a fixing ring is provided on the side wall of the through hole; the transparent body penetrates through the through hole to fix the support part.
CN103830021B公开了一种人工角膜及其制备方法,包括球冠状的角膜体光学功能区和球带状的支撑区,光学功能区与支撑区相互结合,其接合部为相互交织融合的一体式过渡结构;其中,角膜体光学功能区由具有良好生物相容性和透光性的聚羟乙基丙烯酸甲酯水凝胶制成,支撑区由经丝素纤维均匀增强的PHEMA多孔支架制成,两者之间自然一体化连接。CN103830021B discloses an artificial cornea and its preparation method, which includes a spherical corneal body optical functional area and a spherical band-shaped support area, the optical functional area and the support area are combined with each other, and the junction is an integrated transitional structure that interweaves and fuses with each other ; Among them, the optical functional area of the corneal body is made of polyhydroxyethyl acrylate hydrogel with good biocompatibility and light transmission, and the support area is made of PHEMA porous scaffold uniformly reinforced by silk fibers. The natural integration connection between them.
CN104436302B公开了一种纳米超薄生物膜差异修饰前后表面的人工角膜及制作方法,光学部的前表面依次反复沉积有聚阳离子层及表皮生长因子层;光学部的后表面由内而外依次反复沉积有聚阳离子层以及HA层,最外层为HA层,其制备方法包括使人工角膜表面荷以负电荷;使聚阳离子和表皮生长因子交替吸附在人工角膜前表面;使聚阳离子和HA交替吸附在人工角膜后表面,最后再干燥、密封包装。CN104436302B discloses a nano-ultra-thin biofilm differentially modified artificial cornea on the front and rear surfaces and its production method. The front surface of the optical part is repeatedly deposited with a polycation layer and an epidermal growth factor layer; the rear surface of the optical part is repeatedly deposited from the inside to the outside. A polycation layer and an HA layer are deposited, and the outermost layer is an HA layer. The preparation method includes making the surface of the artificial cornea negatively charged; making the polycation and epidermal growth factor alternately adsorbed on the front surface of the artificial cornea; making the polycation and HA alternately Adsorbed on the posterior surface of the artificial cornea, finally dried and sealed.
CN106139249A公开了一种多元聚合物人工角膜的制备方法,包括经过合成多元共聚材料、制备角膜三维支架、使用3D生物打印机打印角膜形状的三维立体支架、利用ECM对三维支架进行功能修饰、残余角膜微组织化方法的构建等步骤,制备了人工角膜。CN106139249A discloses a preparation method of a multi-component polymer artificial cornea, which includes synthesizing multi-component copolymer materials, preparing a three-dimensional corneal bracket, using a 3D bioprinter to print a three-dimensional bracket in the shape of the cornea, using ECM to functionally modify the three-dimensional bracket, and residual corneal microstructure. The artificial cornea was prepared through steps such as the construction of the tissue method.
CN105688282A公开了一种在体诱导细胞化并快速透明的新型生物人工角膜,采用的制备方法包括通过角膜原材料获取、角膜支架制备、角膜支架深度修饰、角膜深度灭活去热原、角膜辐照灭菌、角膜内皮细胞的培养和种植等步骤构建了不同厚度深、浅板层生物人工角膜和全层生物人工角膜。CN105688282A discloses a new type of bioartificial cornea that induces cellularization in vivo and is rapidly transparent. The preparation method adopted includes acquisition of corneal raw materials, preparation of corneal stents, depth modification of corneal stents, deep corneal inactivation and depyrogenation, and corneal irradiation. Bacteria and corneal endothelial cells were cultured and planted to construct deep and shallow lamellar bioartificial corneas and full-thickness bioartificial corneas.
因为,从本质上来看,要获得能够临床应用且稳定的人工角膜,需要解决两大难题:Because, in essence, in order to obtain a clinically applicable and stable artificial cornea, two major problems need to be solved:
(1)人工角膜周边与人眼的优异生物相容性:(1) Excellent biocompatibility between artificial cornea and human eye:
许多人工制作的角膜材料,由于采用高分子材料、金属或无机材料,导致生物相容性不足,产生免疫反应等,引起炎症,发生角膜溶解、人工角膜脱出,其根本原因是人工材料不能与宿主角膜产生理想的生物愈合。Many artificial corneal materials, due to the use of polymer materials, metals or inorganic materials, lead to insufficient biocompatibility, immune reactions, etc., causing inflammation, corneal dissolution, and prolapse of the artificial cornea. The fundamental reason is that artificial materials cannot interact with the host. The cornea produces ideal biological healing.
(2)保持人工角膜中心(贴合瞳孔)部位的光学透明性与生物学惰性:一些材料克服了生物相容性的不足,且与人眼能够紧密贴合,但是,由于细胞长入、新生血管长入,或眼睛中其他物质的粘附与沉积,造成前后膜的形成,使角膜材料在一段时间后,中心部位会逐渐失去光学透明,无法维持最佳视功能,致使人工角膜材料失效。(2) Maintain the optical transparency and biological inertness of the center of the artificial cornea (fitting the pupil): some materials overcome the lack of biocompatibility and can fit closely with the human eye. However, due to cell growth and newborn The growth of blood vessels, or the adhesion and deposition of other substances in the eye, causes the formation of anterior and posterior membranes, so that the central part of the corneal material will gradually lose optical transparency after a period of time, and cannot maintain the best visual function, resulting in the failure of the artificial corneal material.
但是,从目前已有的专利及产品来说,普遍存在如下不足:However, from the existing patents and products, there are generally the following deficiencies:
(1)现有专利较少考虑到人工角膜周边的生物相容性等问题,采用能够促进周边角膜细胞生长的活性成分较少,同时也未考虑到采用梯度的水凝胶作为角膜周边材料的重要性;(1) The existing patents seldom take into account the biocompatibility of the artificial cornea periphery, use less active ingredients that can promote the growth of peripheral corneal cells, and do not consider the use of gradient hydrogel as the corneal peripheral material importance;
(2)多数人工角膜采用一体化设计,中央光学部位也复合了水凝胶成分,这样就很容易造成一些细胞与新生血管长入,或眼睛中其他物质的粘附与沉积,造成前后膜的形成,逐渐失去透明性;(2) Most artificial corneas adopt an integrated design, and the central optical part is also compounded with hydrogel components, which can easily cause some cells and new blood vessels to grow in, or the adhesion and deposition of other substances in the eye, resulting in the anterior and posterior membranes. form, gradually lose their transparency;
(3)现有的人工角膜专利中,所设计的角膜的中央部位都没有采用生物惰性化处理。(3) In the existing artificial cornea patents, the central part of the designed cornea has not been treated with biological inertization.
发明内容Contents of the invention
为了克服现有技术的缺点与不足,本发明的首要目的在于提供一种活性人工角膜。本发明提供了一种具有中央部分光学透明,周边生物活性的新型人工角膜,通过梯度紫外光辐照聚合技术制备中央光学透明,周边具有梯度水凝胶特性的人工角膜基材,再采用纳米涂层技术,在人工角膜基材中央部位(内外面)进行聚偏二氟乙烯、四氟甲烷、七氟丙烷的涂层与等离子体处理,形成惰性表面,进一步对基材周边进行胶原接枝、小分子多肽和bFGF诱导活化,使基材生物活性化与组织工程化,最后获得中央光学性质优异、周边生物相容性好、结构简单、手术方便并且能够长期稳定存在而不脱出的活性人工角膜。In order to overcome the shortcomings and deficiencies of the prior art, the primary purpose of the present invention is to provide an active artificial cornea. The present invention provides a new type of artificial cornea with optical transparency in the center and biological activity in the periphery. The artificial cornea base material with optical transparency in the center and gradient hydrogel characteristics in the periphery is prepared by gradient ultraviolet irradiation polymerization technology, and then nano-coating Coating and plasma treatment of polyvinylidene fluoride, tetrafluoromethane, and heptafluoropropane are carried out on the central part (inside and outside) of the artificial cornea substrate to form an inert surface, and collagen grafting and small molecule Peptides and bFGF induce activation, bioactivate the substrate and engineer the tissue, and finally obtain an active artificial cornea with excellent central optical properties, good peripheral biocompatibility, simple structure, convenient operation, and long-term stable existence without prolapse.
本发明的另一目的在于提供一种上述活性人工角膜的制备方法。Another object of the present invention is to provide a method for preparing the above active artificial cornea.
本发明的目的通过下述技术方案实现:The object of the present invention is achieved through the following technical solutions:
一种活性人工角膜,该人工角膜为含梯度组分的一体式合成高分子聚合物水凝胶结构,包括生物惰性的中央光学部分与生物活性的周边部分。An active artificial cornea is a one-piece synthetic polymer hydrogel structure with gradient components, including a biologically inert central optical part and a biologically active peripheral part.
所述的高分子聚合物为丙烯酸衍生物的聚合物,具体包括甲基丙烯酸甲酯的聚合物,甲基丙烯酸羟乙酯-丙烯酸的共聚物。The high molecular polymer is a polymer of acrylic acid derivatives, specifically including a polymer of methyl methacrylate and a copolymer of hydroxyethyl methacrylate-acrylic acid.
所述的梯度成分是指组成整个人工角膜的高聚物在不同部位的含量呈梯度分布,具体为中央光学部位,即贴近瞳孔位置的人工角膜,其成分为纯PMMA(甲基丙烯酸甲酯的聚合物,即:聚甲基丙烯酸甲酯),直径为5毫米;离开中央部位,其PMMA含量逐渐降低,P(HEMA-AAS)(甲基丙烯酸羟乙酯-丙烯酸的共聚物)的含量逐渐增加,到周边时,PMMA含量为0,全部为P(HEMA-AAS),梯度的变化为半径每增大0.5毫米,PMMA含量下降15%,P(HEMA-AAS)的含量增加15%。Described gradient composition means that the content of the high polymer that forms the whole artificial cornea is distributed in a gradient in different parts, specifically the central optical part, that is, the artificial cornea close to the pupil position, and its composition is pure PMMA (methyl methacrylate polymer, namely: polymethyl methacrylate), with a diameter of 5 mm; away from the central part, its PMMA content gradually decreases, and the content of P (HEMA-AAS) (copolymer of hydroxyethyl methacrylate-acrylic acid) gradually decreases. Increase, when reaching the periphery, the PMMA content is 0, all are P(HEMA-AAS), and the change of the gradient is that every time the radius increases by 0.5 mm, the PMMA content decreases by 15%, and the P(HEMA-AAS) content increases by 15%.
所述的生物惰性的中央光学部分的成分为聚合物PMMA,上面再涂覆透明含氟化合物,得到既可保持光学透明性,也具备生物惰性的光学部分。The composition of the biologically inert central optical part is the polymer PMMA, which is then coated with a transparent fluorine-containing compound to obtain an optical part that can not only maintain optical transparency but also have biological inertness.
所述的涂覆透明含氟化合物,首先,在聚合物PMMA上涂覆50~200纳米的聚偏二氟乙烯涂层,形成纳米氟塑料涂层,然后采用等离子技术,在该涂层上进一步涂覆30~80纳米的四氟甲烷、七氟丙烷涂层,通过双层涂覆产生生物惰性层。For the coating of transparent fluorine-containing compounds, at first, a polyvinylidene fluoride coating of 50 to 200 nanometers is coated on the polymer PMMA to form a nano-fluoroplastic coating, and then plasma technology is used to further coat the coating on the coating. Coating tetrafluoromethane, heptafluoropropane coatings of 30-80 nanometers, and producing a biologically inert layer by double-layer coating.
所述的生物活性的周边部分,其主体由P(HEMA-AAS)水凝胶组成,其中含有贯穿的孔洞结构,其部分通过接枝与分子复合,负载有生物活性成分。The main body of the biologically active peripheral part is composed of P(HEMA-AAS) hydrogel, which contains a penetrating hole structure, part of which is compounded with molecules through grafting, and is loaded with biologically active components.
所述的孔洞结构是通过准分子激光加工技术加工获得,该孔洞孔径为160~200纳米,孔分布在靠外径部位密度大,靠中央部分孔洞少。The hole structure is obtained by excimer laser processing technology, and the hole diameter is 160-200 nanometers, and the hole distribution is denser near the outer diameter, and the hole is less near the central part.
所述的通过接枝与分子复合,负载有生物活性成分:先在水凝胶主体接枝胶原蛋白,然后进行小分子多肽的自组装,再在多肽表面复合上生长因子。Said grafting and compounding of molecules, loaded with bioactive components: first graft collagen on the main body of the hydrogel, then carry out self-assembly of small molecule polypeptides, and then compound growth factors on the surface of the polypeptides.
所述的小分子多肽是V6D2(含缬氨酸及天冬氨酸的小分子肽)与ALPs(含丙氨酸、亮氨酸、脯氨酸和丝氨酸的小分子肽)两种肽的复合物。The small molecular polypeptides are V 6 D 2 (small molecular peptides containing valine and aspartic acid) and ALPs (small molecular peptides containing alanine, leucine, proline and serine). peptide complexes.
所述的生长因子为bFGF和EGF等中的至少一种。其中,bFGF是指碱性成纤维细胞生长因子,EGF是指表皮细胞生长因子。The growth factor is at least one of bFGF, EGF and the like. Wherein, bFGF refers to basic fibroblast growth factor, and EGF refers to epidermal growth factor.
一种活性人工角膜的制备方法,包括如下步骤:A method for preparing an active artificial cornea, comprising the steps of:
第一步:拟以丙烯酸衍生物等为原料,通过光引发剂引发自由基,采用分层梯度紫外光辐照聚合技术,制备具有梯度水凝胶特性的人工角膜基材,基材的中央(与人眼瞳孔贴合,直径为5毫米)部位为纯PMMA,周边则随着半径扩大,PMMA组分含量逐渐递减,P(HEMA-AAS)含量逐渐递增,P(HEMA-AAS)水凝胶结构可保持角膜湿润,并且有益角膜细胞的生长及与人眼角膜的融合。然后,采用准分子激光加工技术,逐层进行穿孔加工,获得具有合理孔洞结构,多孔支架具有类似细胞外基质的特性,能够支持细胞生长、增殖和分泌细胞外基质,使之与宿主角膜愈合成一体,可以稳定支持基材中央(光学部)达到长期存留。如图1所示。The first step: using acrylic acid derivatives as raw materials, using a photoinitiator to induce free radicals, and adopting a layered gradient ultraviolet radiation polymerization technology, an artificial cornea substrate with gradient hydrogel properties is prepared. The center of the substrate ( The part that fits the pupil of the human eye, with a diameter of 5 mm) is pure PMMA, and as the radius expands, the content of PMMA components gradually decreases, and the content of P (HEMA-AAS) gradually increases. P (HEMA-AAS) hydrogel The structure keeps the cornea moist and beneficial to the growth of corneal cells and fusion with the human cornea. Then, excimer laser processing technology is used to perforate layer by layer to obtain a reasonable pore structure. The porous scaffold has characteristics similar to extracellular matrix, which can support cell growth, proliferation and secretion of extracellular matrix, so that it can heal with the host cornea One piece, it can stably support the center of the base material (optical part) to achieve long-term retention. As shown in Figure 1.
所述的丙烯酸衍生物为丙烯酸(钠)(AAS)、甲基丙烯酸甲酯(MMA)、甲基丙烯酸羟乙酯(HEMA)。The acrylic acid derivatives are (sodium) acrylic acid (AAS), methyl methacrylate (MMA), and hydroxyethyl methacrylate (HEMA).
第二步:为降低人工角膜中心部位的生物学活性,我们采用纳米涂层技术,在人工角膜基材中央部位(内外面),进行聚偏二氟乙烯涂层处理,形成纳米氟塑料涂层,然后再在涂层上进一步进行四氟甲烷、七氟丙烷等离子体处理,在基材中心部位形成惰性表面,使光学部位不吸附细胞,避免细胞长入、新生血管长入,或眼睛中其他物质的粘附与沉积,避免其它材料常见的前后膜形成,以保证该部位的长期稳定的视觉功能。The second step: In order to reduce the biological activity of the central part of the artificial cornea, we use nano-coating technology to process polyvinylidene fluoride coating on the central part (inside and outside) of the artificial cornea substrate to form a nano-fluoroplastic coating , and then further conduct tetrafluoromethane and heptafluoropropane plasma treatment on the coating to form an inert surface at the center of the substrate, so that the optical part does not absorb cells, and prevents cells from growing into, new blood vessels from growing into, or other substances in the eye. Adhesion and deposition, to avoid the common front and rear film formation of other materials, to ensure the long-term stable visual function of this part.
第三步:避开中心部位,对基材周边进行胶原蛋白接枝,再进行小分子多肽(V6D2与ALPs两种肽的复合物)的自组装,并进行bFGF、EGF分子复合粘附,使基材生物活性化及组织工程化,获得能够与患者高度相容的人工角膜。The third step: avoiding the central part, carry out collagen grafting on the periphery of the substrate, and then carry out self-assembly of small molecular polypeptides (complexes of two peptides of V 6 D 2 and ALPs), and conduct bFGF and EGF molecular compound adhesion. Attached, the substrate is bioactivated and tissue engineered to obtain an artificial cornea that is highly compatible with the patient.
作为优选的方案,由本发明采用的bFGF、EGF生长因子、小分子多肽活性成分由暨南大学基因工程药物国家工程中心生产,或由广东南海朗肽制药有限公司生产。As a preferred solution, the bFGF, EGF growth factor, and small molecule polypeptide active ingredients used in the present invention are produced by the National Engineering Center for Genetic Engineering Drugs of Jinan University, or produced by Guangdong Nanhai Langtai Pharmaceutical Co., Ltd.
作为优选的方案,由本发明采用的聚偏二氟乙烯由美国杜邦公司或日本三菱公司生产的聚偏二氟乙烯产品。As a preferred solution, the polyvinylidene fluoride used in the present invention is a polyvinylidene fluoride product produced by DuPont of the United States or Mitsubishi of Japan.
作为优选的方案,由本发明采用的四氟甲烷、七氟丙烷由佛山市科的气体化工有限公司生产。As a preferred solution, tetrafluoromethane and heptafluoropropane used in the present invention are produced by Foshan Kedi Gas Chemical Co., Ltd.
本发明相对于现有技术,具有如下的优点及效果:Compared with the prior art, the present invention has the following advantages and effects:
(1)采用梯度功能材料制备技术,以梯度分层浇铸紫外光聚合方法,制备具有梯度MMA-HEMA-AAS组份含量的一体式人工角膜基体材料,基材中心(中央)贴近瞳孔部分为PMMA,随着半径扩展,PMMA比例逐渐降低,P(HEMA-AAS)比例逐渐增加,到基材周边,则全部为P(HEMA-AAS),以此解决人工角膜强度与水凝胶生物相容性的匹配问题,使制作的人工角膜植入体内可以长期稳定存在。(1) Adopt gradient functional material preparation technology, and use gradient layered casting ultraviolet light polymerization method to prepare integrated artificial cornea matrix material with gradient MMA-HEMA-AAS component content. The center (center) of the substrate close to the pupil is PMMA , as the radius expands, the proportion of PMMA decreases gradually, and the proportion of P(HEMA-AAS) gradually increases. When it reaches the periphery of the substrate, it is all P(HEMA-AAS), so as to solve the problem of artificial cornea strength and hydrogel biocompatibility The matching problem of the artificial cornea can exist stably for a long time in the body.
(2)采用准分子激光加工技术,在人工角膜周边制作具有贯穿型孔洞结构,合理的孔结构与分布为宿主角膜细胞的生长提供支持,有利于患者眼睛与人工角膜紧密贴合。(2) Using excimer laser processing technology, a penetrating hole structure is made around the artificial cornea. The reasonable hole structure and distribution provide support for the growth of host corneal cells, which is conducive to the close attachment of the patient's eyes to the artificial cornea.
(3)采用聚偏氟乙烯透明材料的纳米涂层技术、四氟甲烷与七氟丙烷等离子体对人工角膜的中心部位(内外面)进行惰性化处理,使制作的人工角膜中心光学部分保持惰性,细胞与血管无法长入,蛋白质及其他分泌物无法在光学部分粘附,以维持最佳视功能。(3) The nano-coating technology of polyvinylidene fluoride transparent material, tetrafluoromethane and heptafluoropropane plasma are used to inertize the central part (inside and outside) of the artificial cornea, so that the central optical part of the artificial cornea remains inert, and the cells With the inability of blood vessels to grow in, proteins and other secretions cannot adhere to the optical part to maintain optimal visual function.
(4)采用“接枝-复合”技术方法,将I-型胶原、小分子多肽和碱性成纤维生长因子(bFGF)固定于人工角膜周边表面,获得具有生物诱导作用的活性涂层,植入体内后能主动调动机体有利因素,调节宿主细胞生物学行为。(4) Using "grafting-composite" technology, I-type collagen, small molecular polypeptide and basic fibroblast growth factor (bFGF) were fixed on the peripheral surface of the artificial cornea to obtain an active coating with biological induction. After entering the body, it can actively mobilize favorable factors in the body and regulate the biological behavior of host cells.
附图说明Description of drawings
图1是本发明的人工角膜的整体图;其中,(1)-中央光学部分,(2)-带孔洞的周边水凝胶活性部分。Fig. 1 is an overall view of the artificial cornea of the present invention; wherein, (1)-central optical part, (2)-peripheral hydrogel active part with holes.
具体实施方式detailed description
下面结合实施例及附图对本发明作进一步详细的描述,但本发明的实施方式不限于此。The present invention will be further described in detail below in conjunction with the embodiments and the accompanying drawings, but the embodiments of the present invention are not limited thereto.
以丙烯酸、甲基丙烯酸甲酯、甲基丙烯酸羟乙酯为原料,加入光引发剂,通过分层梯度紫外光辐照聚合技术,制备具有梯度水凝胶特性的人工角膜基材,基材的中央(与人眼瞳孔贴合,直径为5毫米)部位为纯PMMA,周边则随着半径扩大,每增加0.5毫米,PMMA组分含量减少15%,P(HEMA-AAS)含量增加15%,直到外边部位的PMMA组分含量为零,P(HEMA-AAS)含量为100%。然后,在人工角膜基材中央部位(内外面),进行聚偏二氟乙烯涂层处理,形成纳米氟塑料涂层,然后再在涂层上进一步进行四氟甲烷、七氟丙烷等离子体处理,在基材中心部位形成惰性表面,最后,采用准分子激光加工技术,对周边进行穿孔加工,再进行胶原蛋白接枝与小分子多肽(V6D2与ALPs两种肽的复合物)的自组装,并进行bFGF分子复合,获得能够与患者高度生物相容的人工角膜。Using acrylic acid, methyl methacrylate, and hydroxyethyl methacrylate as raw materials, adding photoinitiators, through layered gradient ultraviolet radiation polymerization technology, the artificial cornea substrate with gradient hydrogel properties is prepared. The substrate’s The central part (fitting with the pupil of the human eye, with a diameter of 5 mm) is pure PMMA, and the periphery expands with the radius. For every increase of 0.5 mm, the content of PMMA components decreases by 15%, and the content of P (HEMA-AAS) increases by 15%. The PMMA component content until the outer portion was zero, and the P(HEMA-AAS) content was 100%. Then, polyvinylidene fluoride coating is carried out on the central part (inside and outside) of the artificial cornea substrate to form a nano-fluorine plastic coating, and then the coating is further treated with tetrafluoromethane and heptafluoropropane plasma, The central part of the material forms an inert surface. Finally, the excimer laser processing technology is used to perforate the periphery, and then the self-assembly of collagen grafts and small molecule polypeptides (complexes of V 6 D 2 and ALPs peptides) is carried out. And compound bFGF molecules to obtain an artificial cornea that is highly biocompatible with the patient.
选择3个月的日本大耳白兔10只,通过碱烧伤方式进行建模,然后植入本发明的人工角膜,在一个时期内显微镜下观察角膜恢复情况,设定观察指标如下:①人工角膜在位率及在位时间;②出现继发性青光眼情况;③人工角膜前/后增殖膜出现情况;④眼内炎出现情况;⑤角膜溶解情况,动物实验结果表明,本发明的人工角膜在位时间及在位率符合要求;继发性青光眼发生率小,发生比例符合统计要求;通过含氟化合物的处理,本发明的人工角膜基本不出现增殖膜;在植入1周内,会出现轻微的眼内炎,然后逐渐消失;没有出现角膜溶解情况,表明本发明制备的人工角膜具有较好的适用性。Select 10 Japanese big-eared white rabbits for 3 months, carry out modeling by alkali burn, and then implant the artificial cornea of the present invention, and observe the recovery of the cornea under a microscope within a period of time, and set the observation indicators as follows: ①Artificial cornea 2. the occurrence of secondary glaucoma; 3. the occurrence of proliferative membranes before and after the artificial cornea; 4. the occurrence of endophthalmitis; 5. the dissolution of the cornea. The in-position time and in-position rate meet the requirements; the incidence rate of secondary glaucoma is small, and the incidence rate meets the statistical requirements; through the treatment of fluorine-containing compounds, the artificial cornea of the present invention basically does not appear proliferative film; within one week after implantation, there will be Slight endophthalmitis then disappears gradually; no corneal dissolution occurs, indicating that the artificial cornea prepared by the present invention has better applicability.
上述实施例为本发明较佳的实施方式,但本发明的实施方式并不受上述实施例的限制,其他的任何未背离本发明的精神实质与原理下所作的改变、修饰、替代、组合、简化,均应为等效的置换方式,都包含在本发明的保护范围之内。The above-mentioned embodiment is a preferred embodiment of the present invention, but the embodiment of the present invention is not limited by the above-mentioned embodiment, and any other changes, modifications, substitutions, combinations, Simplifications should be equivalent replacement methods, and all are included in the protection scope of the present invention.
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