AccScience Publishing / IJB / Online First / DOI: 10.36922/IJB025290293
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RESEARCH ARTICLE
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3D-printed collagen scaffold and adipose tissue mesenchymal stem cells-derived limbal stem cells for the treatment of limbal stem cell deficiency

Martha Stokking1† Marta Cadenas-Martín1† Ana I Martín-González1 Alba Fernández-Ferrer1 Francisco Arnalich-Montiel2 Maria P De Miguel1
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1 Cell Engineering Laboratory, La Paz University Hospital Health Research Institute, IdiPAZ, 28046 Madrid, Spain.
2 IRYCIS, Ophthalmology Department, Ramón y Cajal University Hospital, Madrid, Spain.
†These authors contributed equally to this work.
Received: 18 July 2025 | Accepted: 8 September 2025 | Published online: 8 September 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

When limbal stem cell deficiency (LSCD) is partial, the usual treatment is covering the corneal surface with amniotic membrane (AM), allowing the growth of the remaining limbal stem cells (LSCs). In cases of complete LSCD, the most common treatment is cultured limbal epithelial transplantation (CLET), with the possibility of rejection. Studies proved that mesenchymal stem cell (MSC) transplantation is as safe and effective as CLET. Recent studies demonstrate a successful differentiation of adipose-derived adult mesenchymal stem cells (ADSCs) to LSCs. Combining AM transplantation with LSCs results in improved treatment efficacy. A disadvantage of using AM is the variability among donors and the risk of rejection. We propose the use of 3D-printed collagen as a scaffold colonized with LSCs derived from ADSCs for the treatment of LSCD in a rat animal model. The 3D-printed collagen scaffolds showed good transparency. In vitro ADSC differentiation to LSCs showed a change in cell morphology, being more pronounced and faster on 3D-printed collagen. 3D-printed collagen was the most efficient differentiation substrate, with the highest percentage of LSC specific markers (p63α and BMI-1) and corneal epithelium (SSEA-4).  The differentiated LSCs in AM or 3D-printed collagen I scaffolds were transplanted into a rat model of LSCD, compared to the standard cell free AM. In all groups the epithelium closed the imposed wound. 3D-printed collagen scaffold integration was statistically superior to AM. Markers for different corneal structures (PAS, BMI-1, p63α, cytokeratins 12 and 13) showed that the generated epithelium was not epithelial but conjunctival, and that the contribution of ADSC-derived LSCs was not enough for re-epithelization of the cornea.

Keywords
Cornea
Vision loss
Mesenchymal stem cells
Limbal stem cell deficiency
Regenerative medicine
Amniotic membrane
Bioprinting
Tissue engineering
Funding
The authors received grants from Ministerio de Ciencia e Innovación, Acción estratégica en Salud. Instituto de Salud Carlos III, Proyectos de I+D+I en Salud (PI23/00207), FIBHULP (Proyectos Luis Álvarez), StemVision and Carl Zeiss AG. M. Cadenas Martin and M. Stokking were financed by the European Social Fund (PI_SEPE_MPDM PROGRAMA INVESTIGO 1785344099 and PI_SEPE_PROGRAMA INVESTIGO 26-23 respectively).
Conflict of interest
The authors declare that the research was conducted without any commercial or financial relationships that could be considered a potential conflict of interest.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing