CN116603054A - Pharmaceutical composition for repairing cornea endothelium - Google Patents
Pharmaceutical composition for repairing cornea endothelium Download PDFInfo
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- CN116603054A CN116603054A CN202310555737.9A CN202310555737A CN116603054A CN 116603054 A CN116603054 A CN 116603054A CN 202310555737 A CN202310555737 A CN 202310555737A CN 116603054 A CN116603054 A CN 116603054A
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- corneal endothelial
- pharmaceutical composition
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/39—Connective tissue peptides, e.g. collagen, elastin, laminin, fibronectin, vitronectin, cold insoluble globulin [CIG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
- A61K31/4409—Non condensed pyridines; Hydrogenated derivatives thereof only substituted in position 4, e.g. isoniazid, iproniazid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
- A61K31/455—Nicotinic acids, e.g. niacin; Derivatives thereof, e.g. esters, amides
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/18—Growth factors; Growth regulators
- A61K38/1825—Fibroblast growth factor [FGF]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P27/00—Drugs for disorders of the senses
- A61P27/02—Ophthalmic agents
Abstract
The invention discloses a medicinal composition for eyes, which comprises 5-60 ng/mL of fibroblast growth factor and 5-60 mug/mL of laminin. The coupling of the fibroblast growth factor and laminin is utilized to improve the basal lamina of the posterior elastic layer, promote the adhesion and functional regeneration of the transplanted/autologous CECs, and achieve the effects of treating the damage of the corneal endothelial cells and promoting the repair. Especially, FGF10 coupled LN511 can remarkably promote the restoration of the transparency and thickness of cornea and promote the density, morphological repair and functional reconstruction of corneal endothelial cells.
Description
Technical Field
The invention belongs to the field of medicines, and particularly relates to a medicinal composition for repairing cornea endothelium.
Background
Corneal endothelial cells (Corneal endothelial cells, CECs) are single-layered hexagonal cells located in the innermost layer of the cornea, whose function is normally a prerequisite for maintaining corneal stromal dehydration to ensure corneal transparency. Human corneal endothelial cells (Human corneal endothelial cells, HCECs) arrest in the G1 phase of the cell cycle with essentially no regenerative capacity. With age, the number of CECs and cell density gradually decrease. Corneal endothelial cell injury may be caused by intraocular inflammation, local trauma, eye surgery or other physical and chemical factors, and when HCECs injury loss exceeds its physiological threshold (< 400/mm 2), corneal endothelial function decompensation occurs, clinical symptoms of corneal irritation are accompanied by blurred vision, epithelial blisters appear in the progressive stage, ocular pain is caused if blisters break, severe cases can be secondary to corneal ulcers and surgical treatment is required. Because of the lack of cornea donor tissue reaching the transplantation level worldwide, the clinical diagnosis and treatment needs cannot be satisfied, so how to maintain the physiological function of the cornea endothelial cells, alleviate the damage caused by various physical and chemical factors, promote the cornea endothelial repair, delay the disease progress and the operation time window are important directions of the current research, but the lower proliferation capacity of the cornea endothelium is a challenge for researchers.
Current strategies for treating corneal endothelial decompensation include methods such as drug therapy, donor cornea transplantation, and tissue engineering cornea endothelial transplantation. For mild corneal endothelial injury, local treatment can play a role. In the aspect of local treatment, the invasiveness of the drug intervention is small, the drug intervention is easier to obtain, a low-traumatic method is provided for treating the corneal endothelial dysfunction, the service life of residual corneal endothelial cells can be prolonged, the disease progress and the operation time window can be delayed, the functional repair of the corneal endothelial cells after the operation can be promoted, and the like. Studies have shown that certain potential pharmaceutical agents can be used to promote the repair of damage to corneal endothelial cells. Hepatocyte growth factors promote the growth and repair of CECs by way of autocrine. We have previously reported that Nicotinamide (NIC) enhances corneal endothelial wound healing by promoting CECs proliferation and inhibiting endothelial-mesenchymal transition (EnMT). Studies have demonstrated the effectiveness of the ROCK inhibitor Y-27632 in endothelial cell regeneration, and can be used to treat corneal endothelial dysfunction by promoting proliferation of CECs and reducing apoptosis. In addition, Y-27632 can treat corneal endothelial dysfunction by improving the adhesion efficiency of cells in combination with cell injection. But the use of drugs has certain limitations.
Disclosure of Invention
The invention provides a medicinal composition for eyes, which comprises 5-60 ng/mL of fibroblast growth factor and 5-60 mug/mL of laminin; the fibroblast growth factor and laminin are used as active substances and have the effects of promoting repairing, growing, migrating, survival, attaching, proliferating and/or differentiating of ocular corneal endothelial cells and/or elastic layer injury after cornea. The pharmaceutical composition can be used for preparing medicines or medical devices for relieving or treating corneal endothelial injury, corneal endothelial lesion, corneal endothelial dysfunction and corneal endothelial cell dysfunction.
Preferably, the laminin is selected from one or more of LN211, LN322, LN 511; the fibroblast growth factor is selected from one or more of FGF1, FGF2 (bFGF), FGF4 and FGF 10.
Preferably, the pharmaceutical composition comprises at least fibroblast growth factor FGF10 and laminin LN511.
Preferably, LN511 is present in a concentration of 10-50. Mu.g/mL and FGF10 is present in a concentration of 10-50ng/mL; more preferably, LN511 is present at a concentration of 10. Mu.g/mL and FGF10 is present at a concentration of 10ng/mL.
In the present invention, the pharmaceutical composition may further comprise one or more of type I collagen fibers, type VIII collagen, type IV collagen, type VI collagen, type XII collagen, fibronectin, nicotinamide, Y-27632.
In another aspect of the invention, the use of the above-described pharmaceutical composition in medicaments or medical devices for repairing corneal endothelial cells against oxidative damage, against apoptosis, against inflammation, reversing corneal endothelial cell-matrix transformation, balancing the homeostasis of the survival microenvironment of the corneal endothelial cells, promoting corneal endothelial cell adhesion, functional regeneration, remodeling and/or maturation is provided.
In another aspect of the invention, the invention provides the use of the above pharmaceutical composition in the preparation of a medicament or medical device for treating or alleviating symptoms such as pain, blurred vision, corneal edema and the like caused by decompensation of corneal endothelial function.
In the present invention, the pharmaceutical composition is administered to the eye of a subject suffering from corneal endothelial cell damage, lesions, dysfunction or functional decompensation in an effective dose.
In the present invention, the term "individual" or "patient" is used interchangeably herein and refers to a vertebrate, preferably a mammal. The mammal may be a human, non-human primate, mouse, rat, rabbit, dog, cat, horse, sheep, monkey, or cow, but is not limited to these examples. Preferably, the patient is a human. Such "individuals" or "patients" typically suffer from or are susceptible to a condition that can be prevented or treated by administration of the above-described pharmaceutical, pharmaceutical combinations of the invention, including, but not limited to, corneal endothelial injury, corneal endothelial lesions, corneal endothelial dysfunction, corneal endothelial cell dysfunction symptoms: abnormal corneal thickness, reduced corneal transparency, corneal edema, reduced or lost vision, dry eyes, pain, etc.
The invention can be mixed by a conventional method by a technician before application, and finally becomes a required pharmaceutical dosage form. Can be in the form of dripping pill, aqueous suspension, aqueous solution, eye drop, injection, colloid, colloidal solution, nanometer preparation or other dosage forms for human, animal or clinic. Preferably, the pharmaceutical composition is administered in the form of an intraocular injection or infusion fluid.
In the present invention, the terms "effective amount", "effective dose" refer to that amount which imparts a therapeutic or inhibitory effect (e.g., controls, relieves, improves, mitigates or slows progression) to "an individual" or "patient"; or the aforementioned drugs, pharmaceutical compositions, medical devices that prevent (e.g., delay onset or reduce risk of developing) a disease, disorder or condition or symptom thereof. The amount effective for this use will depend on, for example, the route of delivery, the concentration or composition of the drug employed, the severity of the corneal endothelial injury, the weight and general health of the individual, and the practitioner's advice on a case-by-case basis. The dose may be administered once a week, or for two days or once a day, or even several times a day. Dosage units may be administered for a short period (e.g., weeks to months) or longer period (months to years). Can be made into any preparation formulation.
In another aspect of the invention, the invention provides the use of the above pharmaceutical composition in the preparation of medicaments or medical devices for corneal endothelial basement membrane, corneal endothelial implant graft carrier, corneal endothelial cell graft carrier, artificial cornea posterior elastic layer, artificial cornea endothelium and artificial whole cornea.
Advantageous effects
1) The extracellular matrix component of the elastic layer after cornea is utilized for the first time to promote the restoration of the elastic layer after cornea, so as to construct the endothelial cell restoration basement membrane.
2) The fibroblast growth factor is coupled with laminin for the first time to improve the basal lamina of the posterior elastic layer, further promote the adhesion and functional regeneration of the transplanted/autologous CECs, and achieve the effects of treating the corneal endothelial cell injury and promoting the repair.
3) The method is characterized in that the fibroblast growth factor is coupled with laminin for the first time and is used for treating serious corneal endothelial diseases, in the stage of disease, the elastic layer behind the cornea is obviously abnormal, the treatment purpose cannot be achieved only by using cell transplantation, and the treatment effect can be achieved only by tearing off the elastic layer behind the abnormal pathological changes and jointly performing corneal endothelial repair promotion treatment or cell transplantation; FGF10 coupled LN511 can remarkably promote the restoration of the transparency and thickness of cornea and promote the density, morphological repair and functional reconstruction of corneal endothelial cells.
Drawings
FIG. 1, effects of different concentrations of drugs on promoting corneal endothelial cell attachment;
FIG. 2. Animal model (A) for removing elastic layer after rabbit cornea establishment, DM with diameter of about 5mm in the center of rabbit cornea is removed by endothelial hook, and the preparation is injected into anterior chamber to form cytokine coating; (B) The extent of the posterior elastic layer tear (circular area) in the center of the cornea;
FIG. 3 shows changes in transparency of rabbit cornea as observed by slit lamp microscopy;
FIG. 4 is a slit lamp microscope view showing cornea transparency, thickness, scar hyperplasia;
FIG. 5 is a confocal microscopy image showing morphological changes in corneal endothelial cells;
FIG. 6F-actin immunofluorescence staining pattern.
Detailed Description
A variety of critical signaling pathways, such as MAPK pathway, TGF-beta pathway, PI3K/AKT pathway, wnt pathway and ROCK pathway, are involved in the process of repairing corneal endothelial injury. The fibroblast growth factor (Fibroblast growth factor) is taken as a polypeptide growth factor with various biological activities, and can regulate and control the signal paths such as PI3K/AKT, wnt and the like to promote the injury repair, cell differentiation and regeneration process of tissues. Laminin (LN), an extracellular matrix glycoprotein, is the major non-collagenous component of the retrocorneal elastic layer.
In the invention, animal models of damage of the elastic layer after cornea with different degrees are built, the effects of adhering the elastic layer after basement membrane repair abnormality by utilizing LN pre-coating and improving cornea endothelial repair (cell growth, migration, survival, attachment, proliferation and differentiation) by coupling FGF are explored, a new thought is provided for treating cornea endothelial function decompensation by tissue engineering technology, and a new scheme is provided for clinical treatment of cornea endothelial diseases.
The corneal endothelium plays an important role in maintaining the transparency of the cornea. When the damage loss degree of HCECs exceeds the physiological critical value, corneal endothelial function decompensation occurs, and the clinical manifestation is corneal irritation symptoms accompanied by blurred vision and edema, epithelial and subcutaneous blisters appear in the progressive stage, and ocular pain is caused if the blisters break. The repair promoting effect of the present invention includes adhesion of corneal endothelial jogging, growth, proliferation and differentiation of cells, migration, inhibition of scar hyperplasia, formation of a corneal endothelial cell layer which makes cells have good morphology and high cell density, and further shows an apoptosis inhibiting effect of corneal endothelial jogging. Therefore, the pharmaceutical composition provided by the invention can be used in medicines or kits for repairing the oxidation injury, apoptosis and inflammation resistance of the corneal endothelial cells, reversing the transformation of the corneal endothelial cells and the matrix, balancing the steady state of the living microenvironment of the corneal endothelial cells, promoting the adhesion, functional regeneration, reconstruction and/or maturation of the corneal endothelial cells; can also be used for treating or relieving symptoms such as pain, blurred vision, corneal edema and the like caused by corneal endothelial function decompensation; can also be used for storing cornea endothelial basement membrane, cornea endothelial implant transplanting carrier, cornea endothelial cell transplanting carrier, artificial cornea back elastic layer, artificial cornea endothelium and artificial whole cornea reagent, improving its preserving effect and promoting its effect after implantation.
The dosage form of the medicament or medical device of the present invention is not particularly limited, and is suitable for topical administration to the eye, but is preferably formulated in the form of an intracameral injection or an intraocular infusion fluid.
The invention is further illustrated by the following examples which illustrate the invention, which are intended to be illustrative only and should not be construed as limiting the scope of the invention. Unless otherwise defined, technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The specific conditions are not noted in the examples and are carried out according to conventional conditions or conditions recommended by the manufacturer. The reagents or apparatus used were conventional products commercially available without the manufacturer's attention.
Preparation of reagents
Preparation of 5-50. Mu.g/mL of a combination preparation of Laminin511 (Biolamina, sundbyberg, sweden), 5-50ng/mL of FGF10 (Wuhan you Sheng commercial Co., ltd.), 5-50. Mu.g/mL of Laminin511 and 5-50ng/mL of FGF10, respectively, placing the above preparations in an ultra clean bench, filtering with a filter with a pore size of 0.22. Mu.m, sub-packaging, mixing the materials in the bench, and storing at a low temperature of 4 ℃.
Example 1 effects of different concentrations of drug combinations on promoting corneal endothelial cell attachment
The prepared LN 511-coated 12-well cell culture plates of 5. Mu.g/mL, 10. Mu.g/mL, 20. Mu.g/mL, and 50. Mu.g/mL of the above split-packs were used, and the control group was coated with DPBS. According to 5X 10 5 Inoculating corneal endothelial cells in each mL, adding DPBS or FGF10 with the concentration of 5ng/mL, 10ng/mL, 20ng/mL and 50ng/mL into the culture solution, observing the adherence condition of the corneal endothelial cells in 30min after inoculation, and photographing by using an inverted microscope; the non-adherent cells were washed off with PBS, and the adherent cells were digested with 0.25% trypsin-EDTA for 5min, and the number of adherent cells was counted using a cytometer, respectively.
As shown in FIG. 1, compared with the control group, LN511 concentration of 10. Mu.g/mL, 20. Mu.g/mL, 50. Mu.g/mL and FGF10 concentration of 10ng/mL, 20ng/mL, 50ng/mL all had the function of promoting endothelial cell adhesion, wherein LN511 and FGF10 concentration of 10. Mu.g/mL and FGF10 concentration of 10ng/mL had the best effect, and the average of 5.09X 10 was reached 5 And (3) per mL, the LN511 and FGF10 drug combination has good function of promoting the adhesion of corneal endothelial cells.
Example 2 animal experiments
Animal model for removing rabbit cornea by flicking
After the new zealand rabbit is anesthetized, a trephine drills a diameter of 5mm on the cornea surface, the bulbar conjunctiva at the position of 11-1 points above the cornea is sheared by corneosclera, a disposable 15-degree puncture knife is used for making an incision with a width of about 2mm at the position of 12 points of the limbus, carbachol injection is injected into the anterior chamber to shrink the pupil, and sodium hyaluronate is injected into the supporting anterior chamber. The cornea posterior elastic layer with the diameter of about 5mm in the center of the cornea of the right eye of the rabbit is torn by an endothelial hook to simulate serious cornea endothelial diseases needing to remove the cornea posterior elastic layer DM, residual sodium hyaluronate and endothelial cell fragments in the anterior chamber are washed by normal saline, and then 250 mu l of gentamicin sulfate and heparin sodium injection are respectively injected into the anterior chamber, so that the gentamicin in the anterior chamber is replaced and exudation in the anterior chamber is prevented. The 10-0 nylon thread is used for intermittently suturing the limbal incision, so that the formation of a good anterior chamber of the rabbit eye is ensured.
After rewarming the preparation stored at low temperature at 4 ℃, 100 μl of the preparation was slowly injected into the anterior chamber using a syringe, the eye pressure Tn of the rabbit eye was measured, the right lateral recumbent position of the rabbit was maintained, the operative eye was kept in the downward position for 1 hour, the preparation was uniformly covered on the surface of the posterior stroma layer of the cornea to form a cytokine coating, and the transparency, thickness, inflammatory reaction in the anterior chamber and recovery of endothelial cell morphology after DM was removed were observed (fig. 2).
The grouping is as follows:
control group: 100 μl DPBS was injected into the anterior chamber
LN511 group: 100 μl LN511 (10 μg/mL) was injected into the anterior chamber;
FGF10 group 100. Mu.l FGF10 (10 ng/mL) was injected into the anterior chamber;
LN511-FGF10 group: mu.l FGF10 (10 ng/mL) coupled LN511 (10. Mu.g/mL) was injected into the anterior chamber.
Experimental results
(1) FGF10 coupled LN511 promotes cornea transparency and thickness recovery and inhibits scar hyperplasia
The slit lamp microscope observation shows that the cornea of the control group still has obvious edema after DM stripping operation for 7 days, the peripheral cornea edema starts to be limited for 10 days, only central area edema is left for 14 days, and large lamellar cornea scars are left in the central area for 30 days. The corneal edema 7 days after the FGF10 alone and LN511 surgery was consistent with the control group, with 10 days of corneal edema significantly localized to the central zone, and 30 days of cornea still had localized edema and left with lamellar pannus. The corneal oedema started to be limited 7 days after FGF10 coupled LN511 surgery, and the cornea restored transparency for 10 days and stabilized for up to 30 days. Cornea OCT shows that the scar is obviously proliferated in the central DM tearing range (about 5 mm) of 30 days after operation of the control group, the scar hyperplasia is only formed in the central tearing area of about 2.5mm in the single FGF10 group and the LN511 group, but the proliferation thickness is reduced compared with that of the control group, the central tearing area of the FGF10 coupled LN511 group is smooth, and no obvious proliferation scar is seen. (FIG. 3, FIG. 4)
(2) FGF10 coupled LN511 for improving corneal endothelial cell morphology
The morphology and density of corneal endothelial cells were observed using a confocal living microscope in the control group, the FGF10 alone group, the LN511 group, and the FGF 10-coupled LN511 group 30 days after DM tear-off. The results showed that the corneal endothelial cell density was increased 30 days after surgery in FGF10 alone and LN511 alone compared with the control group, but the cells were sparse and irregular in morphology and size. The FGF 10-coupled LN511 group had a more uniform corneal endothelial cell density and a regular morphology (fig. 5).
(3) FGF10 coupled LN511 promotes recovery of keratocyte density
F-actin immunofluorescence staining showed morphology of corneal endothelial cells 30 days after DM removal, and the results showed that the endothelial cell skeleton disorder degree of the control group was improved compared with that of the control group in the FGF10 group and LN511 group alone, a small number of cells showed a slightly regular skeleton, and the endothelial cells of the FGF 10-coupled LN511 group showed regular morphology, and a large part showed regular hexagonal morphology (FIG. 6).
Although specific embodiments of the invention have been described in detail, those skilled in the art will appreciate. Numerous modifications and substitutions of details are possible in light of all the teachings disclosed, and such modifications are contemplated as falling within the scope of the present invention. The full scope of the invention is given by the appended claims and any equivalents thereof.
Claims (10)
1. The pharmaceutical composition for eyes is characterized by comprising 5-60 ng/mL of fibroblast growth factor and 5-60 mug/mL of laminin; wherein fibroblast growth factor and laminin are active substances.
2. The pharmaceutical composition of claim 1, wherein said laminin is selected from one or more of LN211, LN322, LN 511; the fibroblast growth factor is selected from one or more of FGF1, FGF2, FGF4 and FGF 10.
3. Pharmaceutical composition according to claim 1 or 2, comprising at least FGF10 and LN511.
4. The pharmaceutical composition of claim 3, wherein said LN511 concentration is 10-50 μg/mL and said FGF10 concentration is 10-50ng/mL.
5. The pharmaceutical composition of any one of claims 1, 2, 4, further comprising one or more of type I collagen fibers, type VIII collagen, type IV collagen, type VI collagen, type XII collagen, fibronectin, nicotinamide, Y-27632.
6. The pharmaceutical composition of any one of claims 1, 2, 4 for use in the eye of a mammal; the mammal includes human, rabbit, mouse, rat, hamster, cat, dog, cow, sheep, monkey.
7. Use of a pharmaceutical composition according to any one of claims 1, 2, 4 for the preparation of a medicament or medical device for promoting repair, growth, migration, survival, cell adhesion, proliferation and/or differentiation, regeneration, reconstruction and/or maturation of corneal endothelial cells and/or post-corneal elastic layer lesions.
8. Use of a pharmaceutical composition according to any one of claims 1, 2, 4 for the preparation of a medicament or medical device for alleviating or treating corneal endothelial injury, corneal endothelial lesions, corneal endothelial dysfunction, corneal endothelial cell dysfunction.
9. Use of a pharmaceutical composition according to any one of claims 1, 2, 4 for the preparation of a medicament or medical device for the treatment or alleviation of symptoms of pain, blurred vision, corneal oedema and the like caused by decompensation of the corneal endothelial function.
10. The use of the pharmaceutical composition according to any one of claims 1, 2, and 4 for the preparation of a medicament or medical device for corneal endothelial basement membrane, corneal endothelial implant graft carrier, corneal endothelial cell graft carrier, post-artificial cornea elastic layer, artificial cornea endothelium and artificial whole cornea.
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