BILATERAL EPITHELIAL DISEASES

Bilateral limbal stem cell deficiency, commonly caused by chemical or thermal injuries or conditions such as Stevens–Johnson Syndrome, can be managed through corneal surface reconstruction using buccal (oral) mucosa as an alternative epithelial source. Following the protocols described by Nishida and under the guidance of Dr. Srinivas K Rao, NCRM has successfully expanded autologous oral mucosal epithelium for transplantation in patients with bilateral limbal stem cell damage. This method is advantageous because oral mucosal epithelium naturally expresses keratin 3, a marker shared with corneal epithelium, and harvesting a small oral biopsy is relatively simple. The transparent, carrier-free epithelial sheets engineered from oral mucosa closely resemble the optical clarity of epithelial sheets derived from limbal stem cells. This core technology paved the way for the development of BEES-HAUS (Buccal Epithelium Expanded and Encapsulated in Scaffold – Hybrid Approach to Urethral Stricture). During NCRM’s research on in-vitro expansion of buccal epithelium, Dr. Suryaprakash proposed the innovative idea of applying buccal epithelial cells endoscopically into the urethra rather than using invasive buccal tissue grafting to treat male urethral strictures. This led to a breakthrough regenerative solution of BEES-HAUS that is minimally invasive, less painful, and requires only a short hospital stay. The clinical application of BEES-HAUS has already begun under the leadership of Dr. Horiguchi and his team in Japan, and a further simplified version, BHES-HAUS (Buccal Epithelium Hashed and Encapsulated in Scaffold – Hybrid Approach to Urethral Stricture) is currently under clinical trial.

 

PUBLICATIONS:

  1. Srinivas KR, Sujatha M, Mohan R, Senthilnagarajan R, Baskar S, Senthil KR. Abraham S. Buccal Epithelium in treating Ocular Surface Disorders . J Stem cell Regen Med. 2008; 4 (1):18-19.

  2. Horiguchi A, Ojima K, Shinchi M, Kushibiki T, Mayumi Y, Kushibiki T, Katoh S, Takeda M, Iwasaki M, Yoshioka H, Suryaprakash V, Balamurugan M, Senthilkumar R, Abraham SJK. In Vitro Culture Expansion and Characterization of Buccal Mucosal Epithelial Cells for Tissue Engineering Applications in Urethral Stricture After Transportation Using a Thermoreversible Gelation Biopreservation and Biobanking 2021.

  3. Katoh S, Rao KS, Suryaprakash V, Horiguchi A, Kushibiki T, Ojima K, Iwasaki M, Takeda M, Senthilkumar R, Rajmohan M, Karthick R, Preethy S, Abraham S. A 3D polymer scaffold platform for enhanced in vitro culture of Human & Rabbit buccal epithelial cells for cell therapies . Tokai J Exp Clin Med 2021; 46(1):1-6

  4. Vaddi SP, Reddy VB, Abraham S. Buccal epithelium Expanded and Encapsulated in Scaffold‐Hybrid Approach to Urethral Stricture (BEES‐HAUS) procedure: A novel cell therapy‐based pilot study . Int J Urol. 2018 Nov 22.

  5. Horiguchi A, Ojima K, Shinchi M, Kushibiki T, Mayumi Y, Miyai K, Katoh S, Takeda M, Iwasaki M, Suryaprakash V, Balamurugan M, Rajmohan M, Preethy S, Abraham SJK. Successful engraftment of epithelial cells derived from autologous rabbit buccal mucosal tissue, encapsulated in a polymer scaffold in a rabbit model of a urethral stricture, transplanted using the transurethral approach. Regen. Ther. 2021; 18:127-132. doi: 10.1016/j.reth.2021.05.004.

  6. Horiguchi A, Shinchi M, Ojima K, Hirano Y, Kushibiki T, Mayumi Y, Miyai K, Miura I, Iwasaki M, Suryaprakash V, Senthilkumar R, Preethy S, Katoh S, Abraham SJK. Engraftment of Transplanted Buccal Epithelial Cells onto the Urethrotomy Site, Proven Immunohistochemically in Rabbit Model; a Feat to Prevent Urethral Stricture Recurrence. Stem Cell Rev Rep. 2022 Oct 28; doi: 10.1007/s12015-022-10466-1.

  7. Senthilkumar R, Yoshioka H, Katoh S, Iwasaki M, VSurya Prakash V, Balamurugan M, Dedeepiya VD, Preethy S, Abraham. Engraftment and proliferation of thermoreversible-gelation-polymer-encapsulated human corneal limbal-stem-cells on ocular surface of a cadaver cornea. Current Eye Research. doi: 10.1080/02713683.2023.2180039.