Design of functional decellularized matrix for conjunctival epithelial stem cell maintenance and ocular surface reconstruction

[Display omitted] •Decellularized matrix derived from subconjunctival fibroblasts (DM-SCF) obtained in situ from conjunctiva was prepared as a stem-cell-friendly scaffold.•The functional niche provided by DM-SCF facilitates stem cell maintenance through Wnt/β-catenin and Notch pathways.•DM-SCF can achieve long-term and superior functional repair of the ocular surface. Conjunctival defects severely impair ocular surface homeostasis and vision.However, the existing conjunctival reconstruction methods are still unable to achieve satisfactory functional replacement of conjunctiva. Scaffold materials that provide a more stem-cell-friendly microenvironment are in urgent need of improvement. Herein we reported a functional conjunctival reconstruction scaffold constructed from decellularized matrix derived from rabbit subconjunctival fibroblasts (DM-SCF) loaded with conjunctival epithelial stem cells (CjESCs) for ocular surface repair. The DM-SCF had a thickness and mechanical strength close to that of normal conjunctiva and showed excellent biocompatibility. CjESCs inoculated on DM-SCF maintained good stem cell properties, which showed long-term maintenance of low differentiation and good proliferation activity.DM-SCF transplantation with CjESCs showed satisfactory results in rabbit models of a large conjunctival defect.The conjunctiva was reconstructed with abundant goblet cell expression and regular fiber arrangement. Protein mass spectrometry revealed the active extracellular matrix components of DM-SCF, regulating the activation of Wnt/β-catenin and Notch pathways for stem cell maintenance. Overall, our study developed a promising new strategy for ocular surface reconstruction by optimizing bioactive scaffold and providing functional stem cell niche, so as to achieve long-standing and superior functional repair.