{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:47:58Z","timestamp":1787028478210,"version":"build-2736575974"},"reference-count":49,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Holostem Terapie Avanzate s.r.l."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Total bilateral Limbal Stem Cells Deficiency is a pathologic condition of the ocular surface due to loss or impairment of corneal stem cell function, altering homeostasis of the corneal epithelium. Cultivated Oral Mucosa Epithelial Transplantation (COMET) is the only autologous treatment for this pathology. During the follow-up, a proper characterization of the transplanted oral mucosa on the ocular surface supports understanding the regenerative process. The previously proposed markers for oral mucosa identification (e.g., keratins 3 and 13) are co-expressed by corneal and conjunctival epithelia. Here, we propose a new specific marker to distinguish human oral mucosa from the epithelia of the ocular surface. We compared the transcriptome of holoclones (stem cells) from the human oral mucosa, limbal and conjunctival cultures by microarray assay. High expression of SOX2 identified the oral mucosa vs. cornea and conjunctiva, while PAX6 was highly expressed in corneal and conjunctival epithelia. The transcripts were validated by qPCR, and immunological methods identified the related proteins. Finally, the proposed markers were used to analyze a 10-year follow-up aniridic patient treated by COMET. These findings will support the follow-up analysis of COMET treated patients and help to shed light on the mechanism of corneal repair and regeneration.<\/jats:p>","DOI":"10.3390\/ijms23105785","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T09:18:08Z","timestamp":1653124688000},"page":"5785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["SOX2 Is a Univocal Marker for Human Oral Mucosa Epithelium Useful in Post-COMET Patient Characterization"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9590-7630","authenticated-orcid":false,"given":"Eustachio","family":"Attico","sequence":"first","affiliation":[{"name":"Centre for Regenerative Medicine \u201cStefano Ferrari\u201d, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3130-7131","authenticated-orcid":false,"given":"Giulia","family":"Galaverni","sequence":"additional","affiliation":[{"name":"Centre for Regenerative Medicine \u201cStefano Ferrari\u201d, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6110-5944","authenticated-orcid":false,"given":"Elisa","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Centre for Regenerative Medicine \u201cStefano Ferrari\u201d, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Losi","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, Unit of Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-6110","authenticated-orcid":false,"given":"Rossella","family":"Manfredini","sequence":"additional","affiliation":[{"name":"Centre for Regenerative Medicine \u201cStefano Ferrari\u201d, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8974-991X","authenticated-orcid":false,"given":"Alessandro","family":"Lambiase","sequence":"additional","affiliation":[{"name":"Department of Sense Organs, Sapienza University of Rome, 00169 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Rama","sequence":"additional","affiliation":[{"name":"Cornea and Ocular Surface Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20121 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziella","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Centre for Regenerative Medicine \u201cStefano Ferrari\u201d, University of Modena and Reggio Emilia, 41125 Modena, Italy"},{"name":"Holostem Terapie Avanzate s.r.l., 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Chiavelli, C., Attico, E., Sceberras, V., Fantacci, M., Melonari, M., and Pellegrini, G. (2019). Stem Cells and Ocular Regeneration. Encyclopedia of Tissue Engineering and Regenerative Medicine, Academic Press.","DOI":"10.1016\/B978-0-12-801238-3.65456-9"},{"key":"ref_2","first-page":"1","article-title":"Rationale for immune response and the eye","volume":"92","author":"Niederkorn","year":"2007","journal-title":"Chem. Immunol. Allergy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1083\/jcb.103.1.49","article-title":"Differentiation-related expression of a major 64K corneal keratin in vivo and in culture suggests limbal location of corneal epithelial stem cells","volume":"103","author":"Schermer","year":"1986","journal-title":"J. Cell Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1136\/bjo.2006.102640","article-title":"Morphological characteristics of the limbal epithelial crypt","volume":"91","author":"Foster","year":"2007","journal-title":"Br. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/ICO.0000000000001820","article-title":"Global Consensus on Definition, Classification, Diagnosis, and Staging of Limbal Stem Cell Deficiency","volume":"38","author":"Deng","year":"2019","journal-title":"Cornea"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/9798374","article-title":"Limbal Stem Cell Deficiency: Current Treatment Options and Emerging Therapies","volume":"2016","author":"Haagdorens","year":"2016","journal-title":"Stem Cells Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e395","DOI":"10.1016\/j.jfo.2018.09.003","article-title":"In vivo confocal microscopy and optical coherence tomography as innovative tools for the diagnosis of limbal stem cell deficiency","volume":"41","author":"Banayan","year":"2018","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_8","unstructured":"(2022, April 28). Orphanet: Limbal Stem Cell Deficiency. Available online: https:\/\/www.orpha.net\/consor\/cgi-bin\/OC_Exp.php?lng=EN&Expert=171673."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1016\/S0140-6736(96)11188-0","article-title":"Long-term restoration of damaged corneal surfaces with autologous cultivated corneal epithelium","volume":"349","author":"Pellegrini","year":"1997","journal-title":"Lancet"},{"key":"ref_10","unstructured":"(2022, April 28). Holoclar|European Medicines Agency. Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/holoclar."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s12015-013-9449-0","article-title":"Mesenchymal Stem Cells, Nanofiber Scaffolds and Ocular Surface Reconstruction","volume":"9","author":"Holan","year":"2013","journal-title":"Stem Cell Rev. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1097\/00003226-200310001-00011","article-title":"Ocular Surface Reconstruction Using Cultivated Mucosal Epithelial Stem Cells","volume":"22","author":"Nakamura","year":"2003","journal-title":"Cornea"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1136\/bjo.2010.188714","article-title":"Long-term results of autologous cultivated oral mucosal epithelial transplantation in the scar phase of severe ocular surface disorders","volume":"95","author":"Nakamura","year":"2010","journal-title":"Br. J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1056\/NEJMoa040455","article-title":"Corneal Reconstruction with Tissue-Engineered Cell Sheets Composed of Autologous Oral Mucosal Epithelium","volume":"351","author":"Nishida","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1167\/iovs.11-7744","article-title":"Cultured Autologous Oral Mucosal Epithelial Cell Sheet (CAOMECS) Transplantation for the Treatment of Corneal Limbal Epithelial Stem Cell Deficiency","volume":"53","author":"Burillon","year":"2012","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1038\/mt.2014.69","article-title":"Evidence of the Survival of Ectopically Transplanted Oral Mucosal Epithelial Stem Cells After Repeated Wounding of Cornea","volume":"22","author":"Sugiyama","year":"2014","journal-title":"Mol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1056\/NEJMp048199","article-title":"Changing the Cell Source in Cell Therapy?","volume":"351","author":"Pellegrini","year":"2004","journal-title":"New Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s40135-020-00263-9","article-title":"Clinical Studies of COMET for Total LSCD: A Review of the Methods and Molecular Markers for Follow-Up Characterizations","volume":"9","author":"Attico","year":"2021","journal-title":"Curr. Ophthalmol. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/S0002-9394(14)72164-6","article-title":"Use of DNA Polymorphisms and the Polymerase Chain Reaction to Examine the Survival of a Human Limbal Stem Cell Allograft","volume":"120","author":"Williams","year":"1995","journal-title":"Am. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1136\/bjo.85.5.604","article-title":"The long term outcome of limbal allografts: The search for surviving cells","volume":"85","author":"Henderson","year":"2001","journal-title":"Br. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s00418-008-0435-6","article-title":"The human keratins: Biology and pathology","volume":"129","author":"Moll","year":"2008","journal-title":"Histochem. Cell Biol."},{"key":"ref_22","first-page":"323","article-title":"The spectrum of cytokeratins expressed in the adult human cornea, limbus and perilimbal conjunctiva","volume":"26","author":"Merjava","year":"2011","journal-title":"Histol. Histopathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4660","DOI":"10.1167\/iovs.09-3377","article-title":"Persistence of Transplanted Oral Mucosal Epithelial Cells in Human Cornea","volume":"50","author":"Chen","year":"2009","journal-title":"Investig. Opthalmology Vis. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.ophtha.2006.09.034","article-title":"Phenotypic Investigation of Human Eyes with Transplanted Autologous Cultivated Oral Mucosal Epithelial Sheets for Severe Ocular Surface Diseases","volume":"114","author":"Nakamura","year":"2007","journal-title":"Ophthalmology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"644","DOI":"10.4103\/0301-4738.109517","article-title":"Oral epithelial cells transplanted on to corneal surface tend to adapt to the ocular phenotype","volume":"62","author":"Vemuganti","year":"2014","journal-title":"Indian J. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Zhang, X., Yin, M., and Zhang, L.-J. (2019). Keratin 6, 16 and 17\u2014Critical Barrier Alarmin Molecules in Skin Wounds and Psoriasis. Cells, 8.","DOI":"10.3390\/cells8080807"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1002\/dvdy.10245","article-title":"Role for keratins 6 and 17 during wound closure in embryonic mouse skin","volume":"226","author":"Mazzalupo","year":"2003","journal-title":"Dev. Dyn."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1046\/j.1523-1747.2001.01327.x","article-title":"Keratins and the Keratinocyte Activation Cycle","volume":"116","author":"Freedberg","year":"2001","journal-title":"J. Investig. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4158","DOI":"10.1167\/iovs.10-6726","article-title":"Overexpression of Pax6 in Mouse Cornea Directly Alters Corneal Epithelial Cells: Changes in Immune Function, Vascularization, and Differentiation","volume":"52","author":"Davis","year":"2011","journal-title":"Investig. Opthalmology Vis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1007\/s00345-019-02864-x","article-title":"Preclinical study for treatment of hypospadias by advanced therapy medicinal products","volume":"38","author":"Sceberras","year":"2019","journal-title":"World J. Urol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2302","DOI":"10.1073\/pnas.84.8.2302","article-title":"Three clonal types of keratinocyte with different capacities for multiplication","volume":"84","author":"Barrandon","year":"1987","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_32","first-page":"56","article-title":"Corneal neovascularization suppressed by TIMP2 released from human amniotic membranes","volume":"21","author":"Ma","year":"2005","journal-title":"Yan Ke Xue Bao"},{"key":"ref_33","first-page":"855","article-title":"Transcriptional signature primes human oral mucosa for rapid wound healing","volume":"10","author":"Uchiyama","year":"2018","journal-title":"Sci. Transl. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/0003-9969(95)00046-R","article-title":"Gene expression of markers associated with proliferation and differentiation in human keratinocytes cultured from epidermis and from buccal mucosa","volume":"40","author":"Brysk","year":"1995","journal-title":"Arch. Oral Biol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1038\/eye.1997.204","article-title":"Do transplanted corneal limbal stem cells survive in vivo long term? Possible techniques to detect donor cell survival by polymerase chain reaction with the amelogenin gene and Y-specific probes","volume":"11","author":"Henderson","year":"1997","journal-title":"Eye"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Utheim, T.P., Utheim, A., Khan, Q.-E., and Sehic, A. (2016). Culture of Oral Mucosal Epithelial Cells for the Purpose of Treating Limbal Stem Cell Deficiency. J. Funct. Biomater., 7.","DOI":"10.3390\/jfb7010005"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ajo.2018.01.020","article-title":"Limbal Stem Cell Deficiency\u2014Demography and Underlying Causes","volume":"188","author":"Vazirani","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.stemcr.2013.11.001","article-title":"Long-Term Stability and Safety of Transgenic Cultured Epidermal Stem Cells in Gene Therapy of Junctional Epidermolysis Bullosa","volume":"2","author":"Carulli","year":"2014","journal-title":"Stem Cell Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1155\/2015\/728307","article-title":"Diversity of Epithelial Stem Cell Types in Adult Lung","volume":"2015","author":"Li","year":"2015","journal-title":"Stem Cells Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.cell.2006.07.024","article-title":"Induction of Pluripotent Stem Cells from Mouse Embryonic and Adult Fibroblast Cultures by Defined Factors","volume":"126","author":"Takahashi","year":"2006","journal-title":"Cell"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/nm.3028","article-title":"The meaning, the sense and the significance: Translating the science of mesenchymal stem cells into medicine","volume":"19","author":"Bianco","year":"2013","journal-title":"Nat. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1177\/10454411000110040101","article-title":"Epithelial Structural Proteins of the Skin and Oral Cavity: Function in Health and Disease","volume":"11","author":"Presland","year":"2000","journal-title":"Crit. Rev. Oral Biol. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1002\/stem.2959","article-title":"SOX2 Regulates P63 and Stem\/Progenitor Cell State in the Corneal Epithelium","volume":"37","author":"Bhattacharya","year":"2018","journal-title":"Stem Cells"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1016\/j.ophtha.2015.04.004","article-title":"In Vivo Confocal Microscopy 1 Year after Autologous Cultured Limbal Stem Cell Grafts","volume":"122","author":"Pedrotti","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"5996","DOI":"10.1167\/iovs.16-20333","article-title":"In Vivo Distribution of Corneal Epithelial Dendritic Cells in Patients With Glaucoma","volume":"57","author":"Mastropasqua","year":"2016","journal-title":"Investig. Opthalmology Vis. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.exer.2017.11.005","article-title":"Human aniridia limbal epithelial cells lack expression of keratins K3 and K12","volume":"167","author":"Latta","year":"2018","journal-title":"Exp. Eye Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/j.1755-3768.2009.01603.x","article-title":"Immunohistochemical expression of epithelial cell markers in corneas with congenital aniridia and ocular cicatrizing pemphigoid","volume":"89","author":"Agrawal","year":"2011","journal-title":"Acta Ophthalmol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3820","DOI":"10.1167\/iovs.06-0293","article-title":"Establishment of a Cultivated Human Conjunctival Epithelium as an Alternative Tissue Source for Autologous Corneal Epithelial Transplantation","volume":"47","author":"Tanioka","year":"2006","journal-title":"Investig. Opthalmology Vis. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"151","DOI":"10.3109\/01913123.2013.776656","article-title":"In VivoCharacterization of Healthy Oral Mucosa by Reflectance Confocal Microscopy: A Translational Research for Optical Biopsy","volume":"37","author":"Contaldo","year":"2013","journal-title":"Ultrastruct. Pathol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/10\/5785\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:16:08Z","timestamp":1760138168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/10\/5785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,21]]},"references-count":49,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["ijms23105785"],"URL":"https:\/\/doi.org\/10.3390\/ijms23105785","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,21]]}}}