Limbal Stromal Cell-Derived Exosomes Promote Corneal Epithelial-like Differentiation of Bone Marrow Mesenchymal Stem Cells Through miR-146a-5p-Associated Activation of the PI3K-Akt Pathway

PURPOSE: This study aimed to investigate whether limbal stromal cell-derived exosomes (L-Exo) promote the acquisition of a corneal epithelial-like phenotype in BMSCs, and to elucidate the underlying mechanisms in a corneal alkali burn model. CONCLUSION: L-Exo induce BMSCs to acquire a corneal epithelial-like phenotype, a process associated with the delivery of exosomal miR-146a-5p and activation of the PI3K-Akt pathway. miR-146a-5p overexpression was sufficient to upregulate Abcb5 and activate PI3K-Akt, but not to induce Krt12 alone, suggesting that additional exosomal components and/or sustained signaling are required for full phenotypic conversion. L-Exo-primed BMSCs promote alkali-burned corneal recovery, representing a potential cell therapy.