Decellularized Amniotic Membrane–Mesenchymal Stem Cell Composite Enhances Corneal Repair via Mitochondrial Bioenergetics Restoration

Corneal alkali burn causes persistent inflammation, fibrosis, neovascularization, and vision impairment. Although amniotic membrane (AM) transplantation and mesenchymal stem cell (MSC)-based therapies have shown therapeutic potential, their combined application as a tissue-engineered construct for alkali-induced corneal injury remains insufficiently explored. Here, we developed a decellularized AM-based bone marrow-derived MSC (BMSC) composite and evaluated its therapeutic effects in a mouse model of corneal alkali burn. Compared with AM transplantation or subconjunctival BMSC injection alone, the BMSC-AM composite more effectively reduced corneal opacity and neovascularization, restored epithelial integrity and stromal architecture, and suppressed inflammatory and fibrotic responses. Moreover, BMSC-AM treatment alleviated oxidative stress, as indicated by reduced reactive oxygen species and malondialdehyde accumulation and increased total antioxidant capacity. Seahorse mitochondrial stress analysis further demonstrated that the composite restored mitochondrial oxidative phosphorylation, with more pronounced effects at 14 days after injury. Collectively, this study establishes a decellularized AM-BMSC composite as a biomaterial-assisted therapeutic platform for corneal alkali injury and suggests that preservation of mitochondrial bioenergetics and attenuation of oxidative stress contribute to its reparative effects.