The Combined Effect of Amniotic Membrane and Moringa oleifera Leaves Derived Gel for Wound and Burn Healing in Rat Model

Application of Amniotic Membrane in Skin Regeneration

Amniotic membrane (AM) is an avascular structure composed of three different layers, which contain collagen, extracellular matrix, and biologically active cells (stem cells). Collagen, a naturally occurring matrix polymer, provides the structural matrix/strength of the amniotic membrane. Tissue remodeling is regulated by growth factors, cytokines, chemokines, and other regulatory molecules produced by endogenous cells within AM. Therefore, AM is considered an attractive skin-regenerating agent. This review discusses the application of AM in skin regeneration, including its preparation for application to the skin and its mechanisms of therapeutic healing in the skin. This review involved collecting research articles that have been published in several databases, including Google Scholar, PubMed, Science Direct, and Scopus. The search was conducted by using the keywords ‘amniotic membrane skin’, ‘amniotic membrane wound healing’, ‘amniotic membrane burn’, ‘amniotic membrane urethral defects’, ‘amniotic membrane junctional epidermolysis bullosa’, and ‘amniotic membrane calciphylaxis’. Ultimately, 87 articles are discussed in this review. Overall, AM has various activities that help in the regeneration and repair of damaged skin.

Silver Nanoparticle Incorporated Human Amniotic Membrane Gel Accelerates Second-Degree Burn Wound Healing in Wister Rat

Burn has terrible consequences for the affected patients, making them vulnerable to wound infections and septicemia, which results in physical and mental disability and death, necessitating superior treatment options. Human amniotic membrane (HAM) has been utilized in burn wounds for decades for its low immunogenicity, angiogenic, anti-inflammatory, and antimicrobial properties and for promoting epithelialization. Silver nanoparticles (AgNPs), on the other hand, have antimicrobial properties and promote fibroblast migration. This study aimed to determine the burn wound healing potential of HAM + AgNPs. The gel was prepared using HAM (1% and 2%), AgNPs, carbopol 934, acrylic acid, glycerine, and triethanolamine, and different physical properties (pH, water absorption, swelling variation, spreadability, etc.) of the gel were determined; nuclear magnetic resonance (NMR) spectroscopy, antibacterial activity, brine shrimp lethality test, and histopathological observation were conducted. In vivo studies with Wistar rats demonstrated better healing capabilities than individual components of the gel. Wound contraction percentage after 20 days was 96.1 ± 0.27% which was highly significant (p < 0.0001), and the epithelialization period was 23.67 ± 2.05 days (p < 0.01) for HAM + AgNPs which was preferable to the positive control, AgNPs, HAM, and negative control; also, the histopathologic observation using hematoxylin and eosin, and Masson's trichrome staining were showed the better healing progress for HAM + AgNPs. Both HAM and AgNPs had antibacterial activities against gram-positive and gram-negative bacteria. These results indicated that the formulated HAM + AgNPs gel had remarkable effectiveness in burn wound healing compared to others. Further studies will be conducted to determine the molecular mechanism behind wound healing.

Scoping Review: Evaluation of Moringa oleifera (Lam.) for Potential Wound Healing in In Vivo Studies

Wound healing is a natural process to restore damaged tissues due to loss of tissue integrity. Moringa oleifera (locally known as merunggai in Malaysia) has been traditionally used in various ailments, including for wound management. To evaluate the wound healing properties in M. oleifera, publications were searched and selected following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement with predetermined inclusion criteria. The databases searched for primary studies include PubMed, Google Scholar, Science Direct, LILACS, ClinicalTrials.gov, and CENTRAL. In total, 18 in vivo studies were included, which involved the leaves, while the remaining 5 studies involved other plant parts tested on excision, incision, dead space, abrasion, and burn-induced wound models. All studies reported significant wound healing abilities. Most studies used different topical formulations of aqueous leaves extract. The accumulation of collagen content and underlying wound healing mechanism through antimicrobial, antioxidant, and anti-inflammatory activities may be contributed by its bioactive phytochemical content, which has the potential to accelerate the wound contraction, increase the rate of epithelialization, and protect tissues against oxidative damage. In conclusion, M. oleifera showed wound healing potential but further studies are warranted to determine the main bioactive phytocompounds and safety.