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Schmiedova I, Slama P, Dembickaja A, Kozova B, Hyneckova V, Gogolkova S, Stastna E, Zahradnicek M, Savic S, Davani A, Hulo E, Martinka E. Clinical Evaluation of AMNIODERM+ ® Wound Dressing Containing Non-Viable Human Amniotic Membrane: Retrospective-Perspective Clinical Trial. BIOTECH 2024; 13:36. [PMID: 39311338 PMCID: PMC11417787 DOI: 10.3390/biotech13030036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/14/2024] [Accepted: 09/16/2024] [Indexed: 09/26/2024] Open
Abstract
Chronic wounds result from the body's inability to heal, causing pain, pathogen entry, limited treatment options, and societal burden. Diabetic foot ulcers are particularly challenging, often leading to severe complications like leg amputation. A clinical study tested AMNIODERM+®, a new device with a lyophilized human amniotic membrane (HAM), on chronic diabetic foot ulcers. Participants had diabetic neuropathic or neuroischemic leg wounds (2-16 cm2) unhealed by 20% after six weeks of standard care. This study showed significant wound healing improvements with AMNIODERM+®. The median wound size reduction after 12 weeks was 95.5%, far exceeding the null hypothesis of 20% change. Additionally, 65% of patients achieved complete ulceration healing, surpassing the 50% efficacy requirement. The median time to full closure was 11.4 weeks, with the proportion of completely healed patients rising progressively, reaching 55% by week 11. These findings, from the clinical trial "Freeze-dried amniotic membrane in the treatment of nonhealing wounds", suggest AMNIODERM+® as a promising future treatment for chronic diabetic foot ulcers. The published results were obtained as part of a clinical trial entitled "Freeze-dried amniotic membrane in the treatment of nonhealing wounds: a single-arm, retrospectively-perspective clinical trial", EUDAMED Nr. CIV-SK-22-10-041146.
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Affiliation(s)
- Iveta Schmiedova
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
- Laboratory of Animal Immunology and Biotechnology, Department of Animal Morphology, Physiology and Genetics, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic
| | - Petr Slama
- Laboratory of Animal Immunology and Biotechnology, Department of Animal Morphology, Physiology and Genetics, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic
| | - Alena Dembickaja
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
- Laboratory of Animal Immunology and Biotechnology, Department of Animal Morphology, Physiology and Genetics, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic
| | - Beata Kozova
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
| | - Vendula Hyneckova
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
| | - Sona Gogolkova
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
| | - Elen Stastna
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
| | - Michal Zahradnicek
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
| | - Stefan Savic
- BioHealing s.r.o., Dr. Slabihoudka 6232/11, 708 00 Ostrava, Czech Republic
| | - Arash Davani
- National Institute of Endocrinology and Diabetology, Kollárová 282/3, 034 91 Ľubochňa, Slovakia
| | - Edward Hulo
- National Institute of Endocrinology and Diabetology, Kollárová 282/3, 034 91 Ľubochňa, Slovakia
| | - Emil Martinka
- National Institute of Endocrinology and Diabetology, Kollárová 282/3, 034 91 Ľubochňa, Slovakia
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Siegmund A, Wolff D, Pagani A, Ruewe M, Klein S, Herr W, Prantl L, Geis S. Allogeneic amnion transplantation for the management of cutaneous graft-versus-host disease with associated ulcers: A promising therapeutic strategy. Ann Hematol 2024:10.1007/s00277-024-05990-8. [PMID: 39237815 DOI: 10.1007/s00277-024-05990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 09/02/2024] [Indexed: 09/07/2024]
Abstract
Allogeneic hematopoietic stem cell transplantation (alloSCT) is the cornerstone treatment for various hematopoietic disorders, but its utility is often compromised by chronic graft-versus-host disease (cGvHD), affecting skin integrity and leading to ulcer formations. Traditional treatments, including systemic and topical therapies, frequently fail in severe cases. This study retrospectively examines three patients with therapy-resistant ulcers due to cGvHD post-alloSCT treated at the University Hospital of Regensburg in 2023. We evaluated the therapeutic impact of human amniotic membrane (hAM) transplantation-a novel approach utilizing hAM's anti-inflammatory, anti-microbial, and anti-fibrotic properties for wound healing. Surgical debridement was followed by hAM application and routine follow-up. HAM transplantation led to complete wound closure in two out of three patients and a significant reduction in local pain and infection rates. The treatment alleviated the need for regular dressing changes within three months in two patients, demonstrating the hAM's efficacy in fostering rapid and sustained healing. The utilization of hAM represents a promising alternative for the management of refractory skin ulcers in cGvHD patients, particularly when conventional methods are inadequate.
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Affiliation(s)
- Andreas Siegmund
- Department of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
| | - Daniel Wolff
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Andrea Pagani
- Department of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Marc Ruewe
- Department of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Silvan Klein
- Department of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Wolfgang Herr
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Sebastian Geis
- Department of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
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Corrêa MEAB, Silveira PCL. Amniotic membrane in wound healing: new perspectives. J Wound Care 2024; 33:612-616. [PMID: 39140406 DOI: 10.12968/jowc.2022.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
There are several reasons for skin damage, including genetic factors, disorders, acute trauma, hard-to-heal wounds, or surgical interventions. Whatever the cause, wounds have a substantial impact on people who experience them, their caregivers and the healthcare system. Advanced wound care products have been researched and developed, providing an opportunity for faster and more complete healing. Tissue engineering (TE) is a promising strategy that can overcome limitations when choosing a graft for a wound. Amniotic membrane is a highly abundant, readily available, and inexpensive biological tissue that does not raise ethical concerns, with many applications in different fields of TE and regenerative medicine. It has attractive physical characteristics, such as elasticity, rigidity and mechanical strength, among others. The effects can also be potentiated by association with other substances, such as hyaluronic acid and growth factors. This paper describes new perspectives involving the use of amniotic membranes.
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Affiliation(s)
- Maria Eduarda Anastácio Borgês Corrêa
- Laboratory of Experimental Physiopathology, Postgraduate Program in Health Sciences, University of the Extreme South of Santa Catarina, Santa Catarina State, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Experimental Physiopathology, Postgraduate Program in Health Sciences, University of the Extreme South of Santa Catarina, Santa Catarina State, Brazil
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Trivedi AH, Wang VZ, McClain EJ, Vyas PS, Swink IR, Snell ED, Cheng BC, DeMeo PJ. The Categorization of Perinatal Derivatives for Orthopedic Applications. Biomedicines 2024; 12:1544. [PMID: 39062117 PMCID: PMC11274709 DOI: 10.3390/biomedicines12071544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/01/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Musculoskeletal (MSK) pathology encompasses an array of conditions that can cause anything from mild discomfort to permanent injury. Their prevalence and impact on disability have sparked interest in more effective treatments, particularly within orthopedics. As a result, the human placenta has come into focus within regenerative medicine as a perinatal derivative (PnD). These biologics are sourced from components of the placenta, each possessing a unique composition of collagens, proteins, and factors believed to aid in healing and regeneration. This review aims to explore the current literature on PnD biologics and their potential benefits for treating various MSK pathologies. We delve into different types of PnDs and their healing effects on muscles, tendons, bones, cartilage, ligaments, and nerves. Our discussions highlight the crucial role of immune modulation in the healing process for each condition. PnDs have been observed to influence the balance between anti- and pro-inflammatory factors and, in some cases, act as biologic scaffolds for tissue growth. Additionally, we assess the range of PnDs available, while also addressing gaps in our understanding, particularly regarding biologic processing methods. Although certain PnD biologics have varying levels of support in orthopedic literature, further clinical investigations are necessary to fully evaluate their impact on human patients.
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Affiliation(s)
- Amol H. Trivedi
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
- Drexel University College of Medicine, Drexel University, University City Campus, Philadelphia, PA 19104, USA
| | - Vicki Z. Wang
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
| | - Edward J. McClain
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
| | - Praveer S. Vyas
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
| | - Isaac R. Swink
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
| | - Edward D. Snell
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
| | - Boyle C. Cheng
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
| | - Patrick J. DeMeo
- Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA; (A.H.T.); (V.Z.W.); (E.J.M.IV); (P.S.V.); (I.R.S.); (E.D.S.); (P.J.D.)
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Pinky, Sharma A, Arora V, Rao EP, Arava S, Agrawal AK, Jassal M, Mohanty S. Modulating the hAM/PCL Biocomposite for Expedited Wound Healing: A Chemical-Free Approach for Boosting Regenerative Potential. ACS Biomater Sci Eng 2024; 10:3842-3854. [PMID: 38754076 DOI: 10.1021/acsbiomaterials.3c01740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
There is an arising need for effective wound dressings that retain the bioactivity of a cellular treatment, but without the high costs and complexities associated with manufacturing, storing, and applying cell-based products. As skin wound recovery is a dynamic and complicated process, a significant obstacle to the healing of skin wounds is the lack of an appropriate wound dressing that can imitate the microenvironment of healthy skin and prevent bacterial infection. It requires the well-orchestrated integration of biological and molecular events. In this study, we have fabricated full-thickness skin graft biocomposite membranes to target full-thickness skin excision wounds. We reinforced human amniotic membrane (hAM) with electrospun polycaprolactone (PCL) to develop composite membranes, namely, PCL/hAM and PCL/hAM/PCL. Composite membranes were compared for physical, biological, and mechanical properties with the native counterpart. PCL/hAM and PCL/hAM/PCL displayed improved stability and delayed degradation, which further synergically improved the rapid wound healing property of hAM, driven primarily by wound closure analysis and histological assessment. Moreover, PCL/hAM displayed a comparable cellular interaction to hAM. On application as a wound dressing, histological analysis demonstrated that hAM and PCL/hAM promoted early epidermis and dermis formation. Studies on in vivo wound healing revealed that although hAM accelerates cell development, the overall wound healing process is similar in PCL/hAM. This finding is further supported by the immunohistochemical analysis of COL-1/COL-3, CD-31, and TGF-β. Overall, this conjugated PCL and hAM-based membrane has considerable potential to be applied in skin wound healing. The facile fabrication of the PCL/hAM composite membrane provided the self-regenerating wound dressing with the desired mechanical strength as an ideal regenerative property for skin tissue regeneration.
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Affiliation(s)
- Pinky
- Stem Cell Facility, DBT-Centre of Excellence for Stem Cell Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Aarushi Sharma
- Stem Cell Facility, DBT-Centre of Excellence for Stem Cell Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Varun Arora
- SMITA Research Lab, Department of Textile and Fibre Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India
| | - E Pranshu Rao
- Stem Cell Facility, DBT-Centre of Excellence for Stem Cell Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Sudheer Arava
- Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Ashwini K Agrawal
- SMITA Research Lab, Department of Textile and Fibre Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India
| | - Manjeet Jassal
- SMITA Research Lab, Department of Textile and Fibre Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India
| | - Sujata Mohanty
- Stem Cell Facility, DBT-Centre of Excellence for Stem Cell Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Dawiec G, Niemczyk W, Wiench R, Niemczyk S, Skaba D. Introduction to Amniotic Membranes in Maxillofacial Surgery-A Scoping Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:663. [PMID: 38674309 PMCID: PMC11051762 DOI: 10.3390/medicina60040663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
Background: Amniotic membrane (AM) holds significant promise in various medical fields due to its unique properties and minimal ethical concerns. This study aims to explore the diverse applications of the human amniotic membrane (HAM) in maxillofacial surgery. Methodology: A comprehensive search was conducted on databases, namely Google Scholar, PubMed, and Scopus, from January 1985 to March 2024. Articles in English, Polish, and Spanish were included, focusing on keywords related to amniotic membrane and oral surgery. Results: Various preservation methods for HAM were identified, namely fresh, decellularized, cryopreserved, lyophilized, and air-dried formats. Clinical studies demonstrated the efficacy of HAM in repairing oral mucosal defects, vestibuloplasty, oronasal fistula closure, cleft palate treatment, bone defect repair, and medication-related osteonecrosis of the jaw (MRONJ). Surgeon evaluations highlighted the ease of handling but noted challenges in suturing and stability during application. Conclusions: Amniotic membranes offer a versatile and effective option in maxillofacial surgery, promoting wound healing, reducing inflammation, and providing a scaffold for tissue regeneration. Further research, including randomized trials and comparative studies, is warranted to validate the efficacy and optimize the utilization of HAM in clinical practice.
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Affiliation(s)
- Grzegorz Dawiec
- Department of Paediatric Otolaryngology, Head and Neck Surgery, Department of Paediatric Surgery, Faculty of Medical Sciences, ul. Medyków 16, 40-752 Katowice, Poland
- Outpatient Clinic for Dental Surgery in Zabrze, University Dental Centre, Silesian Medical University Ltd. in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
- Private Dental Practice NZOZ Stomatologia-Dawiec s.c., Ul. Witczaka 49/15, 41-902 Bytom, Poland
| | - Wojciech Niemczyk
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pl. Traugutta 2, 41-800 Zabrze, Poland; (R.W.); (D.S.)
| | - Rafał Wiench
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pl. Traugutta 2, 41-800 Zabrze, Poland; (R.W.); (D.S.)
| | - Stanisław Niemczyk
- Municipal Hospital No. 4 in Gliwice, Zygmunta Starego 20, 44-100 Gliwice, Poland;
| | - Dariusz Skaba
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pl. Traugutta 2, 41-800 Zabrze, Poland; (R.W.); (D.S.)
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Hu Z, Luo Y, Ni R, Hu Y, Yang F, Du T, Zhu Y. Biological importance of human amniotic membrane in tissue engineering and regenerative medicine. Mater Today Bio 2023; 22:100790. [PMID: 37711653 PMCID: PMC10498009 DOI: 10.1016/j.mtbio.2023.100790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
The human amniotic membrane (hAM) is the innermost layer of the placenta. Its distinctive structure and the biological and physical characteristics make it a highly biocompatible material in a variety of regenerative medicine applications. It also acts as a supply of bioactive factors and cells, which indicate the advantages over other tissues. In this review, we firstly discussed the biological properties of hAM-derived cells in vivo or in vitro, along with their stemness of markers, pointing out a promising source of stem cells for regenerative medicine. Then, we systematically summarized current knowledge on the collection, preparation, preservation, and decellularization of hAM, as well as their characteristics helping to improve the understanding of applications in tissue engineering. Finally, we highlighted the recent advances in which hAM has undergone additional modifications to achieve an adequate perspective of regenerative medicine applications. More investigations are required in utilizing appropriate modifications to enhance the therapeutic effectiveness of hAM in the future.
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Affiliation(s)
- Zeming Hu
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Yang Luo
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Renhao Ni
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Yiwei Hu
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Fang Yang
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Tianyu Du
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Yabin Zhu
- Health Science Center, Ningbo University, Ningbo, 315211, China
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Hosseini M, Shafiee A. Vascularization of cutaneous wounds by stem cells. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2023; 199:327-350. [PMID: 37678977 DOI: 10.1016/bs.pmbts.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Differentiated skin cells have limited self-renewal capacity; thus, the application of stem/progenitor cells, adult or induced stem cells, has attracted much attention for wound healing applications. Upon skin injury, vascularization, known as a highly dynamic process, occurs with the contribution of cells, the extracellular matrix, and relevant growth factors. Considering the importance of this process in tissue regeneration, several strategies have been proposed to enhance angiogenesis and accelerate wound healing. Previous studies report the effectiveness of stem/progenitor cells in skin wound healing by facilitating the vascularization process. This chapter reviews and highlights some of the key and recent investigations on application of stem/progenitor cells to induce skin revascularization after trauma.
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Affiliation(s)
- Motaharesadat Hosseini
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia; ARC Industrial Transformation Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D), Queensland University of Technology, Brisbane, QLD, Australia
| | - Abbas Shafiee
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia; Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
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Jahanafrooz Z, Bakhshandeh B, Behnam Abdollahi S, Seyedjafari E. Human amniotic membrane as a multifunctional biomaterial: recent advances and applications. J Biomater Appl 2023; 37:1341-1354. [PMID: 36331116 DOI: 10.1177/08853282221137609] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The developing fetus is wrapped by a human amniotic membrane or amnion. Amnion is a promising human tissue allograft in clinical application because of its chemical composition, collagen-based, and mechanical properties of the extracellular matrix. In addition, amnion contains cells and growth factors; therefore, meets the essential parameters of tissue engineering. No donor morbidity, easy processing and storage, fewer ethical issue, anti-inflammatory, antioxidant, antibacterial, and non-immunogenic properties are other advantages of amnion usage. For these reasons, amnion can resolve some bottlenecks in the regenerative medicine issues such as tissue engineering and cell therapy. Over the last decades, biomedical applications of amnion have evolved from a simple sheet for skin or cornea repair to high-technology applications such as amnion nanocomposite, powder, or hydrogel for the regeneration of cartilage, muscle, tendon, and heart. Furthermore, amnion has anticancer as well as drug/cell delivery capacity. This review highlights various ancient and new applications of amnion in research and clinical applications, from regenerative medicine to cancer therapy, focusing on articles published during the last decade that also revealed information regarding amnion-based products. Challenges and future perspectives of the amnion in regenerative medicine are also discussed.
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Mechanical reinforcement of amniotic membranes for vesicovaginal fistula repair. J Mech Behav Biomed Mater 2023; 139:105680. [PMID: 36701851 DOI: 10.1016/j.jmbbm.2023.105680] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/23/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Amniotic membranes (AM) have shown its great potential in reconstructive surgery due to their regenerative capacity. However, AM is regarded to be relatively weak when applied for load-bearing purposes. This study aims to produce an AM-based scaffold that can withstand the mechanical loads applied in vesicovaginal fistula repair. Different strategies are investigated to improve the mechanical characteristics of AM. METHODS Single and multilayered AM, and composite constructs of AM with electrospun poly-4-hydroxybutyrate (P4HB) or bovine pericardial tissue combined with the use of fibrin glue, were mechanically tested in this study. Suture retention strength and mechanical characteristics (tensile stress, elongation, tangent modulus and maximum load) were assessed by uniaxial testing. The effect of degradation of the composite constructs on the mechanical characteristics was determined by uniaxial testing after 4 and 8 weeks. RESULTS Single and multilayered AM could not provide the mechanical requirements needed for surgical implantation (>2N load). AM was combined successfully with electrospun P4HB and bovine pericardium with the use of fibrin glue and were able to exceed the 2N load. CONCLUSION The composite constructs with AM showed sufficient mechanical characteristics for surgical implantation. Electrospun P4HB combined with AM seemed the most promising candidate since the mechanical characteristics of P4HB can be further modified to meet the requirements of the application site and the degradation of the P4HB allows a gradual transfer of load. Eventhough the scaffold is intended for fistula repair, it can potentially be applied in surgical reconstruction of other hollow organs by modifying the mechanical characteristics.
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Mohammad-Pour N, Moghimi V, Bidkhori HR, Momeni-Moghaddam M, Naderi-Meshkin H. Comparing the Effects of Two Cryoprotectant Protocols, Dimethyl-Sulfoxide (DMSO) and Glycerol, on the Recovery Rate of Cultured Keratinocytes on Amniotic Membrane. INT J LOW EXTR WOUND 2023:15347346231155751. [PMID: 36794512 DOI: 10.1177/15347346231155751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Background: Off-the-shelf supply of viable engineered tissue is critical for effective and fast treatment of life-threatening injuries such as deep burns. An expanded keratinocyte sheet on the human amniotic membrane (KC sheet-HAM) is a beneficial tissue-engineering product for wound healing. To access an on-hand supply for the widespread application and overcome the time-consuming process, it is necessary to develop a cryopreservation protocol that guarantees the higher recovery of viable keratinocyte sheets after freeze-thawing. This research aimed to compare the recovery rate of KC sheet-HAM after cryopreservation by dimethyl-sulfoxide (DMSO) and glycerol. Methods: Amniotic membrane was decellularized with trypsin, and keratinocytes were cultured on it to form a multilayer, flexible, easy-to-handle KC sheet-HAM. The effects of 2 different cryoprotectants were investigated by histological analysis, live-dead staining, and proliferative capacity assessments before and after cryopreservation. Results: KCs well adhered and proliferated on the decellularized amniotic membrane and successfully represented 3 to 4 stratified layers of epithelialization after 2 to 3 weeks culture period; making it easy to cut, transfer, and cryopreserve. However, viability and proliferation assay indicated that both DMSO and glycerol cryosolutions have detrimental effects on KCs, and KCs-sheet HAM could not recover to the control level after 8 days of culture post-cryo. The KC sheet lost its stratified multilayer nature on AM, and sheet layers were reduced in both cryo-groups compared to the control. Conclusion: Expanding keratinocytes on the decellularized amniotic membrane as a multilayer sheet made a viable easy-to-handle sheet, nonetheless cryopreservation reduced viability and affected histological structure after thawing. Although some viable cells were detectable, our research highlighted the need for a better cryoprotectant protocol other than DMSO and glycerol, specific for the successful banking of viable tissue constructs.
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Affiliation(s)
- Najmeh Mohammad-Pour
- Department of Biology, Faculty of Science, Hakim Sabzevari University, Sabzevar, Iran
- Stem Cells and Regenerative Medicine Department, Academic Center for Education, Culture and Research (ACECR)-Khorasan Razavi, Mashhad, Iran
| | - Vahid Moghimi
- Department of Biology, Faculty of Science, Hakim Sabzevari University, Sabzevar, Iran
- Stem Cells and Regenerative Medicine Department, Academic Center for Education, Culture and Research (ACECR)-Khorasan Razavi, Mashhad, Iran
| | - Hamid Reza Bidkhori
- Stem Cells and Regenerative Medicine Department, Academic Center for Education, Culture and Research (ACECR)-Khorasan Razavi, Mashhad, Iran
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR)-Khorasan Razavi, Mashhad, Iran
| | - Madjid Momeni-Moghaddam
- Stem Cells and Regenerative Medicine Department, Academic Center for Education, Culture and Research (ACECR)-Khorasan Razavi, Mashhad, Iran
| | - Hojjat Naderi-Meshkin
- Stem Cells and Regenerative Medicine Department, Academic Center for Education, Culture and Research (ACECR)-Khorasan Razavi, Mashhad, Iran
- Wellcome-Wolfson Institute for Experimental Medicine, Belfast, UK
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12
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Maljaars LP, Bendaoud S, Kastelein AW, Guler Z, Hooijmans CR, Roovers JPWR. Application of amniotic membranes in reconstructive surgery of internal organs-A systematic review and meta-analysis. J Tissue Eng Regen Med 2022; 16:1069-1090. [PMID: 36333859 PMCID: PMC10099938 DOI: 10.1002/term.3357] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/20/2022] [Indexed: 11/08/2022]
Abstract
Amniotic membrane (AM) has great potential as a scaffold for tissue regeneration in reconstructive surgery. To date, no systematic review of the literature has been performed for the applications of AM in wound closure of internal organs. Therefore, in this systematic review and meta-analysis, we summarize the literature on the safety and efficacy of AM for the closure of internal organs. A systematic search was performed in MEDLINE-PubMed database and OVID Embase to retrieve human and controlled animal studies on wound closure of internal organs. The Cochrane Risk of Bias tool for randomized clinical trials and the SYRCLE risk of bias tool for animal studies were used. Meta-analyses (MAs) were conducted for controlled animal studies to assess efficacy of closure, mortality and complications in subjects who underwent surgical wound closure in internal organs with the application of AM. Sixty references containing 26 human experiments and 36 animal experiments were included. The MAs of the controlled animal studies showed comparable results with regard to closure, mortality and complications, and suggested improved mechanical strength and lower inflammation scores after AM application when compared to standard surgical closure techniques. This systematic review and MAs demonstrate that the application of AM to promote wound healing of internal organs appears to be safe, efficacious, and feasible.
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Affiliation(s)
- Lennart P Maljaars
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Sohayla Bendaoud
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Arnoud W Kastelein
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Zeliha Guler
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Carlijn R Hooijmans
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan-Paul W R Roovers
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
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13
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Shah Z, Bakhshi SK, Bajwa MH, Khalil M, Dewan MC, Shamim SM. Human amniotic membrane as a dural substitute in neurosurgery: A systematic review. Surg Neurol Int 2022; 13:505. [DOI: 10.25259/sni_794_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Background:
Several studies have highlighted the use of human amniotic membrane (HAM) in neurosurgical procedures as an effective dural substitute. HAM has inherent antifibrotic and anti-inflammatory properties and exhibits immunomodulatory effect that makes it an ideal dural substitute. Other advantages including easy availability, low cost of procurement, and storage also render it a promising dural substitute especially in low- and middle-income countries.
Methods:
A systematic literature search was performed using PubMed, Scopus, and Google Scholar databases, using the search terms “human amniotic membrane,” “dural repair,” and “neurosurgery.” To be eligible for inclusion in our review, papers had to report primary data, be published in English language and report dural repair on humans with human amniotic membrane. Eligibility assessment was conducted by two independent reviewers with qualitative analysis on the basis of surgical utility, postoperative complications, and histological analysis.
Results:
Eight articles met the predefined inclusion criteria, including three randomized control trials and five cohort studies. We evaluated the use of HAM grafts in dural repair for elective cranial surgery (four studies), trauma surgery (three studies), and elective spine surgery (one study). Cases with postoperative cerebrospinal fluid (CSF) leak were reported by two studies. Other postoperative complications including meningitis, hydrocephalus, pseudomeningocele, CSF collection in subdural space, and subacute subdural hematoma were reported by one study each. Postsurgical histological analysis was reported by three studies highlighting the antiadhesive and integrative properties of HAM.
Conclusion:
The current review of evidence suggests that in terms of postsurgical outcomes, HAM is comparable with commercially available dural substitutes.
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Affiliation(s)
- Zara Shah
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan,
| | | | | | - Mujtaba Khalil
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan,
| | - Michael C. Dewan
- Department of Neurosurgery, Vanderbilt University Medical Centre, Nashville, United States
| | - Shahzad M. Shamim
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan,
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14
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Pain Management in Older Adults with Chronic Wounds. Drugs Aging 2022; 39:619-629. [PMID: 35829959 DOI: 10.1007/s40266-022-00963-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/03/2022]
Abstract
Older people often suffer from different types of ulcers, with the most prevalent being chronic leg ulcers (CLUs) and diabetic foot ulcers. There are major issues in the current medical approach because these ulcers are hard to heal, and, in the case of CLUs, very painful and with a high frequency of relapse. Older people complain of pain more frequently than young people, frequently due to a combination of painful chronic wounds with other comorbidities (e.g. arthritis, peripheral arterial disease, vertebrogenic pain syndrome). However, chronic pain appears to be managed better by older people because the pain sensitivity is downregulated and the pain threshold is higher in older people. Pain management of chronic wounds is often insufficient, especially in older individuals. It is highly important to use non-traumatic wound dressings and pay attention to patients' feelings and fears because pain in chronic ulcers can impair wound healing. Key factors include good preparation for dressing change and adequate analgesia, ideally a combination of topical and oral agents.
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15
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Mastrogiacomo M, Nardini M, Collina MC, Di Campli C, Filaci G, Cancedda R, Odorisio T. Innovative Cell and Platelet Rich Plasma Therapies for Diabetic Foot Ulcer Treatment: The Allogeneic Approach. Front Bioeng Biotechnol 2022; 10:869408. [PMID: 35586557 PMCID: PMC9108368 DOI: 10.3389/fbioe.2022.869408] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/14/2022] [Indexed: 12/15/2022] Open
Abstract
Cutaneous chronic wounds are a major global health burden in continuous growth, because of population aging and the higher incidence of chronic diseases, such as diabetes. Different treatments have been proposed: biological, surgical, and physical. However, most of these treatments are palliative and none of them can be considered fully satisfactory. During a spontaneous wound healing, endogenous regeneration mechanisms and resident cell activity are triggered by the released platelet content. Activated stem and progenitor cells are key factors for ulcer healing, and they can be either recruited to the wound site from the tissue itself (resident cells) or from elsewhere. Transplant of skin substitutes, and of stem cells derived from tissues such as bone marrow or adipose tissue, together with platelet-rich plasma (PRP) treatments have been proposed as therapeutic options, and they represent the today most promising tools to promote ulcer healing in diabetes. Although stem cells can directly participate to skin repair, they primarily contribute to the tissue remodeling by releasing biomolecules and microvesicles able to stimulate the endogenous regeneration mechanisms. Stem cells and PRP can be obtained from patients as autologous preparations. However, in the diabetic condition, poor cell number, reduced cell activity or impaired PRP efficacy may limit their use. Administration of allogeneic preparations from healthy and/or younger donors is regarded with increasing interest to overcome such limitation. This review summarizes the results obtained when these innovative treatments were adopted in preclinical animal models of diabetes and in diabetic patients, with a focus on allogeneic preparations.
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Affiliation(s)
- Maddalena Mastrogiacomo
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli Studi di Genova, Genova, Italy
- *Correspondence: Maddalena Mastrogiacomo,
| | - Marta Nardini
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli Studi di Genova, Genova, Italy
| | - Maria Chiara Collina
- Unità Operativa Semplice Piede Diabetico e Ulcere Cutanee, IDI-IRCCS, Roma, Italy
| | - Cristiana Di Campli
- Unità Operativa Semplice Piede Diabetico e Ulcere Cutanee, IDI-IRCCS, Roma, Italy
| | - Gilberto Filaci
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli Studi di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ranieri Cancedda
- Emeritus Professor, Università degli Studi di Genova, Genova, Italy
| | - Teresa Odorisio
- Laboratorio di Biologia Molecolare e Cellulare, IDI-IRCCS, Roma, Italy
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16
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Placental Tissues as Biomaterials in Regenerative Medicine. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6751456. [PMID: 35496035 PMCID: PMC9050314 DOI: 10.1155/2022/6751456] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/19/2022] [Indexed: 12/02/2022]
Abstract
Placental tissues encompass all the tissues which support fetal development, including the placenta, placental membrane, umbilical cord, and amniotic fluid. Since the 1990s there has been renewed interest in the use of these tissues as a raw material for regenerative medicine applications. Placental tissues have been extensively studied for their potential contribution to tissue repair applications. Studies have attributed their efficacy in augmenting the healing process to the extracellular matrix scaffolds rich in collagens, glycosaminoglycans, and proteoglycans, as well as the presence of cytokines within the tissues that have been shown to stimulate re-epithelialization, promote angiogenesis, and aid in the reduction of inflammation and scarring. The compositions and properties of all birth tissues give them the potential to be valuable biomaterials for the development of new regenerative therapies. Herein, the development and compositions of each of these tissues are reviewed, with focus on the structural and signaling components that are relevant to medical applications. This review also explores current configurations and recent innovations in the use of placental tissues as biomaterials in regenerative medicine.
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17
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Jeong W, Hong J, Jung M, Jang M, An S, Jo T, Kwon S, Son D. Therapeutic Effects of Amnion-Conjugated Chitosan-Alginate Membranes on Diabetic Wounds in an Induced Diabetic Swine Model: An In Vitro and In Vivo Study. Arch Plast Surg 2022; 49:258-265. [PMID: 35832677 PMCID: PMC9045513 DOI: 10.1055/s-0042-1744429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background
Chitosan (CS) is a well-known antimicrobial dressing material. Moreover, widely used amniotic membranes contain growth factors beneficial for wound healing. Herein, we created a novel amnion-conjugated CS-alginate membrane dressing and tested its wound healing potency in a diabetic swine model.
Methods
The bovine amniotic powder growth factor contents were evaluated by protein assay, and the powder's wound healing effects were assessed in vitro by HaCaT cell scratch closure. In vivo, two minipigs developed streptozotocin-induced diabetes. Serial serum glucose measurements and intravenous glucose tolerance tests were performed to confirm their diabetic status. Twelve square-shaped wounds created on each pig's back were randomly divided into control (
n
= 4), CS (
n
= 4), and amnion-CS (AC;
n
= 4) groups and treated accordingly with different dressings. Wound healing in each group was assessed by measuring wound contraction over time, capturing wound perfusion with indocyanine green (ICG) angiography, and histologically analyzing inflammatory markers.
Results
Amniotic powder elution promoted HaCaT cell migration in the scratch wound model, suggesting its beneficial in vitro wound healing effects. In vivo, the CS and AC groups showed earlier wound contraction initiation and reepithelialization and earlier wound perfusion improvement by ICG angiography than the control group. Additionally, the wound size of the AC group at week 3 was significantly smaller than those in the control group. There was no significant difference in the numbers of acute and chronic inflammatory cells between the groups.
Conclusion
The amnion-conjugated CS-alginate membrane, as well as CS dressing alone, could be a favorable dressing option for diabetic wounds.
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Affiliation(s)
- Woonhyeok Jeong
- Department of Plastic and Reconstructive Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jamin Hong
- Department of Plastic and Reconstructive Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Minho Jung
- Department of Research and Development, Endovision, Daegu, Korea
| | - Mijin Jang
- Laboratory Animal Center, Daegu Gyeongbuk Medical Innovation Foundation, Daegu, Korea
| | - Sanghyun An
- Laboratory Animal Center, Daegu Gyeongbuk Medical Innovation Foundation, Daegu, Korea
| | - Taehee Jo
- Department of Plastic and Reconstructive Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Sunyoung Kwon
- Department of Pathology, Keimyung University School of Medicine, Daegu, Korea
| | - Daegu Son
- Department of Plastic and Reconstructive Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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18
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Kolundzic N, Khurana P, Crumrine D, Celli A, Mauro TM, Ilic D. Epidermal Basement Membrane Substitutes for Bioengineering of Human Epidermal Equivalents. JID INNOVATIONS 2021; 2:100083. [PMID: 35199088 PMCID: PMC8844655 DOI: 10.1016/j.xjidi.2021.100083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/25/2021] [Accepted: 11/10/2021] [Indexed: 10/26/2022] Open
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19
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Using of Amniotic Membrane Derivatives for the Treatment of Chronic Wounds. MEMBRANES 2021; 11:membranes11120941. [PMID: 34940442 PMCID: PMC8706466 DOI: 10.3390/membranes11120941] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 01/04/2023]
Abstract
Amniotic membrane grafts have some therapeutic potential for wounds healing. Early application of amniotic membrane turned out as beneficial in healing ulcers, burns, and dermal injuries. Since the second half of the 20th century, the autotransplants of amniotic/chorion tissue have been also used for the treatment of chronic neuropathic wounds, cornea surface injuries, pterygium and conjunctivochalasis, and dental and neurosurgical applications. The aim of this publication is to prepare a coherent overview of amniotic membrane derivatives use in the field of wound healing and also its efficacy. In total 60 publications and 39 posters from 2000-2020 were examined. In these examined publications of case studies with known study results was an assemblage of 1141 patients, and from this assemblage 977 were successfully cured. In case of posters, the assemblage is 570 patients and 513 successfully cured. From the investigated data it is clear that the treatment efficacy is very high-86% and 90%, respectively. Based on this information the use of the amniotic membrane for chronic wounds can be considered highly effective.
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20
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Odet S, Louvrier A, Meyer C, Nicolas FJ, Hofman N, Chatelain B, Mauprivez C, Laurence S, Kerdjoudj H, Zwetyenga N, Fricain JC, Lafarge X, Pouthier F, Marchetti P, Gauthier AS, Fenelon M, Gindraux F. Surgical Application of Human Amniotic Membrane and Amnion-Chorion Membrane in the Oral Cavity and Efficacy Evaluation: Corollary With Ophthalmological and Wound Healing Experiences. Front Bioeng Biotechnol 2021; 9:685128. [PMID: 34178969 PMCID: PMC8222622 DOI: 10.3389/fbioe.2021.685128] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022] Open
Abstract
Due to its intrinsic properties, there has been growing interest in human amniotic membrane (hAM) in recent years particularly for the treatment of ocular surface disorders and for wound healing. Herein, we investigate the potential use of hAM and amnion-chorion membrane (ACM) in oral surgery. Based on our analysis of the literature, it appears that their applications are very poorly defined. There are two options: implantation or use as a cover material graft. The oral cavity is submitted to various mechanical and biological stimulations that impair membrane stability and maintenance. Thus, some devices have been combined with the graft to secure its positioning and protect it in this location. This current opinion paper addresses in detail suitable procedures for hAM and ACM utilization in soft and hard tissue reconstruction in the oral cavity. We address their implantation and/or use as a covering, storage format, application side, size and number, multilayer use or folding, suture or use of additional protective covers, re-application and resorption/fate. We gathered evidence on pre- and post-surgical care and evaluation tools. Finally, we integrated ophthalmological and wound healing practices into the collected information. This review aims to help practitioners and researchers better understand the application of hAM and ACM in the oral cavity, a place less easily accessible than ocular or cutaneous surfaces. Additionally, it could be a useful reference in the generation of new ideas for the development of innovative protective covering, suturing or handling devices in this specific indication. Finally, this overview could be considered as a position paper to guide investigators to fulfill all the identified criteria in the future.
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Affiliation(s)
- Stéphane Odet
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France
| | - Aurélien Louvrier
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
| | - Christophe Meyer
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France.,Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France
| | | | - Nicola Hofman
- Deutsche Gesellschaft für Gewebetransplantation (DGFG), Hannover, Germany
| | - Brice Chatelain
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France
| | - Cédric Mauprivez
- Pôle Médecine Bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France.,Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, BIOS EA 4691, UFR d'Odontologie, Reims, France
| | - Sébastien Laurence
- Pôle Médecine Bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France.,Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, HERVI EA3801, UFR de Médecine, Reims, France
| | - Halima Kerdjoudj
- Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, BIOS EA 4691, UFR d'Odontologie, Reims, France
| | - Narcisse Zwetyenga
- Chirurgie Maxillo-Faciale - Stomatologie - Chirurgie Plastique Réparatrice et Esthétique - Chirurgie de la main, CHU de Dijon, Dijon, France.,Université Bourgogne Franche-Comté, Besançon, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France.,CHU Bordeaux, Service de chirurgie orale, Bordeaux, France
| | - Xavier Lafarge
- Établissement Français du Sang Nouvelle-Aquitaine, Bordeaux, France/INSERM U1035, Université de Bordeaux, Biothérapie des Maladies Génétiques Inflammatoires et Cancers (BMGIC), Bordeaux, France
| | - Fabienne Pouthier
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France.,Établissement Français du Sang Bourgogne Franche-Comté, Besançon, France
| | - Philippe Marchetti
- CNRS, INSERM, UMR-9020-UMR-S 1277 Canther, Banque de Tissus CHU Lille, Lille, France
| | - Anne-Sophie Gauthier
- Université Bourgogne Franche-Comté, Besançon, France.,Service d'ophtalmologie, CHU Besançon, Besançon, France
| | - Mathilde Fenelon
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France.,CHU Bordeaux, Service de chirurgie orale, Bordeaux, France
| | - Florelle Gindraux
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France.,Service de Chirurgie Orthopédique, Traumatologique et Plastique, CHU Besançon, Besançon, France
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21
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Applications of Human Amniotic Membrane for Tissue Engineering. MEMBRANES 2021; 11:membranes11060387. [PMID: 34070582 PMCID: PMC8227127 DOI: 10.3390/membranes11060387] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/17/2022]
Abstract
An important component of tissue engineering (TE) is the supporting matrix upon which cells and tissues grow, also known as the scaffold. Scaffolds must easily integrate with host tissue and provide an excellent environment for cell growth and differentiation. Human amniotic membrane (hAM) is considered as a surgical waste without ethical issue, so it is a highly abundant, cost-effective, and readily available biomaterial. It has biocompatibility, low immunogenicity, adequate mechanical properties (permeability, stability, elasticity, flexibility, resorbability), and good cell adhesion. It exerts anti-inflammatory, antifibrotic, and antimutagenic properties and pain-relieving effects. It is also a source of growth factors, cytokines, and hAM cells with stem cell properties. This important source for scaffolding material has been widely studied and used in various areas of tissue repair: corneal repair, chronic wound treatment, genital reconstruction, tendon repair, microvascular reconstruction, nerve repair, and intraoral reconstruction. Depending on the targeted application, hAM has been used as a simple scaffold or seeded with various types of cells that are able to grow and differentiate. Thus, this natural biomaterial offers a wide range of applications in TE applications. Here, we review hAM properties as a biocompatible and degradable scaffold. Its use strategies (i.e., alone or combined with cells, cell seeding) and its degradation rate are also presented.
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22
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Kyriakidis C, Lali F, Greco KV, García-Gareta E. Chronic Leg Ulcers: Are Tissue Engineering and Biomaterials Science the Solution? Bioengineering (Basel) 2021; 8:bioengineering8050062. [PMID: 34068781 PMCID: PMC8150748 DOI: 10.3390/bioengineering8050062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
Chronic leg ulcers (CLUs) are full thickness wounds that usually occur between the ankle and knee, fail to heal after 3 months of standard treatment, or are not entirely healed at 12 months. CLUs present a considerable burden on patients, subjecting them to severe pain and distress, while healthcare systems suffer immense costs and loss of resources. The poor healing outcome of the standard treatment of CLUs generates an urgent clinical need to find effective solutions for these wounds. Tissue Engineering and Biomaterials Science offer exciting prospects for the treatment of CLUs, using a broad range of skin substitutes or scaffolds, and dressings. In this review, we summarize and discuss the various types of scaffolds used clinically in the treatment of CLUs. Their structure and therapeutic effects are described, and for each scaffold type representative examples are discussed, supported by clinical trials. Silver dressings are also reviewed due to their reported benefits in the healing of leg ulcers, as well as recent studies on new dermal scaffolds, reporting on clinical results where available. We conclude by arguing there is a further need for tissue-engineered products specifically designed and bioengineered to treat these wounds and we propose a series of properties that a biomaterial for CLUs should possess, with the intention of focusing efforts on finding an effective treatment.
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Affiliation(s)
- Christos Kyriakidis
- Regenerative Biomaterials Group, The RAFT Institute & The Griffin Institute, Northwick Park and Saint Mark’s Hospital, London HA1 3UJ, UK;
| | - Ferdinand Lali
- The Griffin Institute, Northwick Park and Saint Mark’s Hospital, London HA1 3UJ, UK; (F.L.); (K.V.G.)
- Division of Surgery and Interventional Science, Royal Free Hospital Campus, University College London, London NW3 2QG, UK
| | - Karin Vicente Greco
- The Griffin Institute, Northwick Park and Saint Mark’s Hospital, London HA1 3UJ, UK; (F.L.); (K.V.G.)
- Division of Surgery and Interventional Science, Royal Free Hospital Campus, University College London, London NW3 2QG, UK
| | - Elena García-Gareta
- Regenerative Biomaterials Group, The RAFT Institute & The Griffin Institute, Northwick Park and Saint Mark’s Hospital, London HA1 3UJ, UK;
- Division of Biomaterials and Tissue Engineering, Royal Free Hospital Campus, Eastman Dental Institute, University College London, London NW3 2QG, UK
- Correspondence: ; Tel.: +44-0-20-3958-0500
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23
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Exosomes Secreted from Amniotic Membrane Contribute to Its Anti-Fibrotic Activity. Int J Mol Sci 2021; 22:ijms22042055. [PMID: 33669673 PMCID: PMC7922650 DOI: 10.3390/ijms22042055] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/16/2022] Open
Abstract
Amniotic membranes (AM) have anti-fibrotic activity. Exosomes (nano-sized vesicles) function as conduits for intercellular transfer and contain all the necessary components to induce the resolution of fibrosis. In this study, we tested the hypothesis that the anti-fibrotic activity of AM is mediated by exosomes. AM-derived exosomes or amniotic stromal cell-derived exosomes were isolated and characterized. Anti-fibrotic activity of exosomes was evaluated using human hepatic stellate cells (LX-2), an in vitro model of fibrosis. Exosomes isolated from AM tissue-conditioned media had an average size of 75 nm. Exosomes significantly inhibited the proliferation of TGFβ1-activated LX-2 but had no effect on the proliferation of non-activated LX-2 cells. Exosomes also reduced the migration of LX-2 in a scratch wound assay. Furthermore, exosomes reduced the gene expression of pro-fibrotic markers such as COL1A1, ACTA, and TGFβ1 in LX-2 cells. Interestingly, exosomes isolated from AM tissue under hypoxic conditions seemed to show a stronger anti-fibrotic activity than exosomes isolated from tissue under normoxic conditions. Exosomes released by in vitro cultured AM stromal cells were smaller in size compared with tissue exosomes and also showed anti-fibrotic activity on LX-2 cells. In conclusion, AM-tissue-released exosomes contribute to the anti-fibrotic activity of AM. This is the first report of isolation, characterization, and functional evaluation of exosomes derived from amniotic tissues with the direct comparison between tissue-derived exosomes and cultured cell-derived exosomes.
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Dadkhah Tehrani F, Firouzeh A, Shabani I, Shabani A. A Review on Modifications of Amniotic Membrane for Biomedical Applications. Front Bioeng Biotechnol 2021; 8:606982. [PMID: 33520961 PMCID: PMC7839407 DOI: 10.3389/fbioe.2020.606982] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
The amniotic membrane (AM) is the innermost layer of the fetal placenta, which surrounds and protects the fetus. Its unique structure, in addition to its physical and biological properties, makes it a useful substance in many applications related to regenerative medicine. The use of this fantastic substance with a century-old history has produced remarkable results in vivo, in vitro, and even in clinical studies. While the intact or preserved AM is widely used for these purposes, the addition of further modifications to AM can be considered as a relatively new subject in its applications. These modifications are applied to improve AM properties, ease of handling, and durability. Here, we will discuss the cases in which AM has undergone additional modifications besides the required processes for sterilization and preservation. In this article, we have categorized these modifications and discussed their applications and results.
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Affiliation(s)
- Fatemeh Dadkhah Tehrani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Arezoo Firouzeh
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Iman Shabani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Azadeh Shabani
- Preventative Gynecology Research Center, Department of Gynecology and Obstetrics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Huang W, Chen Y, Wang N, Yin G, Wei C, Xu W. Effectiveness and safety of human amnion/chorion membrane therapy for diabetic foot ulcers: An updated meta-analysis of randomized clinical trials. Wound Repair Regen 2020; 28:739-750. [PMID: 32715574 DOI: 10.1111/wrr.12851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/03/2020] [Accepted: 06/25/2020] [Indexed: 02/05/2023]
Abstract
Human amnion/chorion membrane therapy has shown advantages in the management of diabetic foot ulcers and its effectiveness has been evaluated in the systematic reviews and meta-analyses. However, the number of patients included in the previous literatures was small and the safety profile of human amnion/chorion membrane therapy was not concerned. Therefore, we conducted an updated meta-analysis to better understand the effectiveness and safety of human amnion/chorion membrane therapy for diabetic foot ulcers. The PubMed, Embase, Cochrane Library, and ClinicalTrial.gov databases were searched for any randomized clinical trials comparing human amnion/chorion membrane therapy and standard therapy in the treatment of diabetic foot ulcers. Ulcer healing rate was considered as the primary outcome and the secondary outcomes mainly included mean time to ulcer healing and adverse events. Nine RCTs with 541 patients were included. Compared with merely standard therapy, human amnion/chorion membrane therapy plus standard therapy improved the ulcer healing rates at 6 weeks (RR = 3.50, 95% CI: 2.35-5.21), 12 weeks (RR = 2.09, 95% CI: 1.53-2.85) and 16 weeks (RR = 1.70, 95% CI: 1.25-2.30), and also shortened the healing time (MD = -4.58, 95% CI: -5.70 to -3.46). Meanwhile, no significant difference was observed in the number of patients with adverse events (RR = 0.56, 95% CI: 0.31-1.03) between two groups. This meta-analysis suggests that human amnion/chorion membrane therapy as an adjuvant treatment could promote the healing of diabetic foot ulcers and has a safety profile. More evidence from large high-quality randomized clinical trials with long follow-up duration are in urgent need to further confirm our findings.
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Affiliation(s)
- Wentao Huang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Yongsong Chen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Nasui Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Guoshu Yin
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chiju Wei
- Multidisciplinary Research Center, Shantou University, Shantou, China
| | - Wencan Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
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Chen Q, Deng X, Qiang L, Yao M, Guan L, Xie N, Zhao D, Ma J, Ma L, Wu Y, Yan X. Investigating the effects of walnut ointment on non-healing burn wounds. Burns 2020; 47:455-465. [PMID: 32736884 DOI: 10.1016/j.burns.2020.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022]
Abstract
Effective treatments for non-healing burn wounds are an unmet need for 95% of burn sufferers. Approaches currently available to treat non-healing burn wounds are not satisfactory due to undesirable side-effects or expense. The anti-oxidation and antibacterial activities of walnuts are recommended for treating chronic diseases. Walnut ointment has been developed and successfully applied to treat non-healing burn wounds in our hospital for decades. We report herein a detailed retrospective case review examining patients' response to the walnut ointment. The walnut ointment has shortened healing time of non-healing burn wounds and improved clinical outcomes. In order to investigate the mechanism of action, walnut ointment has been applied on wounds of porcine full-thickness burn wound models. Histological and immunohistochemical analysis indicated our walnut ointment supports wound healing through promoting keratinocyte proliferation and differentiation. Taken together, we recommend the walnut ointment offers an effective and economical treatment for patients presenting with non-healing burn wounds.
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Affiliation(s)
- Qian Chen
- School of Clinical Medicine, Ningxia Medical University, Ningxia, China; Department of Burns and Plastic Surgery, Xinyang Central Hospital, Henan, China
| | - Xingwang Deng
- School of Clinical Medicine, Ningxia Medical University, Ningxia, China; Department of Burns and Plastic Surgery, The First People's Hospital of Shizuishan, Ningxia, China
| | - Lijuan Qiang
- School of Clinical Medicine, Ningxia Medical University, Ningxia, China; Department of Burns and Plastic Surgery, People's Hospital of Ningxia Hui Autonomous Region, Ningxia, China
| | - Ming Yao
- Department of Burns and Plastic Surgery, General Hospital of Ningxia Medical University, Ningxia, China
| | - Lifeng Guan
- Department of Burns and Plastic Surgery, General Hospital of Ningxia Medical University, Ningxia, China
| | - Nan Xie
- Clinical Medicine Research Center, National Health Commission, Beijing National Health Hospital, Beijing, China
| | - Dan Zhao
- Tissue Organ Bank & Tissue Engineering Centre, General Hospital of Ningxia Medical University, Ningxia, China
| | - Jiaxiang Ma
- Tissue Organ Bank & Tissue Engineering Centre, General Hospital of Ningxia Medical University, Ningxia, China
| | - Liqiong Ma
- Department of Pathology, General Hospital of Ningxia Medical University, Ningxia, China
| | - Yinsheng Wu
- Department of Burns and Plastic Surgery, General Hospital of Ningxia Medical University, Ningxia, China
| | - Xie Yan
- Tissue Organ Bank & Tissue Engineering Centre, General Hospital of Ningxia Medical University, Ningxia, China; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Yang Y, Zhang Y, Yan Y, Ji Q, Dai Y, Jin S, Liu Y, Chen J, Teng L. A Sponge-Like Double-Layer Wound Dressing with Chitosan and Decellularized Bovine Amniotic Membrane for Promoting Diabetic Wound Healing. Polymers (Basel) 2020; 12:E535. [PMID: 32131412 PMCID: PMC7182886 DOI: 10.3390/polym12030535] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/13/2020] [Accepted: 02/19/2020] [Indexed: 12/12/2022] Open
Abstract
The diabetic wounds do not heal easily in part because they are susceptible to infection due to environmental influences. Wound dressing is crucial to wound healing, as it can basically protect the wound from external damages and provide a suitable microenvironment for tissue regeneration. In this study, a double-layer membrane that consists of chitosan sponge and decellularized bovine amniotic membrane (dBAM) has been developed by freeze-casting method. The results showed that the porous structure of the sponge layer improved the performances of blood coagulation and swelling. The dense dBAM can optimize the mechanical property of wound dressing. In vitro studies revealed that the bilayer membrane had favorable biocompatible, especially for human foreskin fibroblast cells (HFF-1) cell adhesion and proliferation. Moreover, the full-thickness skin defects of diabetic model mice that treated with bilayer membrane showed over 80% closure in 8 days. Our findings imply that the double-layer dressing has great potentials to be used in diabetic patients.
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Affiliation(s)
- Yang Yang
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Yanyan Zhang
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Yishu Yan
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Qian Ji
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Yutong Dai
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Suyuan Jin
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Yanxian Liu
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Jinghua Chen
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, China; (Y.Y.); (Y.Z.); (Y.Y.); (Q.J.); (Y.D.); (S.J.); (Y.L.)
| | - Liping Teng
- School of Medicine, Jiangnan University, Wuxi 214122, China
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Khosravimelal S, Momeni M, Gholipur M, Kundu SC, Gholipourmalekabadi M. Protocols for decellularization of human amniotic membrane. Methods Cell Biol 2019; 157:37-47. [PMID: 32334719 DOI: 10.1016/bs.mcb.2019.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Human amniotic membrane (HAM) has been used as a very promising biological-based product in health centers, especially for skin and cornea wound healing applications. The excellent properties of this membrane make it a potential candidate in treatment of various skin injuries such as bedsores, burn wounds and diabetic ulcers. Such properties are cytobiocompatibility, a structure very similar to normal skin composed of extracellular matrix (ECM) proteins, various growth factors involved in normal wound healing process and antibacterial agents. HAM contains epithelial cells, fibroblasts and mesenchymal stem cells. Therefore, the successful decellularization of HAM with minimal negative effects on its ECM components is very important to avoid graft rejection and shows improved performance. To date, several approaches have been conducted for decellularization of HAM, which is mainly based on enzyme-, detergent- or mechanical procedures with various ranges of success. Here, we describe a systematic detergent-based decellularization protocol as main protocol. We also explain the enzyme- and mechanical-based methods as the alternative protocols for decellularization of HAM.
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Affiliation(s)
- Sadjad Khosravimelal
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, Iran; Department of Medical Biotechnology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Momeni
- Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran; Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mahdieh Gholipur
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Subhas C Kundu
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Guimaraes, Portugal
| | - Mazaher Gholipourmalekabadi
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Reece DS, Burnsed OA, Parchinski K, Marr EE, White RM, Salazar-Noratto GE, Lin ASP, Willett NJ, Guldberg RE. Reduced Size Profile of Amniotic Membrane Particles Decreases Osteoarthritis Therapeutic Efficacy. Tissue Eng Part A 2019; 26:28-37. [PMID: 31269875 DOI: 10.1089/ten.tea.2019.0074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) is a widespread disease that continues to lack approved and efficacious treatments that modify disease progression. Micronized dehydrated human amnion/chorion membrane (μ-dHACM) has been shown to be effective in reducing OA progression, but many of the engineering design parameters have not been explored. The objectives of this study were to characterize the particle size distributions of two μ-dHACM formulations and to investigate the influence of these distributions on the in vivo therapeutic efficacy of μ-dHACM. Male Lewis rats underwent medial meniscus transection (MMT) or sham surgery, and intra-articular injections of saline, μ-dHACM, or reduced particle size μ-dHACM (RPS μ-dHACM) were administered at 24 hours postsurgery (n = 9 per treatment group). After 3 weeks, the animals were euthanized, and left legs harvested for equilibrium partitioning of an ionic contrast agent microcomputed tomography and histological analysis. μ-dHACM and RPS μ-dHACM particles were fluorescently tagged and particle clearance was tracked in vivo for up to 42 days postsurgery. Protein elution from both formulations was quantified in vitro. Treatment with μ-HACM, but not RPS μ-dHACM, reduced lesion volume in the MMT model 3 weeks postsurgery. In contrast, RPS μ-dHACM increased cartilage surface roughness and osteophyte cartilage thickness and volume compared to saline treatment. There was no difference of in vivo fluorescently tagged particle clearance between the two μ-dHACM sizes. RPS μ-dHACM showed significantly greater protein elution in vitro over 21 days. Overall, delivery of RPS μ-dHACM did result in an increase of in vivo joint degeneration and in vitro protein elution compared to μ-dHACM, but did not result in differences in joint clearance in vivo. These results suggest that particle size and factor elution may be tailorable factors that are important to optimize for particulate amniotic membrane treatment to be an effective therapy for OA. Impact Statement Osteoarthritis (OA) is a widespread disease that continues to lack treatments that modify the progression of the disease. Micronized dehydrated human amnion/chorion membrane (μ-dHACM) has been shown to be effective in reducing OA progression, but many of the engineering design parameters have not been explored. This work investigates the effects of particle size profile of the μ-dHACM particles and lays out the methods used in these studies. The results of this work will guide engineers in designing μ-dHACM treatments specifically and disease-modifying OA therapeutics generally, and it demonstrates the utility of novel therapeutic evaluation methods such as contrast-enhanced microcomputed tomography.
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Affiliation(s)
- David S Reece
- Wallace H. Coulter Department of Biomedical Engineering, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - Olivia A Burnsed
- Wallace H. Coulter Department of Biomedical Engineering, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - Kaley Parchinski
- Wallace H. Coulter Department of Biomedical Engineering, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - Elizabeth E Marr
- Wallace H. Coulter Department of Biomedical Engineering, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - Roger M White
- W.P. Carey School of Business, Arizona State University, Tempe, Arizona
| | - Giuliana E Salazar-Noratto
- Wallace H. Coulter Department of Biomedical Engineering, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - Angela S P Lin
- George W. Woodruff School of Mechanical Engineering, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - Nick J Willett
- Department of Orthopaedics, Emory University, Atlanta, Georgia.,Atlanta Veteran's Affairs Medical Center, Decatur, Georgia.,Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - Robert E Guldberg
- Phil and Penny Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, Oregon
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Grémare A, Jean-Gilles S, Musqui P, Magnan L, Torres Y, Fénelon M, Brun S, Fricain JC, L'Heureux N. Cartography of the mechanical properties of the human amniotic membrane. J Mech Behav Biomed Mater 2019; 99:18-26. [PMID: 31325833 DOI: 10.1016/j.jmbbm.2019.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/07/2019] [Accepted: 07/13/2019] [Indexed: 12/16/2022]
Abstract
Because of its low immunogenicity, biological properties, and high availability, the Human Amniotic Membrane (HAM) is widely used in the clinic and in tissue engineering research. However, while its biological characteristics are well described, its mechanical properties remain understudied especially in terms of inter- and intra-HAM variability. To guide bioengineers in the use of this natural biomaterial, a detailed cartography of the HAM's mechanical properties was performed. Maximal force (Fmax) and strain at break (Smax) were identified as the relevant mechanical criteria for this study after a combined analysis of histological sections, thickness measurements after dehydration, and uniaxial tensile tests. Eight HAMs were studied by mechanical cartography using a standardized cutting protocol and sampling pattern. On average, 103 ± 10 samples were retrieved and tested per HAM. Intra-tissue variability highlighted the fact that there were two mechanically distinct areas (placental and peripheral) in each HAM. For all HAMs, placental HAM was significantly stronger by 82 ± 45% and more stretchable by 19 ± 6% than their peripheral counterparts. Our results also demonstrated that placental, but not peripheral, HAM presented isotropic mechanical properties. Thus, placental HAM can be a raw material of choice that could be favored especially in the development of tissue engineering products where mechanical properties play a key role.
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Affiliation(s)
- Agathe Grémare
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France; CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | | | - Pauline Musqui
- CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | - Laure Magnan
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France
| | - Yoann Torres
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France
| | - Mathilde Fénelon
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France; CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | - Stéphanie Brun
- CHU Bordeaux, Gynecology-Obstetrics Service, F-33076 Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France; CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | - Nicolas L'Heureux
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France.
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Fenelon M, Maurel DB, Siadous R, Gremare A, Delmond S, Durand M, Brun S, Catros S, Gindraux F, L'Heureux N, Fricain JC. Comparison of the impact of preservation methods on amniotic membrane properties for tissue engineering applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 104:109903. [PMID: 31500032 DOI: 10.1016/j.msec.2019.109903] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/02/2019] [Accepted: 06/17/2019] [Indexed: 12/30/2022]
Abstract
Human amniotic membrane (hAM) is considered as an attractive biological scaffold for tissue engineering. For this application, hAM has been mainly processed using cryopreservation, lyophilization and/or decellularization. However, no study has formally compared the influence of these treatments on hAM properties. The aim of this study was to develop a new decellularization-preservation process of hAM, and to compare it with other conventional treatments (fresh, cryopreserved and lyophilized). The hAM was decellularized (D-hAM) using an enzymatic method followed by a detergent decellularization method, and was then lyophilized and gamma-sterilized. Decellularization was assessed using DNA staining and quantification. D-hAM was compared to fresh (F-hAM), cryopreserved (C-hAM) and lyophilized/gamma-sterilized (L-hAM) hAM. Their cytotoxicity on human bone marrow mesenchymal stem cells (hBMSCs) and their biocompatibility in a rat subcutaneous model were also evaluated. The protocol was effective as judged by the absence of nuclei staining and the residual DNA lower than 50 ng/mg. Histological staining showed a disruption of the D-hAM architecture, and its thickness was 84% lower than fresh hAM (p < 0.001). Despite this, the labeling of type IV and type V collagen, elastin and laminin were preserved on D-hAM. Maximal force before rupture of D-hAM was 92% higher than C-hAM and L-hAM (p < 0.01), and D-hAM was 37% more stretchable than F-hAM (p < 0.05). None of the four hAM were cytotoxic, and D-hAM was the most suitable scaffold for hBMSCs proliferation. Finally, D-hAM was well integrated in vivo. In conclusion, this new hAM decellularization process appears promising for tissue engineering applications.
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Affiliation(s)
- Mathilde Fenelon
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, Department of Oral Surgery, F-33076 Bordeaux, France.
| | - Delphine B Maurel
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Robin Siadous
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Agathe Gremare
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Samantha Delmond
- CHU Bordeaux, CIC 1401, 33000 Bordeaux, France; Inserm, CIC 1401, 33000 Bordeaux, France
| | - Marlène Durand
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, CIC 1401, 33000 Bordeaux, France; Inserm, CIC 1401, 33000 Bordeaux, France
| | - Stéphanie Brun
- University hospital, Gynecology-Obstetrics Service, F-33076 Bordeaux, France
| | - Sylvain Catros
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, Department of Oral Surgery, F-33076 Bordeaux, France
| | - Florelle Gindraux
- Orthopedic, Traumatology & Plastic Surgery Department, University Hospital of Besançon, Besançon, France; Nanomedicine Lab, Imagery and Therapeutics (EA 4662), SFR FED 4234, University of Franche-Comté, Besançon, France
| | - Nicolas L'Heureux
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, Department of Oral Surgery, F-33076 Bordeaux, France
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Rousselle P, Braye F, Dayan G. Re-epithelialization of adult skin wounds: Cellular mechanisms and therapeutic strategies. Adv Drug Deliv Rev 2019; 146:344-365. [PMID: 29981800 DOI: 10.1016/j.addr.2018.06.019] [Citation(s) in RCA: 270] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/28/2018] [Accepted: 06/25/2018] [Indexed: 12/21/2022]
Abstract
Cutaneous wound healing in adult mammals is a complex multi-step process involving overlapping stages of blood clot formation, inflammation, re-epithelialization, granulation tissue formation, neovascularization, and remodelling. Re-epithelialization describes the resurfacing of a wound with new epithelium. The cellular and molecular processes involved in the initiation, maintenance, and completion of epithelialization are essential for successful wound closure. A variety of modulators are involved, including growth factors, cytokines, matrix metalloproteinases, cellular receptors, and extracellular matrix components. Here, we focus on cellular mechanisms underlying keratinocyte migration and proliferation during epidermal closure. Inability to re-epithelialize is a clear indicator of chronic non-healing wounds, which fail to proceed through the normal phases of wound healing in an orderly and timely manner. This review summarizes the current knowledge regarding the management and treatment of acute and chronic wounds, with a focus on re-epithelialization, offering some insights into novel future therapies.
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Amniotic membrane as novel scaffold for human iPSC-derived cardiomyogenesis. In Vitro Cell Dev Biol Anim 2019; 55:272-284. [PMID: 30798515 DOI: 10.1007/s11626-019-00321-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/08/2019] [Indexed: 12/17/2022]
Abstract
Recent approaches of using decellularized organ matrices for cardiac tissue engineering prompted us to culture human-induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (CMs) on the human amniotic membrane (hAM). Since hAM has been used lately to patch diseased hearts in patients and has shown anti-inflammatory and anti-fibrotic benefits, it qualifies as a cardiac compatible and clinically relevant heart tissue scaffold. The aim of this study was to test the ability of the hAM to support attachment, differentiation, and maturation of hiPSC-derived CMs in vitro. hAMs were prepared from term placenta. An in-house generated hiPSC line was used for CM derivation. hiPSC-derived cardiac progenitors were cultured on the surface of cryopreserved hAMs and in the presence of cytokines promoting cardiac differentiation. CMs grown on hAM and popular basement membrane matrix (BMM) Matrigel™ were compared for the following aspects of cardiac development: the morphology of cardiomyocytes with respect to shape and cellular alignments, levels of cardiac-related gene transcript expression, functionality in terms of spontaneous calcium fluxes and mitochondrial densities and distributions. hAM is biocompatible with hiPSC-derived CMs. hAM increased cardiac transcription regulator and myofibril protein transcript expression, accelerated intracellular calcium transients, and enhanced cellular mitochondrial complexity of its cardiomyocytes in comparison to cardiomyocytes differentiated on Matrigel™. Our data suggests that hAM supports differentiation and improves cardiomyogenesis in comparison to Matrigel™. hAMs are natural, easily and largely available. The method of preparing hAM cardiac sheets described here is simple with potential for clinical transplantation. Graphical abstract A An outline of the differentiation protocol with stage-specific growth factors and culture media used. B Cell fates from pluripotent stem cells to cardiomyocytes during differentiation on the amniotic membrane. C-FPhotomicrographs of cells at various stages of differentiation. Scale bars represent 100 μm.
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Farzamfar S, Salehi M, Ehterami A, Naseri-Nosar M, Vaez A, Zarnani AH, Sahrapeyma H, Shokri MR, Aleahmad M. Promotion of excisional wound repair by a menstrual blood-derived stem cell-seeded decellularized human amniotic membrane. Biomed Eng Lett 2018; 8:393-398. [PMID: 30603224 DOI: 10.1007/s13534-018-0084-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/19/2018] [Accepted: 09/04/2018] [Indexed: 02/06/2023] Open
Abstract
This is the first study demonstrating the efficacy of menstrual blood-derived stem cell (MenSC) transplantation via decellularized human amniotic membrane (DAM), for the promotion of skin excisional wound repair. The DAM was seeded with MenSCs at the density of 3 × 104 cells/cm2 and implanted onto a rat's 1.50 × 1.50 cm2 full-thickness excisional wound defect. The results of wound closure and histopathological examinations demonstrated that the MenSC-seeded DAM could significantly improve the wound healing compared with DAM-treatment. All in all, our data indicated that the MenSCs can be a potential source for cell-based therapies to regenerate skin injuries.
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Affiliation(s)
- Saeed Farzamfar
- 1Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Salehi
- 2Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.,3Tissue Engineering and Stem Cells Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Arian Ehterami
- 2Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahdi Naseri-Nosar
- 3Tissue Engineering and Stem Cells Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Vaez
- 1Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hassan Zarnani
- 4Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,5Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Hamed Sahrapeyma
- 6Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad-Reza Shokri
- 7Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Aleahmad
- 4Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Smeringaiova I, Nyc O, Trosan P, Spatenka J, Burkert J, Bednar J, Jirsova K. Antimicrobial efficiency and stability of two decontamination solutions. Cell Tissue Bank 2018; 19:581-589. [PMID: 30062597 DOI: 10.1007/s10561-018-9707-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 06/22/2018] [Indexed: 11/26/2022]
Abstract
Two decontamination solutions, commercially produced BASE•128 and laboratory decontamination solution (LDS), with analogous content of antibiotic and antimycotic agents, were compared in their antimicrobial efficiency and stability (pH and osmolarity). Both solutions were compared immediately after thawing aliquots frozen for 1, 3 or 6 months. Agar well diffusion method was used to test their antimicrobial efficiency against five human pathogens: Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli and Enterococcus faecalis. The difference in the inhibition of growth between the two decontamination solutions was mostly not statistically significant, with few exceptions. The most pronounced difference between the LDS and BASE•128 was observed in their decontamination efficacy against E. coli and E. faecalis, where the LDS showed to be more efficient than BASE•128. The osmolarity value of LDS decreased with cold-storage, the osmolarity values of the BASE•128 could not be measured as they were below the range of the osmometer. Slight changes were found in pH of the less stable LDS solution, whose pH increased from initial value 7.36 ± 0.07 to 7.72 ± 0.19 after 6 m-storage. We verified that BASE•128 and LDS are similarly efficient in elimination of possible placental bacterial contaminants and may be used for decontamination of various tissues.
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Affiliation(s)
- Ingrida Smeringaiova
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Otakar Nyc
- Department of Clinical Microbiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Peter Trosan
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Jaroslav Spatenka
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Jan Burkert
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Jan Bednar
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Katerina Jirsova
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic.
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Sivasubramanian S, Mohana S, Maheswari P, Victoria V, Thangam R, Mahalingam J, Chandrasekar-Janebjer G, Savariar V, Madhan B, Gunasekaran P, Kitambi SS. Leprosy-associated Chronic Wound Management Using Biomaterials. J Glob Infect Dis 2018; 10:99-107. [PMID: 29910571 PMCID: PMC5987379 DOI: 10.4103/jgid.jgid_79_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Deformities and neuropathic chronic ulcers are the common features associated with leprosy-cured individuals that impact their quality of life and impair rehabilitation efforts. The challenging aspects for treatment of chronic wounds are the factors that inhibit healing. We reasoned that limited success of various therapeutic interventions could be due to the fact that leprosy-cured individual's physiology gets acclimatized to having a chronic wound that any therapeutic intervention is counterbalanced to maintain status quo at the wound site. Therefore, an alternative strategy would be to use biomaterials that gradually alter the wound site allowing the individual's physiology to participate in the healing process. Aims: Developing the human amnion (Amn)-derived biomaterial scaffolds and evaluating its use to heal chronic wounds in leprosy-cured but deformed persons (LCDPs). Materials and Methods: Using an enzymatic protocol, we have developed a rapid method to generate biomaterial scaffolds from discarded human Amn. A clinical trial on 26 LCDPs was performed with the biomaterial, and its wound-healing potential was then compared with LCDPs undergoing standard treatment procedure. Results: Biomaterial-based treatment of chronic wounds on LCDP displayed a higher efficiency in healing when compared to standard treatment. Conclusions: This study exemplifies that biomaterial-based treatment of leprosy-wounds offers an excellent affordable alternative for wound management. This study underlines the importance of involving both local wound environment and systemic effects for healing. In addition, we highlight wound healing as a necessity for successful rehabilitation and reintegration of leprosy-cured person into the society.
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Affiliation(s)
| | - Sambasivam Mohana
- Department of Virology, King Institute of Preventive Medicine and Research, Chennai, Tamil Nadu, India
| | - Paulraj Maheswari
- Department of Virology, King Institute of Preventive Medicine and Research, Chennai, Tamil Nadu, India
| | - Victor Victoria
- Center for Environmental Research and Development, LIFE, Loyola College, Chennai, Tamil Nadu, India
| | - Ramar Thangam
- Department of Virology, King Institute of Preventive Medicine and Research, Chennai, Tamil Nadu, India.,CSIR-Central Leather Research Institute, Chennai, Tamil Nadu, India
| | - Jayashri Mahalingam
- Department of Virology, King Institute of Preventive Medicine and Research, Chennai, Tamil Nadu, India.,Institute for Healthcare Education and Translational Sciences (IHETS), Hyderabad, Telengana, India
| | | | - Vincent Savariar
- Center for Environmental Research and Development, LIFE, Loyola College, Chennai, Tamil Nadu, India
| | - Balaraman Madhan
- CSIR-Central Leather Research Institute, Chennai, Tamil Nadu, India
| | - Palani Gunasekaran
- Department of Virology, King Institute of Preventive Medicine and Research, Chennai, Tamil Nadu, India
| | - Satish S Kitambi
- Institute for Healthcare Education and Translational Sciences (IHETS), Hyderabad, Telengana, India.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Sweden
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Fénelon M, Chassande O, Kalisky J, Gindraux F, Brun S, Bareille R, Ivanovic Z, Fricain JC, Boiziau C. Human amniotic membrane for guided bone regeneration of calvarial defects in mice. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:78. [PMID: 29858670 DOI: 10.1007/s10856-018-6086-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/21/2018] [Indexed: 06/08/2023]
Abstract
Due to its biological properties, human amniotic membrane (hAM) is widely studied in the field of tissue engineering and regenerative medicine. hAM is already very attractive for wound healing and it may be helpful as a support for bone regeneration. However, few studies assessed its potential for guided bone regeneration (GBR). The purpose of the present study was to assess the potential of the hAM as a membrane for GBR. In vitro, cell viability in fresh and cryopreserved hAM was assessed. In vivo, we evaluated the impact of fresh versus cryopreserved hAM, using both the epithelial or the mesenchymal layer facing the defect, on bone regeneration in a critical calvarial bone defect in mice. Then, the efficacy of cryopreserved hAM associated with a bone substitute was compared to a collagen membrane currently used for GBR. In vitro, no statistical difference was observed between the conditions concerning cell viability. Without graft material, cryopreserved hAM induced more bone formation when the mesenchymal layer covered the defect compared to the defect left empty. When associated with a bone substitute, such improved bone repair was not observed. These preliminary results suggest that cryopreserved hAM has a limited potential for GBR.
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Affiliation(s)
- Mathilde Fénelon
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076, Bordeaux, France.
- CHU Bordeaux, Odontology and Oral Health Department, F-33076, Bordeaux, France.
| | - Olivier Chassande
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076, Bordeaux, France
| | - Jérome Kalisky
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076, Bordeaux, France
| | - Florelle Gindraux
- Orthopedic, Traumatologic & Plastic Surgery Service - University Hospital of Besançon, Besançon, France
| | - Stéphanie Brun
- University hospital, Gynecology-Obstetrics Service, F-33076, Bordeaux, France
| | - Reine Bareille
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076, Bordeaux, France
| | - Zoran Ivanovic
- French Blood Establishment (EFS), Aquitaine-Limousin Branch, Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076, Bordeaux, France
- CHU Bordeaux, Odontology and Oral Health Department, F-33076, Bordeaux, France
| | - Claudine Boiziau
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076, Bordeaux, France
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Understanding the Impact of Preservation Methods on the Integrity and Functionality of Placental Allografts. Ann Plast Surg 2018; 79:203-213. [PMID: 28403020 DOI: 10.1097/sap.0000000000001101] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Human placental membranes (hPMs) have a long history in treating burns and wounds. The composition of hPMs includes structural matrix, growth factors, and neonatal cells, all of which contribute to their regenerative potential. However, most hPM products are devitalized after dehydration and irradiation. We compared the functionality of single-layer viable cryopreserved human amniotic membrane (vCHAM) with multilayer devitalized dehydrated human amnion/chorion membrane (dHACM) in wound-relevant models to determine the effect of different processing methods on hPMs. METHODS Viable cryopreserved human amniotic membrane and dHACM were compared with fresh hPM for structural integrity and viability. Viable cell persistence in vCHAM over time was evaluated in vitro and in vivo in a diabetic chronic wound mouse model. Proliferation of cells within fresh hPM and vCHAM was evaluated with bromodeoxyuridine and Ki-67 staining, and proliferation of isolated cells in culture was evaluated. Growth factor release over time and in vitro response to chronic wound stimuli (tumor necrosis factor α, lipopolysaccharide, and hypoxia) were used to compare the functionality of vCHAM and dHACM. RESULTS The structure and thickness of fresh hPM were retained in vCHAM but were compromised in dHACM. Similar to fresh hPM, vCHAM contained viable cells, whereas dHACM did not. Cells in vCHAM remained viable after 4 and 7 days in culture and in an in vitro chronic wound environment and after 4 and 8 days in vivo after application to a mouse chronic wound. Staining for bromodeoxyuridine and Ki-67 did not reveal proliferative cells within fresh hPM and vCHAM. However, isolated cells proliferated in culture. Viable cryopreserved human amniotic membrane increased platelet-derived growth factor BB, hepatocyte growth factor, and epidermal growth factor levels over time and responded to chronic wound stimuli in vitro by significantly increasing levels of vascular endothelial growth factor and prostaglandin E2. Dehydrated human amnion/chorion membrane showed no significant accumulation of growth factors and did not respond to chronic wound stimuli. CONCLUSIONS These results indicate that vCHAM retains intact, native matrix, and viable, active cells and responds to chronic wound stimuli in vitro. The inclusion of multiple layers of hPM does not compensate for structural degradation and loss of viability caused by dehydration as evidenced by a lack of functional response by dHACM. The clinical significance of these results remains to be answered.
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Fénelon M, Catros S, Fricain JC. What is the benefit of using amniotic membrane in oral surgery? A comprehensive review of clinical studies. Clin Oral Investig 2018; 22:1881-1891. [PMID: 29682688 DOI: 10.1007/s00784-018-2457-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Since its first use for the reconstruction of tissue defects in the oral cavity in 1985, human amniotic membrane (hAM) has been widely studied in the field of oral surgery. Despite the growing number of publications in this field, there is no systematic review or meta-analysis concerning its clinical applications, outcome assessments, and relevance in oral surgery. The aim of this review is to provide a thorough understanding of the potential use of hAM for soft and hard tissue reconstruction in the oral cavity. MATERIALS AND METHODS A systematic electronic and a manual literature search of the MEDLINE-PubMed database and Scopus database was completed. Patient, Intervention, Comparison and Outcomes (PICO) technique was used to select the relevant articles to meet the objective. Studies using hAM for oral reconstruction, and conducted on human subjects, were included in this survey. RESULTS A total of 17 articles were analyzed. Five areas of interest were identified as potential clinical application: periodontal surgery, cleft palate and tumor reconstruction, prosthodontics and peri-implant surgery. Overall, periodontal surgery was the only discipline to assess the efficacy of hAM with randomized clinical trials. The wide variability of preservation methods of hAM and the lack of objective measurements were observed in this study. CONCLUSION hAM is already used in the field of oral surgery. Despite this, there is weak clinical evidence demonstrating convincingly the benefit of hAM in this area compared to standard surgery. CLINICAL RELEVANCE Several studies now suggest the interest of hAM for periodontal tissue repair. Due to its biological and mechanical properties, hAM seems to be a promising treatment for wound healing in various areas of oral reconstruction. However, further randomized clinical trials are needed to confirm these preliminary results.
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Affiliation(s)
- M Fénelon
- CHU Bordeaux, Dentistry and Oral Health Department, Place Amélie Raba Léon, 33076, Bordeaux, France. .,INSERM U1026, University of Bordeaux, Tissue Bioengineering (BioTis), 146 rue Léo-Saignat, F-33000, Bordeaux, France.
| | - S Catros
- CHU Bordeaux, Dentistry and Oral Health Department, Place Amélie Raba Léon, 33076, Bordeaux, France.,INSERM U1026, University of Bordeaux, Tissue Bioengineering (BioTis), 146 rue Léo-Saignat, F-33000, Bordeaux, France
| | - J C Fricain
- CHU Bordeaux, Dentistry and Oral Health Department, Place Amélie Raba Léon, 33076, Bordeaux, France.,INSERM U1026, University of Bordeaux, Tissue Bioengineering (BioTis), 146 rue Léo-Saignat, F-33000, Bordeaux, France
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Sivasubramanian S, Chandrasekar G, Svensson Akusjärvi S, Thangam R, Sathuvan M, Kumar RBS, Hussein H, Vincent S, Madhan B, Gunasekaran P, Kitambi SS. Phenotypic Screening Identifies Synergistically Acting Natural Product Enhancing the Performance of Biomaterial Based Wound Healing. Front Pharmacol 2017; 8:433. [PMID: 28769790 PMCID: PMC5513901 DOI: 10.3389/fphar.2017.00433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/16/2017] [Indexed: 11/13/2022] Open
Abstract
The potential of multifunctional wound heal biomaterial relies on the optimal content of therapeutic constituents as well as the desirable physical, chemical, and biological properties to accelerate the healing process. Formulating biomaterials such as amnion or collagen based scaffolds with natural products offer an affordable strategy to develop dressing material with high efficiency in healing wounds. Using image based phenotyping and quantification, we screened natural product derived bioactive compounds for modulators of types I and III collagen production from human foreskin derived fibroblast cells. The identified hit was then formulated with amnion to develop a biomaterial, and its biophysical properties, in vitro and in vivo effects were characterized. In addition, we performed functional profiling analyses by PCR array to understand the effect of individual components of these materials on various genes such as inflammatory mediators including chemokines and cytokines, growth factors, fibroblast stimulating markers for collagen secretion, matrix metalloproteinases, etc., associated with wound healing. FACS based cell cycle analyses were carried out to evaluate the potential of biomaterials for induction of proliferation of fibroblasts. Western blot analyses was done to examine the effect of biomaterial on collagen synthesis by cells and compared to cells grown in the presence of growth factors. This work demonstrated an uncomplicated way of identifying components that synergistically promote healing. Besides, we demonstrated that modulating local wound environment using biomaterials with bioactive compounds could enhance healing. This study finds that the developed biomaterials offer immense scope for healing wounds by means of their skin regenerative features such as anti-inflammatory, fibroblast stimulation for collagen secretion as well as inhibition of enzymes and markers impeding the healing, hydrodynamic properties complemented with other features including non-toxicity, biocompatibility, and safety.
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Affiliation(s)
| | - Gayathri Chandrasekar
- Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetSolna, Sweden
| | | | - Ramar Thangam
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India
- Council of Scientific and Industrial Research – Central Leather Research InstituteChennai, India
| | - Malairaj Sathuvan
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India
| | - R. B. S. Kumar
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India
| | - Hawraa Hussein
- Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetSolna, Sweden
| | - Savariar Vincent
- Center for Environmental Research and Development, Loyola Institute of Frontier Energy, Loyola CollegeChennai, India
| | - Balaraman Madhan
- Council of Scientific and Industrial Research – Central Leather Research InstituteChennai, India
| | - Palani Gunasekaran
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India
| | - Satish S. Kitambi
- Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetSolna, Sweden
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Motamed S, Taghiabadi E, Molaei H, Sodeifi N, Hassanpour SE, Shafieyan S, Azargashb E, Farajzadeh-Vajari F, Aghdami N, Bajouri A. Cell-based skin substitutes accelerate regeneration of extensive burn wounds in rats. Am J Surg 2017; 214:762-769. [PMID: 28522073 DOI: 10.1016/j.amjsurg.2017.04.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 04/15/2017] [Accepted: 04/25/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study investigated the effects of amniotic membrane combined with adipose-derived stem cells or fetal fibroblasts on regenerating extensive burns in rats. METHODS Third degree burns of 1100-1800 mm2 were induced on 32 Sprague-Dawley rats. Burned sites were excised and randomly covered with Vaseline gauze (control), human amniotic membrane (HAM), human fetal fibroblasts seeded on HAM (HAM-FF), or human adipose-derived stem cells seeded on HAM (HAM-ASC), and followed by wound closure and histological assessments. RESULTS Wound closure rates of HAM-FF, HAM-ASC, HAM and control groups at seven and 14 days after the treatment were 42.2% and 81.9%, 41.9% and 81.7%, 33.5% and 74.2%, and 16.5% and 69.7%, respectively. Wounds of HAM-FF, HAM-ASC, HAM and control groups were closed on 40, 40, 50 and 60 days after the treatment, respectively (P < 0.05). Histological assessments revealed lower inflammatory cell infiltration in HAM-ASC and HAM-FF groups. CONCLUSIONS Cell-based engineered skin substitutes seem to accelerate wound regeneration, especially within the first 14 days.
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Affiliation(s)
- Sadrollah Motamed
- Department of Plastic and Reconstructive Surgery, 15th Khordad Hospital, Tehran, Iran
| | - Ehsan Taghiabadi
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hojjat Molaei
- Department of Plastic and Reconstructive Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Sodeifi
- Department of Pathology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | | | - Saeed Shafieyan
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Enzollah Azargashb
- Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Farajzadeh-Vajari
- Department of Gynecology and Obstetrics, Babak Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasser Aghdami
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Amir Bajouri
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Abstract
The cornea has unique features that make it a useful model for regenerative medicine studies. It is an avascular, transparent, densely innervated tissue and any pathological changes can be easily detected by slit lamp examination. Corneal sensitivity is provided by the ophthalmic branch of the trigeminal nerve that elicits protective reflexes such as blinking and tearing and exerts trophic support by releasing neuromediators and growth factors. Corneal nerves are easily evaluated for both function and morphology using standard instruments such as corneal esthesiometer and in vivo confocal microscope. All local and systemic conditions that are associated with damage of the trigeminal nerve cause the development of neurotrophic keratitis, a rare degenerative disease. Neurotrophic keratitis is characterized by impairment of corneal sensitivity associated with development of persistent epithelial defects that may progress to corneal ulcer, melting and perforation. Current neurotrophic keratitis treatments aim at supporting corneal healing and preventing progression of corneal damage. Novel compounds able to stimulate corneal nerve recovery are in advanced development stage. Among them, nerve growth factor eye drops showed to be safe and effective in stimulating corneal healing and improving corneal sensitivity in patients with neurotrophic keratitis. Neurotrophic keratitis represents an useful model to evaluate in clinical practice novel neuro-regenerative drugs.
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Affiliation(s)
- Marta Sacchetti
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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