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Gottlieb J, Hanes DA, Bustos MA, Choe J, Luu A, Seizer D, Hoon DSB, Wilson TG. Impact of Cryopreserved Placental Allografts on Biochemical Recurrence in Prostate Cancer. Cancers (Basel) 2024; 16:2973. [PMID: 39272831 PMCID: PMC11394080 DOI: 10.3390/cancers16172973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 08/16/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Human placental allografts are widely used to promote wound healing. Placental (or amniotic membrane/umbilical cord) allografts are placed along the neurovascular bundles during radical prostatectomy to improve continence and erectile function recovery. It is unknown whether placental allografts impact biochemical recurrence (BCR). METHODS This was a single-surgeon retrospective study of 566 robotic radical prostatectomies performed from April 2015 to March 2021. The patients were divided into three groups: the negative control, Brand A, and Brand B. Brand A and Brand B were both cryopreserved amniotic membrane (CAM) allografts. A total of 324 cases were included for BCR Kaplan-Meier and risk-adjusted multivariate analyses (362 for continence analysis). In vitro analyses were performed to determine the effect of CAM allografts on prostate cancer (PCa) cell line growth. RESULTS For propensity score-matched analysis (adjusting for pre-operative PSA, tumor stage, Gleason Grade, and margin status), (1) the allograft groups did not show differences in time to BCR vs. the negative control group (p = 0.7), and (2) combined allograft treatment groups showed better continence recovery vs. the negative controls (p = 0.01). In vitro, placental allografts reduced PCa cell line growth in co-culture assays. CONCLUSIONS cryopreserved AM allografts (combined or individual brands) did not show a significant effect on BCR but improved continence recovery for PCa patients.
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Affiliation(s)
- Josh Gottlieb
- Department of Urologic Oncology, Providence Saint John's Cancer Institute, Santa Monica, CA 90404, USA
| | - Douglas A Hanes
- Department of Biostatistics, Providence Saint Joseph Health Center, Portland, OR 97213, USA
| | - Matias A Bustos
- Department of Translational Molecular Medicine, Providence Saint John's Cancer Institute, Santa Monica, CA 90404, USA
| | - Jane Choe
- Department of Urologic Oncology, Providence Saint John's Cancer Institute, Santa Monica, CA 90404, USA
| | - Albert Luu
- Department of Urologic Oncology, Providence Saint John's Cancer Institute, Santa Monica, CA 90404, USA
| | - Daniel Seizer
- Department of Urologic Oncology, Providence Saint John's Cancer Institute, Santa Monica, CA 90404, USA
| | - Dave S B Hoon
- Department of Translational Molecular Medicine, Providence Saint John's Cancer Institute, Santa Monica, CA 90404, USA
| | - Timothy G Wilson
- Department of Urologic Oncology, Providence Saint John's Cancer Institute, Santa Monica, CA 90404, USA
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Sabol TJ, Tran GS, Matuszewski J, Weston WW. Standardized reporting of amnion and amnion/chorion allograft data for wound care. Health Sci Rep 2022; 5:e794. [PMID: 36032519 PMCID: PMC9399452 DOI: 10.1002/hsr2.794] [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] [Received: 04/07/2022] [Revised: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 11/22/2022] Open
Abstract
Background The favorable biological and mechanical properties of the most common components of the placenta, the amnion and chorion, have been explored for regenerative medical indications. The use of the combination of amnion and chorion has also become very popular. But, published data from placental tissues in their final, useable form is lacking. During treatment with membrane product, the tissue is usually sterile, intact and laid on a wound or treatment area. The factors available to the treatment area from the applied product need to be elucidated and presented in a relatable form. Current reporting for eluted growth factor results are typically expressed per milliliter, which is not informative with respect to the area of tissue covered by the actual membrane and may differ among techniques. Methods To address this inconsistency, amnion or amnion/chorion were isolated from human placentas and processed by a proprietary procedure. The final dry, sterilized product was evaluated for structural components and growth factor elution. Growth factors were quantified by multiplex panels and ELISAs and the values normalized to specific area and elution volume of finished product. This information allows extrapolation to all membrane sizes and affords cross‐study comparisons. Results Analysis of membrane supernatants show that dehydrated, sterilized amnion and amnion/chorion elute factors that are conducive to wound healing, which are available to recipient tissues. Importantly, these measurable factors eluted from dehydrated, sterilized membranes can be reported as a function of available factors per square centimeter of tissue. Conclusions The standardized characterization of dehydrated, sterilized amnion and amnion/chorion as delivered to recipient tissues permits understanding and comparison of the products across various graft sizes, types, and eluate volumes. Further, reporting this data as a function of cm2 of dehydrated tissue allows extrapolation by independent scientists and clinicians.
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Wound healing ability of acellular fish skin and bovine collagen grafts for split-thickness donor sites in burn patients: Characterization of acellular grafts and clinical application. Int J Biol Macromol 2022; 205:452-461. [PMID: 35176324 DOI: 10.1016/j.ijbiomac.2022.02.055] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 12/12/2022]
Abstract
Due to its high polyunsaturated fatty acid content, acellular fish skin has emerged as a dermal substitute for the promotion of wound healing as it decreases scar formation while providing pain relief. However, various systematic studies on acellular fish skin, such as its biophysical analysis, in vitro activities, and clinical application, have not been sufficiently investigated. In this study, we conducted a comparative study to evaluate the wound-healing ability of acellular fish skin graft (Kerecis®) with that of the widely used bovine collagen skin graft (ProHeal®). The skin grafts were evaluated not only in terms of their biophysical properties, but also their in vitro cellular activities, using fibroblasts, keratinocytes, and human endothelial cells. The clinical study evaluated wound healing in 52 patients with acute burns who underwent skin grafting on donor sites from January 2019 to December 2020. The study was conducted with two groups; while only Kerecis® was tested in one group, Kerecis® and ProHeal® were compared in the other. In both groups, the application time of the dressing material was one to two days after split-thickness skin grafting to the donor sites. The Kerecis®-treatment group experienced faster healing than the other treatment group. In particular, the average wound healing time using the Kerecis® treatment and the ProHeal® treatment was 10.7 ± 1.5 days and 13.1 ± 1.4 days, respectively. We believe that the faster healing of the Kerecis® treatment, compared to that of the ProHeal® treatment, maybe due to the synergistic effect of the unique biophysical structure and the bioactive components of acellular fish skin.
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Marchetto C, Sgrò A, Gamba P, Trojan D, Pagliara C, Midrio P. The use of biological membranes for correction of congenital malformations. Cell Tissue Bank 2022; 23:607-614. [PMID: 35381893 PMCID: PMC9371986 DOI: 10.1007/s10561-022-10003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
Many congenital malformations often require a multidisciplinary and multistep surgical treatment, including the use of biological membranes. Aims of the study were to describe the use of these membranes for the correction of malformations, their clinical performance at follow-up, and patient's tolerance to them. The study included patients treated between 2009 and November 2020 in two referral centers. They were affected by abdominal wall defects (AWD), esophageal atresia/tracheo-esophageal fistula (EA/TEF), diaphragmatic hernia (CDH), spinal defects (SD), and anorectal malformations (ARM). The human origin membranes used during surgery were amniotic membrane, fascia lata, and pericardium provided by the local tissue bank and the porcine-derived membrane available on the market. Thirty-one patients were retrieved. The sample included 10 AWD, 7 EA/TEF, 5 CDH, 4 SD, 2 ARM, and 3 miscellaneous defects. The median age at repair was 139 days (range: 10,5–1494). The median follow-up was 1021 days (range: 485,5–1535). Two patients were lost at follow-up. The defects were successfully repaired and the membranes perfectly tolerated in 28/29 cases. In 1 case of CDH the fascia lata was replaced with a Goretex patch due to recurrence of the defect. This is the largest series on the use of biological membranes in congenital malformations. The variety of tissues allows to choose the best material for each malformation. The excellent tolerance and performance of this first series of patients encourage the use of these membranes to correct different type of malformations at any age.
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Affiliation(s)
- C Marchetto
- Pediatric Surgery, Cà Foncello Hospital, Treviso, Italy
| | - A Sgrò
- Pediatric Surgery, University of Padua, Padua, Italy
| | - P Gamba
- Pediatric Surgery, University of Padua, Padua, Italy
| | - D Trojan
- Fondazione Banca dei Tessuti di Treviso - Onlus, Treviso, Italy
| | - C Pagliara
- Pediatric Surgery, Cà Foncello Hospital, Treviso, Italy.,Pediatric Surgery, University of Padua, Padua, Italy
| | - P Midrio
- Pediatric Surgery, Cà Foncello Hospital, Treviso, Italy. .,Pediatric Surgery, University of Padua, Padua, Italy.
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Chen J, Lopez CD, Girard AO, Abousy M, Redett RJ, Groves M, Yang R. Dehydrated human amnion/chorion membrane allografts for myelomeningocele and wound reconstruction. Childs Nerv Syst 2021; 37:3721-3731. [PMID: 34609611 DOI: 10.1007/s00381-021-05352-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022]
Abstract
A growing body of literature demonstrates the clinical promise of dehydrated human amnion/chorion membrane (dHACM), a cryopreserved tissue product derived from placental amniotic membrane, to enhance post-operative wound healing. The purpose of this study is to review the potential of dHACM to facilitate post-surgical and myelomeningocele wound repair. A comprehensive literature search of PubMed was conducted to identify studies investigating dHACM use in pediatric and surgical wound care published from inception to October 2020. For each study, patient characteristics, wound characteristics, and outcomes following dHACM application were documented and assessed. Of the 190 articles reviewed, 15 publications were included in the final analysis. Results demonstrated that the average wound healing time varied across clinical indications (e.g., 14 days for trauma reconstruction to 116 days for Moh's surgery repair). Across indications, pediatric patients had shorter healing periods compared to adults (P < 0.01). Chronic wounds (> four weeks old) were documented in both adult (n = 3) and pediatric (n = 2) wound repair publications; all chronic surgical wounds demonstrated complete wound closure with dHACM. No complications from dHACM use were reported. Advantages of dHACM included increased patient satisfaction, cost-savings, and faster wound healing. We then present two cases of myelomeningocele wound repair facilitated successfully by dHACM. Overall, dHACM proves to successfully expedite wound repair in pediatric patients with chronic or complicated wounds such as those from myelomeningocele repair. It is important for surgeons to consider wound duration, size, and patient age to better predict graft success in enhancing wound repair.
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Affiliation(s)
- Jonlin Chen
- Department of Plastic & Reconstructive Surgery, The Johns Hopkins School of Medicine, 601 N. Caroline Street, Suite 8161, Baltimore, MD, 21287, USA
| | - Christopher D Lopez
- Department of Plastic & Reconstructive Surgery, The Johns Hopkins School of Medicine, 601 N. Caroline Street, Suite 8161, Baltimore, MD, 21287, USA
| | - Alisa O Girard
- Department of Plastic & Reconstructive Surgery, The Johns Hopkins School of Medicine, 601 N. Caroline Street, Suite 8161, Baltimore, MD, 21287, USA
| | - Mya Abousy
- Department of Plastic & Reconstructive Surgery, The Johns Hopkins School of Medicine, 601 N. Caroline Street, Suite 8161, Baltimore, MD, 21287, USA
| | - Richard J Redett
- Department of Plastic & Reconstructive Surgery, The Johns Hopkins School of Medicine, 601 N. Caroline Street, Suite 8161, Baltimore, MD, 21287, USA
| | - Mari Groves
- Department of Neurosurgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Robin Yang
- Department of Plastic & Reconstructive Surgery, The Johns Hopkins School of Medicine, 601 N. Caroline Street, Suite 8161, Baltimore, MD, 21287, USA.
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Riedel RN, Pérez-Pérez A, Sánchez-Margalet V, Varone CL, Maymó JL. Stem cells and COVID-19: are the human amniotic cells a new hope for therapies against the SARS-CoV-2 virus? Stem Cell Res Ther 2021; 12:155. [PMID: 33648582 PMCID: PMC7919997 DOI: 10.1186/s13287-021-02216-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
A new coronavirus respiratory disease (COVID-19) caused by the SARS-CoV-2 virus, surprised the entire world, producing social, economic, and health problems. The COVID-19 triggers a lung infection with a multiple proinflammatory cytokine storm in severe patients. Without effective and safe treatments, COVID-19 has killed thousands of people, becoming a pandemic. Stem cells have been suggested as a therapy for lung-related diseases. In particular, mesenchymal stem cells (MSCs) have been successfully tested in some clinical trials in patients with COVID-19. The encouraging results positioned MSCs as a possible cell therapy for COVID-19. The amniotic membrane from the human placenta at term is a valuable stem cell source, including human amniotic epithelial cells (hAECs) and human mesenchymal stromal cells (hAMSCs). Interestingly, amnion cells have immunoregulatory, regenerative, and anti-inflammatory properties. Moreover, hAECs and hAMSCs have been used both in preclinical studies and in clinical trials against respiratory diseases. They have reduced the inflammatory response and restored the pulmonary tissue architecture in lung injury in vivo models. Here, we review the existing data about the stem cells use for COVID-19 treatment, including the ongoing clinical trials. We also consider the non-cellular therapies that are being applied. Finally, we discuss the human amniotic membrane cells use in patients who suffer from immune/inflammatory lung diseases and hypothesize their possible use as a successful treatment against COVID-19.
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Affiliation(s)
- Rodrigo N Riedel
- Instituto de Química Biológica (IQUIBICEN), CONICET- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria Pabellón 2, 4° piso, 1428, Buenos Aires, Argentina
| | - Antonio Pérez-Pérez
- Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Hospital Universitario Virgen Macarena, Facultad de Medicina, Universidad de Sevilla, Avenida Sánchez Pizjuán 4, 41009, Sevilla, España
| | - Víctor Sánchez-Margalet
- Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Hospital Universitario Virgen Macarena, Facultad de Medicina, Universidad de Sevilla, Avenida Sánchez Pizjuán 4, 41009, Sevilla, España
| | - Cecilia L Varone
- Instituto de Química Biológica (IQUIBICEN), CONICET- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria Pabellón 2, 4° piso, 1428, Buenos Aires, Argentina
| | - Julieta L Maymó
- Instituto de Química Biológica (IQUIBICEN), CONICET- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria Pabellón 2, 4° piso, 1428, Buenos Aires, Argentina.
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Reed DS, Giles GB, Johnson A, Santamaria JA, Nelson F, Appelo B, DeMartelaere S, Davies BW. Acute Reconstruction of Periorbital Trauma Resulting in Eyelid Anterior Lamella Loss With Simultaneous Full-thickness Skin Grafting and Amniotic Membrane Grafting: A Case Report. Mil Med 2020; 187:e246-e249. [PMID: 33331944 DOI: 10.1093/milmed/usaa326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/01/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
Complex facial lacerations are frequently encountered in the combat environment. Trauma with soft-tissue loss of the periorbital region offers particular challenges in terms of operative reconstruction. Cicatricial changes in the sub-acute phase can lead to eyelid malposition and lagophthalmos. The authors present a novel technique for acute reconstruction of periorbital trauma with eyelid soft-tissue loss with simultaneous full-thickness skin grafting and amniotic membrane grafting. The technique involves standard preparation of the surgical area of injury and infiltration with local anesthetic. Initially, the area of injury is copiously irrigated, and debridement of any necrotic tissue is accomplished. Amniotic membrane grafting is then performed over the defect. Approximately 2 mm × 2 mm full-thickness skin grafts are procured and distributed over the initial amniotic membrane graft. A second amniotic membrane graft is then secured over the skin graft-amniotic membrane graft complex with cyanoacrylate tissue adhesive. A bolstered suture tarsorrhaphy is performed to minimize tissue trauma during the healing process. The operative and postsurgical outcomes were assessed. The graft site healed well without cicatricial changes or lagophthalmos. Peripheral small papillomatous lesions did develop requiring excision for cosmesis, but ultimately the graft site demonstrated appropriate coverage and healthy re-epithelialization over the previous defect. This case demonstrates the viability of simultaneous full-thickness skin grafting with concomitant amniotic membrane grafting for the acute reconstruction of periorbital trauma with eyelid anterior lamella tissue loss. An excellent cosmetic and functional outcome was attained. By providing acute reconstruction, the risk of damage secondary to cicatricial periorbital changes may be avoided.
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Affiliation(s)
- Donovan S Reed
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
| | - Gregory B Giles
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
| | - Anthony Johnson
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
| | - Joseph A Santamaria
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
| | - Frederick Nelson
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
| | - Benjamin Appelo
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
| | - Sheri DeMartelaere
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
| | - Brett W Davies
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, 78234 USA
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