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Montague C, Holt Y, Vlok M, Dhanraj P, Boodhoo K, Maartens M, Buthelezi K, Niesler CU, van de Vyver M. Combined therapeutic use of umbilical cord blood serum and amniotic membrane in diabetic wounds. Biochimie 2024:S0300-9084(24)00171-8. [PMID: 39043358 DOI: 10.1016/j.biochi.2024.07.012] [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: 03/22/2024] [Revised: 06/21/2024] [Accepted: 07/18/2024] [Indexed: 07/25/2024]
Abstract
Diabetic wounds are hard-to-heal due to complex multifactorial dysregulation within the micro-environment, necessitating the development of novel regenerative approaches to stimulate healing. This study investigated whether the combined therapeutic application of two novel cellular tissue products, namely a decellularized collagen-rich amniotic membrane (AmR) and growth factor-rich umbilical cord blood serum (UCBS) could have a positive synergistic effect on long-term healing outcomes by stimulating both superficial wound closure and wound bed regeneration. Full thickness excisional wounds were induced on obese diabetic mice (B6.Cg-lepob/J, ob/ob, n = 23) and treated with either: 1) Standard wound care (control); 2) UCBS; 3) AmR or 4) UCBS + AmR. Macroscopic wound closure was assessed on days 0, 3, 7, 10 and 14 post wounding. To determine the potential impact on wound recurrence, endpoint analysis was performed to determine both the overall quality of healing histologically as well as the molecular state of the wounds on day 14 via proteomic analysis. The data demonstrated the presence of both healers and non-healers. Re-epithelization took place in the healers of all treatment groups, but underlying tissue regeneration was far more pronounced following application of the combined treatment (UCBS + AmR), suggesting improved quality of healing and potentially a reduced change of recurrence long term. In non-healers, wounds failed to heal due to excessive slough formation and a reduction in LTB4 expression, suggesting impaired antimicrobial activity. Care should thus be taken since the cellular tissue product therapy could pose an increased risk for infection in some patients.
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Affiliation(s)
| | - Y Holt
- Next Biosciences, Midrand, South Africa
| | - M Vlok
- Central Analytical Facility, Stellenbosch University, Cape Town, South Africa
| | - P Dhanraj
- Experimental Medicine Research Group, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - K Boodhoo
- Experimental Medicine Research Group, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - M Maartens
- Experimental Medicine Research Group, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - C U Niesler
- Next Biosciences, Midrand, South Africa; Discipline of Biochemistry, School of Life Sciences, University of KwaZulu-Natal (UKZN), Pietermaritzburg, South Africa
| | - M van de Vyver
- Experimental Medicine Research Group, Department of Medicine, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
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2
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Ingraldi AL, Audet RG, Tabor AJ. The Preparation and Clinical Efficacy of Amnion-Derived Membranes: A Review. J Funct Biomater 2023; 14:531. [PMID: 37888195 PMCID: PMC10607219 DOI: 10.3390/jfb14100531] [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: 09/08/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
Biological tissues from various anatomical sources have been utilized for tissue transplantation and have developed into an important source of extracellular scaffolding material for regenerative medicine applications. Tissue scaffolds ideally integrate with host tissue and provide a homeostatic environment for cellular infiltration, growth, differentiation, and tissue resolution. The human amniotic membrane is considered an important source of scaffolding material due to its 3D structural architecture and function and as a source of growth factors and cytokines. This tissue source has been widely studied and used in various areas of tissue repair including intraoral reconstruction, corneal repair, tendon repair, microvascular reconstruction, nerve procedures, burns, and chronic wound treatment. The production of amniotic membrane allografts has not been standardized, resulting in a wide array of amniotic membrane products, including single, dual, and tri-layered products, such as amnion, chorion, amnion-chorion, amnion-amnion, and amnion-chorion-amnion allografts. Since these allografts are not processed using the same methods, they do not necessarily produce the same clinical responses. The aim of this review is to highlight the properties of different human allograft membranes, present the different processing and preservation methods, and discuss their use in tissue engineering and regenerative applications.
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Affiliation(s)
- Alison L. Ingraldi
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Robert G. Audet
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Aaron J. Tabor
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
- Department of Clinical Operations, Axolotl Biologix, Flagstaff, AZ 86001, USA
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3
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Zhang H, Li Y, Chen G, Han F, Jiang W. Human amniotic membrane graft for refractory macular hole: A single-arm meta-analysis and systematic review. J Fr Ophtalmol 2023; 46:276-286. [PMID: 36739260 DOI: 10.1016/j.jfo.2022.07.001] [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] [Received: 06/10/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE The treatment of refractory macular holes is controversial, with human amniotic membrane grafts emerging recently as an attractive option. We performed a meta-analysis and systematic review in this paper to assess the results of human amniotic membrane (hAM) in the treatment of refractory macular hole (MH). METHODS We searched the Cochrane Database of Systematic Reviews, Web of Science, PubMed, Embase, China National Knowledge Infrastructure databases, VIP database, Wanfang Data Knowledge Service Platform, Sinomed, Chinese Clinical Trial Registry, and Clinical Trials.gov. Studies reporting hAM for the treatment of refractory MH were included. The outcomes are MH closure rate, visual acuity (VA) improvement rate, and graft dislocation/contracture rate. RESULTS A total of 8 studies on 103 eyes were included, all of which had undergone failed vitrectomy and internal limiting membrane (ILM) peeling. In all studies, the VA improvement rate was 66% (95%CI: 45 to 84%), the MH closure rate was 94% (95%CI: 84 to 100%) and the hAM graft dislocation/contracture rate was 6% (95%CI: 0 to 15%). In the studies using cryopreserved hAM grafts, the MH closure rate was 99% (95%CI: 94 to 100%) and the hAM graft dislocation/contracture rate was 3% (0%, 10%). The VA improvement rates were 94% (95%CI: 79 to 100%) in the retinal detachment subgroup, 37% (95%CI: 20 to 56%) in the pathologic myopia subgroup, and 62% (95%CI: 14 to 100%) in the idiopathic MH subgroup. CONCLUSION Human amniotic membrane in the treatment of refractory MH results in visual improvement. It has a high macular hole closure rate and low dislocation/contracture rate. Cryopreserved hAM grafts might have better outcomes than dehydrated grafts.
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Affiliation(s)
- Hengdi Zhang
- Ophthalmology Department, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China.
| | - Y Li
- Department of Information, Medical Support Center, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
| | - G Chen
- Department of General surgery center, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
| | - F Han
- Ophthalmology Department, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
| | - W Jiang
- Ophthalmology Department, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
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4
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Bonvallet PP, Damaraju SM, Modi HN, Stefanelli VL, Lin Q, Saini S, Gandhi A. Biophysical Characterization of a Novel Tri-Layer Placental Allograft Membrane. Adv Wound Care (New Rochelle) 2022; 11:43-55. [PMID: 33975444 PMCID: PMC9831246 DOI: 10.1089/wound.2020.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective: Placental tissues, including membranes composed of amnion and chorion, are promising options for the treatment of chronic wounds. Amnion and chorion contain multiple extracellular matrix (ECM) proteins and a multitude of growth factors and cytokines that, when used clinically, assist in the progression of difficult to heal wounds through restoration of a normal healing process. The objective of this study was to characterize the in vitro physical and biological properties of a dehydrated tri-layer placental allograft membrane (TPAM) consisting of a chorion layer sandwiched between two layers of amnion. Approach: Mechanical properties were evaluated by mechanical strength and enzyme degradation assays. The ECM composition of TPAM membranes was evaluated by histological staining while growth factors and cytokine presence was evaluated by a multiplex enzyme-linked immunosorbent assay. Proliferation, migration, and ECM secretion assays were performed with fibroblasts. Immunomodulatory properties were assessed by a pro-inflammatory cytokine reduction assay while the macrophage phenotype was determined by quantifying the ratio of M1 versus M2 secreted factors. Results: The unique three-layer construction improves mechanical handling properties over single- and bi-layer membranes. Results demonstrate that TPAM is rich in ECM proteins, growth factors, cytokines, and tissue inhibitors of metalloproteinases, and favorably influences fibroblast migration, proliferation, and ECM secretion when compared to negative controls. Furthermore, after processing and preservation, these membranes maintain their intrinsic immunomodulatory properties with the ability to suppress pro-inflammatory processes and modulate the M1 and M2 macrophage phenotype toward a pro-regenerative profile when compared to a negative control. Innovation: This is the first study to characterize both the biophysical and biological properties of a tri-layer placental membrane. Conclusion: This work demonstrates that TPAM has improved handling characteristics over single- and bi-layer membranes, stimulates pro-healing cellular responses, and advantageously modulates inflammatory responses, altogether making this scaffold a promising option for treating wounds, especially those that are complex or difficult to heal.
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Affiliation(s)
- Paul P. Bonvallet
- Product Development, Integra Life Sciences, Corp., Princeton, New Jersey, USA
- Correspondence: Product Development, Integra Life Sciences, Corp., 1100 Campus Road, Princeton, NJ 08540, USA.
| | - Sita M. Damaraju
- Product Development, Integra Life Sciences, Corp., Princeton, New Jersey, USA
| | - Heli N. Modi
- Product Development, Integra Life Sciences, Corp., Princeton, New Jersey, USA
| | | | - Qiaoling Lin
- Product Development, Integra Life Sciences, Corp., Princeton, New Jersey, USA
| | - Sunil Saini
- Product Development, Integra Life Sciences, Corp., Princeton, New Jersey, USA
| | - Ankur Gandhi
- Product Development, Integra Life Sciences, Corp., Princeton, New Jersey, USA
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Ramakrishnan R, Harikrishnan VS, Anil A, Arumugham S, Krishnan LK. Extracellular matrix-based combination scaffold for guided regeneration of large-area full-thickness rabbit burn wounds upon a single application. J Biomed Mater Res B Appl Biomater 2021; 110:848-861. [PMID: 34773682 DOI: 10.1002/jbm.b.34965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/07/2021] [Accepted: 10/31/2021] [Indexed: 12/17/2022]
Abstract
Regeneration of large acute and chronic wounds is a concern worldwide. The present study evaluates wound healing competence of a completely human-origin, extracellular matrix (ECM)-based skin substitute/graft. It comprises cell-less amniotic membrane (AM), clinical-grade fibrin (FIB), and hyaluronic acid (HA) termed as AMFIBHA. The use of large-area third-degree rabbit burn wounds evaluated the product efficiency. The AMFIBHA induces hemostasis and permits suture-less positioning on the wound bed. In wet wounds, the AMFIBHA degrades and release biologically active molecules and guide cell migration, proliferation, and regeneration. The study demonstrated the effectiveness of this wound care product in terms of epithelial-dermal regeneration with angiogenesis. The study assessed injury-associated inflammation and different wound healing markers after 28 days of experiment and compared with both positive and negative controls-treated wounds. The regeneration of mature epidermis and dermis with rete pegs and hair follicle-like structure was evident upon a single application. The active involvement of host cells resulted in supple tissue formation. The ECM organization of AMFIBHA-treated tissue resulted in re-gain of mechanical properties comparable to native skin after 56 days. These guided regenerative outcomes reveal a promising translational value of the novel AMFIBHA skin substitute as an off-the-shelf product for clinical use.
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Affiliation(s)
- Rashmi Ramakrishnan
- Division of Thrombosis Research, Department of Applied Biology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, India
| | - Vijayakumar Sreelatha Harikrishnan
- Division of Laboratory Animal Science, Department of Applied Biology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, India
| | - Arya Anil
- Division of Laboratory Animal Science, Department of Applied Biology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, India
| | - Sabareeswaran Arumugham
- Division of Experimental Pathology, Department of Applied Biology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, India
| | - Lissy Kalliyana Krishnan
- Division of Thrombosis Research, Department of Applied Biology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, India
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Insights on the Human Amniotic Membrane in Clinical Practice with a Focus on the New Applications in Retinal Surgery. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-020-00190-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lay SummaryRecently, the use of the human amniotic membrane (hAM) has been extended to treat retinal disorders such as refractory macular holes, retinal breaks and dry and wet age-related macular degeneration. Not only the hAM has proved to be an excellent tool for repairing retinal tissue, but it has also shown a promising regeneration potential. This review aims to highlight the novel use of the hAM in treating retinal diseases. Although the hAM has been used in the ocular anterior segment reconstruction for more than 60 years, in the last 2 years, we have found in literature articles showing the use of the hAM in the retinal surgery field with interesting results in terms of tissue healing and photoreceptor regeneration.
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Applications of the Amniotic Membrane in Vitreoretinal Surgery. J Clin Med 2020; 9:jcm9082675. [PMID: 32824838 PMCID: PMC7463634 DOI: 10.3390/jcm9082675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 11/23/2022] Open
Abstract
Recently, the use of the human amniotic membrane (hAM) has been extended to treat retinal disorders, such as macular holes that failed to close and retinal tears. The hAM has demonstrated the induction of a recovery process of the external retinal layers involving the external limiting membrane (ELM) and the ellipsoid zone (EZ). After that, the application of the hAM for retinal pathologies was extended to large macular tears, high myopic retinal detachment associated with MH, paravascular tears, serous macular detachment associated with optic pit, complicated retinal detachment and advanced age-related macular degeneration (AMD). The hAM has shown a potential in repairing retinal tissue through a regeneration process. This review aims to highlight the use of the hAM in various vitreo-retinal surgical fields, and to confront it with other cutting-edge surgical techniques used to treat challenging vitreo-retinal pathologies.
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Rizzo S, Caporossi T, Tartaro R, Finocchio L, Pacini B, Bacherini D, Virgili G. Human Amniotic Membrane Plug to Restore Age-Related Macular Degeneration Photoreceptor Damage. Ophthalmol Retina 2020; 4:996-1007. [PMID: 32344157 DOI: 10.1016/j.oret.2020.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Age-related macular degeneration (AMD) is the leading cause of legal blindness in adults 65 years of age and older. Choroidal neovascularization (CNV) can complicate AMD and lead to severe visual acuity reduction. Despite the several treatments available, if the retinal pigment epithelium is damaged, we have to cope with the impossibility of restoring acceptable visual acuity using only medical treatments. DESIGN Prospective, consecutive, interventional study. PARTICIPANTS Eleven patients affected by AMD, 6 patients affected by CNV, and 5 patients affected by geographic atrophy. METHODS All patients underwent a pars plana vitrectomy with subretinal implantation of human amniotic membrane (hAM) to induce photoreceptor regeneration and partial visual acuity restoration. MAIN OUTCOME MEASURES Primary study outcome was visual acuity improvement. Secondary outcomes were multimodal imaging results. RESULTS Mean preoperative best-corrected visual acuity (BCVA) was 20/2000 (2 logarithm of the minimum angle of resolution [logMAR]), and all the patients showed a BCVA of counting fingers or less. Mean final BCVA was 20/400 (1.31 logMAR), ranging from 20/2000 to 20/100 (2-0.7 logMAR). OCT angiography was used to measure retinal vascularization in the treated eye compared with the fellow eye. A high correlation between BCVA and deep vascular density was evidenced. Adaptive optics findings, obtained over the retinal area where the highest functionality was observed, were evaluated using microperimetry. The images showed possible photoreceptor presence over the hAM membrane. CONCLUSIONS This work supports the feasibility and safety of the hAM to promote partial retinal function restoration 6 months after surgery with visual acuity improvement. The advanced diagnostics help to understand the interaction between the hAM and photoreceptors and suggest that photoreceptor regeneration may occur.
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Affiliation(s)
- Stanislao Rizzo
- Department of Ophthalmology, Catholic University of Sacred Hearth-Foundation "Policlinico Universitario A. Gemelli"-IRCCS, Rome, Italy
| | - Tomaso Caporossi
- Department of NEUROFARBA, Ophthalmology, University of Florence-Careggi, Florence, Italy.
| | - Ruggero Tartaro
- Department of NEUROFARBA, Ophthalmology, University of Florence-Careggi, Florence, Italy
| | - Lucia Finocchio
- Department of NEUROFARBA, Ophthalmology, University of Florence-Careggi, Florence, Italy
| | - Bianca Pacini
- Department of NEUROFARBA, Ophthalmology, University of Florence-Careggi, Florence, Italy
| | - Daniela Bacherini
- Department of NEUROFARBA, Ophthalmology, University of Florence-Careggi, Florence, Italy
| | - Gianni Virgili
- Department of NEUROFARBA, Ophthalmology, University of Florence-Careggi, Florence, Italy
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Canciello A, Teti G, Mazzotti E, Falconi M, Russo V, Giordano A, Barboni B. Progesterone Prolongs Viability and Anti-inflammatory Functions of Explanted Preterm Ovine Amniotic Membrane. Front Bioeng Biotechnol 2020; 8:135. [PMID: 32258004 PMCID: PMC7089934 DOI: 10.3389/fbioe.2020.00135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/10/2020] [Indexed: 12/21/2022] Open
Abstract
Amniotic membrane (AM) is considered an important medical device with many applications in regenerative medicine. The therapeutic properties of AM are due to its resistant extracellular matrix and to the large number of bioactive molecules released by its cells. An important goal that still remains to be achieved is the identification of cultural and preservation protocols able to maintain in time the membrane morphology and the biological properties of its cells. Recently, our research group demonstrated that progesterone (P4) is crucial in preventing the loss of the epithelial phenotype of amniotic epithelial cells in vitro. Followed by this premise, it has been evaluated whether P4 may also affect AM properties in a short-term culture. Results confirm that P4 preserves AM integrity and architecture with respect to untreated AM, which showed alterations in morphology. Transmission electron microscopy (TEM) analyses demonstrate that P4 also maintains unaltered cell-cell junctions, nuclear status, and intracellular organelles. On the contrary, an untreated AM experienced an extensive cell death and a strong reduction of immunomodulatory properties, measured in terms of anti-inflammatory cytokine expression and secretion. Overall, these results could open to new strategies to ameliorate the protocols for cryopreservation and tissue culture, which represent preliminary stages of AM application in regenerative medicine.
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Affiliation(s)
- Angelo Canciello
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy.,Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA, United States
| | - Gabriella Teti
- Department for Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Eleonora Mazzotti
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | - Mirella Falconi
- Department for Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Valentina Russo
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | - Antonio Giordano
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA, United States.,Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Barbara Barboni
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
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10
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Caporossi T, Angelis L, Pacini B, Tartaro R, Finocchio L, Barca F, Rizzo S. A human Amniotic Membrane plug to manage high myopic macular hole associated with retinal detachment. Acta Ophthalmol 2020; 98:e252-e256. [PMID: 31318489 DOI: 10.1111/aos.14174] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/28/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the efficacy of the human amniotic membrane (hAM) to treat (HMMH) associated with retinal detachment (RD). MATERIAL AND METHODS Ten eyes of 10 patients with recurrent HMMH and RD, who had already undergone one or more pars plana vitrectomy (PPV), underwent a PPV with an hAM plug implanted in the macular hole. The initial five patients enrolled were tamponaded with (SO) while the subsequent five patients with 10% octafluoropropane (C3 F8 ). Silicon oil was removed in all five patients 2 months later. No statistical differences were reported between the two groups. RESULTS Final retinal reattachment was achieved in all the patients. BCVA improved from 1.73 logMAR to 0.94 logMAR after 6 months. No adverse events were registered during follow-up. CONCLUSION An hAM plug is an efficient substrate to manage HMMH associated with RD resulting in encouraging visual acuity recovery.
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Affiliation(s)
- Tomaso Caporossi
- Department of Translational Surgery and Medicine, Ophthalmology University of Florence Careggi, Florence Italy
| | - Lorenzo Angelis
- Department of Translational Surgery and Medicine, Ophthalmology University of Florence Careggi, Florence Italy
| | - Bianca Pacini
- Department of Translational Surgery and Medicine, Ophthalmology University of Florence Careggi, Florence Italy
| | - Ruggero Tartaro
- Department of Translational Surgery and Medicine, Ophthalmology University of Florence Careggi, Florence Italy
| | - Lucia Finocchio
- Department of Translational Surgery and Medicine, Ophthalmology University of Florence Careggi, Florence Italy
| | - Francesco Barca
- Department of Translational Surgery and Medicine, Ophthalmology University of Florence Careggi, Florence Italy
| | - Stanislao Rizzo
- Department of Translational Surgery and Medicine, Ophthalmology University of Florence Careggi, Florence Italy
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Cunningham BW, Seiber B, Riggleman JR, Van Horn MR, Bhat A. An investigational study of a dual-layer, chorion-free amnion patch as a protective barrier following lumbar laminectomy in a sheep model. J Tissue Eng Regen Med 2019; 13:1664-1671. [PMID: 31243876 DOI: 10.1002/term.2920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 01/15/2023]
Abstract
The inherent properties of the human amniotic membrane (HAM) suggest its potential for use as a physical barrier during surgery to protect neural elements and vessels from the surrounding environment. The objective of this study was to evaluate the effect of a dual-layer, chorion-free amnion patch (DLAM; ViaShield®, Globus Medical Inc., Audubon, PA, USA) processed from HAM as a protective barrier following lumbar laminectomy in a sheep model. A multiplex immunoassay was performed to quantify the inherent cytokines present in the amnion after processing. Twelve skeletally mature female crossbred Suffolk sheep were randomly divided into two equal post-operative periods (4 and 10 weeks). Each sheep underwent a laminectomy at L3 and L5, and one of the surgical sites randomly received the DLAM treatment. At each postsurgical time point, the extent of epidural fibrosis and neurohistopathological responses at the laminectomy sites was assessed based on epidural fibrosis-dura tenacity scores and decalcified histology, respectively. Immunoassay results showed that inflammatory mediators and immunomodulatory cytokines were present in the amnion after processing, but no proangiogenic cytokines were detected. At 10 weeks, tissue tenacity was significantly less in the DLAM treatment group when compared with the operative control (1.2 ± 0.4 vs. 2.8 ± 0.4, p < 0.05), demonstrating the ability of DLAM to act as a barrier and cover the dura. Gross observations showed fewer fibroblasts in the DLAM group in comparison with the control at both post-operative time points. Fibroblast infiltration analysis indicated that at both 4 and 10 weeks, there were significantly more infiltrated fibroblasts in the operative control sites than in the DLAM-treated sites, expressed as a percentage of the total number of fibroblasts present (4 weeks: 72.3 ± 10.2% vs. 10.8 ± 10.1%, p < .05; 10 weeks: 84.9 ± 15.8% vs. 43.1 ± 11.6%, p < .05). Additionally, fibroblasts travelled further into the dura in the operative control group compared with the DLAM-treated group at both time points. In conclusion, this study found that DLAM reduced fibroblast infiltration and tissue tenacity following lumbar laminectomy in a sheep animal model. These findings support the potential use of DLAM in clinical practice as a protective barrier for neural elements and anterior vessels.
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Affiliation(s)
- Bryan W Cunningham
- Musculoskeletal Research Center, Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Breanna Seiber
- Product Development, Globus Medical Inc., Audubon, PA, USA
| | - Jessica R Riggleman
- Musculoskeletal Education and Research Center, Globus Medical Inc., Audubon, PA, USA
| | - Margaret R Van Horn
- Musculoskeletal Education and Research Center, Globus Medical Inc., Audubon, PA, USA
| | - Archana Bhat
- Product Development, Globus Medical Inc., Audubon, PA, USA
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12
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Borghesi J, Ferreira Lima M, Mario LC, de Almeida da Anunciação AR, Silveira Rabelo AC, Giancoli Kato Cano da Silva M, Assunpção Fernandes F, Miglino MA, Oliveira Carreira AC, Oliveira Favaron P. Canine amniotic membrane mesenchymal stromal/stem cells: Isolation, characterization and differentiation. Tissue Cell 2019; 58:99-106. [PMID: 31133253 DOI: 10.1016/j.tice.2019.04.007] [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: 02/04/2019] [Revised: 04/03/2019] [Accepted: 04/18/2019] [Indexed: 01/06/2023]
Abstract
The amniotic membrane can be considered as one of the sources of isolation of these cells, since it is found in the fetal maternal interface and has low immunogenicity. Mesenchymal stromal/stem cells (MSCs) have not been identified in canine amniotic membrane (AMC). Therefore, our objective was to isolate, culture, characterize and differentiate cells derived from canine amniotic membrane (AMC) and to verify its immunological and tumorigenic potential. For this, 12 dogs fetuses of each gestational age 32, 43 and 55 days were used, and the isolation and culture of the AMC were performed. We observed that the cells presented fibroblastoid morphology and high confluence even after freezing. We also observed that, when induced, they were able to differentiate into osteogenic, adipogenic, and chondrogenic cells, as well as being CD34- and CD105+. Regarding the immunological markers, we found that IL-1, IL-2, IL-6, IL-10 and MHC II were not expressed, whereas MHC I was expressed. After application of AMC cells in nude mice we can verify that there was no tumor formation. Based on this, we conclude that canine amniotic membrane is a good and accessible source for obtaining MSCs of low immunogenic and tumorigenic potential for veterinary therapeutic applications.
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Affiliation(s)
- Jéssica Borghesi
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ-USP), Sao Paulo, Brazil.
| | | | - Lara Carolina Mario
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ-USP), Sao Paulo, Brazil
| | | | - Ana Carolina Silveira Rabelo
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ-USP), Sao Paulo, Brazil
| | | | - Fausto Assunpção Fernandes
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ-USP), Sao Paulo, Brazil
| | - Maria Angélica Miglino
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ-USP), Sao Paulo, Brazil
| | - Ana Claudia Oliveira Carreira
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ-USP), Sao Paulo, Brazil; NUCEL (Cell and Molecular Therapy Center), School of Medicine, Internal Medicine Department, University, Sao Paulo, Sao Paulo, Brazil.
| | - Phelipe Oliveira Favaron
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ-USP), Sao Paulo, Brazil
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Affiliation(s)
- Adam Price-Evans
- Future Science Group, Unitec House, 2 Albert Place, London N3 1QB, UK
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