60: Cryopreserved umbilical cord as a meningeal patch for in-utero spina bifida repair in sheep model

Papanna, Ramesha; Mann, Lovepreet K.; Won, Jong Jin; Vu, Thai; Patel, Rajan; Narayana, Ponnada A.; Jain, Ranu; Fletcher, Stephen; Bockhorst, Kurt H.

doi:10.1016/j.ajog.2018.11.067

Cited by 6 publications

(12 citation statements)

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“…The human umbilical cord (HUC) has become a tissue of great and increasing interest in regenerative medicine. HUC byproducts, such as cells and extracts, have been studied in vitro and in vivo with encouraging results in tissue outcomes (Iftimia-Mander et al, 2013;Papanna et al, 2015b;Wu et al, 2018). HUC Mesenchymal Stem Cells (MSCs), especially those isolated from the Wharton's Jelly (WJ), are already being used in clinical trials which have reported safety and efficacy in wound healing (Couto et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Use of Human Umbilical Cord and Its Byproducts in Tissue Regeneration

Velarde

Castañeda

Morales

et al. 2020

Front. Bioeng. Biotechnol.

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The fresh or cryopreserved human umbilical cord (HUC) and its byproducts, such as cells and extracts, have different uses in tissue regeneration. Defining what HUC byproduct is more effective in a particular application is a challenge. Furthermore, the methods of isolation, culture and preservation, may affect cell viability and regenerative properties. In this article, we review the HUC and its byproducts' applications in research and clinical practice. We present our results of successful use of HUC as a patch to treat gastroschisis and its potential to be applied in other conditions. Our in vitro results show an increase in proliferation and migration of human fibroblasts by using an acellular HUC extract. Our goal is to promote standardization of procedures and point out that applications of HUC and its byproducts, as well as the resulting advances in regenerative medicine, will depend on rigorous quality control and on more research in this area.

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Section: Introductionmentioning

confidence: 99%

Use of Human Umbilical Cord and Its Byproducts in Tissue Regeneration

Velarde

Castañeda

Morales

et al. 2020

Front. Bioeng. Biotechnol.

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“…Moreover, when compared to AM, UC contains significantly higher amounts of high‐molecular‐weight hyaluronic acid (HA) and HA‐containing active matrix component . The regenerative therapeutic effect of human cryopreserved UC (cUC) in the repair of skin defects associated with bone exposure is reported in several animal models of spina bifida . In these models, cUC results in regeneration of epidermal, dermal, and subdermal components with minimal inflammatory cell migration .…”

Section: Introductionmentioning

confidence: 99%

“…31,32 In these models, cUC results in regeneration of epidermal, dermal, and subdermal components with minimal inflammatory cell migration. 31 In comparison with acellular dermal matrix where there was an equal amount of cellular ingrowth, there was decreased acute inflammation and more organized cellular ingrowth of epidermal and meningeal cells in the human cUC. 32 Preliminary studies using the commercially available UC product NEOX™ CORD 1K (Amniox Medical, Inc., Miami, FL) further suggest cUC is safe and useful in promoting healing of complex foot ulcers with osteomyelitis, with healing rates reported from 79 to 100% when combined with negative pressure therapy.…”

Section: Introductionmentioning

confidence: 99%

An open‐label trial of cryopreserved human umbilical cord in the treatment of complex diabetic foot ulcers complicated by osteomyelitis

Marston

Lantis

et al. 2019

Wound Repair Regeneration

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Clinical trials of potential new therapies for diabetic foot ulcers rarely enroll patients whose wounds extend to muscle, fascia, or bone with clinical and radiographic evidence of underlying osteomyelitis. An open‐label, multicenter trial of cryopreserved human umbilical cord (TTAX01) was undertaken in 32 subjects presenting with such complex wounds with a mean duration of 6.1 ± 9.0 (range: 0.2–47.1) months and wound area at screening of 3.8 ± 2.9 (range: 1.0–9.6) cm2. Aggressive surgical debridement at baseline resulted in 17 minor amputations and an increase in mean wound area to 7.4 ± 5.8 (range: 1.1–28.6) cm2. All subjects were placed on systemic antibiotics for at least 6 weeks in conjunction with baseline application of TTAX01. Repeat applications were made at no less than 4‐week intervals over the 16‐week trial. Initial closure occurred in 18 of 32 (56%) wounds, with 16 (50%) of these having confirmed closure in 16 weeks with a median of one‐product application. Cases with biopsy confirmed osteomyelitis (n = 20) showed initial closure in 12 (60%) wounds and confirmed closure in 10 (50%) wounds. Four of the five ulcers presenting as recurrences experienced confirmed closure. Mean overall time to healing was 12.8 ± 4.3 weeks. Mean wound area reduction from baseline was 91% for all wounds. Of the 16 wounds without confirmed closure during the 16‐week treatment period, five (31.3%) achieved 99–100% wound area reduction by their final visit. The product was well tolerated. Two minor amputations occurred during the study period due to recurrent or persistent osteomyelitis; however, there were no major amputations.

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“…After harvesting the cord, the umbilical vessels are removed and the umbilical cord is flattened to create patches of various sizes. We recently reported that HUC used for repair in a surgically created SB sheep model was found to provide a watertight barrier, helped regenerate the skin defect, preserved spinal cord anatomy, and prevented hind brain herniation . However, HUC has not been studied in a physiologic SB model.…”

Section: Introductionmentioning

confidence: 99%

“…We recently reported that HUC used for repair in a surgically created SB sheep model was found to provide a watertight barrier, helped regenerate the skin defect, preserved spinal cord anatomy, and prevented hind brain herniation. 11 However, HUC has not been studied in a physiologic SB model. The rationale for adopting HUC as a patch material for SB surgery is based on the promising clinical experience of HUC gained from its use in the repair of corneas, skin, tendons, and ligaments 12 and its demonstrated antiinflammatory and anti-scarring effects.…”

Section: Introductionmentioning

confidence: 99%