Amniotic Membrane and Its Derivatives: Novel Therapeutic Modalities in Liver Disorders

Abstract

The liver is a vital organ responsible for metabolic and digestive functions, protein synthesis, detoxification, and numerous other necessary functions. Various acute, chronic, and neoplastic disorders affect the liver and hamper its biological functions. Most of the untreated liver diseases lead to inflammation and fibrosis which develop into cirrhosis. The human amniotic membrane (hAM), the innermost layer of the fetal placenta, is composed of multiple layers that include growth-factor rich basement membrane, epithelial and mesenchymal stromal cell layers. hAM possesses distinct beneficial anti-fibrotic, anti-inflammatory and pro-regenerative properties via the secretion of multiple potent trophic factors and/or direct differentiation into hepatic cells which place hAM-based therapies as potential therapeutic strategies for the treatment of chronic liver diseases. Decellularized hAM is also an ideal scaffold for liver tissue engineering as this biocompatible niche provides an excellent milieu for cell proliferation and hepatocytic differentiation. Therefore, the current review discusses the therapeutic potential of hAM and its derivatives in providing therapeutic solutions for liver pathologies including acute liver failure, metabolic disorders, liver fibrosis as well as its application in liver tissue engineering.

Amnion-derived hydrogels as a versatile platform for regenerative therapy: from lab to market

“…( Ohno et al, 1983 ; Liu et al, 2019 ; Shariatzadeh et al, 2021 ). The basement membrane of AM also contains collagen (type III, IV, and V) and various non-collagenous glycoproteins, such as elastin, laminin, nidogen, fibronectin, and vitronectin as well as glycosaminoglycans like hyaluronic acid ( Arki et al, 2023 ; Fitriani et al, 2023 ). The stromal layer is composed of three sublayers, including 1) compact layer, 2) fibroblast layer, and 3) intermediate layer ( Dadkhah Tehrani et al, 2021 ).…”

“…TGF-β1 stimulates fibrogenesis by encouraging the synthesis of ECM and the deposition of collagen by resident cells ( Gonçalves et al, 2014 ). The anti-fibrotic characteristic of AM is attributed to its inhibition effect on the expression of TGF-β1 receptors in fibroblast cells ( Arki et al, 2023 ). For example, the AM patch has been used in the treatment of liver fibrosis for reducing collagen deposition by down-regulating the pro-fibrotic factors, such as TGF-β1 and IL-1 ( Sant’Anna et al, 2016 ).…”