Biological properties and surgical applications of the human amniotic membrane

Abstract

The amniotic membrane (AM) is the inner part of the placenta. It has been used therapeutically for the last century. The biological proprieties of AM include immunomodulatory, anti-scarring, anti-microbial, pro or anti-angiogenic (surface dependent), and tissue growth promotion. Because of these, AM is a functional tissue for the treatment of different pathologies. The AM is today part of the treatment for various conditions such as wounds, ulcers, burns, adhesions, and skin injury, among others, with surgical resolution. This review focuses on the current surgical areas, including gynecology, plastic surgery, gastrointestinal, traumatology, neurosurgery, and ophthalmology, among others, that use AM as a therapeutic option to increase the success rate of surgical procedures. Currently there are articles describing the mechanisms of action of AM, some therapeutic implications and the use in surgeries of specific surgical areas, this prevents knowing the therapeutic response of AM when used in surgeries of different organs or tissues. Therefore, we described the use of AM in various surgical specialties along with the mechanisms of action, helping to improve the understanding of the therapeutic targets and achieving an adequate perspective of the surgical utility of AM with a particular emphasis on regenerative medicine.

Amniotic membrane dressings for treatment of aplasia cutis in newborns

“…Excessive collagen and fibronectin lead to fibrosis, which disrupts wound healing and causes scarring. 22 Fibrosis occurs when cytokines like IL-1, IL-6, IL-11, IL-13, IL-17, TNFα, and TGF-β combine with various cells, such as macrophages, monocytes, neutrophils, stromal cells, fibroblasts, and myofibroblasts. 23 β and its receptor expression.…”

PURION® processed human amnion chorion membrane allografts retain material and biological properties supportive of soft tissue repair

“…The clinical impact of amniotic membrane allografts as barriers has been demonstrated in cases to limit postoperative adhesion in abdominal, otolaryngologic, and laminectomy surgery and ocular injuries. [32][33][34][35][36][37] The processing and preservation of LHACM and DHACM produce allografts that function as membrane barriers. However, it is also critical to understand the impact of processing techniques on the biomolecules embedded within the allografts.…”

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

“…Moreover, the sterility of the product should not be compromised. Furthermore, the AM product is supposed to be placed from the epithelial side on the wound bed to encourage angiogenesis ( Munoz-Torres et al, 2023 ). Among all AM products, there is only one product in gel form (i.e., AmnioBarrier) which is under development to be tested for clinical trials and is not on the market yet.…”

“…However, in serious injuries, medical interventions such as transplanting tissue substitutes (i.e., autografts, allografts, or xenografts) or stimulating tissue regeneration using tissue-engineered constructs (TECs) are required ( Gaharwar et al, 2020 ). Among various TECs or bio-derived scaffolds, the amniotic membrane also named as amnion (AM) has gained great attention for tissue engineering (TE) and regenerative medicine (RM), thanks to its exquisite biological characteristics, including excellent biocompatibility, anti-bacterial, anti-inflammatory, anti-fibrotic, immunomodulatory and angiogenic properties ( Munoz-Torres et al, 2023 ). AM meets all basic requirements of TE, including a rich source of stem cells, growth factors, and bioactive molecules as well as extracellular matrix (ECM) components that further highlight its eligibility for therapeutic purposes ( Jahanafrooz et al, 2023 ).…”