The repairing of full-thickness skin deficiency and its biological mechanism using decellularized human amniotic membrane as the wound dressing

Abstract

Human amniotic membrane (HAM) was a biocompatible scaffold with advantages of anti-inflammatory, low antigen, feasibility, tolerance and low cost. In our previous work, HAM was treated to be decellularized using surfactant, lipase and DNAase methods and the efficacy as an implantable biological mesh was verified after decellularization treatment. In this work, we used the previous protocol to decellularize the fresh HAM, and applied it to repair full-thickness skin defects with Sprague-Dawley rats as the test animals. The wound healing progress was followed in the duration of 8months, and the biological repairing mechanism was explored. From the wound area alteration, white blood cell (WBC) measurements and H&E staining, dHAM was detected to promote the wound healing, comparing with the traditional clinic treatment. Immunohistochemical analyses of the bio-factors involved in the wound healing, vascular endothelial growth factor (VEGF), alpha-smooth muscle actin (α-SMA) and transforming growth factor beta-1 (TGF-β1), exhibited that dHAM enhanced VEGF and α-SMA secretion but reduced TGF-β1 expression at early stage, which alleviated the wound inflammation, promoted the tissue regeneration and relieved the scar formation.

Tissue-Engineered Grafts from Human Decellularized Extracellular Matrices: A Systematic Review and Future Perspectives

“…In particular, acellular amniotic membrane was investigated as a scaffold to support/deliver epithelial cells [240], limbal stem cells [296], human adipose stem cells [297], differentiated neural-like cells [298], mice ovarian follicular culture [299], as well as a scaffold with cell-guiding ability [300] but it may also be used as a surgical patch/mesh [301] for reconstruction of vessels [302] (also once rolled up [303,304]); bladder [305] or circumferential urethral defect [306], reconstruction of esophageal wall [307], cardiac [120,308] and cerebrospinal fluid [308] applications, endometrial fibrosis treatment [309], soft tissue damage, limbal stem cell deficiency [293], skin defects also due to ulcers or severe skin burns or for corneal defects [310,311,312], treatment of pharyngocutaneous fistula after total laryngectomy [291], and for fetoscopic closure of iatrogenic defects in fetal membranes [313].…”

“…The in vivo behavior of AM-derived scaffolds was evaluated in: rat model of intrauterine adhesion [306]; third-degree skin burns in BALB/c mice [312]; full-thickness skin defects in Sprague Dawley rats [310]; patients experiencing pharyngocutaneous fistula because of surgical treatment of laryngeal squamous cell carcinoma [291]; BALB/c mice in which myocardial infarction was induced [319]; uterus of rabbits [301]; subcutaneously in the left hemiback of rats [316]; in the left pulmonary artery of pig after a left posterolateral thoracotomy [302]; in dogs urethral defect model [306]; for closure of fetoscopic entry wounds in the exposed rabbit amniotic sac [313]; and deep flexor tendon of the chicken toe [320].…”

Instructive microenvironments in skin wound healing: Biomaterials as signal releasing platforms

“…Among the many processes available for creating 3D environments, the most successful ones are summarized in the following section. Special mention goes to 3D bioprinting [212][213][214][215] and decellularized scaffolds [216][217][218], which offer promising potential in terms of signalling modulation and biomimetism. In terms of macrodimensionality, 3D additive manufacturing techniques represent some of the most promising and flexible methods to process artificial skin tissue for wounds because of their versatility, reproducibility and low-cost [219,220].…”

Hyperdry human amniotic membrane application as a wound dressing for a full-thickness skin excision after a third-degree burn injury

“…In this study, the high expression of TGF-β1 on POD 7 is considered to reflect the migration of M2 macrophages that exert a powerful anti-inflammatory effect to reduce and terminate the inflammatory response. It has been reported that the AM significantly increases growth factors early in wound healing but acts to suppress it later [ 58 ]. Since IL-10 remains in HD-AM, it is considered to exhibit the same action as fresh or cryopreserved AM.…”