Use of Amnion for the Treatment of Stevens-Johnson Syndrome

Prasad, J.K.; Feller, Irving; Thomson, Philip D.

doi:10.1097/00005373-198610000-00016

Cited by 37 publications

(18 citation statements)

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“…In an extensive literature review, Cauchi et al reported that 50% of the cases of bilateral limbal stem cell deficiency were caused by chemical burns, whereas this same etiology was responsible for 100% of the cases of unilateral limbal stem cell deficiency (10) . The use of AM has already been well documented in the treatment of cutaneous ulcers (11)(12)(13)(14) . It was first used in ophthalmology in 1940 to treat conjunctival defects (15)(16)(17) .…”

Section: Discussionmentioning

confidence: 99%

“…It was first used in ophthalmology in 1940 to treat conjunctival defects (15)(16)(17) . AM works in a therapeutic manner, with specific properties that promote ocular surface repair, such as anti-adhesive and antibacterial effects, wound protection, pain reduction, and especially, in promoting reepithelialization (11)(12)(13)(14)18,19) . It can also serve as a barrier against fibroblast proliferation and exhibits low immunogenicity due to not exhibiting higher histocompatibility antigens (HLA-A, B, or DR), which prevents rejection in the host (20) .…”

Section: Discussionmentioning

confidence: 99%

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Limbal transplantation at a tertiary hospital in Brazil: a retrospective study

Moreira

Magalhães

Pereira

et al. 2015

Arquivos Brasileiros De Oftalmologia

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Purpose: Epidemiological analysis of limbal transplantation surgeries performed in the Ophthalmologic Hospital of Sorocaba. Methods: Retrospective medical records review of 30 patients who underwent limbal stem cell transplants between January 2003 and March 2008. Cases involving conjunctival limbal autograft were classified as group I, and those involving conjunctival limbal allograft as group II. Results: Two patients were excluded due to incomplete data during postoperative follow-up. Of the total sample of 28 patients, 53.6% constituted group I, whereas 46.4% were included in group II. Males were predominant (67.9%), and right eyes were the most prevalent (67.9%). The mean age was 40.3 years. Unilateral cases accounted for 60.7%. The most frequent pathology causing limbal system failure was chemical burns (53%). The mean length of time from diagnosis to surgery was 11.18 years. The limbal graft and amniotic membrane were associated in 75% of all cases, and tarsorrhaphy in 57.1%. The average follow-up period was 24.84 months. The uncorrected visual acuity improved in 38% of the cases, was unchanged in 28.5%, and deteriorated in 33.3%. There was no persistent epithelial defect in 75% of the patients. The conjunctivalization rate was similar between the groups (53.3% and 58.3%, respectively). The transparency improved in only 38.4% of the cases, and 28.5% of the surgeries performed were successful. The most prevalent complication was persistent epithelial defect, which occurred in 25% of the patients, followed by corneal melting in 14.2%. Other complications observed included infectious ulcers, limbal graft necrosis or ischemia, perforation, and descemetocele. Conclusion: Chemical burns remain the main cause of limbal stem cell deficiency. In these cases, limbal transplantation is the standard procedure to restore the ocular surface even though the success rate is low. Keywords

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Limbal transplantation at a tertiary hospital in Brazil: a retrospective study

Moreira

Magalhães

Pereira

et al. 2015

Arquivos Brasileiros De Oftalmologia

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“…Key words: Amniotic fluid -Amniotic membrane -Amniotic cell conditioned medium -Wound healing Human amniotic membrane (AM) has been used on burned and ulcerated skin surfaces for over 80 years and is today an established treatment for a variety of indications [14,17,20]. The beneficial effects of AM have been attributed to its ideal wound dressing properties, including its ability to reduce bacterial growth and its extremely low antigenicity [1,15] [2,9].…”

Section: Discussionmentioning

confidence: 99%

“…Human amniotic membrane has been established as an effective biological wound dressing [3,18,19]. Many authors have reported that amniotic membrane can reduce pain, prevent infection and promote angiogenesis [5,14,15]. Furthermore, it has been shown that human amniotic epithelial cells do not express HLA-A, -B, -C or -DR antigens.…”

Section: Discussionmentioning

confidence: 99%

Growth stimulatory effects of amniotic fluid and amniotic cell conditioned medium on human cells involved in wound healing

Kratz

Hægerstrand

Palmer³

1993

Eur J Plast Surg

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Amniotic membrane has been used successfully as a biological dressing for various kinds of wounds. In order to study exocrine activity in amniotic cells, we assessed the incorporation of 3H-thymidine in human fibroblasts and the increase in the number of human keratinocytes when stimulated with amniotic fluid and conditioned medium from amniotic cells. Both amniotic fluid and conditioned medium were shown to stimulate these cell types, which are crucial to the wound healing process. Amniotic fluid was the most potent of the two media tested. The effect exerted by amniotic fluid and conditioned medium were comparable to that of 10% fetal calf serum and a dose-dependent reponse was seen when the media were diluted. These results indicate that the special healing features seen in fetal wounds bathed in amniotic fluid, together with the wound healing properties of amniotic membrane used as a biological wound dressing, may be due to the exocrine activity of the amniotic cells.

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“…According to a previous report detailing the constituents of HAM, the specialized arrangement of the intracellular cytoskeletal filaments of the epithelial layer (such as actin, α-actinin, spectrin, ezrin, cytokeratins, vimentin, and desmoplakin) has a role in the structural integrity and modulation of cell shape and of junctional permeability (Wolf et al 1991). Because of these properties, HAM has been used clinically to promote epithelialization for the treatment of burns and skin ulcers, as a dressing for wounds or skin grafts (Prasad et al 1986;Subrahmanyam 1995;Trelford and Trelford-Sauder 1979), and for ocular surface reconstitution. It has been considered a suitable tissue for stem-cell culture and allotransplantation based on its anti-inflammatory effects, low immunogenicity, non-tumorigenicity, and the few ethical problems involved with its use (Lwebuga-Mukasa et al 1984;Toda et al 2007;van der Linden et al 1996).…”

Section: Discussionmentioning

confidence: 99%

Effects of human amniotic membrane grafts combined with marrow mesenchymal stem cells on healing of full-thickness skin defects in rabbits

et al. 2009

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We have investigated the wound-healing effects of mesenchymal stem cells (MSCs) in combination with human amniotic membrane (HAM) when grafted into full-thickness skin defects of rabbits. Five defects in each of four groups were respectively treated with HAM loaded with autologous MSCs (group A), HAM loaded with allologous MSCs (group B), HAM with injected autologous MSCs (group C), and HAM with injected allologous MSCs (group D). The size of the wounds was calculated for each group at 7, 12, and 15 days after grafting. The wounds were subsequently harvested at 25 days after grafting. Sections stained with hematoxylin and eosin were used to determine the quality of wound healing, as based on the characteristics and amount of granulated tissue in the epidermal and dermal layers. Groups A and B showed the most pronounced effect on wound closure, with statistically significant improvement in wound healing being seen on post-operative days 7, 12, and 15. Although a slight trend toward improved wound healing was seen in group A compared with group B, no statistically significant difference was found at any time point between the two groups. Histological examination of healed wounds from groups A and B showed a thin epidermis with mature differentiation and collagen bundle deposition plus recovered skin appendages in the dermal layer. In contrast, groups C and D showed thickened epidermis with immature epithelial cells and increased fibroblast proliferation with only partially recovered skin appendages in the dermal layer. Thus, the graft of HAM loaded with MSCs played an effective role during the healing of skin defects in rabbits, with no significant difference being observed in wound healing between autologous and allologous MSC transplantation.

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Use of Amnion for the Treatment of Stevens-Johnson Syndrome

Cited by 37 publications

References 0 publications

Limbal transplantation at a tertiary hospital in Brazil: a retrospective study

Limbal transplantation at a tertiary hospital in Brazil: a retrospective study

Growth stimulatory effects of amniotic fluid and amniotic cell conditioned medium on human cells involved in wound healing

Effects of human amniotic membrane grafts combined with marrow mesenchymal stem cells on healing of full-thickness skin defects in rabbits

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