Amniotic fluid allograft enhances the host response to ventral hernia repair using acellular dermal matrix

Abstract

Ventral hernia repair (VHR) with acellular dermal matrix (ADM) has high rates of recurrence that may be improved with allogeneic growth factor augmentation such as amniotic fluid allograft (AFA). We hypothesized that AFA would modulate the host response to improve ADM incorporation in VHR. Lewis rats underwent chronic VHR with porcine ADM alone or with AFA augmentation. Tissue harvested at 3, 14, or 28 days was assessed for region‐specific cellularity, and a validated histomorphometric score was generated for tissue incorporation. Expression of pro‐inflammatory (Nos1, Tnfα), anti‐inflammatory (Arg1, Il‐10, Mrc1) and tissue regeneration (Col1a1, Col3a1, Vegf, and alpha actinin‐2) genes were quantified using quantitative reverse‐transcription polymerase chain reaction. Amniotic fluid allograft treatment caused enhanced vascularization and cellularization translating to increased histomorphometric scores at 14 days, likely mediated by upregulation of pro‐regeneration genes throughout the study period and molecular evidence of anti‐inflammatory, M2‐polarized macrophage phenotype. Collectively, this suggests AFA may have a therapeutic role as a VHR adjunct.

Comparative Analysis of Co-Cultured Amniotic Cell-Conditioned Media with Cell-Free Amniotic Fluid Reveals Differential Effects on Epithelial–Mesenchymal Transition and Myofibroblast Activation

“…Recent studies have highlighted the utility of AF [ 27 , 30 , 34 , 35 , 36 , 37 ] and AFC- or AEC-conditioned media [ 66 , 67 ], but the underlying mechanisms through which their therapeutic effects are mediated have received less study. Here we show that co-culturing AECs and AFCs in SFM1 produces a more diverse proteome, and that the resulting coACCM activates EMT and MFA, while AF inhibits these processes.…”

“…Cell-free AF (cfAF, herein referred to as AF for the remainder) is safe and appears to be effective in treating wounds, osteoarthritis, and other degenerative conditions in both the clinic [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] and research lab [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. It is clear that this complex biofluid contains proteins with chemotactic, pro-growth, and anti-inflammatory properties [ 46 , 47 , 48 ], but open questions remain regarding its use in regenerative medicine.…”

Advances on the modification and biomedical applications of acellular dermal matrices

“…Zhu et al [40] indicated that ADM can provide a suitable microenvironment for adipose-derived stem cells (ADSCs), and in vivo implanted ratADSC-pADM exhibited improved vascularization and mitigated inflammatory response compared to untreated pADM. Van Eps et al [63] demonstrated that the amniotic fluid allograft treatment of ADM caused enhanced vascularization and cellularization, which was reflected by increased histomorphometric scores at 14 days.…”

Cell-Free Amniotic Fluid and Regenerative Medicine: Current Applications and Future Opportunities

“…Furthermore, two different studies, one in a rabbit model of corneal wound healing and the other in fetal mice with cleft palate, independently observed accelerated reepithelization of the cornea or palatal edge, respectively, upon treatment with cfAF [ 65 , 66 ]. Finally, in a rat model of hernia repair, treatment with cfAF resulted in accelerated healing along with increased vascularity, collagen maturation, and re-epithelialization compared to controls [ 67 ]. Thus, cfAF can promote healing through stimulating angiogenesis and promoting re-epithelialization, and shows significant efficacy in treating wounds in animal models.…”