Amniotic membrane and its epithelial and mesenchymal stem cells as an appropriate source for skin tissue engineering and regenerative medicine

Abstract

One of the main goals of tissue engineering and regenerative medicine is to develop skin substitutes for treating deep dermal and full thickness wounds. In this regard, both scaffold and cell source have a fundamental role to achieve exactly the same histological and physiological analog of skin. Amnion epithelial and mesenchymal cells possess the characteristics of pluripotent stem cells which have the capability to differentiate into all three germ layers and can be obtained without any ethical concern. Amniotic cells also produce different growth factors, angio-modulatory cytokines, anti-bacterial peptides and a wide range of anti-inflammatory agents which eventually cause acceleration in wound healing. In addition, amniotic membrane matrix exhibits characteristics of an ideal scaffold and skin substitute through various types of extracellular proteins such as collagens, laminins and fibronectins which serve as an anchor for cell attachment and proliferation, a bed for cell delivery and a reservoir of drugs and growth factors involved in wound healing process. Recently, isolation of amniotic cells exosomes, surface modification and cross-linking approaches, construction of amnion based nanocomposites and impregnation of amnion with nanoparticles, construction of amnion hydrogel and micronizing process promoted its properties for tissue engineering. In this manuscript, the recent progress was reviewed which approve that amnion-derived cells and matrix have potential to be involved in skin substitutes; an enriched cell containing scaffold which has a great capability to be translated into the clinic.

Preparation of placental tissue transplants and their application in skin wound healing and chosen skin bullous diseases ‐ Stevens‐Johnson syndrome and toxic epidermal necrolysis treatment

“…AECs and AMSCs can be obtained from the amnion in large amounts, which is possible due to the fact that the amnion is avascular and can be easily detached from the chorionic plate . It was shown that AMSCs have the potential to induce AECs differentiation into keratinocytes, which can be used in tissue engineering to create skin substitutes …”

“…Amniotic membrane, AMSCs and AECs are often used in skin tissue engineering as a drug reservoir or to develop skin substitutes . Human amniotic cells and amniotic membrane's matrix have the ability to store drugs and release them in the body, which is clinically useful, because at the same time they show resistance to many drugs, for example, to paclitaxel (PTX) .…”

“…22,26 It was shown that AMSCs have the potential to induce AECs differentiation into keratinocytes, which can be used in tissue engineering to create skin substitutes. 27,28 Other important features of amniotic stem cells are their immunomodulatory properties-they can suppress several types of immune cells, including T-and B-lymphocytes, natural killer (NK) cells and dendritic cells. [29][30][31][32][33][34] The most common anti-inflammatory and anti-fibrotic factors secreted by the placenta include hyaluronic acid, tissue inhibitors of metalloproteinases (TIMPs), interleukins, prostaglandins and migration-inhibitory factor (MIF).…”

“…In recent years, as the result of increasing knowledge about the amniotic membrane and placenta-derived stem Amniotic membrane, AMSCs and AECs are often used in skin tissue engineering as a drug reservoir or to develop skin substitutes. 27 Human amniotic cells and amniotic membrane's matrix have the ability to store drugs and release them in the body, which is clinically useful, because at the same time they show resistance to many drugs, for example, to paclitaxel (PTX). 96 To form skin substitute, AECs are cultured on de-epidermised dermis or on AMSCs seeded fibrin scaffold, which results in stratified epithelium formation.…”

Producing Human Amniotic Epithelial Cells-only Membrane for Transplantation

“…hAECs have a characteristic of immune privilege due to a low expression of surface marker major histocompatibility complex, class II, DR (HLA-DR) [11]. Many studies have showed that hAECs have therapeutic potential on multiple sclerosis, immunomodulation, inflammation suppression, angiogenesis promotion, oxidative stress inhibition, neurogenesis induction, matrix metalloproteinases regulation, and remyelination stimulation [12-14]. Thus, hAECs can be applied to cellular transplantation for clinical use.…”