Amniotic Product Treatments: Clinical and Basic Science Evidence

Huddleston, Hailey P.; Cohn, Matthew R.; Haunschild, Eric D.; Wong, Stephanie E.; Farr, Jack; Yanke, Adam B.

doi:10.1007/s12178-020-09614-2

Cited by 29 publications

(19 citation statements)

References 34 publications

(33 reference statements)

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“…Placenta-derived products, including cryopreserved amniotic membrane (AM) and umbilical cord (UC), are currently being investigated given their commercial availability, long history of safe use, and their known antiinflammatory, anti-scarring, and pro-regenerative properties. [15][16][17][18] In a preclinical study, Raines et al 19 found that intra-articular injection of AM/UC particulate dose-dependently attenuates cartilage degeneration in a rat OA model. A recent prospective pilot study further demonstrated that one or two injections of 50 mg AM/ UC particulate significantly improved pain and physical function in mild knee OA for up to 6 months.…”

Section: Introductionmentioning

confidence: 99%

<p>Intra-Articular Injection of Amniotic Membrane and Umbilical Cord Particulate for the Management of Moderate to Severe Knee Osteoarthritis</p>

Mead¹,

Mead²

2020

ORR

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Objective: To evaluate the long-term benefit of a single injection of amniotic membrane/ umbilical cord (AM/UC) particulate in patients with moderate to severe knee osteoarthritis (OA). Methods: A single-center, investigator-initiated, retrospective study of patients who received intra-articular injection of 100 mg lyophilized and micronized AM/UC for radiographically confirmed, Kellgren-Lawrence (KL) grade 3 or 4 symptomatic knee OA. Data regarding demographics, OA severity, comorbidities, treatment regimens, complications, and patient-reported outcomes were collected and assessed. Patient Global Impression of Change (PGIC) was assessed on a 7-point scale, and Global Perceived Improvement (GPI), expressed as percent improvement relative to baseline, was used to further quantify the degree of symptomatic change. Clinically important response to treatment was assessed at 12 months using simplified OMERACT-OARSI responder criteria. Results: A total of 42 patients with KL grade 3 (36%) and 4 (64%) knee OA were included for analysis. Prior to injection, patient-rated pain was 6.6 ± 1.5 out of 10 (median: 7, range: 3-10) despite prior treatment with oral/topical NSAIDs (62%) and intra-articular injection(s) of corticosteroids (57%) and/or hyaluronic acid (48%). Twelve months following AM/UC injection, 31 patients (74%) reported significant clinical improvement via PGIC, and the OMERACT-OARSI treatment response rate was 81% (34/42). GPI of pain and function was 62 ± 24%, 69 ± 27%, 69 ± 27%, and 64 ± 31% at 1, 3, 6, and 12 months, respectively. Symptomatic improvement was maintained for an average duration of 12.1 ± 4.5 months (median: 12, range: 3-22). One patient developed swelling in the knee within 36 hours of injection. No other adverse events or complications were reported. Conclusion: Intra-articular injection of AM/UC particulate may be effective in alleviating pain and improving function in patients with moderate to severe knee OA, with the potential to delay total knee replacement for up to 12 months.

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Section: Introductionmentioning

confidence: 99%

<p>Intra-Articular Injection of Amniotic Membrane and Umbilical Cord Particulate for the Management of Moderate to Severe Knee Osteoarthritis</p>

Mead¹,

Mead²

2020

ORR

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“…[ 140 ] Therefore, in recent years, extensive research has been performed to explore the application of decellularized human amniotic membrane and umbilical cord (AM/UC) for the treatment of chronic wounds. [ 141 ] These grafts are Epifix, originated from human amnion matrix, and Neox, originated from human AM/UC tissue. [ 142 ] Interestingly, amniotic membranes were not rejected by the immune system owing to human leukocyte antigen (HLA) expression.…”

Section: Immunomodulatory Hydrogels For Chronic Skin Woundsmentioning

confidence: 99%

Rational Design of Immunomodulatory Hydrogels for Chronic Wound Healing

2021

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With all the advances in tissue engineering for construction of fully functional skin tissue, complete regeneration of chronic wounds is still challenging. Since immune reaction to the tissue damage is critical in regulating both the quality and duration of chronic wound healing cascade, strategies to modulate the immune system are of importance. Generally, in response to an injury, macrophages switch from pro‐inflammatory to an anti‐inflammatory phenotype. Therefore, controlling macrophages’ polarization has become an appealing approach in regenerative medicine. Recently, hydrogels‐based constructs, incorporated with various cellular and molecular signals, have been developed and utilized to adjust immune cell functions in various stages of wound healing. Here, the current state of knowledge on immune cell functions during skin tissue regeneration is first discussed. Recent advanced technologies used to design immunomodulatory hydrogels for controlling macrophages’ polarization are then summarized. Rational design of hydrogels for providing controlled immune stimulation via hydrogel chemistry and surface modification, as well as incorporation of cell and molecules, are also dicussed. In addition, the effects of hydrogels’ properties on immunogenic features and the wound healing process are summarized. Finally, future directions and upcoming research strategies to control immune responses during chronic wound healing are highlighted.

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“…Implanted acellular PM graft in a subcutaneous mouse model encouraged migration and infiltration of host cells during the healing process, specifically of fibroblast-like cells, macrophages, endothelial cells, and fewer T-cells than the control graft [ 77 ]. PM has been successfully used in ophthalmology for almost 30 years for the treatment of corneal lesions, retinal detachment, and limbal cell regeneration [ 78 , 79 ]. Both intact and denuded PM used in ocular reconstruction in a rabbit model achieved re-epithelialization and integration into the rabbit tissue by 3-weeks post-surgery, with lower inflammatory responses noted in denuded PM treated eyes [ 80 ].…”

Section: Placental Membranementioning

confidence: 99%

Placental Tissues as Biomaterials in Regenerative Medicine

Roy

Mantay

Brannan

et al. 2022

BioMed Research International

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Placental tissues encompass all the tissues which support fetal development, including the placenta, placental membrane, umbilical cord, and amniotic fluid. Since the 1990s there has been renewed interest in the use of these tissues as a raw material for regenerative medicine applications. Placental tissues have been extensively studied for their potential contribution to tissue repair applications. Studies have attributed their efficacy in augmenting the healing process to the extracellular matrix scaffolds rich in collagens, glycosaminoglycans, and proteoglycans, as well as the presence of cytokines within the tissues that have been shown to stimulate re-epithelialization, promote angiogenesis, and aid in the reduction of inflammation and scarring. The compositions and properties of all birth tissues give them the potential to be valuable biomaterials for the development of new regenerative therapies. Herein, the development and compositions of each of these tissues are reviewed, with focus on the structural and signaling components that are relevant to medical applications. This review also explores current configurations and recent innovations in the use of placental tissues as biomaterials in regenerative medicine.

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Amniotic Product Treatments: Clinical and Basic Science Evidence

Cited by 29 publications

References 34 publications

<p>Intra-Articular Injection of Amniotic Membrane and Umbilical Cord Particulate for the Management of Moderate to Severe Knee Osteoarthritis</p>

<p>Intra-Articular Injection of Amniotic Membrane and Umbilical Cord Particulate for the Management of Moderate to Severe Knee Osteoarthritis</p>

Rational Design of Immunomodulatory Hydrogels for Chronic Wound Healing

Placental Tissues as Biomaterials in Regenerative Medicine

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