Decellularized human amniotic membrane engraftment in combination with adipose‐derived stem cells transplantation, synergistically improved diabetic wound healing

Abstract

Background One of the most important and common complications of diabetes is a disorder and defect in diabetic wound healing. Aims The aim of present study was to investigate the synergistic effects of decellularized human amniotic membrane (dHAM) engraftment and adipose‐derived stem cells (ADSs) transplantation in the healing of delayed and ischemic diabetic wound. Methods Sixty diabetic male rats were randomly divided into four groups (n = 15), including untreated (Control) group, engraftment by dHAM (dHAM) group, transplanted by ADSs (ADS) group, and engraftment by dHAM plus transplanted by ADSs (dHAM + ADS) group. Sampling was performed on Days 7, 14, and 21 after surgery. Evaluation tests included stereology, immunohistochemistry, molecular, and biomechanical. Results Our results showed that the wound closure rate, volumes of newly formed epidermis and dermis, density of fibroblasts and blood vessels, collagen deposition, density of proliferation cells, expression levels of TGF‐β and VEGF genes, and biomechanical characteristics were significantly higher in all treated groups compared with control group; however, these changes were considerable in the combination group. This is while that the density of neutrophils and expression levels of TNF‐α and IL‐1β genes in the treated groups, especially in the combination group, were significantly reduced compared with control group. Conclusion Generally, the simultaneous use of dHAM and ADS accelerates healing and improves the quality of repaired diabetic wounds.

Assessment of the proteome profile of decellularized human amniotic membrane and its biocompatibility with umbilical cord‐derived mesenchymal stem cells

“…Earlier studies have reported that preserving the ECM components of decellularized bio-scaffolds provides a suitable microenvironment for allogeneic cells for attachment, proliferation, and differentiation along various lineages. 59,60 Moreover, numerous studies have suggested the combined use of MSCs with a D-hAM, [61][62][63] (i) to enhance healing capacity by accelerating the reepithelialization, modulating inflammation, promoting granulation tissue formation and regulating remodeling of ECM 64 (ii) to increase its anti-infective effects resulting from the increased production of anti-inflammatory proteins like interleukin-10 (IL-10) and M2 macrophages and the reduced expression of pro-inflammatory cytokines like interleukin-1 (IL-1), interleukin-6 (IL-6), and transforming growth factor-β (TGF-β) 65 (iii) to induce and maintain multilineage differentiation in response to various stimulus from three dimensional system, 66 and (iv)to direct angiogenesis by secreting pro-angiogenic factors such as VEGF, insulin like growth factor (IGF), and angiogenin. 67 Hence, we hypothesized that D-hAM would support the attachment and proliferation of hUC-MSC while proving to be a biocompatible scaffold for future tissue engineering and regenerative applications.…”