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Dawiec G, Niemczyk W, Wiench R, Niemczyk S, Skaba D. Introduction to Amniotic Membranes in Maxillofacial Surgery-A Scoping Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:663. [PMID: 38674309 PMCID: PMC11051762 DOI: 10.3390/medicina60040663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
Background: Amniotic membrane (AM) holds significant promise in various medical fields due to its unique properties and minimal ethical concerns. This study aims to explore the diverse applications of the human amniotic membrane (HAM) in maxillofacial surgery. Methodology: A comprehensive search was conducted on databases, namely Google Scholar, PubMed, and Scopus, from January 1985 to March 2024. Articles in English, Polish, and Spanish were included, focusing on keywords related to amniotic membrane and oral surgery. Results: Various preservation methods for HAM were identified, namely fresh, decellularized, cryopreserved, lyophilized, and air-dried formats. Clinical studies demonstrated the efficacy of HAM in repairing oral mucosal defects, vestibuloplasty, oronasal fistula closure, cleft palate treatment, bone defect repair, and medication-related osteonecrosis of the jaw (MRONJ). Surgeon evaluations highlighted the ease of handling but noted challenges in suturing and stability during application. Conclusions: Amniotic membranes offer a versatile and effective option in maxillofacial surgery, promoting wound healing, reducing inflammation, and providing a scaffold for tissue regeneration. Further research, including randomized trials and comparative studies, is warranted to validate the efficacy and optimize the utilization of HAM in clinical practice.
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Affiliation(s)
- Grzegorz Dawiec
- Department of Paediatric Otolaryngology, Head and Neck Surgery, Department of Paediatric Surgery, Faculty of Medical Sciences, ul. Medyków 16, 40-752 Katowice, Poland
- Outpatient Clinic for Dental Surgery in Zabrze, University Dental Centre, Silesian Medical University Ltd. in Katowice, Pl. Akademicki 17, 41-902 Bytom, Poland
- Private Dental Practice NZOZ Stomatologia-Dawiec s.c., Ul. Witczaka 49/15, 41-902 Bytom, Poland
| | - Wojciech Niemczyk
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pl. Traugutta 2, 41-800 Zabrze, Poland; (R.W.); (D.S.)
| | - Rafał Wiench
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pl. Traugutta 2, 41-800 Zabrze, Poland; (R.W.); (D.S.)
| | - Stanisław Niemczyk
- Municipal Hospital No. 4 in Gliwice, Zygmunta Starego 20, 44-100 Gliwice, Poland;
| | - Dariusz Skaba
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pl. Traugutta 2, 41-800 Zabrze, Poland; (R.W.); (D.S.)
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Ingraldi AL, Audet RG, Tabor AJ. The Preparation and Clinical Efficacy of Amnion-Derived Membranes: A Review. J Funct Biomater 2023; 14:531. [PMID: 37888195 PMCID: PMC10607219 DOI: 10.3390/jfb14100531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
Biological tissues from various anatomical sources have been utilized for tissue transplantation and have developed into an important source of extracellular scaffolding material for regenerative medicine applications. Tissue scaffolds ideally integrate with host tissue and provide a homeostatic environment for cellular infiltration, growth, differentiation, and tissue resolution. The human amniotic membrane is considered an important source of scaffolding material due to its 3D structural architecture and function and as a source of growth factors and cytokines. This tissue source has been widely studied and used in various areas of tissue repair including intraoral reconstruction, corneal repair, tendon repair, microvascular reconstruction, nerve procedures, burns, and chronic wound treatment. The production of amniotic membrane allografts has not been standardized, resulting in a wide array of amniotic membrane products, including single, dual, and tri-layered products, such as amnion, chorion, amnion-chorion, amnion-amnion, and amnion-chorion-amnion allografts. Since these allografts are not processed using the same methods, they do not necessarily produce the same clinical responses. The aim of this review is to highlight the properties of different human allograft membranes, present the different processing and preservation methods, and discuss their use in tissue engineering and regenerative applications.
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Affiliation(s)
- Alison L. Ingraldi
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Robert G. Audet
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Aaron J. Tabor
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
- Department of Clinical Operations, Axolotl Biologix, Flagstaff, AZ 86001, USA
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Ashurko I, Tarasenko S, Magdalyanova M, Bokareva S, Balyasin M, Galyas A, Khamidova M, Zhornik M, Unkovskiy A. Comparative analysis of xenogeneic collagen matrix and autogenous subepithelial connective tissue graft to increase soft tissue volume around dental implants: a systematic review and meta-analysis. BMC Oral Health 2023; 23:741. [PMID: 37817128 PMCID: PMC10566022 DOI: 10.1186/s12903-023-03475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/29/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVE The gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to be used as an alternative. This systematic review aimed to assess the effectiveness XCM in comparison to CTG for the increasing the thickness of the soft tissue around implants. DATA All studies included at least two parallel groups comparing the use of CTG and XCM with a minimum follow-up of 3 months. As the primary outcome, the amount of soft tissue thickness gain after soft tissue augmentation with XCM or CTG was assessed. Secondary outcomes were clinical and patient-related outcomes; evaluation of aesthetic outcomes, patient-reported outcomes measures (PROMs) and complications. Eligible studies were selected based on the inclusion criteria. Meta-analysis was applied whenever possible. The quality of the evidence of studies including in meta-analysis was assessed using the GRADE approach. SOURCE A systematic literature search up to January 2022 was conducted using the following electronic databases: PubMed (MEDLINE), Scopus, Cochrane Library, LILACS, eLIBRARY.RU. Unpublished researches, the gray literature, nonprofit reports, government studies and other materials were reviewed electronically using an EASY search. An additional manual search was carried out in November 2022. STUDY SELECTION Of the 1376 articles from the initial search, 8 randomized controlled trials (RCTs) (306 patients and 325 implants) were included in this systematic review, and 7 studies were part of the meta-analysis. Meta-analysis revealed that XCM is less effective than the CTG in increasing soft tissue thickness around dental implants. However, XCM also provides soft tissue thickness gain and can be recommended for use in various clinical situations. CLINICAL SIGNIFICANCE Previous systematic reviews and meta-analyses have shown that autologous grafts are more effective than collagen matrices in increasing soft tissue thickness, however, the latter can be used as an alternative. Studies included in previous systematic reviews varied in design, which could lead to limitations. The present systematic review and meta-analysis includes for the first time only randomized controlled clinical trials with collagen matrix of xenogeneic origin in the test group. Tight eligibility criteria were established, and the main parameter studied was soft tissue thickness. It was found that xenogeneic collagen matrix is effective for increasing soft tissue thickness around dental implants, however, the results obtained using an autogenous connective tissue graft are superior.
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Affiliation(s)
- Igor Ashurko
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Svetlana Tarasenko
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Mary Magdalyanova
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Svetlana Bokareva
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | | | - Anna Galyas
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Marina Khamidova
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Mariia Zhornik
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Alexey Unkovskiy
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia.
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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Sacco R, Akintola O, Sacco N, Acocella A, Calasans-Maia MD, Maranzano M, Olate S. The Use of Human Amniotic Membrane (hAM) as a Treatment Strategy of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Systematic Review and Meta-Analysis of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050968. [PMID: 37241200 DOI: 10.3390/medicina59050968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Background and objectives: Although it is very uncommon, medication-induced osteonecrosis of the jaw (also known as MRONJ) can have serious consequences. Traditionally, this adverse event has been recognised in patients who were treated with bisphosphonate (BP) drugs. Nevertheless, in recent years, it has been established that individuals having treatment with various types of medications, such as a receptor activator of nuclear factor kappa-Β ligand inhibitor (denosumab) and antiangiogenic agents, have had the same issue. The purpose of this research is to determine if the application of human amniotic membrane (hAM) may be used as a therapy for MRONJ. Material and Methods: A multi-source database (MEDLINE, EMBASE, AMED, and CENTRAL) systematic search was performed. The major objective of this study is to obtain an understanding of the efficacy of hAM when it is employed as a treatment modality for MRONJ. The protocol of this review was registered in the INPLASY register under the number NPLASY202330010. Results: The authors were able to include a total of five studies for the quality analysis, whereas for the quantity evaluation, only four studies were eligible. A total of 91 patients were considered for the investigation. After treatment with human amniotic membrane (hAM), a recurrence of osteonecrosis was observed in n = 6 cases (8.8%). The combined efficacy of surgical therapy and the use of hAM resulted in an overall success rate of 91.2%. Intraoperative complications were only documented in one article, and they were mostly caused by the positioning of the hAM, which led to wound breakdown at the surgical site. Conclusions: Based on the small amount of data and low-quality research included in this study, using human amniotic membranes to treat MRONJ might represent a feasible option. Nevertheless, further studies with a wider patient population are required to understand the long-term impacts.
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Affiliation(s)
- Roberto Sacco
- Oral Surgery Department, School of Medical Sciences, Division of Dentistry, The University of Manchester, Manchester M13 9PL, UK
- FACOP-Faculdade do Centro Oeste Paulista, Dental School, Oral Surgery Department, Bauru 17499-010, Brazil
- Oral Surgery Department, King's College Hospital NHS Trust, London SE5 9RW, UK
| | - Oladapo Akintola
- Oral Surgery Department, King's College Hospital NHS Trust, London SE5 9RW, UK
| | - Nicola Sacco
- Anaesthetic & Critical Care, University of Campania Luigi Vanvitelli, 80138 Caserta, Italy
| | | | | | - Massimo Maranzano
- Oral and Maxillofacial Surgery Department, Manchester University NHS Foundation Trust (MFT), Manchester M13 9WL, UK
| | - Sergio Olate
- Division of Oral and Maxillofacial Surgery, Universidad de La Frontera, Temuco 4780000, Chile
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Navakauskienė R, Žukauskaitė D, Borutinskaitė VV, Bukreieva T, Skliutė G, Valatkaitė E, Zentelytė A, Piešinienė L, Shablii V. Effects of human placenta cryopreservation on molecular characteristics of placental mesenchymal stromal cells. Front Bioeng Biotechnol 2023; 11:1140781. [PMID: 37122871 PMCID: PMC10133466 DOI: 10.3389/fbioe.2023.1140781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Cryopreservation of placenta tissue for long-term storage provides the opportunity in the future to isolate mesenchymal stromal cells that could be used for cell therapy and regenerative medicine. Despite being widely used, the established cryopreservation protocols for freezing and thawing still raise concerns about their impact on molecular characteristics, such as epigenetic regulation. In our study, we compared the characteristics of human placental mesenchymal stromal cells (hPMSCs) isolated from fresh (native) and cryopreserved (cryo) placenta tissue. We assessed and compared the characteristics of native and cryo hPMSCs such as morphology, metabolic and differentiation potential, expression of cell surface markers, and transcriptome. No significant changes in immunophenotype and differentiation capacity between native and cryo cells were observed. Furthermore, we investigated the epigenetic changes and demonstrated that both native and cryo hPMSCs express only slight variations in the epigenetic profile, including miRNA levels, DNA methylation, and histone modifications. Nevertheless, transcriptome analysis defined the upregulation of early-senescence state-associated genes in hPMSCs after cryopreservation. We also evaluated the ability of hPMSCs to improve pregnancy outcomes in mouse models. Improved pregnancy outcomes in a mouse model confirmed that isolated placental cells both from native and cryo tissue have a positive effect on the restoration of the reproductive system. Still, the native hPMSCs possess better capacity (up to 66%) in comparison with cryo hPMSCs (up to 33%) to restore fertility in mice with premature ovarian failure. Our study demonstrates that placental tissue can be cryopreserved for long-term storage with the possibility to isolate mesenchymal stromal cells that retain characteristics suitable for therapeutic use.
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Affiliation(s)
- Rūta Navakauskienė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
- *Correspondence: Rūta Navakauskienė, ; Volodymyr Shablii,
| | - Deimantė Žukauskaitė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | | | - Tetiana Bukreieva
- Laboratory of Biosynthesis of Nucleic Acids, Department of Functional Genomics, Institute of Molecular Biology and Genetics, National Academy of Science, Kyiv, Ukraine
- Placenta Stem Cell Laboratory, Cryobank, Institute of Cell Therapy, Kyiv, Ukraine
| | - Giedrė Skliutė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
- Nanodiagnostika, Ltd., Vilnius, Lithuania
| | - Elvina Valatkaitė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Aistė Zentelytė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | | | - Volodymyr Shablii
- Laboratory of Biosynthesis of Nucleic Acids, Department of Functional Genomics, Institute of Molecular Biology and Genetics, National Academy of Science, Kyiv, Ukraine
- Placenta Stem Cell Laboratory, Cryobank, Institute of Cell Therapy, Kyiv, Ukraine
- *Correspondence: Rūta Navakauskienė, ; Volodymyr Shablii,
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Odet S, Solecki L, Meyer C, Weber E, Chatelain B, Euvrard E, Barrabé A, Gualdi T, Parmentier AL, Tatu L, Pouthier F, Louvrier A, Gindraux F. Human amniotic membrane application in oral surgery—An ex vivo pilot study. Front Bioeng Biotechnol 2022; 10:968346. [DOI: 10.3389/fbioe.2022.968346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of this pilot porcine study was to explore and illustrate the surgical application of human amniotic membrane (hAM) in an ex vivo model of medication-related osteonecrosis of the jaw (MRONJ).Material and methods: Five oral and maxillofacial surgeons participated to this study. MRONJ was simulated on porcine mandible specimens. hAM was applied using four different techniques: implantation with complete coverage, implantation with partial coverage, apposition and covering graft material. At the same time, the surgeons evaluated how well the hAM handled and its physical properties during the surgery.Results: Surgeons found that hAM had suitable mechanical properties, as it was easy to detach from the support, handle, bind to the defect and bury. hAM was also found to be strong and stable. The “implantation with complete coverage” and “implantation with partial coverage” techniques were the preferred choices for the MRONJ indication.Conclusion: This study shows that hAM is a graft material with suitable properties for oral surgery. It is preferable to use it buried under the gingiva with sutures above it, which increases its stability. This technical note aims to educate surgeons and provide them with details about the handling of hAM in oral surgery.Clinical relevance: Two surgical techniques for hAM application in MRONJ were identified and illustrated. hAM handling and physical properties during surgery were reported.
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Questions about Residual Cell Viability in Cryopreserved Human Amniotic Membrane and Its Impact on Clinical Applications. Biomedicines 2022; 10:biomedicines10102456. [PMID: 36289719 PMCID: PMC9598775 DOI: 10.3390/biomedicines10102456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
We questioned the relevance of evaluating residual cell viability in human amniotic membrane (hAM) after its cryopreservation since cell survival is controversial and its ability to act as a matrix (including the presence of growth factors and cytokines) appears to be most important for tissue regeneration purposes. We also discussed the usefulness of osteodifferentiating amniotic cells in whole hAM for bone repair applications. We have evidence that determining residual cell viability after cryopreservation and hAM osteodifferentiation is not justified.
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Sabol TJ, Tran GS, Matuszewski J, Weston WW. Standardized reporting of amnion and amnion/chorion allograft data for wound care. Health Sci Rep 2022; 5:e794. [PMID: 36032519 PMCID: PMC9399452 DOI: 10.1002/hsr2.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 11/22/2022] Open
Abstract
Background The favorable biological and mechanical properties of the most common components of the placenta, the amnion and chorion, have been explored for regenerative medical indications. The use of the combination of amnion and chorion has also become very popular. But, published data from placental tissues in their final, useable form is lacking. During treatment with membrane product, the tissue is usually sterile, intact and laid on a wound or treatment area. The factors available to the treatment area from the applied product need to be elucidated and presented in a relatable form. Current reporting for eluted growth factor results are typically expressed per milliliter, which is not informative with respect to the area of tissue covered by the actual membrane and may differ among techniques. Methods To address this inconsistency, amnion or amnion/chorion were isolated from human placentas and processed by a proprietary procedure. The final dry, sterilized product was evaluated for structural components and growth factor elution. Growth factors were quantified by multiplex panels and ELISAs and the values normalized to specific area and elution volume of finished product. This information allows extrapolation to all membrane sizes and affords cross‐study comparisons. Results Analysis of membrane supernatants show that dehydrated, sterilized amnion and amnion/chorion elute factors that are conducive to wound healing, which are available to recipient tissues. Importantly, these measurable factors eluted from dehydrated, sterilized membranes can be reported as a function of available factors per square centimeter of tissue. Conclusions The standardized characterization of dehydrated, sterilized amnion and amnion/chorion as delivered to recipient tissues permits understanding and comparison of the products across various graft sizes, types, and eluate volumes. Further, reporting this data as a function of cm2 of dehydrated tissue allows extrapolation by independent scientists and clinicians.
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Odet S, Meyer C, Gaudet C, Weber E, Quenot J, Derruau S, Laurence S, Bompy L, Girodon M, Chatelain B, Mauprivez C, Brenet E, Kerdjoudj H, Zwetyenga N, Marchetti P, Hatzfeld AS, Toubeau D, Pouthier F, Lafarge X, Redl H, Fenelon M, Fricain JC, Di Pietro R, Ledouble C, Gualdi T, Parmentier AL, Louvrier A, Gindraux F. Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study. Front Bioeng Biotechnol 2022; 10:936074. [PMID: 35935507 PMCID: PMC9355383 DOI: 10.3389/fbioe.2022.936074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/13/2022] [Indexed: 01/08/2023] Open
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a complication of certain pharmacological treatments such as bisphosphonates, denosumab, and angiogenesis inhibitors. There are currently no guidelines on its management, particularly in advanced stages. The human amniotic membrane (hAM) has low immunogenicity and exerts anti-inflammatory, antifibrotic, antimicrobial, antiviral, and analgesic effects. It is a source of stem cells and growth factors promoting tissue regeneration. hAM acts as an anatomical barrier with suitable mechanical properties (permeability, stability, elasticity, flexibility, and resorbability) to prevent the proliferation of fibrous tissue and promote early neovascularization at the surgical site. In oral surgery, hAM stimulates healing and facilitates the proliferation and differentiation of epithelial cells in the oral mucosa and therefore its regeneration. We proposed using cryopreserved hAM to eight patients suffering from cancer (11 lesions) with stage 2–3 MRONJ on a compassionate use basis. A collagen sponge was added in some cases to facilitate hAM grafting. One or three hAMs were applied and one patient had a reapplication. Three patients had complete closure of the surgical site with proper epithelialization at 2 weeks, and two of them maintained it until the last follow-up. At 1 week after surgery, three patients had partial wound dehiscence with partial healing 3 months later and two patients had complete wound dehiscence. hAM reapplication led to complete healing. All patients remained asymptomatic with excellent immediate significant pain relief, no infections, and a truly positive impact on the patients’ quality of life. No adverse events occurred. At 6 months of follow-up, 80% of lesions had complete or partial wound healing (30 and 50%, respectively), while 62.5% of patients were in stage 3. Radiological evaluations found that 85.7% of patients had stable bone lesions (n = 5) or new bone formation (n = 1). One patient had a worsening MRONJ but remained asymptomatic. One patient did not attend his follow-up radiological examination. For the first time, this prospective pilot study extensively illustrates both the handling and surgical application of hAM in MRONJ, its possible association with a collagen sponge scaffold, its outcome at the site, the application of multiple hAM patches at the same time, and its reapplication.
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Affiliation(s)
- Stéphane Odet
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
| | - Christophe Meyer
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France
| | - Camille Gaudet
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
| | - Elise Weber
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
| | - Julie Quenot
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
| | - Stéphane Derruau
- Pôle Médecine bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France
- Université de Reims Champagne-Ardenne, Laboratoire BioSpecT EA-7506, UFR de Pharmacie, Reims, France
| | - Sebastien Laurence
- Pôle Médecine bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France
- Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, HERVI EA3801, UFR de Médecine, Reims, France
| | - Lisa Bompy
- Chirurgie Maxillo-Faciale - Stomatologie - Chirurgie Plastique Réparatrice et Esthétique - Chirurgie de la main, CHU de Dijon, Dijon, France
| | - Marine Girodon
- Chirurgie Maxillo-Faciale - Stomatologie - Chirurgie Plastique Réparatrice et Esthétique - Chirurgie de la main, CHU de Dijon, Dijon, France
| | - Brice Chatelain
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
| | - Cédric Mauprivez
- Pôle Médecine bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France
- Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, BIOS EA 4691, Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, Reims, France
| | - Esteban Brenet
- Service d’ORL et chirurgie cervico-faciale, CHU Reims, Reims, France
| | - Halima Kerdjoudj
- Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, BIOS EA 4691, Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, Reims, France
| | - Narcisse Zwetyenga
- Chirurgie Maxillo-Faciale - Stomatologie - Chirurgie Plastique Réparatrice et Esthétique - Chirurgie de la main, CHU de Dijon, Dijon, France
| | - Philippe Marchetti
- Banque de Tissus CBP CHU Lille, Lille, France
- Institut de Cancérologie ONCOLILLE CANTHER, UMR9020 CNRS–U1277 Inserm—Université de Lille, Lille, France
| | - Anne-Sophie Hatzfeld
- Banque de Tissus CBP CHU Lille, Lille, France
- Institut de Cancérologie ONCOLILLE CANTHER, UMR9020 CNRS–U1277 Inserm—Université de Lille, Lille, France
| | | | - Fabienne Pouthier
- Activité d’Ingénierie Cellulaire et Tissulaire (AICT), Établissement Français du Sang Bourgogne Franche-Comté, Besançon, France
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
| | - Xavier Lafarge
- Établissement Français du Sang Nouvelle-Aquitaine, Bordeaux, France
- INSERM U1035, Université de Bordeaux, Biothérapie des Maladies Génétiques Inflammatoires et Cancers (BMGIC), Bordeaux, France
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA, Research Center, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Mathilde Fenelon
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
- CHU Bordeaux, Service de chirurgie orale, Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
- CHU Bordeaux, Service de chirurgie orale, Bordeaux, France
| | - Roberta Di Pietro
- Department of Medicine and Ageing Sciences, Gabriele D’Annunzio University of Chieti-Pescara, Chieti, Italy
- StemTeCh Group, Gabriele D’Annunzio Foundation, University of Chieti-Pescara, Chieti, Italy
| | - Charlotte Ledouble
- Pôle Médecine bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France
- Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, BIOS EA 4691, Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, Reims, France
| | | | | | - Aurélien Louvrier
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
| | - Florelle Gindraux
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France
- *Correspondence: Florelle Gindraux,
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10
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Flores AI, Pipino C, Jerman UD, Liarte S, Gindraux F, Kreft ME, Nicolas FJ, Pandolfi A, Tratnjek L, Giebel B, Pozzobon M, Silini AR, Parolini O, Eissner G, Lang-Olip I. Perinatal derivatives: How to best characterize their multimodal functions in vitro. Part C: Inflammation, angiogenesis, and wound healing. Front Bioeng Biotechnol 2022; 10:965006. [PMID: 35992360 PMCID: PMC9386263 DOI: 10.3389/fbioe.2022.965006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Perinatal derivatives (PnD) are birth-associated tissues, such as placenta, umbilical cord, amniotic and chorionic membrane, and thereof-derived cells as well as secretomes. PnD play an increasing therapeutic role with beneficial effects on the treatment of various diseases. The aim of this review is to elucidate the modes of action of non-hematopoietic PnD on inflammation, angiogenesis and wound healing. We describe the source and type of PnD with a special focus on their effects on inflammation and immune response, on vascular function as well as on cutaneous and oral wound healing, which is a complex process that comprises hemostasis, inflammation, proliferation (including epithelialization, angiogenesis), and remodeling. We further evaluate the different in vitro assays currently used for assessing selected functional and therapeutic PnD properties. This review is a joint effort from the COST SPRINT Action (CA17116) with the intention to promote PnD into the clinics. It is part of a quadrinomial series on functional assays for validation of PnD, spanning biological functions, such as immunomodulation, anti-microbial/anti-cancer activities, anti-inflammation, wound healing, angiogenesis, and regeneration.
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Affiliation(s)
- Ana I. Flores
- Regenerative Medicine Group, Research Institute Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Caterina Pipino
- Center for Advanced Studies and Technology (CAST), Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio Chieti-Pescara, StemTech Group, Chieti, Italy
| | - Urška Dragin Jerman
- University of Ljubljana, Faculty of Medicine, Institute of Cell Biology, Ljubljana, Slovenia
| | - Sergio Liarte
- Laboratorio de Regeneración, Oncología Molecular y TGF-β, IMIB-Arrixaca, Murcia, Spain
- *Correspondence: Günther Eissner, ; Sergio Liarte,
| | - Florelle Gindraux
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 466, Université Bourgogne Franche-Comté, Besançon, France
| | - Mateja Erdani Kreft
- University of Ljubljana, Faculty of Medicine, Institute of Cell Biology, Ljubljana, Slovenia
| | - Francisco J. Nicolas
- Laboratorio de Regeneración, Oncología Molecular y TGF-β, IMIB-Arrixaca, Murcia, Spain
| | - Assunta Pandolfi
- Center for Advanced Studies and Technology (CAST), Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio Chieti-Pescara, StemTech Group, Chieti, Italy
| | - Larisa Tratnjek
- University of Ljubljana, Faculty of Medicine, Institute of Cell Biology, Ljubljana, Slovenia
| | - Bernd Giebel
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Michela Pozzobon
- Department of Women’s and Children’s Health, University of Padova, Padova, Italy and Foundation Institute of Pediatric Research Fondazione Città Della Speranza, Padova, Italy
| | | | - Ornella Parolini
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Günther Eissner
- Systems Biology Ireland, School of Medicine, Conway Institute, University College Dublin, Dublin, Ireland
- *Correspondence: Günther Eissner, ; Sergio Liarte,
| | - Ingrid Lang-Olip
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
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11
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Hazarika K, Malik K, Adhyapok A, Debnath S. Lyophilised amniotic membrane in intraoral surgical defects: A prospective clinical study. Ann Maxillofac Surg 2022; 12:5-10. [PMID: 36199459 PMCID: PMC9527846 DOI: 10.4103/ams.ams_152_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/06/2022] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction: The incidence of infection and scarring in intraoral raw wounds are decreased when wounds are grafted with biological materials. The favourable results of many studies about amniotic membrane in wound healing inspired us to investigate the effects of lyophilised amniotic membrane in intaoral surgical defects. The aim of this study was to evaluate the healing of oral mucosal defects after application of lyophilised amniotic membrane (AM). Methods: Fifteen patients with oral precancerous lesions were included in this study. Lyophilised amniotic membrane was applied to the intraoral surgical defect, after wide excision of the lesion. The effectiveness of the lyophilised AM was evaluated by scoring the following parameters operability, haemostatic status, pain, feeding situation, epithelialisation, change in mouth opening, mucosal suppleness and safety. Results: The lyophilised amniotic membrane has been found to be effective in this study after evaluation of the parameters. No infection or allergic reaction was noticed after application of the lyophilised amniotic membrane in intraoral surgical defects. Discussion: In our study, the size and site of the surgical defect influenced the scar contracture so we suggest lyophilised AM may not prevent scarring for extensive surgical defects. All other findings regarding the effectiveness of lyophilised amniotic membrane in oral wound healing are in accordance with the findings of other studies conducted on hyperdry and cryopreserved AM. Conclusion: Within the limitations of the study, the results showed that the lyophilised amniotic membrane is a cost effective material for immediate coverage of the intraoral surgical defects.
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12
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Babaki D, Khoshsimaybargard M, Yaghoubi S, Gholami M. Comparison of Vestibular Depth Relapse and Wound Healing After Reconstructive Preprosthetic Surgery Using Cryopreserved Amniotic Membrane and Acellular Dermal Matrix - A Comparative Study. Ann Maxillofac Surg 2021; 11:12-16. [PMID: 34522647 PMCID: PMC8407648 DOI: 10.4103/ams.ams_322_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: The significance of membranes as wound dressing in oral surgeries has been reported by previous studies. The aim of the present split-mouth randomized clinical study was to assess and compare the wound dressing properties of acellular dermal matrix (ADM) and cryopreserved human amniotic membrane (AM) after reconstructive preprosthetic oral surgery. Materials and Methods: Twenty-eight patients with complete mandibular edentulism and resorbed alveolar bone were included. After taking mandibular impression, a clear acrylic splint with increased labial flange height was created. In each participant, labial vestibular depth was elevated using the Clark's technique. Subsequently, half of the exposed periosteum was covered with ADM while the other half was covered with cryopreserved human AM. Vestibule depth and relapse in the two sides were measured immediately after vestibuloplasty and at the end of the 1st week, 2nd week, 1st month, and 3rd months with graduations of 0.1 mm. Furthermore, after 3 and 7 days, samples were collected from graft material, and the macrophage population was analyzed by flow cytometry. Results: There was no significant difference in the relapse of vestibule depth between the two grafts at different time intervals. However, the frequency of wound-infiltrating macrophages (CD68+ cells) was significantly higher in areas covered by ADM after 3 and 7 days. Discussion: ADM is as effective as cryopreserved AM in terms of maintaining the postoperative vestibular depth. On the other hand, our results suggested that the onset of healing phase in ADM-covered areas occurs faster compared to the periosteum covered with cryopreserved human AM. This clinical trial showed significantly faster postoperative healing onset when ADM was used than when cryopreserved human AM was applied on the periosteum.
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Affiliation(s)
- Danial Babaki
- Department of Biomedical Engineering, Tagliatela College of Engineering, University of New Haven, CT, USA
| | | | - Sanam Yaghoubi
- Genetics Department, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Mahdi Gholami
- Department of Oral and Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.,Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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13
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Gulameabasse S, Gindraux F, Catros S, Fricain JC, Fenelon M. Chorion and amnion/chorion membranes in oral and periodontal surgery: A systematic review. J Biomed Mater Res B Appl Biomater 2021; 109:1216-1229. [PMID: 33354857 DOI: 10.1002/jbm.b.34783] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/13/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022]
Abstract
The aim of this study was to perform a systematic review on the clinical applications where chorion membrane (CM) and amnion/chorion membrane (ACM) were used for oral tissue regeneration procedures. Selection of articles was carried out by two evaluators in Pubmed and Scopus databases, and Outcomes (PICO) method was used to select the relevant articles. Clinical studies reporting the use of CM or ACM for oral soft and hard tissue regeneration were included. The research involved 21 studies conducted on 375 human patients. Seven clinical applications of CM and ACM in oral and periodontal surgery were identified: gingival recession treatment, intrabony and furcation defect treatment, alveolar ridge preservation, keratinized gum width augmentation around dental implants, maxillary sinus membrane repair, and large bone defect reconstruction. CM and ACM were compared to negative controls (conventional surgeries without membrane) or to the following materials: collagen membranes, dense polytetrafluoroethylene membranes, platelet-rich fibrin membranes, amnion membranes, and to a bone substitute. Several studies support the use of CM and ACM as an efficient alternative to current techniques for periodontal and oral soft tissue regeneration procedures. However, further studies are necessary to increase the level of evidence and especially to demonstrate their role for bone regeneration.
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Affiliation(s)
- Sarah Gulameabasse
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
| | - Florelle Gindraux
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France
- Service de Chirurgie Orthopédique, Traumatologique et Plastique, CHU Besançon, Besançon, France
| | - Sylvain Catros
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
| | - Jean-Christophe Fricain
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
| | - Mathilde Fenelon
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
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14
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Odet S, Louvrier A, Meyer C, Nicolas FJ, Hofman N, Chatelain B, Mauprivez C, Laurence S, Kerdjoudj H, Zwetyenga N, Fricain JC, Lafarge X, Pouthier F, Marchetti P, Gauthier AS, Fenelon M, Gindraux F. Surgical Application of Human Amniotic Membrane and Amnion-Chorion Membrane in the Oral Cavity and Efficacy Evaluation: Corollary With Ophthalmological and Wound Healing Experiences. Front Bioeng Biotechnol 2021; 9:685128. [PMID: 34178969 PMCID: PMC8222622 DOI: 10.3389/fbioe.2021.685128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022] Open
Abstract
Due to its intrinsic properties, there has been growing interest in human amniotic membrane (hAM) in recent years particularly for the treatment of ocular surface disorders and for wound healing. Herein, we investigate the potential use of hAM and amnion-chorion membrane (ACM) in oral surgery. Based on our analysis of the literature, it appears that their applications are very poorly defined. There are two options: implantation or use as a cover material graft. The oral cavity is submitted to various mechanical and biological stimulations that impair membrane stability and maintenance. Thus, some devices have been combined with the graft to secure its positioning and protect it in this location. This current opinion paper addresses in detail suitable procedures for hAM and ACM utilization in soft and hard tissue reconstruction in the oral cavity. We address their implantation and/or use as a covering, storage format, application side, size and number, multilayer use or folding, suture or use of additional protective covers, re-application and resorption/fate. We gathered evidence on pre- and post-surgical care and evaluation tools. Finally, we integrated ophthalmological and wound healing practices into the collected information. This review aims to help practitioners and researchers better understand the application of hAM and ACM in the oral cavity, a place less easily accessible than ocular or cutaneous surfaces. Additionally, it could be a useful reference in the generation of new ideas for the development of innovative protective covering, suturing or handling devices in this specific indication. Finally, this overview could be considered as a position paper to guide investigators to fulfill all the identified criteria in the future.
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Affiliation(s)
- Stéphane Odet
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France
| | - Aurélien Louvrier
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
| | - Christophe Meyer
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France.,Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France
| | | | - Nicola Hofman
- Deutsche Gesellschaft für Gewebetransplantation (DGFG), Hannover, Germany
| | - Brice Chatelain
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France
| | - Cédric Mauprivez
- Pôle Médecine Bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France.,Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, BIOS EA 4691, UFR d'Odontologie, Reims, France
| | - Sébastien Laurence
- Pôle Médecine Bucco-dentaire, Hôpital Maison Blanche, CHU Reims, Reims, France.,Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, HERVI EA3801, UFR de Médecine, Reims, France
| | - Halima Kerdjoudj
- Université de Reims Champagne Ardenne, Biomatériaux et Inflammation en Site Osseux, Pôle Santé, URCA, BIOS EA 4691, UFR d'Odontologie, Reims, France
| | - Narcisse Zwetyenga
- Chirurgie Maxillo-Faciale - Stomatologie - Chirurgie Plastique Réparatrice et Esthétique - Chirurgie de la main, CHU de Dijon, Dijon, France.,Université Bourgogne Franche-Comté, Besançon, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France.,CHU Bordeaux, Service de chirurgie orale, Bordeaux, France
| | - Xavier Lafarge
- Établissement Français du Sang Nouvelle-Aquitaine, Bordeaux, France/INSERM U1035, Université de Bordeaux, Biothérapie des Maladies Génétiques Inflammatoires et Cancers (BMGIC), Bordeaux, France
| | - Fabienne Pouthier
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France.,Établissement Français du Sang Bourgogne Franche-Comté, Besançon, France
| | - Philippe Marchetti
- CNRS, INSERM, UMR-9020-UMR-S 1277 Canther, Banque de Tissus CHU Lille, Lille, France
| | - Anne-Sophie Gauthier
- Université Bourgogne Franche-Comté, Besançon, France.,Service d'ophtalmologie, CHU Besançon, Besançon, France
| | - Mathilde Fenelon
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France.,CHU Bordeaux, Service de chirurgie orale, Bordeaux, France
| | - Florelle Gindraux
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France.,Service de Chirurgie Orthopédique, Traumatologique et Plastique, CHU Besançon, Besançon, France
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15
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Applications of Human Amniotic Membrane for Tissue Engineering. MEMBRANES 2021; 11:membranes11060387. [PMID: 34070582 PMCID: PMC8227127 DOI: 10.3390/membranes11060387] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/17/2022]
Abstract
An important component of tissue engineering (TE) is the supporting matrix upon which cells and tissues grow, also known as the scaffold. Scaffolds must easily integrate with host tissue and provide an excellent environment for cell growth and differentiation. Human amniotic membrane (hAM) is considered as a surgical waste without ethical issue, so it is a highly abundant, cost-effective, and readily available biomaterial. It has biocompatibility, low immunogenicity, adequate mechanical properties (permeability, stability, elasticity, flexibility, resorbability), and good cell adhesion. It exerts anti-inflammatory, antifibrotic, and antimutagenic properties and pain-relieving effects. It is also a source of growth factors, cytokines, and hAM cells with stem cell properties. This important source for scaffolding material has been widely studied and used in various areas of tissue repair: corneal repair, chronic wound treatment, genital reconstruction, tendon repair, microvascular reconstruction, nerve repair, and intraoral reconstruction. Depending on the targeted application, hAM has been used as a simple scaffold or seeded with various types of cells that are able to grow and differentiate. Thus, this natural biomaterial offers a wide range of applications in TE applications. Here, we review hAM properties as a biocompatible and degradable scaffold. Its use strategies (i.e., alone or combined with cells, cell seeding) and its degradation rate are also presented.
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16
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Fenelon M, Etchebarne M, Siadous R, Grémare A, Durand M, Sentilhes L, Catros S, Gindraux F, L'Heureux N, Fricain JC. Comparison of amniotic membrane versus the induced membrane for bone regeneration in long bone segmental defects using calcium phosphate cement loaded with BMP-2. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 124:112032. [PMID: 33947534 DOI: 10.1016/j.msec.2021.112032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 12/12/2022]
Abstract
Thanks to its biological properties, the human amniotic membrane (HAM) combined with a bone substitute could be a single-step surgical alternative to the two-step Masquelet induced membrane (IM) technique for regeneration of critical bone defects. However, no study has directly compared these two membranes. We first designed a 3D-printed scaffold using calcium phosphate cement (CPC). We assessed its suitability in vitro to support human bone marrow mesenchymal stromal cells (hBMSCs) attachment and osteodifferentiation. We then performed a rat femoral critical size defect to compare the two-step IM technique with a single-step approach using the HAM. Five conditions were compared. Group 1 was left empty. Group 2 received the CPC scaffold loaded with rh-BMP2 (CPC/BMP2). Group 3 and 4 received the CPC/BMP2 scaffold covered with lyophilized or decellularized/lyophilized HAM. Group 5 underwent a two- step induced membrane procedure with insertion of a polymethylmethacrylate (PMMA) spacer followed by, after 4 weeks, its replacement with the CPC/BMP2 scaffold wrapped in the IM. Micro-CT and histomorphometric analysis were performed after six weeks. Results showed that the CPC scaffold supported the proliferation and osteodifferentiation of hBMSCs in vitro. In vivo, the CPC/BMP2 scaffold very efficiently induced bone formation and led to satisfactory healing of the femoral defect, in a single-step, without autograft or the need for any membrane covering. In this study, there was no difference between the two-step induced membrane procedure and a single step approach. However, the results indicated that none of the tested membranes further enhanced bone healing compared to the CPC/BMP2 group.
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Affiliation(s)
- Mathilde Fenelon
- Univ. Bordeaux, INSERM, BIOTIS, U1026, F-33000 Bordeaux, France; CHU Bordeaux, Service de chirurgie orale, F-33076 Bordeaux, France.
| | - Marion Etchebarne
- Univ. Bordeaux, INSERM, BIOTIS, U1026, F-33000 Bordeaux, France; CHU Bordeaux, Department of maxillofacial surgery, F-33076 Bordeaux, France
| | - Robin Siadous
- Univ. Bordeaux, INSERM, BIOTIS, U1026, F-33000 Bordeaux, France
| | - Agathe Grémare
- Univ. Bordeaux, INSERM, BIOTIS, U1026, F-33000 Bordeaux, France; CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | - Marlène Durand
- Univ. Bordeaux, INSERM, BIOTIS, U1026, F-33000 Bordeaux, France; CHU Bordeaux, CIC 1401, 33000, Bordeaux, France; INSERM, CIC 1401, 33000 Bordeaux, France
| | - Loic Sentilhes
- CHU Bordeaux, Department of Obstetrics and Gynecology, F-33076, Bordeaux, France
| | - Sylvain Catros
- Univ. Bordeaux, INSERM, BIOTIS, U1026, F-33000 Bordeaux, France; CHU Bordeaux, Service de chirurgie orale, F-33076 Bordeaux, France
| | - Florelle Gindraux
- Service de Chirurgie Orthopédique, Traumatologique et Plastique, CHU Besançon, F-25000 Besançon, France; Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, F-25000 Besançon, France
| | | | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, BIOTIS, U1026, F-33000 Bordeaux, France; CHU Bordeaux, Service de chirurgie orale, F-33076 Bordeaux, France
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17
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Dadkhah Tehrani F, Firouzeh A, Shabani I, Shabani A. A Review on Modifications of Amniotic Membrane for Biomedical Applications. Front Bioeng Biotechnol 2021; 8:606982. [PMID: 33520961 PMCID: PMC7839407 DOI: 10.3389/fbioe.2020.606982] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
The amniotic membrane (AM) is the innermost layer of the fetal placenta, which surrounds and protects the fetus. Its unique structure, in addition to its physical and biological properties, makes it a useful substance in many applications related to regenerative medicine. The use of this fantastic substance with a century-old history has produced remarkable results in vivo, in vitro, and even in clinical studies. While the intact or preserved AM is widely used for these purposes, the addition of further modifications to AM can be considered as a relatively new subject in its applications. These modifications are applied to improve AM properties, ease of handling, and durability. Here, we will discuss the cases in which AM has undergone additional modifications besides the required processes for sterilization and preservation. In this article, we have categorized these modifications and discussed their applications and results.
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Affiliation(s)
- Fatemeh Dadkhah Tehrani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Arezoo Firouzeh
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Iman Shabani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Azadeh Shabani
- Preventative Gynecology Research Center, Department of Gynecology and Obstetrics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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18
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Etchebarne M, Fricain JC, Kerdjoudj H, Di Pietro R, Wolbank S, Gindraux F, Fenelon M. Use of Amniotic Membrane and Its Derived Products for Bone Regeneration: A Systematic Review. Front Bioeng Biotechnol 2021; 9:661332. [PMID: 34046400 PMCID: PMC8144457 DOI: 10.3389/fbioe.2021.661332] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/13/2021] [Indexed: 02/05/2023] Open
Abstract
Thanks to their biological properties, amniotic membrane (AM), and its derivatives are considered as an attractive reservoir of stem cells and biological scaffolds for bone regenerative medicine. The objective of this systematic review was to assess the benefit of using AM and amniotic membrane-derived products for bone regeneration. An electronic search of the MEDLINE-Pubmed database and the Scopus database was carried out and the selection of articles was performed following PRISMA guidelines. This systematic review included 42 articles taking into consideration the studies in which AM, amniotic-derived epithelial cells (AECs), and amniotic mesenchymal stromal cells (AMSCs) show promising results for bone regeneration in animal models. Moreover, this review also presents some commercialized products derived from AM and discusses their application modalities. Finally, AM therapeutic benefit is highlighted in the reported clinical studies. This study is the first one to systematically review the therapeutic benefits of AM and amniotic membrane-derived products for bone defect healing. The AM is a promising alternative to the commercially available membranes used for guided bone regeneration. Additionally, AECs and AMSCs associated with an appropriate scaffold may also be ideal candidates for tissue engineering strategies applied to bone healing. Here, we summarized these findings and highlighted the relevance of these different products for bone regeneration.
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Affiliation(s)
- Marion Etchebarne
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
- CHU Bordeaux, Department of Maxillofacial Surgery, Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
- CHU Bordeaux, Service de Chirurgie Orale, Bordeaux, France
| | - Halima Kerdjoudj
- Université de Reims Champagne Ardenne, EA 4691, Biomatériaux et Inflammation en Site Osseux (BIOS), Reims, France
- Université de Reims Champagne Ardenne, UFR d'Odontologie, Reims, France
| | - Roberta Di Pietro
- Department of Medicine and Ageing Sciences, Gabriele D'Annunzio University of Chieti-Pescara, Chieti, Italy
- StemTeCh Group, Gabriele D'Annunzio Foundation, Gabriele D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Susanne Wolbank
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Florelle Gindraux
- Service de Chirurgie Orthopédique, Traumatologique et Plastique, CHU Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France
| | - Mathilde Fenelon
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
- CHU Bordeaux, Service de Chirurgie Orale, Bordeaux, France
- *Correspondence: Mathilde Fenelon
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Cell-Based Therapies for Age-Related Macular Degeneration. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1256:265-293. [PMID: 33848006 DOI: 10.1007/978-3-030-66014-7_11] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Age-related macular degeneration (AMD) is a leading cause of blindness worldwide. The pathogenesis of AMD involves dysfunction and loss of the retinal pigment epithelium (RPE), a monolayer of cells that provide nourishment and functional support for the overlying photoreceptors. RPE cells in mammals are not known to divide, renew or regenerate in vivo, and in advanced AMD, RPE loss leads to degeneration of the photoreceptors and impairment of vision. One possible therapeutic approach would be to support and replace the failing RPE cells of affected patients, and indeed moderate success of surgical procedures in which relatively healthy autologous RPE from the peripheral retina of the same eye was transplanted under the retina in the macular area suggested that RPE replacement could be a means to attenuate photoreceptor cell loss. This prompted exploration of the possibility to use pluripotent stem cells (PSCs) as a potential source for "healthy and young" RPE cells for such cell-based therapy of AMD. Various approaches ranging from the use of allogeneic embryonic stem cells to autologous induced pluripotent stem cells are now being tested within early clinical trials. Such PSC-derived RPE cells are either injected into the subretinal space as a suspension, or transplanted as a monolayer patch upon scaffold support. Although most of these approaches are at early clinical stages, safety of the RPE product has been demonstrated by several of these studies. Here, we review the concept of cell-based therapy of AMD and provide an update on current progress in the field of RPE transplantation.
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de la Torre P, Flores AI. Current Status and Future Prospects of Perinatal Stem Cells. Genes (Basel) 2020; 12:genes12010006. [PMID: 33374593 PMCID: PMC7822425 DOI: 10.3390/genes12010006] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/18/2020] [Accepted: 12/20/2020] [Indexed: 02/05/2023] Open
Abstract
The placenta is a temporary organ that is discarded after birth and is one of the most promising sources of various cells and tissues for use in regenerative medicine and tissue engineering, both in experimental and clinical settings. The placenta has unique, intrinsic features because it plays many roles during gestation: it is formed by cells from two individuals (mother and fetus), contributes to the development and growth of an allogeneic fetus, and has two independent and interacting circulatory systems. Different stem and progenitor cell types can be isolated from the different perinatal tissues making them particularly interesting candidates for use in cell therapy and regenerative medicine. The primary source of perinatal stem cells is cord blood. Cord blood has been a well-known source of hematopoietic stem/progenitor cells since 1974. Biobanked cord blood has been used to treat different hematological and immunological disorders for over 30 years. Other perinatal tissues that are routinely discarded as medical waste contain non-hematopoietic cells with potential therapeutic value. Indeed, in advanced perinatal cell therapy trials, mesenchymal stromal cells are the most commonly used. Here, we review one by one the different perinatal tissues and the different perinatal stem cells isolated with their phenotypical characteristics and the preclinical uses of these cells in numerous pathologies. An overview of clinical applications of perinatal derived cells is also described with special emphasis on the clinical trials being carried out to treat COVID19 pneumonia. Furthermore, we describe the use of new technologies in the field of perinatal stem cells and the future directions and challenges of this fascinating and rapidly progressing field of perinatal cells and regenerative medicine.
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21
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Fenelon M, Etchebarne M, Siadous R, Grémare A, Durand M, Sentilhes L, Torres Y, Catros S, Gindraux F, L'Heureux N, Fricain JC. Assessment of fresh and preserved amniotic membrane for guided bone regeneration in mice. J Biomed Mater Res A 2020; 108:2044-2056. [PMID: 32319212 DOI: 10.1002/jbm.a.36964] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 03/23/2020] [Accepted: 03/28/2020] [Indexed: 12/13/2022]
Abstract
Thanks to its biological properties, the human amniotic membrane (HAM) can be used as a barrier membrane for guided bone regeneration (GBR). However, no study has assessed the influence of the preservation method of HAM for this application. This study aimed to establish the most suitable preservation method of HAM for GBR. Fresh (F), cryopreserved (C) lyophilized (L), and decellularized and lyophilized (DL) HAM were compared. The impact of preservation methods on collagen and glycosaminoglycans (GAG) content was evaluated using Masson's trichrome and alcian blue staining. Their suture retention strengths were assessed. In vitro, the osteogenic potential of human bone marrow mesenchymal stromal cells (hBMSCs) cultured on the four HAMs was evaluated using alkaline phosphatase staining and alizarin red quantification assay. In vivo, the effectiveness of fresh and preserved HAMs for GBR was assessed in a mice diaphyseal bone defect after 1 week or 1 month healing. Micro-CT and histomorphometric analysis were performed. The major structural components of HAM (collagen and GAG) were preserved whatever the preservation method used. The tearing strength of DL-HAM was significantly higher. In vitro, hBMSCs seeded on DL-HAM displayed a stronger ALP staining, and alizarin red staining quantification was significantly higher at Day 14. In vivo, L-HAM and DL-HAM significantly enhanced early bone regeneration. One month after the surgery, only DL-HAM slightly promoted bone regeneration. Several preserving methods of HAM have been studied for bone regeneration. Here, we have demonstrated that DL-HAM achieved the most promising results for GBR.
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Affiliation(s)
- Mathilde Fenelon
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Oral Surgery, CHU Bordeaux, Bordeaux, France
| | - Marion Etchebarne
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Maxillofacial Surgery, CHU Bordeaux, Bordeaux, France
| | - Robin Siadous
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France
| | - Agathe Grémare
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Odontology and Oral Health, CHU Bordeaux, Bordeaux, France
| | - Marlène Durand
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,CHU Bordeaux, CIC 1401, Bordeaux, France.,INSERM, CIC 1401, Bordeaux, France
| | - Loic Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
| | - Yoann Torres
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France
| | - Sylvain Catros
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Oral Surgery, CHU Bordeaux, Bordeaux, France
| | - Florelle Gindraux
- Department of Orthopedic, Traumatology & Plastic Surgery, University Hospital of Besançon, Besançon, France.,Nanomedicine Lab, Imagery and Therapeutics (EA 4662), SFR FED 4234, University of Franche-Comté, Besançon, France
| | - Nicolas L'Heureux
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France
| | - Jean-Christophe Fricain
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Oral Surgery, CHU Bordeaux, Bordeaux, France
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22
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Zhang C, Du T, Mu G, Wang J, Gao X, Long F, Wang Q. Evaluation and ultrastructural changes of amniotic membrane fragility after UVA/riboflavin cross-linking and its effects on biodegradation. Medicine (Baltimore) 2020; 99:e20091. [PMID: 32443319 PMCID: PMC7254827 DOI: 10.1097/md.0000000000020091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study aims to evaluate the changes of fragility and ultrastructure of amniotic membrane after cross-linking by UVA/riboflavin.Forty-nine fresh amniotic membranes were randomly divided into 3 groups. Eighteen were in group A (CX group) and immersed in 0.1% riboflavin solution for 10 min for UVA/riboflavin cross-linking. Sixteen were in group B (B2 group), soaked for 10 min with 0.1% riboflavin. After soaking, membranes in group A and B were transferred into corneal preservation solution. Fifteen pieces were in group C, directly into corneal preservation solution. The biomechanical and ultrastructural changes of the amniotic tissue before and after cross-linking were examined (CX group = 13, B2 group = 11, C group = 15). The amniotic membrane tissue of group A (n = 5) and B (n = 5) was transplanted into 16 eyes of the rabbits, respectively, and the dissolution time of the amniotic membrane tissue was investigated.After cross-linking, compared with the control group, the elastic modulus of the low-stress area of the amniotic membrane (Elow) was higher, while the elastic modulus of the high-stress area of the amniotic membrane (Ehigh) was lower, with no significant difference in the tensile strength. Also, the collagen fibers showed coarse and bamboo-like changes. In group A, amniotic membranes began to dissolve 4 weeks after conjunctiva transplantation, and all amniotic membranes were dissolved and absorbed 6 weeks after conjunctiva transplantation. In group B, some amniotic membrane tissues were still visible 6 weeks after conjunctiva transplantation.This study suggested that after amniotic membrane cross-linking, the brittleness was increased, the hardness was enhanced, and the morphology of the collagen fiber was changed. The cross-linked amniotic membrane showed resistance to tissue dissolution.
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Affiliation(s)
| | | | | | - Jia Wang
- Shandong Provincial Hospital, Jinan
- Aier Eye Hospital Group, LiaochengAier Eye Hospital, Liaocheng
| | - Xin Gao
- Jinan Second People's Hospital
| | - Fumin Long
- People's Hospital of Taierzhuang District, Zaozhuang, China
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23
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Martelloni M, Montagner G, Trojan D, Abate R. Amniotic Membrane In Palatal Epithelial-Connective Tissue Reconstruction. Int Med Case Rep J 2019; 12:349-354. [PMID: 31819667 PMCID: PMC6875521 DOI: 10.2147/imcrj.s213275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/22/2019] [Indexed: 11/27/2022] Open
Abstract
Mucogingival surgery has the objective to obtain coverage of the recession, with a favorable long-term prognosis, but also to minimize postoperative problems and surgery-related risks. Human amniotic membrane is increasingly employed for periodontal tissue repair in order to promote epithelialization and to reduce pain and scar tissue formation. A 38-year-old female patient reports dental hypersensitivity resulting from gingival recession affecting tooth 4.1. A mucogingival surgical procedure was proposed and a partial-thickness flap of epithelial-connective tissue was harvested from the palate and grafted on to the receiving site. The amniotic membrane was positioned at the donor site to reduce postoperative morbidity and to encourage rapid palatal healing. One week after the application of HAM (human amniotic membrane), the wound was healed and 1 month after the donor site was completely re-epithelialized. The present case report suggests that in the surgical treatment of gingival recession with palatal epithelial-connective tissue graft, HAM promotes rapid epithelialization of the palatal donor site wound with a reduction in morbidity.
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Affiliation(s)
| | | | - Diletta Trojan
- Treviso Tissue Bank Foundation Onlus, Treviso, 31100, Italy
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24
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Grémare A, Jean-Gilles S, Musqui P, Magnan L, Torres Y, Fénelon M, Brun S, Fricain JC, L'Heureux N. Cartography of the mechanical properties of the human amniotic membrane. J Mech Behav Biomed Mater 2019; 99:18-26. [PMID: 31325833 DOI: 10.1016/j.jmbbm.2019.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/07/2019] [Accepted: 07/13/2019] [Indexed: 12/16/2022]
Abstract
Because of its low immunogenicity, biological properties, and high availability, the Human Amniotic Membrane (HAM) is widely used in the clinic and in tissue engineering research. However, while its biological characteristics are well described, its mechanical properties remain understudied especially in terms of inter- and intra-HAM variability. To guide bioengineers in the use of this natural biomaterial, a detailed cartography of the HAM's mechanical properties was performed. Maximal force (Fmax) and strain at break (Smax) were identified as the relevant mechanical criteria for this study after a combined analysis of histological sections, thickness measurements after dehydration, and uniaxial tensile tests. Eight HAMs were studied by mechanical cartography using a standardized cutting protocol and sampling pattern. On average, 103 ± 10 samples were retrieved and tested per HAM. Intra-tissue variability highlighted the fact that there were two mechanically distinct areas (placental and peripheral) in each HAM. For all HAMs, placental HAM was significantly stronger by 82 ± 45% and more stretchable by 19 ± 6% than their peripheral counterparts. Our results also demonstrated that placental, but not peripheral, HAM presented isotropic mechanical properties. Thus, placental HAM can be a raw material of choice that could be favored especially in the development of tissue engineering products where mechanical properties play a key role.
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Affiliation(s)
- Agathe Grémare
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France; CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | | | - Pauline Musqui
- CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | - Laure Magnan
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France
| | - Yoann Torres
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France
| | - Mathilde Fénelon
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France; CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | - Stéphanie Brun
- CHU Bordeaux, Gynecology-Obstetrics Service, F-33076 Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France; CHU Bordeaux, Odontology and Oral Health Department, F-33076 Bordeaux, France
| | - Nicolas L'Heureux
- Univ. Bordeaux, INSERM, Tissue Bioengineering, U1026, F-33076, Bordeaux, France.
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25
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Fenelon M, Maurel DB, Siadous R, Gremare A, Delmond S, Durand M, Brun S, Catros S, Gindraux F, L'Heureux N, Fricain JC. Comparison of the impact of preservation methods on amniotic membrane properties for tissue engineering applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 104:109903. [PMID: 31500032 DOI: 10.1016/j.msec.2019.109903] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/02/2019] [Accepted: 06/17/2019] [Indexed: 12/30/2022]
Abstract
Human amniotic membrane (hAM) is considered as an attractive biological scaffold for tissue engineering. For this application, hAM has been mainly processed using cryopreservation, lyophilization and/or decellularization. However, no study has formally compared the influence of these treatments on hAM properties. The aim of this study was to develop a new decellularization-preservation process of hAM, and to compare it with other conventional treatments (fresh, cryopreserved and lyophilized). The hAM was decellularized (D-hAM) using an enzymatic method followed by a detergent decellularization method, and was then lyophilized and gamma-sterilized. Decellularization was assessed using DNA staining and quantification. D-hAM was compared to fresh (F-hAM), cryopreserved (C-hAM) and lyophilized/gamma-sterilized (L-hAM) hAM. Their cytotoxicity on human bone marrow mesenchymal stem cells (hBMSCs) and their biocompatibility in a rat subcutaneous model were also evaluated. The protocol was effective as judged by the absence of nuclei staining and the residual DNA lower than 50 ng/mg. Histological staining showed a disruption of the D-hAM architecture, and its thickness was 84% lower than fresh hAM (p < 0.001). Despite this, the labeling of type IV and type V collagen, elastin and laminin were preserved on D-hAM. Maximal force before rupture of D-hAM was 92% higher than C-hAM and L-hAM (p < 0.01), and D-hAM was 37% more stretchable than F-hAM (p < 0.05). None of the four hAM were cytotoxic, and D-hAM was the most suitable scaffold for hBMSCs proliferation. Finally, D-hAM was well integrated in vivo. In conclusion, this new hAM decellularization process appears promising for tissue engineering applications.
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Affiliation(s)
- Mathilde Fenelon
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, Department of Oral Surgery, F-33076 Bordeaux, France.
| | - Delphine B Maurel
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Robin Siadous
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Agathe Gremare
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Samantha Delmond
- CHU Bordeaux, CIC 1401, 33000 Bordeaux, France; Inserm, CIC 1401, 33000 Bordeaux, France
| | - Marlène Durand
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, CIC 1401, 33000 Bordeaux, France; Inserm, CIC 1401, 33000 Bordeaux, France
| | - Stéphanie Brun
- University hospital, Gynecology-Obstetrics Service, F-33076 Bordeaux, France
| | - Sylvain Catros
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, Department of Oral Surgery, F-33076 Bordeaux, France
| | - Florelle Gindraux
- Orthopedic, Traumatology & Plastic Surgery Department, University Hospital of Besançon, Besançon, France; Nanomedicine Lab, Imagery and Therapeutics (EA 4662), SFR FED 4234, University of Franche-Comté, Besançon, France
| | - Nicolas L'Heureux
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, Laboratory BioTis, UMR 1026, F-33076 Bordeaux, France; CHU Bordeaux, Department of Oral Surgery, F-33076 Bordeaux, France
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26
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Can the amniotic membrane be used to treat peripheral nerve defects? A review of literature. HAND SURGERY & REHABILITATION 2019; 38:223-232. [PMID: 31185315 DOI: 10.1016/j.hansur.2019.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 02/03/2023]
Abstract
Human amniotic membrane is currently being used in ophthalmology and dermatology applications. The objective of this review was to establish proof-of-concept for using amniotic membrane to treat peripheral nerve defects. We performed a search using: 1) PubMed with the keywords/MeSH terms: "amnion", "amniotic membrane", "angiogenesis", "anti-microbial", "characteristic", "chorion", "epithelialization", "fibrosis", "gap", "growth factors", "use", "nerve"; 2) the American clinical trials registry with "amniotic membrane"; 3) Lim Jeremy's book "A primer on amniotic membrane regenerative healing"; 4) the search engine Google. Our findings pointed to the amniotic membrane being a biodegradable and bioactive scaffold that contains many growth factors important for efficient nerve regeneration. Multiple animal studies and the single human clinical trial performed up to now have highlighted its role in preventing recurrence of perineural adhesions, reducing fibrosis, accelerating nerve repair and improving nerve function. Thus, the amniotic membrane has ideal properties for treating peripheral nerve injuries. It could very likely prevent neuroma formation. The best format would be a freeze-dried one containing the amnion and chorion layers in order to preserve all its growth factors, and facilitate its handling and storage in the operating room.
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