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Ma R, Li Y, Dong X, Zhang Y, Chen X, Zhang Y, Zou H, Wang Y. PAX6/CXCL14 regulatory axis promotes the repair of corneal injury by enhancing corneal epithelial cell proliferation. J Transl Med 2024; 22:458. [PMID: 38750454 PMCID: PMC11094923 DOI: 10.1186/s12967-024-05270-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 05/02/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Corneal injuries, often leading to severe vision loss or blindness, have traditionally been treated with the belief that limbal stem cells (LSCs) are essential for repair and homeostasis, while central corneal epithelial cells (CCECs) were thought incapable of such repair. However, our research reveals that CCECs can fully heal and maintain the homeostasis of injured corneas in rats, even without LSCs. We discovered that CXCL14, under PAX6's influence, significantly boosts the stemness, proliferation, and migration of CCECs, facilitating corneal wound healing and homeostasis. This finding introduces CXCL14 as a promising new drug target for corneal injury treatment. METHODS To investigate the PAX6/CXCL14 regulatory axis's role in CCECs wound healing, we cultured human corneal epithelial cell lines with either increased or decreased expression of PAX6 and CXCL14 using adenovirus transfection in vitro. Techniques such as coimmunoprecipitation, chromatin immunoprecipitation, immunofluorescence staining, western blot, real-time PCR, cell colony formation, and cell cycle analysis were employed to validate the axis's function. In vivo, a rat corneal epithelial injury model was developed to further confirm the PAX6/CXCL14 axis's mechanism in repairing corneal damage and maintaining corneal homeostasis, as well as to assess the potential of CXCL14 protein as a therapeutic agent for corneal injuries. RESULTS Our study reveals that CCECs naturally express high levels of CXCL14, which is significantly upregulated by PAX6 following corneal damage. We identified SDC1 as CXCL14's receptor, whose engagement activates the NF-κB pathway to stimulate corneal repair by enhancing the stemness, proliferative, and migratory capacities of CCECs. Moreover, our research underscores CXCL14's therapeutic promise for corneal injuries, showing that recombinant CXCL14 effectively accelerates corneal healing in rat models. CONCLUSION CCECs play a critical and independent role in the repair of corneal injuries and the maintenance of corneal homeostasis, distinct from that of LSCs. The PAX6/CXCL14 regulatory axis is pivotal in this process. Additionally, our research demonstrates that the important function of CXCL14 in corneal repair endows it with the potential to be developed into a novel therapeutic agent for treating corneal injuries.
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Affiliation(s)
- Ruijue Ma
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, 300020, China
| | - Yingxi Li
- Department of Pathogen Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300070, China
| | - Xiaoli Dong
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, 300020, China
| | - Yiming Zhang
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300070, China
| | - Xiaosu Chen
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Yue Zhang
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, 300020, China
| | - Haohan Zou
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, 300020, China
| | - Yan Wang
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, 300020, China.
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Wilson SE, Goshe JM. Prevention and Treatment of Persistent Epithelial Defects After Common Refractive Surgery Procedures. J Refract Surg 2024; 40:e117-e124. [PMID: 38346121 DOI: 10.3928/1081597x-20240102-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
PURPOSE To discuss the prevention and treatment of persistent epithelial defects after the most common refractive surgeries-photorefractive keratectomy, laser in situ keratomileusis, or small incision lenticule extraction. METHODS PubMed was used to search the medical literature. RESULTS Persistent epithelial defects are infrequent after photorefractive keratectomy, laser in situ keratomileusis, or small incision lenticule extraction. In the authors' opinion, any persistent epithelial defect present at 1 week or beyond after surgery should be treated aggressively with a properly fit bandage contact lens, lubrication with non-preserved artificial tears, and treatment of any eyelid abnormalities, including nocturnal lagophthalmos. Consideration should be given for presumptive treatment for herpes simplex virus or varicella zoster virus infection. If the persistent epithelial defect does not close within 2 weeks, then other measures should be considered, such as autologous serum drops, topical losartan, amniotic membranes, and topical human recombinant nerve growth factor to limit corneal scarring fibrosis and microbial infection. CONCLUSIONS Persistent epithelial defects are among the most feared complications of refractive surgery. Timely and aggressive treatment should be instituted to close the epithelium prior to the development of scarring fibrosis and/or microbial corneal infection. [J Refract Surg. 2024;40(2):e117-e124.].
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Galiano RD, Orgill DP, Armstrong DG, Glat PM, Carter MJ, Zelen CM. A Prospective Multicenter Study of a Weekly Application Regimen of Viable Human Amnion Membrane Allograft in the Management of Nonhealing Diabetic Foot Ulcers. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5291. [PMID: 37811353 PMCID: PMC10558221 DOI: 10.1097/gox.0000000000005291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 08/09/2023] [Indexed: 10/10/2023]
Abstract
Background Diabetic foot ulcers (DFUs) pose a significant clinical challenge for providers and patients, and often precede devastating complications such as infection, hospitalization, and amputation. Therefore, advanced treatment options are needed to facilitate the healing of chronic DFUs and improve outcomes in this high-risk population. Cryopreserved viable human amnion membrane allograft (vHAMA) has shown great promise in the treatment of recalcitrant DFUs as a supplement to standard of care (SOC). Placental grafts are rich in extracellular matrix proteins, growth factors, and cytokines, which can induce angiogenesis and dermal fibroblast proliferation, resulting in accelerated healing. Methods In this prospective, multicenter single arm trial, 20 patients with nonhealing DFUs received weekly application of vHAMA, in addition to SOC, for up to 12 weeks. The primary study endpoint was proportion of healed wounds at 12 weeks. Secondary endpoints included proportion of wounds healed at 6 weeks, time to heal, and percentage area wound reduction. Subjects were evaluated for ulcer healing and assessed for adverse events at every treatment visit. Results At study conclusion, 85% of patients receiving vHAMA healed. Ten wounds healed (50%) by 6 weeks, and 17 wounds (85%) healed by 12 weeks. The mean time to heal was 46.6 days (95% CI: 35.1-58.0), and the average number of vHAMAs used was 5.4 (SD: 3.25). The mean PAR was 86.3% (SD: 40.51). Conclusions Aseptically processed, cryopreserved vHAMA should be considered as a safe and effective option for DFUs refractory to SOC therapy.
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Affiliation(s)
- Robert D. Galiano
- From the Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Dennis P. Orgill
- Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass
| | - David G. Armstrong
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif
| | - Paul M. Glat
- Department of Surgery, Drexel University School of Medicine, Philadelphia, Pa
| | | | - Charles M. Zelen
- Department of Research, Professional Education and Research Institute, Roanoke, Va
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Geng X, Wang Y, Cui H, Li C, Cheng B, Cui B, Liu R, Zhang J, Zhu L, Li J, Shen J, Li Z. Carboxymethyl chitosan regulates macrophages polarization to inhibit early subconjunctival inflammation in conjunctival injury. Int J Biol Macromol 2023:125159. [PMID: 37268068 DOI: 10.1016/j.ijbiomac.2023.125159] [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: 12/12/2022] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 06/04/2023]
Abstract
Persistent subconjunctival inflammation leads to subconjunctival fibrosis and eventual visual impairment. There is an unmet need for how to effectively inhibit subconjunctival inflammation. Herein, the effect of carboxymethyl chitosan (CMCS) on subconjunctival inflammation was investigated and the mechanism was involved. The evaluation of cytocompatibility demonstrated that CMCS had good biocompatibility. The in vitro results showed that CMCS inhibited secretions of pro-inflammatory cytokines (IL-6, TNF-α, IL-8 and IFN-γ) and chemokines (MCP-1), and downregulated TLR4/MyD88/NF-κB pathway in M1. The in vivo results displayed that CMCS alleviated conjunctival edema and congestion, and improved conjunctival epithelial reconstruction significantly. Both in vitro and in vivo results demonstrated that CMCS inhibited the infiltration of macrophages and reduced the expressions of iNOS, IL-6, IL-8 and TNF-α in the conjunctiva. Given that CMCS indicated the activities of inhibiting M1 polarization, NF-κB pathway, and subconjunctival inflammation, which may be employed as a potent treatment for subconjunctival inflammation.
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Affiliation(s)
- Xingchen Geng
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Yiwei Wang
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Haohao Cui
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Chengcheng Li
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Boyuan Cheng
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Bingbing Cui
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Ruixing Liu
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Junjie Zhang
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Lei Zhu
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Jingguo Li
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
| | - Jianliang Shen
- School of Ophthalmology and Optometry, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325027, China.
| | - Zhanrong Li
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
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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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Ghavami Shahri SH, Balali-Mood M, Heidarzadeh HR, Abrishami M. Ophthalmic Complications and Managements of Sulfur Mustard Exposure: A Narrative Review. ARCHIVES OF IRANIAN MEDICINE 2022; 25:647-657. [PMID: 37543890 PMCID: PMC10685765 DOI: 10.34172/aim.2022.100] [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: 04/30/2022] [Accepted: 05/23/2022] [Indexed: 08/07/2023]
Abstract
Sulfur mustard (SM) is a lethal chemical agent that affects many organs, particularly the eyes, respiratory system and skin. Even asymptomatic patients with documented SM vapor exposure may develop organ disorder many years later. Patients with even minor signs in the acute stage may experience late complications that necessitate surgery. Early decontamination and conservative measures could help the patients and decrease the complications. Despite decades of research, there is still no effective treatment for either acute or long-term SM-induced ocular complications. Even after multiple medications and surgical procedures, the majority of patients continue to have symptoms. For dry eye, punctual occlusion, autologous eye drops, and aggressive lubrication are used; for persistent epithelial defects (PED), tarsorrhaphy, amniotic membrane transplant, and stem cell transplantation are used; for total limbal stem cell deficiency (LSCD), living-related conjunctivolimbal allograft and keratolimbal allograft are used; for corneal vascularization, steroids, non-steroidal anti-inflammatory drugs, and anti-vascular endothelial growth factor prescribed; and for corneal opacities, corneal transplantation is done. Platelet rich plasma and topical drops containing stem cell transplantation for LSCD, photodynamic therapy paired with subconjunctival or topical anti-vascular endothelial growth factors for corneal vascularization, topical curcumin and topical ciclosporin-A for dry eye, and orbital fat-derived stem cells for PED are all alternative treatments that can be suggested. Despite the experimental and clinical research on the complications of SM exposure over the past decades, there is still no effective treatment for eye complications. However, supportive medical and surgical management has been applied with relatively good outcome.
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Affiliation(s)
| | - Mahdi Balali-Mood
- Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Mojtaba Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Birjand, Iran
- Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Canada
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Sutureless Amniotic Membrane Transplantation in Inflammatory Corneal Perforations. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Introduction: The aim of this study was to evaluate the efficacy of sutureless amniotic membrane transplantation (SAMT) in patients with corneal perforation secondary to ocular surface inflammatory diseases. Methods: Twelve eyes of eleven patients with corneal perforation associated with Sjögren’s syndrome and ocular cicatricial pemphigoid were included. Surgical procedure consisted in the application of two layers of amniotic membrane covering the corneal perforation and a therapeutic contact lens placed above the two layers, followed by sutureless tarsorrhaphy with Steri-strip applied for 15 days to immobilize the eyelids. All patients underwent slit-lamp examination, fluorescein corneal staining, and anterior segment optical coherence tomography (AS-OCT), preoperatively and post-surgery, weekly for one month, and then every two weeks for three months. Results: All 12 eyes had complete resolution of corneal perforation. Pachymetry measurements improved in all eyes, and complete healing of the corneal ulcer was obtained following treatment and maintained up to 3 months follow-up in all patients. Conclusions: SAMT was proven to be a safe and effective option for the management of inflammatory corneal perforation. The procedure is non-traumatic and easy to perform since the surgical technique is sutureless and does not require topical therapy because it takes advantage of the intrinsic properties of the membrane itself.
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Mirzayan R, Suh BD. Interposition of human amniotic membrane at the bone-tendon interface of a full-thickness rotator cuff repair. JSES REVIEWS, REPORTS, AND TECHNIQUES 2022; 2:75-80. [PMID: 37588290 PMCID: PMC10426662 DOI: 10.1016/j.xrrt.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- Raffy Mirzayan
- Department of Orthopaedic Surgery, Kaiser Permanente Southern California, Baldwin Park, CA, USA
| | - Brian D. Suh
- Department of Radiology, Kaiser Permanente Southern California, Baldwin Park, CA, USA
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9
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Boss CK, Gibson DJ, Schultz G, Whitley RD, Hernandez JA, Abbott JR, Plummer CE. Therapeutic effects of equine amniotic membrane suspension on corneal re-epithelialization and haze in a modified lagomorph ex vivo wound healing model. Vet Ophthalmol 2021; 25:153-164. [PMID: 34787351 DOI: 10.1111/vop.12953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/22/2021] [Accepted: 10/30/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the therapeutic effects of topical equine amniotic membrane (eAM) suspension following corneal wounding in a controlled experimental setting. PROCEDURES Equine amniotic membrane was collected, gamma irradiated, homogenized for topical suspension preparation, and cryopreserved. Corneoscleral rims harvested from fresh rabbit globes were wounded via keratectomy and were maintained in an air-liquid interface ex vivo corneal culture model. Treatment groups included topical gamma irradiated eAM suspension (n = 20) and a control group (n = 20). Re-epithelialization of the wound was assessed with daily photographic evaluation of area of fluorescein uptake (mm2 ). Corneal wound haze after a 21-day period was assessed by photographic analysis of haze area (mm2 ) and pixel intensity (0-255). Histologic processing of corneal tissue was performed, and protein identification of eAM suspension using Liquid chromatography-mass spectrometry (LC-MS). RESULTS The average day of complete corneal re-epithelialization in controls (5.5 ± 1.1) and topically treated (5.5 ± 0.6) corneas, and rates of reduction in area of fluorescein uptake over time did not significantly differ (p = .44). The corneal wound haze was significantly reduced in mean area by approximately 52% and intensity by 57% in corneas treated with topical eAM suspension (p < .05), compared to controls 21 days following wounding. Protein analysis identified numerous proteins, specifically decorin, dermatopontin, and lumican, which have previously been documented in eAM. CONCLUSIONS Area and intensity of corneal wound haze were significantly reduced in corneas treated with gamma irradiated eAM suspension, which may be due to previously identified therapeutic proteins which promote corneal clarity.
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Affiliation(s)
- Christine K Boss
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Daniel J Gibson
- College of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gregory Schultz
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - R David Whitley
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Jorge A Hernandez
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | | | - Caryn E Plummer
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.,Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Schmiedova I, Ozanova Z, Stastna E, Kiselakova L, Lipovy B, Forostyak S. Case Report: Freeze-Dried Human Amniotic Membrane Allograft for the Treatment of Chronic Wounds: Results of a Multicentre Observational Study. Front Bioeng Biotechnol 2021; 9:649446. [PMID: 34249879 PMCID: PMC8264202 DOI: 10.3389/fbioe.2021.649446] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/28/2021] [Indexed: 12/03/2022] Open
Abstract
An inability of the human body to heal acute wounds under certain conditions results in the formation of chronic ulcers. Chronic wounds not only cause significant pain and discomfort for patients but also serve as an entry for microorganisms into the human body, which can result in serious life-threatening problems and become a significant burden for the patients and society. The current work present results of a multicentre prospective observational study demonstrating the use of a lyophilized amniotic membrane (AM) in the treatment of chronic wounds (various etiologies). Lyophilized AM produced under the commercial brand Amnioderm® was used as an allograft material for therapy of chronic wounds, in addition to chronic ulcer standard-of-care (SoC) protocols. The duration of wounds considered for the application of AM ranged between 2 months and 11 years. In total, 16 patients were enrolled to the study, of which eight were completely healed, six demonstrated a significantly reduced ulcer size, and two did not respond to the AM therapy. The current study unambiguously demonstrates an effective alternative to the standard of chronic wound care and confirms a significant effect of the AM application for chronic wound management as a new SoC.
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Affiliation(s)
- Iveta Schmiedova
- PrimeCell Bioscience Inc., Ostrava, Czechia.,BioHealing, Brno, Czechia
| | - Zuzana Ozanova
- PrimeCell Bioscience Inc., Ostrava, Czechia.,BioHealing, Brno, Czechia
| | | | | | - Bretislav Lipovy
- Department of Burns and Plastic Surgery, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Brno, Czechia
| | - Serhiy Forostyak
- PrimeCell Bioscience Inc., Ostrava, Czechia.,BioHealing, Brno, Czechia.,Department of Burns and Plastic Surgery, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Brno, Czechia
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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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12
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Tong CM, He B, Iovieno A, Yeung SN. Diagnosis and management of limbal stem cell deficiency, challenges, and future prospects. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1933441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C. Maya Tong
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Canada
| | - Bonnie He
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Alfonso Iovieno
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Sonia N. Yeung
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
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13
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Lipový B, Hladík M, Štourač P, Forostyak S. Case Report: Wound Closure Acceleration in a Patient With Toxic Epidermal Necrolysis Using a Lyophilised Amniotic Membrane. Front Bioeng Biotechnol 2021; 9:649317. [PMID: 33937217 PMCID: PMC8085411 DOI: 10.3389/fbioe.2021.649317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/23/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Toxic epidermal necrolysis (TEN) is a rare life-threatening disease that mainly affects the skin and mucous membranes, resulting from a toxic delayed-type hypersensitivity (DTH) reaction (type IV reaction) to the presence of foreign antigens such as drugs. The clinical symptoms are caused by pathophysiological processes leading to massive apoptosis of keratinocytes in the dermo-epidermal junction. This results in the formation of a bulla and subsequent separation of the entire epidermis with the exposure of the dermis. The current approach in the local therapy of TEN prefers the use of biological dressings, which helps provide several critical requirements for defect healing; in particular, it helps in the acceleration of the spontaneous wound closure (re-epithelialization) of the skin defect and the reduction of the risk of development of various complications and infections, such as the risk of pathological scar maturation. This paper is a case report of the use of a lyophilized amniotic membrane (AM) for accelerating wound healing in a patient with TEN. Case Presentation: We report a case of an 8-year-old girl transferred to our center with a histologically confirmed diagnosis of TEN. Despite the application of immunosuppressive therapy consisting of corticosteroids and intravenous immunoglobulins, we have observed disease progression and exfoliation of up to 60% of the total body surface area (TBSA). In the facial area, which is cosmetically privileged, we decided to use the lyophilized amniotic membrane (Amnioderm®) to cover up approximately 2% of the TBSA. Within 2 days after the application, we observed accelerated reepithelialisation, with rapid wound closure. We have not observed any side effects nor infections during the subsequent phases of wound healing. Skin defects in non-facial areas of the body were treated with synthetic dressings. When compared to the areas covered with the lyophilized AM, the healing process was prolonged. Conclusions: To our knowledge, this is the first case study using a lyophilized amniotic membrane in the treatment of a patient with TEN. The AM application in the cosmetically-privileged area (face), proved to be very efficient in the treatment of TEN patients. The use of this allogeneic material demonstrated excellent biocompatibility and caused a unique acceleration of epithelialization and wound healing, yielding also excellent long-term results. The current study opens broad possibilities for clinical application of the used material, the improvement of current therapy of patients with TEN and better outcomes and recovery of patients.
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Affiliation(s)
- Bretislav Lipový
- Department of Burns and Plastic Surgery, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia.,Central European Institute of Technology, Brno University of Technology, Brno, Czechia
| | - Martin Hladík
- Department of Burns and Plastic Surgery, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia
| | - Petr Štourač
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia
| | - Serhiy Forostyak
- Department of Burns and Plastic Surgery, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia.,PrimeCell Bioscience Inc., Prague, Czechia.,National Tissue Centre Inc., Ostrava, Czechia
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14
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Zhu YT, Li F, Zhang Y, Chen SY, Tighe S, Lin SY, Tseng SCG. HC-HA/PTX3 Purified From Human Amniotic Membrane Reverts Human Corneal Fibroblasts and Myofibroblasts to Keratocytes by Activating BMP Signaling. Invest Ophthalmol Vis Sci 2020; 61:62. [PMID: 32462202 PMCID: PMC7405802 DOI: 10.1167/iovs.61.5.62] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose Fibrosis or scarring is a pathological outcome of wound healing and is characterized by terminally differentiated myofibroblasts. Heavy chain-hyaluronic acid/pentraxin 3 (HC-HA/PTX3) is a unique matrix component purified from amniotic membrane that exerts an anti-inflammatory effect. Herein, we investigate whether HC-HA/PTX3 can also exert an antiscarring effect. Methods Human corneal fibroblasts and myofibroblasts were seeded on plastic, immobilized HA or HC-HA/PTX3 or on plastic with or without soluble HA and HC-HA/PTX3 in DMEM+10% FBS, with or without AMD3100 or SB431542 in DMEM+ITS with or without transforming growth factor–β1 (TGF-β1). Transcript expression of keratocyte and signaling markers was determined by RT-qPCR. Immunostaining was performed to monitor cytolocalization of signaling markers and α-SMA. Western blotting was used to measure relative protein level. Results Human corneal fibroblasts and myofibroblasts cultured in or on HC-HA/PTX3, but not HA, were refrained from cytoplasmic expression of αSMA and nuclear translocation of pSMAD2/3 when challenged with exogenous TGF-β1. Such an antiscarring action by suppressing canonical TGF-β1 signaling was surprisingly accompanied by phenotypic reversal to keratocan-expressing keratocytes through activation of BMP signaling. Further investigation disclosed that such phenotypic reversal was initiated by cell aggregation mediated by SDF1-CXCR4 signaling highlighted by nuclear translocation of CXCR4 and upregulation of CXCR4 transcript and protein followed by activation of canonical BMP signaling. Conclusions These findings collectively provide mechanistic understanding explaining how amniotic membrane transplantation exerts an antiscarring action. In addition, HC-HA/PTX3 and derivatives may be developed into a new biologic to treat corneal blindness caused by stromal scar or opacity in the future.
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15
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Klama-Baryła A, Rojczyk E, Kitala D, Łabuś W, Smętek W, Wilemska-Kucharzewska K, Kucharzewski M. Preparation of placental tissue transplants and their application in skin wound healing and chosen skin bullous diseases - Stevens-Johnson syndrome and toxic epidermal necrolysis treatment. Int Wound J 2020; 17:491-507. [PMID: 31943788 DOI: 10.1111/iwj.13305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Abstract
Unique properties of amniotic membrane make it a promising source for tissue engineering and a clinically useful alternative for patients suffering from chronic wounds including, for example, ulcers, burns, ocular surface damages and wounds occurring in the course of bullous diseases like stevens-johnson syndrome and toxic epidermal necrolysis. Its use has many advantages over standard wound care, as it contains pluripotent cells, nutrients, anti-fibrotic and anti-inflammatory cytokines, growth factors and extracellular matrix (ECM) proteins. Placental tissues can be prepared as a medical component, an advanced therapy medicinal product or a tissue graft. In addition to basic preparation procedures such as washing, rinsing, cutting, drying and sterilisation, there are many optional steps such as perforation, crosslinking and decellularisation. Finally, transplants should be properly stored-in cryopreserved or dehydrated form. In recent years, many studies including basic science and clinical trials have proven the potential to expand the use of amniotic membrane and amnion-derived cells to the fields of orthopaedics, dentistry, surgery, urology, vascular tissue engineering and even oncology. In this review, we discuss the role of placental tissues in skin wound healing and in the treatment of various diseases, with particular emphasis on bullous diseases. We also describe some patented procedures for placental tissue grafts preparation.
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Affiliation(s)
- Agnieszka Klama-Baryła
- The Burn Centre of Stanisław Sakiel in Siemianowice Śląskie, Siemianowice Śląskie, Poland
| | - Ewa Rojczyk
- Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Diana Kitala
- The Burn Centre of Stanisław Sakiel in Siemianowice Śląskie, Siemianowice Śląskie, Poland
| | - Wojciech Łabuś
- The Burn Centre of Stanisław Sakiel in Siemianowice Śląskie, Siemianowice Śląskie, Poland
| | - Wojciech Smętek
- The Burn Centre of Stanisław Sakiel in Siemianowice Śląskie, Siemianowice Śląskie, Poland
| | | | - Marek Kucharzewski
- Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
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16
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Gholipourmalekabadi M, Farhadihosseinabadi B, Faraji M, Nourani MR. How preparation and preservation procedures affect the properties of amniotic membrane? How safe are the procedures? Burns 2019; 46:1254-1271. [PMID: 31445711 DOI: 10.1016/j.burns.2019.07.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 05/14/2019] [Accepted: 07/03/2019] [Indexed: 12/22/2022]
Abstract
Human amniotic membrane (AM) has been widely used for tissue engineering and regenerative medicine applications. AM has many favorable characteristics such as high biocompatibility, antibacterial activity, anti-scarring property, immunomodulatory effects, anti-cancer behavior and contains several growth factors that make it an excellent natural candidate for wound healing. To date, various methods have been developed to prepare, preserve, cross-link and sterilize the AM. These methods remarkably affect the morphological, physico-chemical and biological properties of AM. Optimization of an effective and safe method for preparation and preservation of AM for a specific application is critical. In this review, the isolation, different methods of preparation, preservation, cross-linking and sterilization as well as their effects on properties of AM are well discussed. For each section, at least one effective and safe protocol is described in detail.
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Affiliation(s)
- Mazaher Gholipourmalekabadi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medicine Sciences, Tehran, Iran
| | - Behrouz Farhadihosseinabadi
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Faraji
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Nourani
- Chemical Injuries Research Center, Systems Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Costa D, Leiva M, Sanz F, Espejo V, Esteban J, Vergara J, Díaz C, Huguet E, Cairó M, Ríos J, Peña MT. A multicenter retrospective study on cryopreserved amniotic membrane transplantation for the treatment of complicated corneal ulcers in the dog. Vet Ophthalmol 2019; 22:695-702. [DOI: 10.1111/vop.12643] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/30/2018] [Accepted: 12/01/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Daniel Costa
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
| | - Marta Leiva
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
| | | | | | | | | | - Clinio Díaz
- Clínica Ocular Veterinaria Gran Canaria Spain
| | | | - Martí Cairó
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
| | - José Ríos
- Laboratory of Biostatistics & Epidemiology, Facultat de Medicina Universitat Autònoma de Barcelona Bellaterra Spain
- Biostatistics and Medical Statistics Core Facility IDIBAPS, Hospital Clínic Barcelona Spain
| | - Maria Teresa Peña
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
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Abstract
PURPOSE Adhesions between the extraocular muscles and surrounding tissues pose a main cause of failure of strabismus reoperations. Amniotic membrane (AM) transplantation during extraocular muscle surgery, to prevent the formation of adhesions, has been a subject of research during the past decade. This review aims to determine the value, indications, and tips on usage of AM transplantation during strabismus surgery. MATERIALS AND METHODS All references cited in PubMed in English were searched using the key words: amniotic membrane strabismus or amniotic membrane extraocular muscles, and a brief summary of these was described. In addition, certain articles were chosen to provide introductory information on wound healing and fibrosis, AM properties and how it works after transplantation, and AM processing and preservation. RESULTS AM used for transplantation during extraocular muscle surgery may be cryopreserved, dried, or fresh. It may be oriented with its stroma or epithelium towards the muscle. It may or may not be fixed with sutures. What were the best choices? Various studies attempted to answer these questions. Many of the studies reviewed, however, were inconclusive or contradictory. Fresh AM seemed effective, but carried a risk of transmission of communicable diseases. Dried membrane was not of value in preventing adhesions. Histopathologically, cryopreserved membrane prevented the development of adhesions in the region of its presence, regardless of its orientation, and without the need for suture fixation. To accentuate this histopathological effect during clinical practice, it was recommended to utilize the largest segment possible of cryopreserved membrane and limit its usage to cases where adhesions are expected to be the main cause of failure of strabismus surgery. CONCLUSION Cryopreserved AM transplantation was safe and histopathologically effective in preventing adhesions. This effect was, however, less pronounced clinically. Its use during strabismus reoperations is merited if previous recommendations and precautions are considered.
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Röck T, Bartz-Schmidt KU, Landenberger J, Bramkamp M, Röck D. Amniotic Membrane Transplantation in Reconstructive and Regenerative Ophthalmology. Ann Transplant 2018. [PMID: 29507278 PMCID: PMC6248296 DOI: 10.12659/aot.906856] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background The goal of this study was to investigate numbers, indications, surgical techniques, and experiences of amniotic membrane transplantation at the University Eye Hospital Tübingen over the last 16 years. Material/Methods Data from all amniotic membrane transplantations from January 2001 to December 2016 were retrospectively analyzed. Data was accessed from the electronic database and the annual reports of the Eye Bank at the University Eye Hospital Tübingen. Results A total of 771 amniotic membrane transplantations were performed between 2001 and 2016 at the University Eye Hospital Tübingen. The mean number of amniotic membrane transplantations was 48 per year (range: 7–81). Overall, the mean number of amniotic membrane transplantations more than doubled, from 31 amniotic membrane transplantations per year during the first 8-year period to 66 amniotic membrane transplantations per year during the second 8-year period (p<0.0001). The most common surgical indications for amniotic membrane transplantation were corneal ulcers and persistent corneal epithelial defects. The inlay, overlay, and sandwich technique became the favored surgical methods for various disorders of the ocular surface. Conclusions Our study showed a significant increase of amniotic membrane transplantations from 2001 to 2016. This increase is likely influenced by the introduction of different surgical amniotic membrane transplantation techniques, the rising knowledge about containing growth factors, neurotrophins and cytokines, and the demographic change with aging of the population.
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Affiliation(s)
- Tobias Röck
- Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | | | | | - Matthias Bramkamp
- Department of General Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Daniel Röck
- Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
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Abstract
Purpose To investigate if a suspension made with amniotic membrane could have a beneficial effect on ocular surface diseases. Methods In the Imola branch of the Eye Bank of Emilia Romagna, the authors prepared a suspension containing homogenized amniotic membrane previously conserved at −80 degrees Celsius. Subsequently, the authors gave this preparation to 21 patients: 8 had undergone lamellar keratoplasty, 4 had undergone penetrating keratoplasty, 2 had undergone photorefractive keratectomy with a delay of epithelialization, 3 had neurotrophic corneal ulcers, 2 had corneal burning, 1 had torpid corneal ulcer, and 1 had Sjögren syndrome. Each patient had been treated with conventional therapy for at least, 4 months without any clinical improvement. In this sample of eyes the authors evaluated the transparency and integrity of epithelium before and after the therapy by means of a fluorescein staining test, examining the area of epithelial defect as well as the phlogistic situation and the symptoms referred by patients. Nine eyes from this group of patients were studied by impression cytology before and after 3 months of use of suspension. The follow-up was 5 months of once-weekly visits. Results In all patients, after 15 to 30 days the corneas became negative to fluorescein staining test and the epithelium seemed more complete and regular, there was an evident decrease of phlogistic situation in the conjunctiva, and an improvement of symptoms was referred by patients. The situation was stable during the whole follow-up. No side effects were noted. The impression cytology repeated 3 months after the treatment showed a significant corneal recovery of the cytologic situation with an important decrease of CK19 + cells on the corneal surface. Conclusions This new therapy, which is less traumatic than an implant of amniotic membrane, is safe, and can be repeated for a long period, could help patients with corneal superficial defects.
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Affiliation(s)
- Po. Bonci
- Department of Ophthalmology, Eye Bank, S. Maria della Scaletta Hospital, Imola (BO) - Italy
| | - Pa. Bonci
- Department of Ophthalmology, Eye Bank, S. Maria della Scaletta Hospital, Imola (BO) - Italy
| | - A. Lia
- Department of Ophthalmology, Eye Bank, S. Maria della Scaletta Hospital, Imola (BO) - Italy
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Kalogeropoulos D, Geka A, Malamos K, Kanari M, Kalogeropoulos C. New Therapeutic Perceptions in a Patient with Complicated Herpes Simplex Virus 1 Keratitis: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1382-1389. [PMID: 29279602 PMCID: PMC5753617 DOI: 10.12659/ajcr.906506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Patient: Male, 80 Final Diagnosis: Unilateral complicated Herpetic Simplex Virus 1 Keratitis Symptoms: Visual impairment Medication: Anti-herpetic treatment • Anti-VEGF • Cyclosporine A • Matrix regeneration therapy Clinical Procedure: Amniotic membrane and limbal stem cell transplantation Specialty: Ophthalmology
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Affiliation(s)
- Dimitrios Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Aliki Geka
- Department of Ophthalmology, Olympion Private Hospital, Patras, Greece
| | - Konstantinos Malamos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Kanari
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Chris Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Röck T, Bartz-Schmidt KU, Röck D. Management of a neurotrophic deep corneal ulcer with amniotic membrane transplantation in a patient with functional monocular vision: A case report. Medicine (Baltimore) 2017; 96:e8997. [PMID: 29390295 PMCID: PMC5815707 DOI: 10.1097/md.0000000000008997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
RATIONALE Amniotic membrane transplantation (AMT) has been performed therapeutically in humans for over 100 years. In recent 2 decades AMTs have been used increasingly and successfully to treat various types of ophthalmic indications. PATIENT CONCERNS An 83-year-old man was referred to our eye hospital with a refractory neurotrophic deep corneal ulcer of the left eye. DIAGNOSES The best-corrected visual acuity of the left eye was 0.5 (0.3 logMAR) and of the right eye was 0.05 (1.3 logMAR), which was caused by a central retinal vein occlusion 5 years previously. In cases of binocular vision, a large amniotic membrane patch can cover the whole cornea, including the optical axis. However, in cases with functional monocular vision, as in the case reported here, the AMT has to be performed without the involvement of the optical axis to ensure vision for the patient. Otherwise the patient would have a massively restricted view like looking through waxed paper for at least 2-4 weeks until the overlay dissolved. INTERVENTIONS For this case, an AMT using a modified sandwich technique was applied without involvement of the optic axis to ensure vision for the patient. This case report illustrates this eye's course of healing over time. OUTCOMES A reduction in the inflammation and healing of the corneal ulcer could be seen. In addition, the corneal vascularization decreased. Six months after the AMT, a slit-lamp examination revealed stable findings. The best-corrected visual acuity of the left eye had increased to 0.8 (0.1 logMAR). LESSONS To the best of our knowledge, a case report on the management of a neurotrophic deep corneal ulcer with AMT in a patient with functional monocular vision has never been undertaken before.
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Kassem RR, El-Mofty RMAM, Khodeir MM, Hamza WM. A comparative study of different amniotic membrane orientations during extraocular muscle surgery in rabbits. Curr Eye Res 2017; 43:325-332. [PMID: 29144789 DOI: 10.1080/02713683.2017.1401645] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To histopathologically compare the effect of different orientations of cryopreserved human amniotic membrane (AM) transplant during extraocular muscle surgery in rabbits. METHODS Fifty-two albino rabbit eyes underwent 4-mm resection of the superior rectus. Eyes were randomly divided into four groups. In Group C (Control group, 16 eyes) the muscle was not wrapped with amniotic membrane. In the three AM groups, cryopreserved AM was wrapped around the muscle, oriented with either its stroma (Group S, 15 eyes) or epithelium (Group E, nine eyes) towards the muscle, or folded on itself with the epithelium externally (Group F, 12 eyes). The rabbits were sacrificed and the eyes were enucleated 6 weeks after surgery. Histopathological examination was conducted for periamniotic, foreign body, scleral, and conjunctival inflammation, conjunctival vascularity, adhesions and muscle fibrosis. RESULTS In all AM eyes, the AM was surrounded by periamniotic inflammation, with no adhesions detected between the muscle and surrounding tissues in the segment where the AM was present, but detected elsewhere. Adhesions were detected in all group C eyes. Foreign body inflammation was significantly less in Group C than in each of the AM groups (p < .05), but was insignificantly different among the three AM groups (p > .05). Scleral inflammation was absent in all specimens. No significant differences were noted among all groups in terms of conjunctival vascularity, conjunctival inflammation, or muscle fibrosis (p > .05). CONCLUSIONS All AM orientations were equally effective in preventing the development of postoperative adhesions between the extraocular muscle and surrounding tissues.
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Amniotic membrane use for management of corneal limbal stem cell deficiency. Curr Opin Ophthalmol 2017; 28:363-369. [DOI: 10.1097/icu.0000000000000386] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Limbal conjunctival versus amniotic membrane in the intraoperative application of mitomycin C for recurrent pterygium: a randomized controlled trial. Graefes Arch Clin Exp Ophthalmol 2016; 255:375-385. [PMID: 27761704 DOI: 10.1007/s00417-016-3509-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/25/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE This study compared the outcomes of a limbal conjunctival autograft (LCAG) with those of an amniotic membrane graft (AMG) followed by intraoperative 0.02 % mitomycin C (MMC) to treat recurrent pterygium. METHODS In this randomized controlled trial, ninety-six eyes with recurrent pterygium were enrolled and randomly allocated into two groups using a computer-generated random number table. Pterygium removal was followed by intraoperative 0.02 % MMC for 3 min and then either LCAG or AMG transplantation. The major outcomes were recurrence rate, conjunctival inflammation grade, healing time of the corneal epithelial defect, eye-movement amplitude (EMA), uncorrected distance visual acuity (UDVA), and complications. RESULTS A follow-up of 12 months was conducted for 93 eyes of 82 patients. Grade D (recurrence) presented in one eye of the LCAG group and five eyes of the AMG group, with no between-group difference (p = 0.196). However, Grades A, B, and C presented in 46, zero and zero eyes of the LCAG group respectively, and in 37, two and two eyes of the AMG group respectively, with the surgical bed generally showing a better appearance in the LCAG group than in the AMG group (p = 0.008). Compared with baseline values, the postoperative EMA improved significantly in both groups (p < 0.001 for the LCAG group; p = 0.001 for the AMG group), as did UDVA (p = 0.005 for the LCAG group; p = 0.012 for the AMG group). No between-group differences were found in terms of the healing time for epithelial defect, conjunctival inflammation grade, or the frequency of complications such as punctate epithelial keratitis, episcleral melting, corneal pannus, and delayed corneal epithelium healing. CONCLUSIONS LCAG transplantation with intraoperative 0.02 % MMC is as efficacious in treating recurrent pterygium as AMG transplantation with MMC. The former procedure results in an attractive cosmetic appearance but might result in limbal damage in some eyes. The surgeon's familiarity with these procedures should determine the method of treatment.
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DiDomenico LA, Orgill DP, Galiano RD, Serena TE, Carter MJ, Kaufman JP, Young NJ, Zelen CM. Aseptically Processed Placental Membrane Improves Healing of Diabetic Foot Ulcerations: Prospective, Randomized Clinical Trial. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1095. [PMID: 27826487 PMCID: PMC5096542 DOI: 10.1097/gox.0000000000001095] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 08/31/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allogeneic grafts derived from amnion/chorion are known to be efficacious in healing chronic diabetic foot ulcerations (DFUs). The goal of this study was to compare aseptically processed dehydrated human amnion and chorion allograft (dHACA) versus standard of care (SOC) in facilitating wound closure in nonhealing DFUs. METHODS Patients with DFUs treated with SOC (off-loading, appropriate debridement, and moist wound care) after a 2-week screening period were randomized to either SOC or wound-size-specific dHACA (AmnioBand, Musculoskeletal Transplant Foundation, Edison, N.J.) applied weekly for up to 12 weeks plus SOC. Primary endpoint was the percentage of wounds healed at 6 weeks between groups. RESULTS At 6 weeks, 70% (14/20) of the dHACA-treated DFUs healed compared with 15% (3/20) treated with SOC alone. Furthermore, at 12 weeks, 85% (17/20) of the DFUs in the dHACA group healed compared with 25% (5/20) in the SOC group, with a corresponding mean time to heal of 36 and 70 days, respectively. At 12 weeks, the mean number of grafts used per healed wound for the dHACA group was 3.8 (median 3.0), and mean cost of the tissue to heal a DFU was $1400. The mean wastage at 12 weeks was 40%. One adverse event and 1 serious adverse event occurred in the dHACA group; neither was graft related. Three adverse events and 1 serious adverse event occurred in the SOC group. CONCLUSION Aseptically processed dHACA heals diabetic foot wounds significantly faster than SOC at 6 and 12 weeks with minimal graft wastage.
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Affiliation(s)
- Lawrence A. DiDomenico
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Dennis P. Orgill
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Robert D. Galiano
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Thomas E. Serena
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Marissa J. Carter
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Jarrod P. Kaufman
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Nathan J. Young
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Charles M. Zelen
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
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Vlasov A, Sia RK, Ryan DS, Mines MJ, Stutzman RD, Rivers BA, Tseng SC, Bower KS. Sutureless cryopreserved amniotic membrane graft and wound healing after photorefractive keratectomy. J Cataract Refract Surg 2016; 42:435-43. [DOI: 10.1016/j.jcrs.2015.11.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 11/27/2015] [Indexed: 11/25/2022]
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Kohanim S, Palioura S, Saeed HN, Akpek EK, Amescua G, Basu S, Blomquist PH, Bouchard CS, Dart JK, Gai X, Gomes JAP, Gregory DG, Iyer G, Jacobs DS, Johnson AJ, Kinoshita S, Mantagos IS, Mehta JS, Perez VL, Pflugfelder SC, Sangwan VS, Sippel KC, Sotozono C, Srinivasan B, Tan DTH, Tandon R, Tseng SCG, Ueta M, Chodosh J. Acute and Chronic Ophthalmic Involvement in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis - A Comprehensive Review and Guide to Therapy. II. Ophthalmic Disease. Ocul Surf 2016; 14:168-88. [PMID: 26882981 DOI: 10.1016/j.jtos.2016.02.001] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 02/03/2016] [Accepted: 02/03/2016] [Indexed: 02/07/2023]
Abstract
Our purpose is to comprehensively review the state of the art with regard to Stevens- Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), with particular attention to improving the management of associated ocular surface complications. SJS and TEN are two ends of a spectrum of immune-mediated disease, characterized in the acute phase by a febrile illness followed by skin and mucous membrane necrosis and detachment. Part I of this review focused on the systemic aspects of SJS/TEN and was published in the January 2016 issue of this journal. The purpose of Part II is to summarize the ocular manifestations and their management through all phases of SJS/TEN, from acute to chronic. We hope this effort will assist ophthalmologists in their management of SJS/TEN, so that patients with this complex and debilitating disease receive the best possible care and experience the most optimal outcomes in their vision and quality of life.
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Affiliation(s)
- Sahar Kohanim
- Vanderbilt Eye Institute, Vanderbilt University School of Medicine, USA
| | - Sotiria Palioura
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, USA
| | - Hajirah N Saeed
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, USA
| | - Esen K Akpek
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, USA
| | - Guillermo Amescua
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, USA
| | | | | | | | - John K Dart
- Moorfields Eye Hospital, NHS Foundation Trust, UK
| | - Xiaowu Gai
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, USA
| | | | - Darren G Gregory
- Rocky Mountain Lions Eye Institute, University of Colorado School of Medicine, USA
| | - Geetha Iyer
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Sankara Nethralaya, India
| | - Deborah S Jacobs
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, USA; Boston Foundation for Sight, USA
| | | | | | | | - Jodhbir S Mehta
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Victor L Perez
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, USA
| | | | | | | | | | - Bhaskar Srinivasan
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Sankara Nethralaya, India
| | - Donald T H Tan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Radhika Tandon
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, India
| | - Scheffer C G Tseng
- Ocular Surface Center, Ocular Surface Research & Education Foundation, USA
| | - Mayumi Ueta
- Kyoto Prefectural University of Medicine, Japan
| | - James Chodosh
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, USA.
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Tok OY, Tok L, Atay IM, Argun TC, Demirci N, Gunes A. Toxic keratopathy associated with abuse of topical anesthetics and amniotic membrane transplantation for treatment. Int J Ophthalmol 2015; 8:938-44. [PMID: 26558205 DOI: 10.3980/j.issn.2222-3959.2015.05.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/11/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT). METHODS Fifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination. RESULTS All patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco. CONCLUSION AMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.
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Affiliation(s)
- Ozlem Yalcin Tok
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Levent Tok
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Inci Meltem Atay
- Department of Psychiatry, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Tugba Cakmak Argun
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Nazire Demirci
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Alime Gunes
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
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Vasania VS, Hari A, Tandon R, Shah S, Haldipurkar S, Shah S, Sachan S, Viswanathan C. Transplantation of Autologous Ex Vivo Expanded Human Conjunctival Epithelial Cells for Treatment of Pterygia: A Prospective Open-label Single Arm Multicentric Clinical Trial. J Ophthalmic Vis Res 2015; 9:407-16. [PMID: 25709763 PMCID: PMC4329698 DOI: 10.4103/2008-322x.150800] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 10/12/2013] [Indexed: 11/04/2022] Open
Abstract
Purpose: To establish the efficacy and safety of ex vivo cultured autologous human conjunctival epithelial cell (hCjEC) transplantation for treatment of pterygia. Methods: Twenty-five patients with pterygia were recruited at different centers across the country. Autologous hCjEC grafts were prepared from conjunctival biopsy specimens excised from the healthy eye and cultured ex vivo on human amniotic membrane mounted on inserts using a unique mounting device. The hCjEC grafts were then transported in an in-house designed transport container for transplantation. Post-surgery, the patients were followed up on days 1, 7, 14, 30, 90, and 180 as per the approved study protocol. Clinical outcomes were assessed by slit lamp examination, visual acuity, imprint cytology, fluorescein/rose bengal staining, Schirmer's test, and photographic evaluation three and 6 months post-transplantation. Results: Two patients were lost to follow-up and final analysis included 23 cases. No recurrence of pterygium was observed in 18 (78.3%) patients; all of these eyes showed a smooth conjunctival surface without epithelial defects. Recurrence was observed in 5 (21.7%) patients at 3 months post-treatment. No conjunctival inflammation, secondary infections or other complications were reported. Adequate goblet cells were present in 19 (82.6%) patients at the site of transplantation. Conclusion: We have, for the 1st time, standardized a protocol for preparing autologous hCjEC grafts that can be safely transported to multiple centers across the country for transplantation. The clinical outcome was satisfactory for treating pterygia.
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Affiliation(s)
- Viraf Sam Vasania
- Regenerative Medicine Group, Reliance Life Sciences Pvt. Ltd., Navi Mumbai, Maharashtra, India
| | - Aarya Hari
- Regenerative Medicine Group, Reliance Life Sciences Pvt. Ltd., Navi Mumbai, Maharashtra, India
| | - Radhika Tandon
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Shah
- Department of Ophthalmology, King Edward Memorial Hospital, Pune, Maharashtra, India
| | | | - Smitesh Shah
- Dr. Shah's Laser Eye Institute, Kalyan West, Thane, Maharashtra, India
| | - Shailendra Sachan
- Regenerative Medicine Group, Reliance Life Sciences Pvt. Ltd., Navi Mumbai, Maharashtra, India
| | - Chandra Viswanathan
- Regenerative Medicine Group, Reliance Life Sciences Pvt. Ltd., Navi Mumbai, Maharashtra, India
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Hu F, Zeng XY, Xie ZL, Liu LL, Huang L. Clinical outcomes of amniotic membrane loaded with 5-FU PLGA nanoparticles in experimental trabeculectomy. Int J Ophthalmol 2015; 8:29-34. [PMID: 25709903 DOI: 10.3980/j.issn.2222-3959.2015.01.05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 12/03/2014] [Indexed: 09/26/2022] Open
Abstract
AIM To evaluate the effect of amniotic membrane loaded with 5-fluorouracil poly (lactic-co-glycolic acid) (PLGA) nanoparticles (5-FU-NPs) in the surgical outcomes of experimental trabeculectomy in rabbits. METHODS Thirty-two New Zealand white rabbits were randomly categorized into four groups with 8 rabbits in each group. Group 1, the control group, performed traditional trabeculectomy without adjuvant treatment. While the experimental groups performed compound trabeculectomy with different implantations including amniotic membrane (group 2), 5-FU-NPs (group 3) and amniotic membrane loaded with 5-FU-NPs (group 4). Clinical evaluations including IOP measurement and filtration bleb analysis were performed in all groups postoperatively. RESULTS There is no significant difference of mean IOP in all groups at first 7d after surgery. While at P14, mean IOPs of experimental group 2 (9.8±2.1 mm Hg), groups 3 (8.9±2.8 mm Hg) and group 4 (7.6±2.3 mm Hg) were significantly reduced compared to control group (12.4±2.6 mm Hg; n=8, P<0.05). At P21, mean IOPs of groups 3 (11.7±3.2 mm Hg) and group 4 (9.9±1.6 mm Hg) were significantly decreased compare to control group (17.9±1.6 mm Hg) and group 2 (16.6±2.8 mm Hg; n=8, P<0.05). At P28, mean IOPs of groups 3 (13.8±3.3 mm Hg) and group 4 (10.6±2.0 mm Hg) were also significantly reduced compare to control group (19.4±2.3 mm Hg) and group 2 (18.5±2.4 mm Hg; n=8, P<0.05). Meanwhile mean IOP of group 4 is significantly decreased compared to group 3 at P28 (n=8, P<0.05). Survival analysis of functional filtration blub in all groups revealed the longest survival time in group 4 (24.9±5.1d) compared to that in group 3 (20.6±4.3d), group 2 (15.0±5.2d) and control group (10.1±5.7d). CONCLUSION Amniotic membrane loaded with 5-Fu-NPs may function as an effective anti-scarring implant and provides improved long-term surgical outcomes for experimental trabeculectomy in rabbits.
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Affiliation(s)
- Fang Hu
- Department of Ophthalmology, the First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Xiang-Yun Zeng
- Department of Ophthalmology, the First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Zhao-Lian Xie
- Department of Ophthalmology, the First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Lin-Lin Liu
- Department of Ophthalmology, the First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Liang Huang
- Department of Ophthalmology, the First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
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Siu GDJY, Young AL, Cheng LL. Long-term symptomatic relief of bullous keratopathy with amniotic membrane transplant. Int Ophthalmol 2015; 35:777-83. [PMID: 25586624 DOI: 10.1007/s10792-015-0038-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/04/2015] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to assess the long-term outcome of patients with symptomatic bullous keratopathy after amniotic membrane transplant. A retrospective cohort study includes that 20 patients with symptomatic bullous keratopathy, who have underwent amniotic membrane transplant at the Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Hospital, Hong Kong between 04/1998 and 06/2011, were invited back. Clinical examination was performed, including, pain score assessment (pain score out of 10), epithelial healing, and vision. A total of 21 eyes of 20 patients returned for our study. The majority of eyes experienced pain reduction (94 %), with a significant mean pain score difference of 6.8 ± 2.6, 2-tail p < 0.001 (99 % CI 4.9-8.7). The mean pre-operative and post-operative pain scores were 7.3 ± 2.9 and 0.5 ± 1.0, respectively. 16 eyes (76 %) were completely pain free, and 10 eyes (47 %) remained symptom free after a mean follow-up of 39.0 ± 36.3 months (range 5-171 months). The median epithelial healing time was 2 weeks (range 1-20 weeks). Amniotic membrane transplant may be considered as a longer-term treatment for bullous keratopathy patients, especially in patients with poorer visual prognosis, but it may also be used as an interim measure for patients awaiting corneal transplant.
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Affiliation(s)
- Gillian D J Y Siu
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Hospital, Shatin, Hong Kong SAR
| | - Alvin L Young
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Hospital, Shatin, Hong Kong SAR.
| | - Lulu L Cheng
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Hospital, Shatin, Hong Kong SAR
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Li YH, Cheng CY, Wang NK, Tan HY, Tsai YJ, Hsiao CH, Ma DHK, Yeh LK. Characterization of the modified chitosan membrane cross-linked with genipin for the cultured corneal epithelial cells. Colloids Surf B Biointerfaces 2014; 126:237-44. [PMID: 25576808 DOI: 10.1016/j.colsurfb.2014.12.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/13/2014] [Accepted: 12/16/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To modify a chitosan membrane (CM) by cross-linking the chitosan with genipin, a naturally occurring cross-linker extracted from Gardenia jasminoides fructus, with the aim of developing a new cell culture support and to observe the phenotypes of cultured human corneal epithelial cells (HCECs) on genipin-cross-linked chitosan membrane (GCM). METHODS We tested the cross-linking characteristics and mechanical strength of the GCM. CMs modified by cross-linking with different concentrations of genipin were prepared to investigate the rate of membrane degradation. The biocompatibility of the GCMs was investigated by determining the viability of HCECs cultured on them in vitro. The morphology of the HCECs cultured on CM or GCM was analyzed by confocal microscopy and scanning electron microscopy (SEM). Immunocytochemical staining was conducted to determine the phenotypes of the cultured cells. RESULTS The fixation index of the GCM was 31 ± 3% after treatment of CM with 0.5mM genipin. A stress-strain test showed that the GCM could tolerate three times the mechanical force of noncross-linked CM. The biodegradation rate of GCM was much slower than for CM. A 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay showed that cell viability was not affected by cross-linking with 5.0mM genipin. SEM showed that the cultured HCECs adhered to and grew well on the surface of the GCM. Immunocytochemical staining showed keratin 3 (K3) and connexin 43 (Cx-43) immunoreactive HCECs on the GCM and their proliferative ability was not significantly affected by strong immunoreactivity of Ki-67 and p63 markers. CONCLUSIONS GCM has potential as a scaffold for corneal epithelium in ocular surface surgery and greater mechanical strength and slower degradation than unmodified CM.
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Affiliation(s)
- Ya-Han Li
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Yi Cheng
- Department of Cosmetic Science, Graduate Institute of Health Industry Technology, Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Kwei-Shan, Tao-Yuan, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan; Chang-Gung University College of Medicine, Taiwan
| | - Hsin-Yuan Tan
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan; Chang-Gung University College of Medicine, Taiwan
| | - Yueh-Ju Tsai
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan; Chang-Gung University College of Medicine, Taiwan
| | - Ching-Hsi Hsiao
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan; Chang-Gung University College of Medicine, Taiwan
| | - David Hui-Kang Ma
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan; Chang-Gung University College of Medicine, Taiwan
| | - Lung-Kun Yeh
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan; Chang-Gung University College of Medicine, Taiwan.
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Nguyen P, Rue K, Heur M, Yiu SC. Ocular surface rehabilitation: Application of human amniotic membrane in high-risk penetrating keratoplasties. Saudi J Ophthalmol 2014; 28:198-202. [PMID: 25278797 DOI: 10.1016/j.sjopt.2014.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/01/2014] [Accepted: 06/15/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Human amniotic membrane is a versatile tool for management of ocular surface disorders. This study evaluates the effect of cryopreserved human amniotic membrane (hAM) on one-year survival of penetrating keratoplasties (PKP) in high-risk recipients. METHOD This is a retrospective noncomparative cohort study of 58 consecutive eyes undergoing PKP with concurrent placement of a self-retained cryopreserved hAM (PROKERA®) at a tertiary care center from January 2009 to July 2010. RESULTS Mean patient age was 66.7 ± 17.2 years and 30 (54%) were males. 51 eyes were pseudophakic and one aphakic. 27 eyes were glaucomatous; 24 had glaucoma drainage device and 2 had previous endocyclophotocoagulation. 12 patients had PKP for the first time and 46 had repeat PKP (average number of prior PKP = 1.63 ± 1.1, range: 1-5). Risk factors for graft failure included repeat PKP (79.3%), corneal neovascularization (51.7%), preexisting glaucoma (46.6%), and presence of anterior synechiae (37.9%). Both First Transplant and Repeat Transplant groups had similar survival rates until 6 months after transplant (75% vs 74%, odds ratio = 1.06, p = 1.00). At 12 months, First Transplant group showed a better survival rate (67% vs 43%, odds ratio = 2.60, p = 0.20). Eyes with >3 risk factors had a higher graft failure rate (odds ratio = 5.81, p = 0.003). CONCLUSION Survey of the literature suggests that high-risk PKP with concurrent hAM placement demonstrate comparable graft survival. Presence of multiple risk factors is associated with poor survival.
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Affiliation(s)
- Pho Nguyen
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Kelly Rue
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Martin Heur
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Samuel C Yiu
- Department of Ophthalmology, The Wilmer Eye Institute, The John Hopkins University, Baltimore, MD, USA
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Iravani K, Hashemi SB, Tehrani M, Rashidi M. Amniotic membrane in reconstruction of larynx following chondrosarcoma resection: a case report. Am J Otolaryngol 2014; 35:520-3. [PMID: 24746631 DOI: 10.1016/j.amjoto.2014.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 03/17/2014] [Indexed: 11/18/2022]
Abstract
Chondrosarcomas of the larynx are rare malignancies and frequently located in cricoid cartilage. They are characterized by a low tendency to metastasis (low grade type). The treatment of choice is surgery, which may be endoscopic or open partial surgery, if extension of the cancer is limited. Prognosis is generally good. In this report, a case of low grade chondrosarcoma of the larynx is presented, which was treated surgically with a combined use of amniotic membrane and stent in airway reconstruction following laryngofissure approach for resection of the tumor.
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Affiliation(s)
- Kamyar Iravani
- Department of otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Basir Hashemi
- Department of otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maryam Tehrani
- Department of otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohsen Rashidi
- Department of otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
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Ferrari S, Barbaro V, Di Iorio E, Fasolo A, Ponzin D. Advances in corneal surgery and cell therapy: challenges and perspectives for eye banks. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.09.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Liu J, Sheha H, Fu Y, Liang L, Tseng SC. Update on amniotic membrane transplantation. EXPERT REVIEW OF OPHTHALMOLOGY 2014; 5:645-661. [PMID: 21436959 DOI: 10.1586/eop.10.63] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cryopreserved amniotic membrane modulates adult wound healing by promoting epithelialization while suppressing stromal inflammation, angiogenesis and scarring. Such clinical efficacies of amniotic membrane transplantation have been reported in several hundred publications for a wide spectrum of ophthalmic indications. The success of the aforementioned therapeutic actions prompts investigators to use amniotic membrane as a surrogate niche to achieve ex vivo expansion of ocular surface epithelial progenitor cells. Further investigation into the molecular mechanism whereby amniotic membrane exerts its actions will undoubtedly reveal additional applications in the burgeoning field of regenerative medicine. This article will focus on recent advances in amniotic membrane transplantation and expand to cover its clinical uses beyond the ocular surface.
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Affiliation(s)
- Jingbo Liu
- Ocular Surface Center, 7000 SW, 97 Avenue, Suite 213, Miami, FL 33173, USA
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Alió JL, Abad M, Scorsetti DH. Preparation, indications and results of human amniotic membrane transplantation for ocular surface disorders. Expert Rev Med Devices 2014; 2:153-60. [PMID: 16293052 DOI: 10.1586/17434440.2.2.153] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In comparison with other biologic tissues used as reconstructive grafts, the amniotic membrane has the advantage that it is thinner and better tolerated by the patient. Amniotic membrane, when appropriately preserved, can be used as a substrate replacement, such that host cells can migrate into the membrane to form new and healthy tissue. The amniotic membrane is the deeper layer of the fetal membrane; it is avascular, multilayered tissue with antiangiogenic, antiscarring and anti-inflammatory properties. Since it does not express antigens of histocompatibility, the membrane is never rejected by the receiving tissues. In addition, the beneficial effects of reducing inflammation and neovascularization persist for a long time, if properly cryopreserved.
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Affiliation(s)
- Jorge L Alió
- Vissum, Instituto Oftalmológico de Alicante, Research, Development and Innovation Department, Miguel Hernandez University, Alicante, Spain.
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Cirman T, Beltram M, Schollmayer P, Rožman P, Kreft ME. Amniotic membrane properties and current practice of amniotic membrane use in ophthalmology in Slovenia. Cell Tissue Bank 2013; 15:177-92. [PMID: 24352631 DOI: 10.1007/s10561-013-9417-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 12/12/2013] [Indexed: 01/01/2023]
Abstract
Amniotic membrane (AM) is the innermost, multilayered part of the placenta. When harvested, processed and stored properly, its properties, stemming from AM biological composition, make it a useful tissue for ophthalmic surgery. AM was shown to have several beneficial effects: it promotes epithelization, has antimicrobial effects, decreases inflammation, fibrosis and neovascularization. Many case reports and case series as well as practical experience (e.g. reconstruction of conjunctival and corneal defects, treatment of corneal ulcers) demonstrated the beneficial effect of AM for different ophthalmological indications. The combination of the above mentioned beneficial effects and reasonable mechanical properties are also the reason why AM is used as a substrate for ex vivo expansion of epithelial progenitor cells. Recently, amnion-derived cells, which also have stem cell characteristics, have been proposed as potential contributors to cell-based treatment of ocular surface disease. However, the use of AM remains one of the least standardized methods in ophthalmic surgery. In this review, the various properties of AM and its current clinical use in ophthalmology in Slovenia are discussed.
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Affiliation(s)
- Tina Cirman
- Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
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Molecular and biochemical expression of TLRs in human amniotic membrane: a comparative study of fresh and cryopreserved specimens. Graefes Arch Clin Exp Ophthalmol 2013; 252:267-74. [DOI: 10.1007/s00417-013-2540-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 11/04/2013] [Accepted: 11/20/2013] [Indexed: 01/21/2023] Open
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Kassem RR, Khodeir MM, Salem M, Abdel-Hamid MA, El-Mofty RMAM, Kamal AM, Elhilali HM. Effect of cryopreserved amniotic membrane on the development of adhesions and fibrosis after extraocular muscle surgery in rabbits. Acta Ophthalmol 2013; 91:e140-8. [PMID: 23356348 DOI: 10.1111/j.1755-3768.2012.02563.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To histopathologically evaluate the effect of cryopreserved human amniotic membrane (AM) transplant on preventing the development of postoperative adhesions after extraocular muscle surgery. METHODS Ten albino rabbits were used. The superior rectus muscles were bilaterally resected. In right eyes, the muscle was wrapped with cryopreserved human AM (group AM). In left eyes, the muscle was not wrapped with AM and served as a control group (group C). The rabbits were killed, and the eyes were enucleated 6 weeks after surgery to perform histopathological examination. RESULTS On histopathological examination, the AM was present in eight eyes, surrounded by periamniotic inflammation, with no adhesions detected between rectus muscle and sclera, conjunctiva and Tenon's capsule in the segment where the AM was present, but detected elsewhere. Adhesions were detected in the other two eyes of group AM, in which the AM was absent, and in all group C eyes. When comparing eye pairs of each rabbit, AM eyes showed significantly less adhesions between the muscle and sclera (p = 0.009) and between the muscle and Tenon's capsule and conjunctiva (p = 0.008), in the region of AM application, and significantly more foreign body inflammation (p = 0.031), than C eyes. The differences between AM and C eye pairs, in terms of conjunctival inflammation and vascularity and muscle fibrosis, were insignificant (p > 0.05). CONCLUSIONS Cryopreserved AM is effective in reducing postoperative extraocular muscle adhesions. Its application is, therefore, recommended during strabismus reoperations.
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Affiliation(s)
- Rehab R Kassem
- Ophthalmology Department, Cairo University, Egypt Pathology Department, Cairo University, Egypt.
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Ricci E, Vanosi G, Lindenmair A, Hennerbichler S, Peterbauer-Scherb A, Wolbank S, Cargnoni A, Signoroni PB, Campagnol M, Gabriel C, Redl H, Parolini O. Anti-fibrotic effects of fresh and cryopreserved human amniotic membrane in a rat liver fibrosis model. Cell Tissue Bank 2012; 14:475-88. [PMID: 22926336 DOI: 10.1007/s10561-012-9337-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 08/10/2012] [Indexed: 01/31/2023]
Abstract
The human amniotic membrane (hAM), thanks to its favorable properties, including anti-inflammatory, anti-fibrotic and pro-regenerative effects, is a well-known surgical material for many clinical applications, when used both freshly after isolation and after preservation. We have shown previously that hAM patching is a potential approach to counteract liver fibrosis. Indeed, when fresh hAM was used to cover the liver surface of rats with liver fibrosis induced by the bile duct ligation (BDL) procedure, the progression and severity of fibrosis were significantly reduced. Since cryopreservation enables safety and long-term storage of hAM but may influence its functional properties, here we compared the anti-fibrotic effects of fresh and cryopreserved hAM in rats with BDL-induced liver fibrosis. After BDL, the rat liver was covered with a piece of fresh or cryopreserved hAM, or left untreated. Six weeks later, the degree of liver fibrosis was assessed histologically using the Knodell and the METAVIR scoring systems. Digital image analysis was used to quantify the percentage of the areas of each liver section displaying ductular reaction, extracellular matrix (ECM) deposition, activated myofibroblasts and hepatic stellate cells (HSCs). Liver collagen content was also determined by spectrophotometric technique. The degree of liver fibrosis, ductular reaction, ECM deposition, and the number of activated myofibroblasts and HSCs were all significantly reduced in hAM-treated rats compared to control animals. Fresh and cryopreserved hAM produced the same anti-fibrotic effects. These findings indicate that cryopreservation maintains the anti-fibrotic properties of hAM when used as a patch to reduce the severity of liver fibrosis.
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Affiliation(s)
- Emanuele Ricci
- Centro di Ricerca E. Menni, Fondazione Poliambulanza Istituto Ospedaliero, Via Bissolati 57, 25124, Brescia, Italy
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Stevenson W, Cheng SF, Dastjerdi MH, Ferrari G, Dana R. Corneal neovascularization and the utility of topical VEGF inhibition: ranibizumab (Lucentis) vs bevacizumab (Avastin). Ocul Surf 2012; 10:67-83. [PMID: 22482468 DOI: 10.1016/j.jtos.2012.01.005] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 01/10/2012] [Accepted: 01/14/2012] [Indexed: 12/21/2022]
Abstract
Corneal avascularity is necessary for the preservation of optimal vision. The cornea maintains a dynamic balance between pro- and antiangiogenic factors that allows it to remain avascular under normal homeostatic conditions; however, corneal avascularity can be compromised by pathologic conditions that negate the cornea's "angiogenic privilege." The clinical relevance of corneal neovascularization has long been recognized, but management of this condition has been hindered by a lack of safe and effective therapeutic modalities. Herein, the etiology, epidemiology, pathogenesis, and treatment of corneal neovascularization are reviewed. Additionally, the authors' recent findings regarding the clinical utility of topical ranibizumab (Lucentis®) and bevacizumab (Avastin®) in the treatment of corneal neovascularization are summarized. These findings clearly indicate that ranibizumab and bevacizumab are safe and effective treatments for corneal neovascularization when appropriate precautions are observed. Although direct comparisons are not conclusive, the results suggest that ranibizumab may be modestly superior to bevacizumab in terms of both onset of action and degree of efficacy. In order to justify the increased cost of ranibizumab, it will be necessary to demonstrate meaningful treatment superiority in a prospective, randomized, head-to-head comparison study.
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Affiliation(s)
- William Stevenson
- Schepens Eye Research Institute, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
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Abstract
The clinical need for an alternative to donor corneal tissue has encouraged much interest in recent years. An artificial cornea whether it be bio-engineered or a synthetic keratoprosthesis must fulfill the functions of the cornea it replaces: transparent, refractive surface, protection, non-immunogenic. A wide range of implants and biomedical devices have been developed in an attempt to correct corneal blindness. Limitation of existing biomaterials are evident when reviewing keratoprosthesis surgery complications. These include infection, intraocular inflammation, retromembrane formation, inadequate interface seal thus epithelial downgrowth and glaucoma. Attempts to improve healing in such cases have involved using various polymers or tissues to surround the optic. The successes and failures of synthetic prostheses that have been implanted in humans is discussed. More recently, the idea of a bio-engineered cornea has arisen. Tissue-engineering involves the manipulation of cells using in vitro techniques to create a composite tissue, which could then be implanted in vivo. Corneal equivalents have been reconstructed from corneal cell lines. They already have their potential uses in the biomedical world: as replacements for animals in toxicology testing and pharmacological studies, as well as in basic research into cell-cell and cell-matrix interactions of corneal wound healing. Current research is ongoing to determine if the bio-engineered cornea will have a role in corneal transplant surgery.
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Affiliation(s)
- JULIE ALBON
- Department of Optometry and Vision Sciences, Cardiff University, UK
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Kassem RR, Abdel-Hamid MA, Khodeir MM. Effect of lyophilized amniotic membrane on the development of adhesions and fibrosis after extraocular muscle surgery in rabbits. Curr Eye Res 2011; 36:1020-7. [PMID: 21942278 DOI: 10.3109/02713683.2011.601842] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To histopathologically evaluate the influence of lyophilized human amniotic membrane transplant on the development of postoperative adhesions and fibrosis after extraocular muscle surgery. METHODS Ten albino rabbits were used. The superior rectus muscle was resected 4 mm in both eyes. In right eyes, the superior rectus muscle was wrapped with lyophilized (air-dried, freeze-dried) human amniotic membrane (group AM). In left eyes, the superior rectus muscle was not wrapped with amniotic membrane, and served as a control group (group C). The rabbits were sacrificed and the eyes were enucleated 6 weeks after surgery to perform histopathological examination. RESULTS Two rabbits died 1 week after surgery and were excluded. Histopathological evaluation of both eyes of the remaining 8 rabbits was done. The amniotic membrane was not seen in all eyes. On comparing eye pairs of each rabbit, right eyes showed significantly less conjunctival inflammation (p = 0.034), but insignificantly less foreign body inflammation (p = 0.625), adhesions between sclera and muscle (p = 0.206), muscle fibrosis (p = 1.000), and conjunctival hyperemia (p = 0.059) as compared to left eyes. CONCLUSIONS Lyophilized amniotic membrane insignificantly reduces postoperative adhesions and fibrosis, when used to wrap the operated upon extraocular muscles, limiting the benefit of this membrane in strabismus surgery.
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Sha Q, Jiao GY, Cui HB, Jie W, Sun LB, Chen M, Fu SB. Inhibitory effect of biopolymer materials on scar formation following trabeculectomy. Int J Ophthalmol 2011; 4:380-3. [PMID: 22553685 DOI: 10.3980/j.issn.2222-3959.2011.04.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 07/26/2011] [Indexed: 11/02/2022] Open
Abstract
AIM To investigate the inhibitory effects of amniotic membrane, polylactic acid membrane and chitosan membrane on scar formation following trabeculectomy. METHODS A total of 24 New Zealand white rabbits (48 eyes) were randomly divided into 4 groups: amniotic membrane group, polylactic acid membrane group, chitosan membrane group, and control group, with 6 rabbits (12 eyes) in each group. The left eyes underwent routine trabeculectomy, and the right eyes were considered as controls. Amniotic membrane, polylactic acid membrane and chitosan membrane were respectively installed under sclera flap in three groups, but any treatment was not applied in control group. Intraocular pressure, conjunctival filtering bleb, and anterior chamber inflammation responses were monitored at day 1, 3, 7, 14, 28 and 56 post-operatively. Eyeball tissue underwent histopathological examination at day 56 post-operatively. RESULTS Fibrocytes and inflammatory cells were reduced in amniotic membrane, polylactic acid membrane and chitosan membrane groups compared to that in control group. At day 1 post-operatively, intraocular pressure was decreased in three membrane groups compared to that in control group. At day 14 post-operatively, the intraocular pressure was decreased significantly, while it of three membrane groups was significantly lower than that of preoperative (P<0.01). There were no significant differences among three membrane groups (P>0.05). Filtering bleb of four groups was clearly observed at day 7 post-operatively, but there was no significant difference in pair-wise comparison. At day 28 and 56 post-operatively, filtering bleb in control group was significantly narrowed compared to that in three membrane groups (P<0.05), but there was no significant difference in pair-wise comparison of three membrane groups. CONCLUSION All amniotic membrane, polylactic acid membrane and chitosan membrane can effectively inhibit scar formation following trabeculectomy, the effect of amniotic membrane is the best.
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Affiliation(s)
- Qian Sha
- Eye Disease Prevention Institute, Harbin 150010, Heilongjiang Province, China
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Pessolato AGT, Martins DDS, Ambrósio CE, Mançanares CAF, de Carvalho AF. Propolis and amnion reepithelialise second-degree burns in rats. Burns 2011; 37:1192-201. [PMID: 21741176 DOI: 10.1016/j.burns.2011.05.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Revised: 05/13/2011] [Accepted: 05/24/2011] [Indexed: 10/18/2022]
Abstract
Burns are serious consequences of trauma in terms of both imminent mortality and prolonged periods of morbidity. They are often accompanied by unsatisfactory cosmetic as well as functional and psychological outcomes. These complications emphasise the need for stronger efforts in achieving greater diversity and effectiveness in the treatment of skin burns. This study aimed to verify the effectiveness of gross and microscopic epidermal and dermal responses in the process of regenerative repair or healing of burns in rats that were treated either daily with 5% propolis ointment or by autologous amnion graft. Second-degree burns were inflicted in the neck region of female rats by contact with a hot metal (at 130 °C) for 5 s. Propolis treatment accelerated the process of tissue repair and led to decreased local inflammation, which indicates that treatment with propolis was successful in the initial period (7 days) and stimulated the production of collagen fibre (assessed by morphometry) in all the periods evaluated (14 and 21 days). Amnion treatment inhibited local inflammation (assessed macroscopically), stimulated local epithelial regeneration (assessed microscopically) and stimulated the production of collagen fibre (assessed by morphometry) in the days following burn. These treatments offer new therapeutic strategies for treating severe skin burns; these strategies may allow the minimisation of scar formation, a more rapid return of function and, ultimately, a better quality of life for burn patients.
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Affiliation(s)
- Alicia Greyce Turatti Pessolato
- Faculty of Veterinary Medicine and Animal Science, Department of Surgery, University of São Paulo, São Paulo 05508-270, São Paulo, Brazil.
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