Amnion Research Articles

Mesenchymal stromal cells (MSCs) are currently used in clinical practice as a therapeutic agent for immunomodulation and tissue repair. They are found in all supporting tissues, including perinatal tissues such as umbilical cord and amniotic membranes (amnion and chorion). Perinatal tissues have attracted interest due to their availability, minimal ethical and legal concerns, and high banking potential for allogeneic applications. Many studies have compared the efficacy of MSCs from different sources, without reaching a consensus on the most effective to use in a given clinical situation. This study compared the transcriptomic signatures of MSCs derived from adult bone marrow (BM-MSCs)-the reference source most widely used in clinical trials-with those of perinatal MSCs (P-MSCs). Our data were analyzed jointly with three independent transcriptome datasets. Unsupervised principal component analysis revealed a major stratification according to tissue origin, accounting for 16.6% of the total transcriptomic variance, without any detectable bias from batch effects or cell culture procedures. Supervised differential expressed gene analysis between BM and perinatal samples revealed 819 genes presenting differential expression. Gene Set Enrichment Analysis highlighted that adult BM-MSCs are implicated in adipogenesis and osteoblast differentiation, whereas P-MSCs upregulated gene sets implicated in cell cycle regulation, functions classically described in the literature. Among the different sources of variability, we showed that perinatal tissues have a strongly distinct transcriptional signature compared with adult BM, independent of the production center or the culture conditions used. The in-depth study of transcript profiles therefore seems to remain a valuable and robust characterization tool for cell therapy banking.

Aim This study aims to comprehensively analyse the developmental progress of bone graft materials and barrier membranes in the field of oral-maxillofacial bone regeneration, with a particular emphasis on emerging therapeutic approaches for bone regeneration. Materials and methods This study systematically searched 16 clinical trial registries using key terms such as “bone regeneration” and “osteoconduction” to identify relevant trials. The retrieved studies were then categorized and analysed on the basis of registration year, research phase, material/drug classification, and geographical distribution. Results In the field of bone graft materials and barrier membranes, clinical trials involving synthetic bone graft materials ( N = 90) and xenogeneic bone graft materials ( N = 67) have been the most common. In the category of barrier membranes, collagen membranes still dominate ( N = 53), whereas other natural membranes, such as amniotic and chorionic membranes, are in clinical trials. Resorbable polyester membranes ( N = 24), titanium mesh ( N = 13) and nonresorbable polytetrafluoroethylene membranes ( N = 11) are commonly studied barrier membranes. Platelet-rich fibrin (PRF) ( N = 71) is the most frequently used type of bioactive adjuvant. Some trials have explored the synergistic effects of statins ( N = 17) and plant-derived active extracts ( N = 16). Conclusion Research on bone regeneration is undergoing a paradigm shift from the conventional “bone graft + barrier membrane” approach to integrated multicomponent strategies. These advanced strategies combine tunable biodegradable scaffolds, growth factors, and small-molecule drugs to achieve personalized and cost-effective bone defect repair. Future research priorities will focus on optimizing material degradation kinetics and spatial maintenance properties to enhance clinical outcomes.

Comparative evaluation of the mechanical properties of amniotic membranes for corneal grafting: Effects of cryopreservation, lyophilization, and dehydration.

Introduction: Gastroschisis, a congenital abdominal wall defect, causes external protrusion of intestines and organs due to incomplete wall closure near the umbilicus. Accurate prenatal diagnosis through ultrasonography requires skilled operators to detect the defect and guide management. Early identification enables perinatal care planning to minimize complications, such as organ perforation, and optimize neonatal outcomes. This case report examines the prenatal diagnosis and management of gastroschisis in a primigravida, highlighting ultrasonography's role in clinical decision-making. Case Description: A 26-year-old primigravida at 34–35 weeks gestation was referred from Zubir Mahmud Regional Hospital with a prenatal diagnosis of gastroschisis. She reported severe abdominal pain and vaginal spotting for three weeks. Physical examination indicated stable hemodynamics, with obstetric findings including a fundal height of 26 cm, estimated fetal weight of 2015 g, left-sided fetal back, fetal heart rate of 142 beats/min, breech presentation, and no contractions. Speculum examination revealed a closed external cervical os, no dilation, negative fluxus, positive flour, protruding amniotic membranes, and a positive nitrazine test. Vaginal examination showed a posterior, soft cervix with no dilation or palpable fetal parts. The pregnancy was diagnosed with congenital gastroschisis, and a cesarean section was planned to prevent abdominal organ perforation. Conclusion: Gastroschisis, identified at 34–35 weeks gestation, necessitates early prenatal diagnosis to prepare for appropriate perinatal care. Cesarean delivery is a preferred strategy to reduce risks of organ damage, supporting improved neonatal outcomes in affected pregnancies.

Defective wounds pose health risks, and treatment is challenging. Umbilical cord-derived mesenchymal stem cells (UCMSCs) show promise for healing. Primary UCMSCs were isolated and extracted invitro, and the proliferation and differentiation characteristics were detected by flow cytometry and trilineage differentiation, and a 3D spherical cell culture was performed. The human amniotic membranes (HAMs) were decellularized, and two-dimensional suspension cells and 3D spheroids were compounded onto the decellularized HAMs (dHAMs) to make biological dressings, and the cytocompatibility of the bio-scaffold was detected invitro. A rat model evaluated wound healing with 3D-UCMSCs-dHAM, measuring changes and conducting biopsies. 3D-UCMSCs can be tightly attached to the basal layer of dHAMs and form protein adhesions with fiber scaffolds to create good biological dressings. In rat animal experiments, histopathological examination confirmed that the healing quality of the biological dressing treatment group was higher; infiltrating fibroblasts were present in the dermis, neovascularization occurred, inflammatory infiltration was reduced, myofibroblast proliferation was reduced, collagen matrix production was reduced, and epidermal regeneration was complete. The biological dressing of 3D-UCMSCs-dHAM on the full-thickness defect wound of rats accelerates the remodeling and maturation of tissues, promotes the generation of neovascularization and the regeneration of skin attachments, and provides a new way for the treatment of 3D-UCMSCs in skin wounds in the future.

Chronic ocular surface pain (COSP) is defined as ocular pain that is perceived to originate from the ocular surface and persists for more than 3 months. Clear epidemiological data on COSP prevalence are lacking. In 2025, a total of 100 eye care providers were surveyed, including 50 optometrists and 50 ophthalmologists. The survey aimed to assess the percentage of their weekly patient volume diagnosed with COSP, the diagnostic methods used, contributing etiologies, and current management strategies. Additionally, practitioners identified key indicators of successful treatment and attributes they believed would have the greatest impact on patient outcomes. Lastly, they rated their satisfaction with current therapeutic options. An estimated 33% of optometrists' patients and 29% of ophthalmologists' patients had COSP. Of those diagnosed with dry eye disease (DED), 63% also had COSP. Providers managed COSP with over-the-counter (OTC) artificial tears (97% of respondents), OTC gels and ointments (90%), hot compresses (86%), and prescription therapies indicated for DED (30-88%), while a minority routinely used amniotic membranes (37%), serum tears (26%), intense pulsed light (18%), and LipiFlow (16%). The proportions of providers who were satisfied or very satisfied with these therapies were as follows: 64% for amniotic membranes and serum tears, 63% for device-based therapies, 40% for prescription medications, and 21% for OTC drops, ointments, and hot compresses. This survey provides initial insight into the prevalence of COSP among patients in US eye care clinics, along with perspectives on managing this condition from both optometrists and ophthalmologists. The most common therapeutic strategies for COSP (OTC artificial tears, gels, and ointments) were associated with the lowest levels of provider satisfaction. COSP and dry eye disease are distinct but closely linked conditions. These results demonstrate an unmet need for new treatment options to address COSP.

Maternal outcomes among women with intellectual disabilities in comparison with the general population (IDcare)

This study aimed to evaluate the long-term structural integrity, sterility, and bioactivity of air-dried human amniotic membranes (AD-hAM) sterilized with gamma radiation after storage for one and two years. hAM were obtained following elective cesarean delivery under sterile conditions, processed using standardized air-drying protocols, and sterilized with gamma radiation at 15, 20, or 25 kGy. Histological examination showed preservation of the stromal matrix, despite partial epithelial detachment and reduced cell density after air-drying compared with frozen hAM (F-hAM). Bioburden testing confirmed the absence of microbial contamination before and after gamma irradiation and after one year of storage at 4°C. Microbial impermeability assays further demonstrated that irradiated membranes remained effective barriers against several bacterial types even after two years of storage at 4°C. Total protein content and levels of basic fibroblast growth factor and transforming growth factor-beta declined significantly in a dose-dependent manner (p < 0.05) following air-drying and irradiation. Despite this decline, key structural features and barrier function were preserved. These findings validate air-drying combined with gamma sterilization as an effective method for producing sterile, shelf-stable hAM grafts with preserved mechanical integrity, supporting their use as safe biological dressings. However, the observed reduction in protein and cytokine content highlights the need to balance sterilization efficacy with bioactivity preservation.

Background: Mesenchymal stem cells (MSCs) are adult stem cell types. When examined by phase contrast microscopy, they appear spindle-shaped and fibroblast-like cell aggregates. Up to now, MSCs have been isolated from many tissues such as bone marrow, adipose tissue, cartilage, placenta, amniotic membrane and umbilical cord. Our aim in this study was to isolate mesenchymal stem cells from amniotic membrane by explant culture technique easily and without needing a large amount of equipment. Materials and Methods: In the cell culture laboratory, amniotic membranes were dissected into small pieces and explant culture medium was created. Then, flow cytometry analysis was performed at passage 3 (P3) to determine the characterization of proliferating cells. Differentiation experiments were conducted to show the changes in adipogenic, chondogenic and osteogenic direction. Results: In our study, mesenchymal stem cells were isolated from the human amniotic membrane by explant cell culture technique. Flow cytometry analysis showed that the cells expressed mesenchymal stem cell markers (CD73 and CD90) but not hematopoietic stem cell markers (CD34). In differentiation experiments, adipogenic, chondrogenic and osteogenic changes were observed. Conclusions: After the widespread use of mesenchymal stem cells isolated from the umbilical cord as a valuable source of regenerative and reparative medicine, studies on the isolation of mesenchymal stem cells from the amniotic membrane have intensified.

During the LUCS of the operation theatre (OT), the newly collected human amniotic fluid membrane and amniotic fluid of thoroughly examined mothers are used to treat chronic non-healing ulcers, including burns in various body parts. Several scientists have dried chemically and heat-treated human amniotic membranes (dHAM), which are used clinically to close and protect wounds from infection. The newly collected amniotic membranes were also used to treat burns and other non-healing ulcers. The main advantage of this method is that the persistence of cellular components, growth factors, and cytokines is newly collected and remains intact, as they are not artificially processed or dried and are not combined as a biological framework or as a suitable biological bandage for healing wounds and ulcers. Amniotic fluids also contain cellular substances having wound-healing properties. Amniotic membrane and amniotic fluid also have immunomodulatory effects and inhibit inflammatory responses. Pregnancy-specific substances have the potential for future clinical use in regenerative medicine and translation science.

Chronic cervicitis is a clinical syndrome characterized by persistent inflammation of the cervical epithelium. Women with chronic cervicitis often experience symptoms such as vaginal discharge, dyspareunia, post-coital bleeding, and fatigue. The treatment of chronic cervicitis is controversial, particularly in cases where no specific pathogenic agent be identified. Natural wound dressings with human amniotic membranes have been successfully used in tissue healing procedures. Thus, this approach may be a potential therapeutic option for patients suffering from chronic cervicitis. This case series reports on five women diagnosed with chronic cervicitis. These patients had negative Pap smears, human papillomavirus (HPV) typing tests, and colposcopic biopsies, indicating no infections or malignancies. Despite receiving oral antibiotics, their symptoms did not improve, leading to the decision to treat them with amniotic membrane. The cervix was assessed using a speculum, and amniotic membranes manufactured by Sinacell Company were inserted into the affected cervical areas. The patients were instructed to avoid sexual intercourse for one week and continue using oral antibiotics. At the follow-up, all patients significantly improved without any adverse events. Additionally, colposcopic examinations revealed that most patients showed improvement in cervical inflammation and bleeding. The amniotic membrane can assist women with chronic cervicitis by alleviating symptoms and enhancing the healing of cervical ulcers without complications.

METTL3 promotes human amniotic epithelial stem cells differentiation into insulin-producing cells by regulation of MaFA expression.

Considering the increase in cesarean surgeries in recent years and, therefore, the complications related to this type of surgical wound, attention has been drawn to treatment methods such as biological wound dressings. In this case series, the authors describe the treatment of infected cesarean wounds with impaired healing in 4 women. For this aim, human placentas were collected under sterile conditions and amniotic membranes were separated from the placenta. To decrease immunogenic response, the membrane was decellularized using 1% Triton-x-100, 1mmol/L EDTA, and Trypsin 0.05. Then, using glycerol and Dulbecco Modified Eagle Medium, the decellularized amniotic membrane (dAM) was frozen for 3 months at -80 °C. After this period, the dAM was used to dress the wounds of the 4 patients. All patients treated with dAM achieved complete wound healing, indicating that dAM may be an effective treatment method for cesarean section wounds, especially those prone to complications.

Background Corneal perforation is a disaster of ocular morbidity that leads to profound visual loss. Also corneal thinning is one of the important aspects of corneal affection and occurs with the same causes of corneal perforation. Aim To evaluate the combined use of histoacryl and amniotic membrane transplantation for corneal thinning and perforation. Patients and methods This prospective, noncomparative, interventional, and case series was carried out on 30 eyes of 30 patients, aged more than 18 years old, with corneal thinning and perforation 3 mm or less due to various etiology as postinfective keratitis and ocular surface disease, immunological disease, diseases of eyelid causing thinning and perforation such as lagophthalmos. All patients were subjected to amniotic membrane transplantation as a patch over histoacryl only or with another overlay membrane with a stitch with an evaluation of the combined use of histoacryl and amniotic membrane. Results There was a significant difference between the cause and both the site of corneal thinning and/or perforation and pathology. There was a significant difference in the time of vascularization and dislodge of histoacryl after 3 months. There was a significant difference in the time of the absorption of the membrane being delayed according to the causes. There was a significant difference between the causes and resolution of stromal infiltration, procedure, and dislodged of histoacryl after 3 months. There was a significant difference between the visual acuity after 1 month and after 3 months. Conclusion Amniotic membranes and tissue adhesive are very effective tools in the surgical management of corneal thinning and perforation as they promote healing and prevent complications.

Background/Objectives: The amniotic membrane, which is widely available and inexpensive, has received recent attention for its potential applications in wound healing. This is the first study to use a large database to examine the efficacy of amniotic membrane grafting compared to other skin substitutes. Methods: The TriNetX electronic health database was queried in October 2024 for patients with burns or chronic skin ulcers. Patients were stratified by treatment with amniotic membrane grafts or another skin substitute. These patients were then 1:1 propensity score-matched based on age, demographics, and comorbidities. Group differences were assessed with risk ratios and p-values. Results: A total of 557 patients remained in each group after propensity score matching. Patients who were treated with amniotic membrane grafts had significantly decreased hypertrophic scarring (1.7% vs. 6.2%, p < 0.0001), local skin infections (17.4% vs. 29.9%, p < 0.0001), and acute postoperative pain (3.7% vs. 7.8%, p = 0.003). Additionally, subsequent split-thickness skin grafting was utilized significantly less after amniotic membrane grafts. When compared to skin substitutes for large wounds (>100 cm2), the advantages of amniotic membrane were even more pronounced. Conclusions: This multi-institutional study supports amniotic membranes as a viable alternative to conventional bioengineered skin substitutes. Further research should evaluate amniotic membranes in wound beds of different sizes to better characterize their use in preparation for or as an alternative to skin grafting itself.

The antibacterial properties of amniotic membranes are the reason for their wide clinical use. Amniotic membrane soaked in antibiotics can be used in local antibiotic therapy, creating new options for the treatment of infections. The aim of this study was to analyse the inhibiting effect of both human and porcine amniotic membranes soaked in antibiotics on the growth of microorganisms. Human and porcine placentas were collected during natural births, under aseptic conditions. Each amnion was divided into three parts: intravital; cryopreserved; and radio-sterilised. Discs of 8mm in diameter were cut from the amniotic membrane. The discs were incubated in antibiotics (gentamicin, neomycin sulfate and colistin) for three hours and then subjected to microbiological tests to assess the inhibition of bacterial growth. The inhibiting effect on microorganisms-Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae- were examined. The findings of the study showed that porcine amniotic membrane was as effective in carrying antibiotics as human amnion. The ability of cryopreserved or radio-sterilised amniotic membrane to inhibit the growth of microorganisms was not reduced compared to that of fresh amnion. There was a statistically significant difference in the studied groups. The highest growth inhibition efficacy was noted for Escherichia coli, meticilin-sensitive Staphylococcus aureus, Acinetobacter baumannii-sensitive extended-spectrum beta-lactamase. The highest mean zones of growth inhibition were obtained for gentamicin and neomycin sulfate. This study revealed that both human and porcine amniotic membranes can be used in carrying antibiotics. Differently prepared amniotic membrane can be successfully used in microorganism inhibition.

Wound healing is a complex process involving multiple phases aimed at repairing damaged tissues. Disruptions in this process can lead to chronic wounds and infections. Effective treatments that maintain cellular bioactivity while being cost-effective and easy to manufacture and store are needed. The amniotic membrane (AM) is highly biocompatible and rich in bioactive factors, making it valuable for regenerative medicine. Bovine AM is noteworthy for its large size, which facilitates its use in medical settings. However, preserving its bioactivity during storage is a challenge. Therefore, this study aimed to evaluate the effect of bovine lyophilized AM on full-thickness skin wound healing in dogs, compared to that of fresh AM. Bovine AM was collected, lyophilized, and characterized by quantifying growth factors, including vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), as well as collagen, glycosaminoglycans (GAGs), elastin, and DNA. Additionally, the surface morphology was imaged using scanning electron microscopy (SEM). The effects of conditioned media from fresh and lyophilized AM on fibroblast and endothelial cell proliferation were compared. In vivo, three full-thickness skin wounds were created on the back in twelve dogs and treated with saline (control), fresh AM, or lyophilized AM, and monitored for healing over 1, 3, and 5 weeks. The fresh AM contained 57.3 ± 6.21 µg/mg collagen, 5.62 ± 1.1 µg/mg GAGs, 11.6 ± 4.52 µg/mg elastin, and 46.3 ± 12.8 ng/mg DNA, with VEGF and bFGF levels of 5.43 ± 2.485 and 1.97 ± 0.482 ng/mg, respectively. The lyophilized AM contained 217.74 ± 8.78 µg/mg collagen, 14.4 ± 1.56 µg/mg GAGs, 43.2 ± 6.8 µg/mg elastin, and 234.6 ± 21.5 ng/mg DNA, with VEGF and bFGF levels of 28.12 ± 7.6 and 13.3 ± 6.89 ng/mg, respectively. SEM revealed a monolayer with poorly defined borders in fresh AM, whereas lyophilized AM displayed a well-defined apical border with few microvilli. Lyophilized AM-conditioned media promoted greater endothelial cell and fibroblast proliferation. Compared with those in the fresh AM and control groups, wounds treated with lyophilized AM healed faster, with narrower edges and more pronounced re-epithelization and collagen remodeling at 1-, 3-, and 5-weeks post-wounding. Histopathology revealed quicker granulation and inflammatory cell infiltration in the first week for lyophilized AM, and better re-epithelization and collagen remodeling in subsequent stages. In conclusion, the amniotic membrane, particularly in its lyophilized form, offers significant benefits for skin wound healing due to its bioactivity, availability, and cost-effectiveness.

Comparative Analysis of PTFE and Amniotic Tissue Membranes for Alveolar Ridge Preservation After Tooth Extraction

Abstract Background VACTERL is a rare association of congenital abnormalities with incidence 1/10 000 to 1/40 000 live births. VACTERL association is typically defined by the presence of at least three of the following congenital malformations: vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities. We are presenting a case report of natural delivery of live born full-term fetus with VACTERL association. Our aim is to emphasize the role of prenatal diagnostics of fetal malformations in order to avoid deliveries of polymalformative fetuses with poor prognosis and mental trauma of the parents. Methods A 18-year-old primiparous woman in 38th gestational week was admitted in the department because of spontaneous rupture of amniotic membranes and irregular uterine activity. History of the patient indicated insufficient monitoring during the pregnancy. Ultrasound examination showed hypotrophic and polymalformative fetus. The amount of amniotic fluid was increased despite of definite rupture of amniotic sac. Presence of only two umbilical vessels was established. Results Regardless of the manifestation of fetal distress during the delivery, medical council decided that cesarean section was unjustified because of unsecure prognosis of the newborn and the labor should be completed vaginally. Hypotrophic male with multiple congenital malformations was born that required surgical intervention in the postpartum period. Lethal outcome occurred due to multiple organ failure. Conclusions The prognosis of VACTERL is determined by the number, severity, and nature of abnormalities present. The ultrasound can identify not only the defects but also specify the prognosis of the fetus.

Background Gestational diabetes mellitus (GDM) can lead to a larger baby and a cesarean section. Aim This study examined the accuracy of ultrasonographic measurements of umbilical cord thickness and fetal interventricular septum (IVS) in pregnant women with and without GDM to predict fetal macrosomia and reduce mother and newborn health risks. Patients and methods This prospective comparative case–control study examined 124 pregnant women. The participants had to be 25–35 years old, 28–36 weeks pregnant, singleton, 18–27 kg/m2 BMI, primi or multigravida status, intact amniotic membranes, and normal umbilical cord morphology (two arteries and one vein). Two equal-sized groups were formed: group A contains pregnant women with GDM, and group B contains healthy pregnant women with normal blood glucose levels. Results Both groups showed a positive correlation between umbilical cord diameter, birth weight, hemoglobin A1c %, postprandial plasma glucose, and IVS thickness. Umbilical cord and interventricular septal cut-off values were greater than or equal to 1.8 cm and greater than or equal to 3.9 mm, with 80–90% sensitivity and 65–80% specificity. In the third trimester, overgrowth fetuses had significantly larger umbilical cords and IVS than average-weight babies. Group B had a significantly higher mean gestational age at delivery difference than group A. Conclusion Ultrasonic fetal heart IVS thickness may predict fetal overgrowth better than umbilical cord thickness. To reduce feto-maternal complications, sonographic fetal overgrowth prediction is crucial.