Amniotic Membrane for Dry Eye, Keratitis, Recurrent Erosion, Infectious Keratitis, Chemical Burns, Graft Versus Host Disease (GVHD), Stevens Johnson Disease (SJS), Non healing ulcers, Chronic Eye Pain, Neuropathy

In our recent PodCast Dr. Cremers's Podcast, we discussed the uses of Amniotic Membrane and how it works. 

Amniotic Membrane has been uses for so many conditions for the eye (ie, for Dry Eye, Keratitis, Recurrent Erosion, Infectious Keratitis, Chemical Burns, Graft Versus Host Disease (GVHD), Stevens Johnson Disease (SJS), Non healing ulcers, Chronic Eye Pain, Neuropathy) and for the body (ie, non-healing diabetic ulcers, mouth wound, skin wounds, prevention of wound adhesions after surgery, facial rejuvenation (DREAM Procedure: not sure if this is still done..)

Here are some of the references discussed in the podcast. Save your eyes & please list to the podcast.

SLC

References: 

1. 

Front Bioeng Biotechnol. 2020; 8: 606982.

Published online 2021 Jan 13. doi: 10.3389/fbioe.2020.606982

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839407/

Amniotic membrane features	Contributing factors	References
Biological properties
• Anti-inflammatory effect	Trapping inflammatory cells and driving them to apoptosis through its pro-apoptotic agents; production of anti-inflammatory factors by its epithelial cells; suppression the pro-inflammatory cytokines such as interleukin 1 alpha and 1 beta; production of MMP’s inhibitors; expression of migration inhibitory factor (MIF); expression of anti-inflammatory cytokines such as IL-1 receptor antagonist; secretion of anti-inflammatory factors such as PGE2, TGF-β, HGF, TNF-α, and MIF from mesenchymal and epithelial cells of AM	Mamede et al., 2012; Islam et al., 2015; Rocha and Baptista, 2015; Ilic et al., 2016
• Antibacterial and antiviral effect	Expression of natural antibacterial molecules such as β-defensins, elafin, and cystatin E; adhesion to wound surface and to act as a barrier against bacterial infiltration	Mamede et al., 2012; Islam et al., 2015; Castellanos et al., 2017; Milan et al., 2020
• Low antigenicity and non-immunogenicity	Lack of human leukocyte antigens A, B, C, and DR antigens, or β2-microglobulin on the surface of AM epithelial cells; absence of vessels, lymph, and nerves, in its structure	Mamede et al., 2012; Chopra and Thomas, 2013; Castellanos et al., 2017
• Anti-scarring and anti-adhesive effect in wound healing	Reduction of proteases activity due to the secretion of tissue inhibitors of metalloproteinases (TIMPs); the decreased activity of fibroblasts through downregulation of TGF-β with AM hyaluronic acid content	Mamede et al., 2012; Castellanos et al., 2017
• Angiogenesis and anti-angiogenesis properties (surface dependent)	Angiogenesis properties: secretion of VEGF, IL-8, angiogenin, interferon-γ, IL-6, bFGF, EGF, and PDGF by AM mesenchymal cells Anti-angiogenesis properties: secretion of IL-1, IL-2 receptor antagonist, IL-10, endostatin, TIMP-1, -2, -3, and -4, thrombospondin, and heparin sulfate proteoglycan by AM epithelial cells	Islam et al., 2015; Ilic et al., 2016
• An anticancer agent with low tumorigenicity	Secretion of pro-apoptotic agents; secretion of IL-1, IL-2 receptor antagonist, IL-10, and endostatin which all inhibit tumor growth	Islam et al., 2015; Jafari et al., 2020
• Promotion of epithelialization	Secretion of growth factors such as EGF, KGF, and HGF	Mamede et al., 2012; Islam et al., 2015; Ilic et al., 2016; Castellanos et al., 2017
• Pain reliever		Mamede et al., 2012
• Support cell adhesion and growth	Its hyaluronic acid content and proteins such as fibronectin, laminin, collagens, and proteoglycans act as a ligand for integrin receptors	Ilic et al., 2016
Mechanical properties (intact AM)
• Direct tensile mechanical properties	Placental: Force before rupture: 1.2 ± 0.2 N Strain at break: 19% ± 3% N Peripheral: Force before rupture: 0.68 ± 0.08 N Strain at break: 16% ± 1% N	Litwiniuk et al., 2017
• Young’s modulus	2.29–3.6 MPa	Niknejad et al., 2008
• Tensile strength	5.475 ± 0.135 MPa	Cai et al., 2015; Ramesh et al., 2017
• Elastic modulus	4.048 ± 1.702 MPa

2. https://doc-0k-bk-apps-viewer.googleusercontent.com/viewer/secure/pdf/1j94aopc9pf02v73ojfbapi8bn4mn197/4c6g8cos507uefuq3dqnbjv5a0u5eltt/1662655425000/gmail/02842459341791447327/ACFrOgBeI2qlrsgr2P91JonWIiHujenPP80M2b5dawUfhNFxt7rftUuYsDkMgZ_n2U-J0tU_6dERBHSY79DgC7I6fzdLsrSDScYl2iGLDWq1Ju5VR6nZWaPf1AuprxU=?print=true&nonce=f9aeduevoprcu&user=02842459341791447327&hash=chon9vni2mt2rhonb6frb5uln578mj22

3. https://pubmed.ncbi.nlm.nih.gov/11900323/

4. https://journals.lww.com/corneajrnl/Abstract/1995/09000/Transplantation_of_Preserved_Human_Amniotic.6.aspx

5. https://bjo.bmj.com/content/82/3/235.long

6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC513860/