Amniotic membrane applied to burns healing: Pre-clinical study
DOI:
https://doi.org/10.33448/rsd-v10i4.14286Keywords:
Burns; Amnion; Wound Healing; Skin; Rats; Biomedical engineering.Abstract
This preclinical study aimed to evaluate the tissue repair process of burns treated with human amniotic membrane (hAM) patches in rats. Twenty-four rats were subjected to superficial burns of partial thickness, and randomly allocated into two groups: Control and Treated Group, subdivided into two experimental periods of 7th and 14th days. The lesions were evaluated by digitalized images (macroscopy) and by the analysis of histological sections stained in H&E to quantify the number of inflammatory cells and fibroblasts present in the different experimental times (histomorphometry). The histomorphometric analyses were performed blindly. Statistical analysis employed Kolmogorov-Smirnov and Mann Whitney tests, with 95% confidence interval at 5% significance level (p <0.05). Macroscopically, the lesions of Treated group presented a crust formation before Control Group, and there were no signs of infection in both groups. Microscopically, the qualitative analysis showed a faster evolution in the healing process of the Treated groups compared to the Control, with reduction of the inflammatory infiltrate, intense fibroblasts proliferation and better organization of the collagen fibers. The quantitative analysis showed statistically significant results regarding the reduction of inflammatory cells (p<0.0001) at 7th and 14 th day and increased proliferation of fibroblasts at 14th day (p<0.0001) in lesions treated with hAM compared to Control group. The results of this preclinical study demonstrated that the application of hAM patches reduces the inflammatory process and accelerates the onset of the proliferative phase in burn injuries.
References
Ahuja, N., Jin, R., Powers, C., Billi, A., & Bass, K. (2020). Dehydrated Human Amnion Chorion Membrane as Treatment for Pediatric Burns. Adv Wound Care, 9(11), 602-611. doi:10.1089/wound.2019.0983.
Balbino, C. A., Pereira, L. M., & Curi, R. (2005). Mechanisms involved in healing: a review. Brazilian journal of pharmaceutical sciences, 41(1), 27-51.
Baradaran-Rafii, A., Aghayan, H-R., Arjmand, B., & Javadi, M-A. (2007). Amniotic Transplantation. Ophthalmic Reearch. 2(1):58-75.
Barbuto, R. C., Araújo, I. D., Bonomi, D. O., Tafuri, L. S. A., Calvão Neto, A., Malinowski, R., Bardin, V. S. S., Leite, M. D., & Duarte, I. G. L. (2015) Use of the amniotic membrane to cover the peritoneal cavity in the reconstruction of the abdominal wall with polypropylene mesh in rats. Rev. Col. Bras. Cir., 42(1), 49-55. doi: 10.1590/0100-69912015001010.
Campelo, M. B. D., Santos, J. A. F., Maia Filho, A. L. M., Ferreira, D. C. L., Sant’Anna, L. B., Oliveira, R. A., Maia, L. F., & Arisawa, E. A. L. S. (2018). Effects of the application of the amniotic membrane in the healing process of skin wounds in rats. Acta Cir. Bras, 33(2), 144-155. doi: 10.1590 / s0102-865020180020000006.
Cargnoni, A, Di Marcello, M., Campagnol, M., Nassuato, C., Albertini, A., & Parolini, O. (2009). Amniotic membrane patching promotes ischemic rat heart repair. Cell Transplant, 18, 1147-1159. doi: 10.3727/096368909X12483162196764.
Dovi, J. V., He, L. K., & DiPietro, L. A. (2003). Accelerated wound closure in neutrophil-depleted mice. J Leukoc Biol, 73(4), 448-55. doi: 10.1189/jlb.0802406.
Duarte, I. G. L, Duval-Araujo, I. (2014). Amniotic membrane as a biological dressing in infected wound healing in rabbits. Acta Cir. Bras., 29(5), 334-339. doi: 10.1590/S0102-86502014000500008.
Eskandarlou, M., Azimi, M., Rabiee, S., & Rabiee, M. A. S. (2016). The Healing Effect of Amniotic Membrane in Burn Patients. World J Plast Surg, 5(1), 39-44.
Guo, H. F., Ali, R. M., Hamid, R. A., Zaini, A. A., & Khaza'ai, H. (2017). A new model for studying deep partial-thickness burns in rats. Int J Burns Trauma, 7(6), 107-114.
Hana, L. G., Zhaob, Q. L., Yoshida, T., Okabe, M., Soko, C., Rehman M. U., Kondo, T., & Nikaido, T. (2019). Differential response of immortalized human amnion mesenchymal and epithelial cells against oxidative stress. Free Radical Biology and medicine, 135, 79–86. doi: 10.1016/j.freeradbiomed.2019.02.017.
Hennerbichler, S., Reichl, B., Pleiner, D., Gabriel, C., Eibl, J., & Redl, H. (2007). The influence of various storage conditions on cell viability in amniotic membrane. Cell tissue banking, 8(1), 1-8. doi.org/10.1007/s10561-006-9002-3.
Jeschke, M. G., Van Baar, M. E., Choudhry, M. A., Chung, K. K., Gibran, N. S. & Logsetty, S. (2020). Burn injury. Nature reviews Disease Primers, 6(11), 1-25. doi: 10.1038/s41572-020-0145-5.
Kibe, Y., Takenaka, H., Kishimoto, S. (2000). Spatial and temporal expression of basic fibroblast growth factor protein during wound healing of rat skin. Br J Dermatol, 143(4), 720-7. doi: 10.1046/j.1365-2133.2000.03824-x.
Kitala, D., Klama-Baryła, A., Łabuś, W., Ples, M., Misiuga, M., Kraut, M., Szapski, M., Bobinski, R., Pielesz, A., Los, M. J., & Kucharzewski, M. (2019) Amniotic cells share clusters of differentiation of fibroblasts and keratinocytes, influencing their ability to proliferate and aid in wound healing while impairing their angiogenesis capability. Eur J Pharmacol., 854, 167-178. doi: 10.1016/j.ejphar.2019.02.043.
Koche, J. C. (2011). Fundamentos de metodologia científica. Petrópolis: Vozes.
Kshersagar, J., Kshirsagar, R., Desai, S., Bohara, R., & Joshi, M. (2018). Decellularized amnion scaffold with activated PRP: a new paradigm dressing material for burn wound healing. Cell Tissue Bank. 19(3), 423-436. doi: 10.1007/s10561-018-9688-z.
Kumar, V., Abbas, A. K., Fausto, N., & Mitchell, R. N. (2013). Robbins. Patologia básica. In: Kumar, V., Abbas, A. K., Fausto, N., Mitchell, R. N. Inflamação e Reparo. 9ª. ed. Rio de Janeiro: Elsevier, 29-73.
Lakatos, E. M. & Marconi, M. A. (2019). Fundamentos de metodologia científica. 8° Ed – [3. Reimpr.]. São Paulo: Atlas.
Lashgari, M. H., Rostami, M. H. H., & Etemad, O. (2019). Assessment of outcome of using amniotic membrane enriched with stem cells in scar formation and wound healing in patients with burn wounds. Bali Med J, 8(1), 41-46. doi: 10.15562/bmj.v8i1.1223.
Lima, D. F., Lima, L. N. S., Carvalho, M. D. M., Carvalho, L. R. B., Maia, N. M. F. S., & Landim, C. A. P. (2016). Profile of hospitalized patients in a burn care unit. Rev Enferm UFPE online, 10(Suppl. 3), 1423-31. doi: 10.5205/reuol.7057-60979-3-SM-1.1003sup201610.
Mohammadi, A. A., Eskandari, S., Johari, H. G., & Rajabnejad, A. (2017). Using Amniotic Membrane as a Novel Method to Reduce Post-burn Hypertrophic Scar Formation: A Prospective Follow-up Study. J Cutan Aesthet Surg, 10(1), 13-17.
Nicodemo, M. C., Neves, L. R., Aguiar, J. C., Brito, F. S., Ferreira, I., Sant’Anna, L. B., Raniero, L. J., Martins, R. A. L., Barja, P. R., & Arisawa, E. A. L. S. (2017). Amniotic membrane as an option for treatment of acute Achilles tendon injury in rats. Acta Cir Bras, 32(2), 125-139. doi:10.1590 / s0102-865020170205.
Peacock, J. R., Winkle, W. V. (1984). The wound repair. Philadelphia: W B Saunders.
Polit, D. F. & Beck, C. T. (2011). Fundamentos de pesquisa em enfermagem: avaliação de evidências para a prática da enfermagem. 7. ed. Porto Alegre: Editora Artmed.
Qian, L. W., Fourcaudot, A. B., Yamane, K., You, T., Chan, R. K., & Leung, K. P. (2016) Exacerbated and prolonged inflammation impairs wound healing and increases scarring. Wound Repair Regen, 24(1), 26-34. doi: 10.1111/wrr.12381.
Rahman, M. S., Islam, R., Rana, M. M., Spitzhorn, L. S., Rahman, M. S., Adjaye, J., & Asaduzzaman, S. M. (2019). Characterization of burn wound healing gel prepared from human amniotic membrane and Aloe vera extract. BMC Complement Altern Med. 19(1), 115. doi: 10.1186/s12906-019-2525-5.
Rana, M. M., Rahman, M. S., Ullah, M. A., Siddika, A., Hossain, M. L., Akhter, M. S., Hasan, M. Z., & Asaduzzaman, S. M. (2020). Amnion and collagen-based blended hydrogel improves burn healing efficacy on a rat skin wound model in the presence of wound dressing biomembrane. Biomed Mater Eng., 31(1), 1-17. doi: 10.3233/BME-201076.
Ravishanker, R., Bath, A. S., & Roy, R. (2003). "Amnion Bank" - the use of long term glycerol preserved amniotic membranes in the management of superficial and superficial partial thickness burns. Burns, 29(4), 369-74. doi: 10.1016/s0305-4179(02)00304-2.
Raza, M. S., Asif, M. U., Abidin, Z. U., Khalid, F. A., Ilyas, A., & Tarar, M. N. (2020). Glycerol Preserved Amnion: A Viable Source of Biological Dressing for Superficial Partial Thickness Facial. Burns. J Coll Physicians Surg Pak, 30(4), 394-398. doi: 10.29271/jcpsp.2020.04.394.
Reilly, D. A., Hickey, S., Glat, P., Lineaweaver, W. C., & Goverman, J. (2017) Clinical Experience: Using Dehydrated Human Amnion/Chorion Membrane Allografts for Acute and Reconstructive Burn Care. Ann Plast Surg, 78(2 Suppl 1), S19-S26.doi: 10.1097/SAP.0000000000000981
Rowan, M. P., Cancio, L. C., Elster, E. A., Burmeister, D. M., Rose, L. F., Natesan, S., Chan, R. K., Christy, R. J., & Chung, K. K. (2015). Burn wound healing and treatment: review and advancements. Crit Care, 12 (19), 243. doi: 10.1186/s13054-015-0961-2.
Salehi, S. H., As'adi, K., Mousavi, S. J., & Shoar, S. (2015). Evaluation of Amniotic Membrane Effectiveness in Skin Graft Donor Site Dressing in Burn Patients. Indian J Surg, 77(Suppl 2), 427-31.doi: 10.1007/s12262-013-0864-x.
Sant’Anna, L. B., Hage, R., Cardoso, M. A. G., Arisawa, E. A. L., Cruz, M. M., Parolini, O., Cargnoni, A., & Sant’anna, N. (2016) Antifibrotic effects of human amniotic membrane transplantation in established biliary fibrosis induced in rats. Cell Transplant, 25, 2245-2257. doi: 10.3727/096368916X692645.
Sant'Anna, L. B., Cargnoni, A., Ressel, L., Vanosi, G., & Parolini, O. (2011). Amniotic membrane application reduces liver fibrosis in a bile duct ligation rat model. Cell Transplant. 20(3), 441-453. doi:10.3727/096368910X52225.
Shakespeare, P. (2001). Burn wound healing and skin substitutes. Burns, 27(5), 517-22. doi: 10.1016/S0305-4179(01)00017-1.
Shu, J., He, X., Li, H., Liu, X., Qiu, X., Zhou, T., Wang, P., & Huang, X. (2018). The Beneficial Effect of Human Amnion Mesenchymal Cells in Inhibition of Inflammation and Induction of Neuronal Repair in EAE Mice. Journal of Immunology Research, 2, 1-10. doi: 10.1155/2018/5083797.
Silini, A. R., Magatti, M., Cargnoni, A., & Parolini, O. (2017). Is Immune Modulation the Mechanism Underlying the Beneficial Effects of Amniotic Cells and Their Derivatives in Regenerative Medicine?. Cell Transplant, 26(4), 531-539. doi:10.3727/096368916X693699.
Steen, E. H., Wang, X., Balaji, S., Butte, M. J., Bollyky, P. L., & Keswani, S. G. (2020). The role of the anti-inflammatory cytokine interleukin-10 in tissue fibrosis. Advances in wound care, 9(4), 184-198.
Wasiak, J & Cleland, H. (2015). Burns: dressings. BMJ Clinical Evidence, 1903.
World Health Organization. Burns. Geneva: WHO, 2018.
Zhang, K., Lui, V. C. H., Chen, Y., Lok, C. N., & Wong, K. K. Y. (2020). Delayed application of silver nanoparticles reveals the role of early inflammation in burn wound healing. Sci Rep, 10(1), 6338. doi: 10.1038/s41598-020-63464-z.
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Copyright (c) 2021 Fernanda Cláudia Miranda Amorim; Emilia Ângela Loschiavo Arisawa; Luciana Barros Sant’Anna; Khetyma Moreira Fonseca; Davidson Ribeiro Costa; Ana Beatriz Mendes Rodrigues; Jancineide Oliveira de Carvalho
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