Background: Amniotic membrane has been widely used in the treatment of several acute and chronic diseases, and surgical reconstructions. Here we report the successful application of a commercial lyophilized, powdered, amniotic membrane (AMX) to a patient with a treatment-refractory diabetic ulcer, with further investigations on AMX angiogenic and anti-inflammatory properties. Objective: To investigate the topical, continuous, treatment with AMX on a chronic diabetic foot ulcer, along with its angiogenic in vitro properties and proteomic profile. Methods: A 77-year old woman was treated with AMX 2–3 drops 4–6 times a day for 2 months. Amniotic fluid stem cells were tested for proliferation and angiogenesis potential with or without AMX. ELISA quantification was conducted on NGF, TGF-alpha, NT-3, and IL1-ra. Proteomic analysis was also performed on AMX. Results: At 2-month follow-up, the ulcer was reduced by 60% and it remained steady after 3-months. At 4-month follow-up, the lesion showed signs of re-epithelization. Cells, with or without AMX, were prone to form endothelial tubules with similar characteristics. Proteomic analysis confirmed that AMX retains proteins involved in anti-inflammatory and angiogenesis pathways. Conclusions: AMX ameliorated pain and extent of a chronic diabetic ulcer. The effect could be ascribed to angiogenesis and epithelium stimulation that was confirmed in in vitro. Multiple wound healing-involved proteins were detected but further studies are needed to assess their specific role. © 2019 Elsevier GmbH
Topical application of lyophilized and powdered human amniotic membrane promotes diabetic ulcer healing
Pozzobon M.;Rigon M.;Franchin C.;Arrigoni G.;Simonato M.;Vedovelli L.
2019
Abstract
Background: Amniotic membrane has been widely used in the treatment of several acute and chronic diseases, and surgical reconstructions. Here we report the successful application of a commercial lyophilized, powdered, amniotic membrane (AMX) to a patient with a treatment-refractory diabetic ulcer, with further investigations on AMX angiogenic and anti-inflammatory properties. Objective: To investigate the topical, continuous, treatment with AMX on a chronic diabetic foot ulcer, along with its angiogenic in vitro properties and proteomic profile. Methods: A 77-year old woman was treated with AMX 2–3 drops 4–6 times a day for 2 months. Amniotic fluid stem cells were tested for proliferation and angiogenesis potential with or without AMX. ELISA quantification was conducted on NGF, TGF-alpha, NT-3, and IL1-ra. Proteomic analysis was also performed on AMX. Results: At 2-month follow-up, the ulcer was reduced by 60% and it remained steady after 3-months. At 4-month follow-up, the lesion showed signs of re-epithelization. Cells, with or without AMX, were prone to form endothelial tubules with similar characteristics. Proteomic analysis confirmed that AMX retains proteins involved in anti-inflammatory and angiogenesis pathways. Conclusions: AMX ameliorated pain and extent of a chronic diabetic ulcer. The effect could be ascribed to angiogenesis and epithelium stimulation that was confirmed in in vitro. Multiple wound healing-involved proteins were detected but further studies are needed to assess their specific role. © 2019 Elsevier GmbH
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