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The Use of Human Amnion/Chorion for the Enhancement of Collagen Synthesis and Acceleration of Wound Healing in a Diabetic Rat Model

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Abstract

Diabetic patients have impaired wound repair due to decreased fibroblast infiltration, growth factor production, and angiogenesis. Decellularized human amnion/chorion placental connective tissue matrix (PCTM) has high levels of extracellular matrix components, is rich in growth factors that promote angiogenesis, and has anti-inflammatory properties, so it was hypothesized that PCTM could enhance healing in diabetic rats. Fibroblasts were cultured in a 10% PCTM solution, and controls were unaugmented. Real-time PCR and thymidine and proline uptake were used to determine fibroblast proliferation and collagen type I synthesis, respectively. Two dorsal dermal lesions were subsequently induced in eighteen diabetic rats. One lesion was untreated; the other was covered with PCTM or porcine small intestinal submucosa (SIS) and secured with sutures. Rats were sacrificed 1, 2, or 3 weeks postoperatively and analyzed on macroscopic appearance, fibrosis, epithelialization, and inflammation. In vitro placental augmentation resulted in a six-fold increase in collagen synthesis and a significant increase in fibroblast proliferation. In vivo PCTM treatments significantly increased epithelialization without increasing inflammation. PCTM-treated wounds had re-epithelialized within 2 weeks, whereas SIS treatments required three. These results indicate that PCTM accelerates healing due to enhanced fibroblast proliferation and collagen type I production. Diabetes is a challenging wound repair model; as such PCTM may have implications for treating injuries in both diabetic and healthy patients.

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Authors and Affiliations

  1. Orthopedic Research Lab, Feinstein Institute for Medical Research, Manhasset, NY, USA

    John Schwartz, Zalak Parikh & Ian R. Sigal

  2. Department of Orthopedic Surgery, North Shore LIJ Health System, Manhattan, NY, USA

    Stelios Koutsoumbelis & Daniel A. Grande

  3. Hospital for Special Surgery, New York, NY, USA

    David M. Dines & Joshua Dines

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  1. John Schwartz
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  2. Stelios Koutsoumbelis
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Correspondence to Daniel A. Grande.

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Daniel A Grande holds stock options in Aedicell.

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Schwartz, J., Koutsoumbelis, S., Parikh, Z. et al. The Use of Human Amnion/Chorion for the Enhancement of Collagen Synthesis and Acceleration of Wound Healing in a Diabetic Rat Model. Regen. Eng. Transl. Med. 7, 41–46 (2021). https://doi.org/10.1007/s40883-020-00156-0

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  • DOI: https://doi.org/10.1007/s40883-020-00156-0

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