A Review of the Therapeutic Potential of the Amniotic Membrane in Peripheral Nerve Regeneration

Document Type : Review Article

Authors

1 MSc Student in Human Genetics, Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 MSc Student in Human Genetics, Department of Genetics, School of Advanced Technologies in Medical Sciences, Golestan, Iran.

3 PhD. Candidate in Medical Genetics, Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor of Molecular Medicine, Department of Genetics and Molecular Biology, School of Medicine, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/jims.v43.i816.0559

Abstract

Background: Peripheral nerve injury is a common clinical problem that can have serious consequences for patients. These injuries are usually caused by factors such as trauma, crush, infection, or ischemia, and can result in sensory and motor dysfunction, muscle atrophy, and even complete limb paralysis. The process of peripheral nerve repair is strongly influenced by factors such as scar formation and fibrosis at the site of injury, which impede axonal growth and the restoration of nerve function.
Methods: This article explores the unique properties of the amniotic membrane and its therapeutic potential in the regeneration of peripheral nerves. The analysis will encompass the biological structure of the amniotic membrane, the characteristics of the stem cells it contains, and the underlying mechanisms involved in tissue repair. Furthermore, this study will include a comprehensive review of existing clinical and laboratory research on the application of the amniotic membrane for the repair of peripheral nerves.
Findings: Several methods are currently being used to facilitate peripheral nerve repair, including drugs, autologous tissues, and biomaterials; however, each approach has its limitations. As a result, the amniotic membrane, as a prenatal tissue, has attracted significant attention due to its beneficial biological properties that that can aid the neural repair process. This membrane is composed of mesenchymal and epithelial stem cells, possessing the capability to secrete growth factors and cytokines. The membrane demonstrates anti-inflammatory, antimicrobial, and antifibrotic effects, which can facilitate the healing process and help mitigate side effects.
Conclusion: Given its unique properties, the amniotic membrane could serve as a promising therapeutic option for repairing peripheral nerve injuries.

Highlights

Mohammad Kazemi: Google Scholar

Keywords

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References

  1. Takaku S, Tsukamoto M, Niimi N, Yako H, Sango K. Exendin-4 promotes Schwann cell survival/migration and myelination in vitro. Int J Mol Sci 2021; 22(6): 2971.
  2. Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma 1998; 45(1): 116–22.
  3. Lavorato A, Aruta G, De Marco R, Zeppa P, Titolo P, Colonna MR, et al. Traumatic peripheral nerve injuries: a classification proposal. J Orthop Traumatol 2023; 24(1): 20.
  4. Bai J, Liu C, Kong L, Tian S, Yu K, Tian D. Electrospun polycaprolactone (PCL)-amnion nanofibrous membrane promotes nerve regeneration and prevents fibrosis in a rat sciatic nerve transection model. Front Surg 2022; 9: 842540.
  5. Shahrokh Shahraki S, Yavari M, Tabrizi A. Effect of amniotic membrane nerve wrapping in final results of traumatic peripheral nerve repair. World J Plast Surg 2022; 11(2): 90–4.
  6. Zhang ZY, Yang J, Fan ZH, Wang DL, Wang YY, Zhang T, et al. Fresh human amniotic membrane effectively promotes the repair of injured common peroneal nerve. Neural Regen Res 2019;14(12): 2199-208.
  7. O'Kane S, Ferguson MW. Transforming growth factor beta s and wound healing. Int J Biochem Cell Biol 1997; 29(1): 63-78.
  8. Langeveld M, Hundepool CA, Duraku LS, Power DM, Rajaratnam V, Zuidam JM. Surgical treatment of peripheral nerve neuromas: a systematic review and meta-analysis. Plast Reconstr Surg 2022; 150(4): 823e–34e.
  9. Li Z, Qin H, Feng Z, Liu W, Zhou Y, Yang L, et al. Human umbilical cord mesenchymal stem cell-loaded amniotic membrane for the repair of radial nerve injury. Neural Regen Res 2013; 8(36): 3441–8.
  10. Sousa JPM, Deus IA, Monteiro CF, Custódio CA, Gil J, Papadimitriou L, et al. Amniotic membrane-derived multichannel hydrogels for neural tissue repair. Adv Healthc Mater 2024; 13(27): e2400522.
  11. Shahrokh Shahraki S, Yavari M, Tabrizi A. Effect of amniotic membrane nerve wrapping in final results of traumatic peripheral nerve repair. World J Plast Surg 2022; 11(2): 90–4.
  12. Sanluis-Verdes A, Sanluis-Verdes N, Manso-Revilla MJ, Castro-Castro AM, Pombo-Otero J, Fraga-Mariño M, et al. Tissue engineering for neurodegenerative diseases using human amniotic membrane and umbilical cord. Cell Tissue Bank 2017; 18(1): 1-15.
  13. Wassmer CH, Berishvili E. Immunomodulatory properties of amniotic membrane derivatives and their potential in regenerative medicine. Curr Diab Rep 2020; 20(8): 31.
  14. Bourgeois M, Loisel F, Obert L, Pluvy I, Gindraux F. Can the amniotic membrane be used to treat peripheral nerve defects? A review of literature. Hand Surg Rehabil 2019; 38(4): 223–32.
  15. Arki MK, Moeinabadi-Bidgoli K, Hossein-Khannazer N, Gramignoli R, Najimi M, Vosough M. Amniotic membrane and its derivatives: novel therapeutic modalities in liver disorders. Cells 2023; 12(16): 2114.
  16. Ramuta TŽ, Šket T, Starčič Erjavec M, Kreft ME. Antimicrobial activity of human fetal membranes: from biological function to clinical use. Front Bioeng Biotechnol 2021; 9: 691522.
  17. Fesli A, Sari A, Yilmaz N, Comelekoglu U, Tasdelen B. Enhancement of nerve healing with the combined use of amniotic membrane and granulocyte-colony-stimulating factor. J Plast Reconstr Aesthet Surg 2014; 67(6): 837–43.
  18. Jahanafrooz Z, Bakhshandeh B, Behnam Abdollahi S, Seyedjafari E. Human amniotic membrane as a multifunctional biomaterial: recent advances and applications. J Biomater Appl 2023; 37(8): 1341-54.
  19. Mamede AC, Carvalho MJ, Abrantes AM, Laranjo M, Maia CJ, Botelho MF. Amniotic membrane: from structure and functions to clinical applications. Cell Tissue Res 2012; 349(2): 447–58.
  20. Shuang-zhi H, Ping S, Xi-ning P. Culture and identification of human amniotic mesenchymal stem cells. Chin Med Sci J 2010; 25(4): 211–4.
  21. Morandi F, Marimpietri D, Görgens A, Gallo A, Srinivasan RC, El-Andaloussi S, et al. Human amnion epithelial cells impair T cell proliferation: the role of HLA-G and HLA-E molecules. Cells 2020; 9(9): 2123.
  22. Klaffenbach D, Friedrich D, Strick R, Strissel PL, Beckmann MW, Rascher W, et al. Contribution of different placental cells to the expression and stimulation of antimicrobial proteins (AMPs). Placenta 2011; 32(11): 830–7.
  23. Ramuta TŽ, Šket T, Starčič Erjavec M, Kreft ME. Antimicrobial activity of human fetal membranes: from biological function to clinical use. Front Bioeng Biotechnol 2021; 9: 691522.
  24. Yadav MK, Go YY, Kim SH, Chae SW, Song JJ. Antimicrobial and antibiofilm effects of human amniotic/chorionic membrane extract on Streptococcus pneumoniae. Front Microbiol 2017; 8:1 948.
  25. Yoshii S, Oka M, Shima M, Taniguchi A, Akagi M. Bridging a 30-mm nerve defect using collagen filaments. J Biomed Mater Res A 2003; 67: 467-74.
  26. Toda A, Okabe M, Yoshida T, Nikaido T. The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharmacol Sci 2007; 105(3): 215-28.
  27. Goonetilleke M, Kuk N, Correia J, Hodge A, Moore G, Gantier MP, et al. Addressing the liver progenitor cell response and hepatic oxidative stress in experimental non-alcoholic fatty liver disease/non-alcoholic steatohepatitis using amniotic epithelial cells. Stem Cell Res Ther 2021; 12(1): 429.
  28. Sousa JPM, Deus IA, Monteiro CF, Custódio CA, Gil J, Papadimitriou L, et al. Amniotic Membrane-Derived Multichannel Hydrogels for Neural Tissue Repair. Adv Healthc Mater 2024; 13(27): e2400522.
Journal of Isfahan Medical School
Volume 43, Issue 816
4th Week, July
July and August 2025
Pages 559-569

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History

  • Receive Date: 03 October 2024
  • Accept Date: 05 May 2025

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