Abstract
In the past 20 years, human amniotic membrane (hAM) has become widely recommended as an ophthalmic surgical patch, and as a substrate for stem cell tissue equivalents for ocular surface reconstruction. HAM reduces ocular surface scarring and inflammation, and enhances epithelialization. In addition, it shows limited immunogenicity and some anti-microbial properties. Thanks to these properties, hAM has been also used in wound healing, especially for burns and ulcers. Since its first clinical applications, hAM has been used for other indications, such as oral and maxillofacial, earnose- throat, gynaecological and orthopaedic surgeries. This review will describe: (i) past and current clinical uses of hAM; (ii) accepted processing methods, including preparation, preservation, sterilization and de-epithelialization and their impact on the properties of hAM, especially growth factor release, cell viability and immunological properties; (iii) its applications in tissue engineering, namely as scaffold or carrier of biological molecules. Economical aspects are presented at the end of this review. Existing patents are reported for each section and existing marketed products are listed. Patents, products and ongoing clinical trials, were identified by electronic searches on the internet in January 2013. In conclusion, in view of published data, hAM seems to have real market potential in regenerative medicine, in particular in emerging fields such as oral and maxillofacial, ear-nose-throat, gynaecological and orthopaedic surgery.
Keywords: Clinical uses, economical aspects, growth factors, human amniotic membrane (hAM), marketed products, patents, processing, tissue engineering.