Amniotic Membrane Transplantation for Wound Healing, Tissue Regeneration and Immune Modulation

Abstract

Amniotic membrane transplantation (AMT) has emerged as a versatile therapeutic modality with significant applications in wound healing, tissue regeneration, and ophthalmology. This review comprehensively evaluates AMT's efficacy in acute and chronic wound management, where it has been shown to alleviate pain, reduce infection risk, and facilitate epithelialization. In chronic wounds, AMT enhances healing through mechanisms such as re-epithelialization, angiogenesis, and immune modulation. Additionally, AMT exhibits promise in nerve regeneration, demonstrating potential in the repair of peripheral and central nervous system injuries by fostering neural recovery and minimizing scar formation. In ophthalmology, AMT is instrumental in corneal surface reconstruction, conjunctival repairs, and the management of dry eye syndrome and limbal stem cell deficiency. While the benefits of AMT are well-documented, this review also addresses significant challenges, including variability in success rates across different clinical conditions, ethical concerns regarding donor tissue usage, and regulatory hurdles impacting its broader clinical application. Furthermore, we integrate recent advances in the understanding of AMT's molecular mechanisms - such as its antioxidant effects via Nrf2/HO-1 pathway and immune modulation via P2X7 receptor pathways - and highlight innovative strategies including the incorporation of nanoceria nanoparticles, Vitamin D3 supplementation, and gene therapy approaches to enhance AMT outcomes. By exploring these dimensions, the review highlights not only the current state of AMT but also its potential future role in advancing regenerative medicine, including emerging applications in spinal cord repair, orthopaedics, and tissue engineering. This updated synthesis aims to inform clinicians and researchers about the multifaceted applications of AMT, promoting further investigation and optimization of this promising therapeutic approach.

Keywords: Amniotic membrane; Gene therapy; Immunology; Nanoparticles; Nerve regeneration; Ophthalmology; Stem cells; Tissue regeneration; Transplantation; Wound healing.