Dehydrated human amnion/chorion tissue in difficult–to-heal DFUs: a case series

Objective: Pressure ulcers (PU; also known as pressure injuries) affect about three million adults in the US and cost an estimated $11 billion dollars annually to treat. Prevention is most desirable, however, once a patient develops a PU, the focus shifts to effective treatment and rapid closure to improve health outcomes. We sought to evaluate outcomes in 10 patients with category II and III PUs treated with dehydrated human amnion/chorion membrane (dHACM) allografts. Method: All patients were treated with weekly application of dHACM plus standard wound care (SoC) and followed for eight weeks. Results: Of the PUs, two were category II and eight were category III. The average PU size at dHACM initiation was 3.42±1.76cm2. After the first application of dHACM 7/10 (70%) of PUs responded to treatment with a reduction in wound size. Within two weeks of dHACM initiation into the plan of care, 4/10 (40%) of PUs had reduced in size by >50%. By week four, 60% of PUs (6/10) had reduced in size by >50%. Overall, during the eight week evaluation period, 9/10 PUs reduced in size, three of which healed completely. Conclusion: dHACM allografts appear to be a viable treatment option for category II and III PUs.

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Micronized Dehydrated Human Amnion Chorion Membrane Injection in the Treatment of Knee Osteoarthritis—A Large Retrospective Case Series

The Journal of Knee Surgery ◽

10.1055/s-0039-3400951 ◽

2019 ◽

Author(s):

Kris J. Alden ◽

Stan Harris ◽

Brandon Hubbs ◽

Kimberly Kot ◽

Niki B. Istwan ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Intervention ◽

Case Series ◽

The United States ◽

Common Adverse Event ◽

Human Amniotic Membrane ◽

Retrospective Case ◽

Human Amnion ◽

Knee Oa

AbstractOsteoarthritis (OA) of the knee is a leading cause of chronic pain and disability in the United States. Current treatment options primarily target OA symptoms reserving surgical intervention and knee replacement for those who fail conservative measures. With average age of patients with knee OA decreasing, regenerative treatment approaches to reduce symptoms, increase quality of life, and delay the need for surgical intervention are increasingly sought. Human amniotic membrane contains growth factors and cytokines, which promote epithelial cell migration and proliferation, stimulate metabolic processes leading to collagen synthesis, and attract fibroblasts, while also reducing pain and inflammation. Micronization of the tissue allows for suspension in normal saline and injection. We conducted a retrospective review of 100 knees treated for symptomatic OA with micronized dehydrated human amnion/chorion membrane (mdHACM) and followed for 6 months. Our purpose is to present our experience and patient outcomes. Data were abstracted from electronic medical records of 82 consecutive OA patients (100 knees) injected with 100 mg mdHACM. Patient age, gender, adverse events and routinely collected Knee Injury and Osteoarthritis Outcome Score (KOOS) were evaluated. Effectiveness of mdHACM treatment was measured by serial KOOS at baseline, and posttreatment at 6 weeks, 3, and 6 months. Overall mean KOOS for the cohort was 40 at baseline, improving to 52, 62, and 65 at 6 weeks, 3 months, and 6 months post-mdHACM injection. Percent increases were 32, 56, and 65%, respectively. Quality of life and sports/recreation domains improved by 111 and 118%, respectively, at 6 months. Pain scores improved by 67% at 6 months. All scores improved throughout the observation period. The most common adverse event was pain after injection lasting 2 to 7 days, observed in 68% of cases. This represents the largest single-physician experience with mdHACM for treatment of knee OA reported to date. Injectable mdHACM appears to be a potentially useful treatment option for knee OA patients. Controlled studies are underway to confirm these observations.

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The Use of Dehydrated Human Amnion/Chorion Membrane Allograft Injection for the Treatment of Tendinopathy or Arthritis: A Case Series Involving 40 Patients

PM&R ◽

10.1016/j.pmrj.2017.04.011 ◽

2017 ◽

Vol 9 (12) ◽

pp. 1236-1243 ◽

Cited By ~ 16

Author(s):

Alfred C. Gellhorn ◽

Alex Han

Keyword(s):

Case Series ◽

Human Amnion

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Kalinin: A new epithelial basement membrane adhesion molecule

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100085198 ◽

1991 ◽

Vol 49 ◽

pp. 178-179

Author(s):

Douglas R. Keene ◽

Gregory P. Lunstrum ◽

Patricia Rousselle ◽

Robert E. Burgeson

Keyword(s):

Basement Membrane ◽

Culture Media ◽

Polyacrylamide Gel Electrophoresis ◽

Human Keratinocytes ◽

Positive Staining ◽

Human Amnion ◽

Epithelial Basement Membrane ◽

Type Vii Collagen ◽

Keratinocyte Cell ◽

Epithelial Basement

A mouse monoclonal antibody produced from collagenase digests of human amnion was used by LM and TEM to study the distribution and ultrastructural features of an antigen present in epithelial tissues and in cultured human keratinocytes, and by immunoaffinity chromatography to partially purify the antigen from keratinocyte cell culture media.By immunofluorescence microscopy, the antigen displays a tissue distribution similar to type VII collagen; positive staining of the epithelial basement membrane is seen in skin, oral mucosa, trachea, esophagus, cornea, amnion and lung. Images from rotary shadowed preparations isolated by affinity chromatography demonstrate a population of rod-like molecules 107 nm in length, having pronounced globular domains at each end. Polyacrylamide gel electrophoresis suggests that the size of this molecule is approximately 440kDa, and that it is composed of three nonidentical chains disulfide bonded together.

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Fibrillin molecules aggregate to form an extendible beaded structure which is a major component of “Elastin Associated” microfibrils

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100153208 ◽

1989 ◽

Vol 47 ◽

pp. 246-247

Author(s):

Douglas R. Keene ◽

B. Kerry Maddox ◽

Marie B. Spurgin ◽

Lynn Y. Sakai ◽

Robert W. Glanville

Keyword(s):

Molecular Sieve ◽

Room Temperature ◽

Culture Medium ◽

Weight Fraction ◽

Ammonium Bicarbonate ◽

High Molecular Weight Fraction ◽

Bicarbonate Buffer ◽

Human Amnion ◽

Gold Conjugate ◽

Ammonium Bicarbonate Buffer

A mouse monoclonal antibody was used to identify beaded aggregates found in guanidine extracts of human amnion as assemblies of fibrillin molecules. These aggregates were also shown to be a major component of extracellular matrix microfibrils. We further demonstrated that the periodicity of these aggregates can be increased when subjected to mechanical stress.Human amnion was extracted with guanidine and the extracted material purified using ion exchange and molecular sieve chromatography. A high molecular weight fraction was precipitated by dialyzing against dilute acetic acid. Part of the precipitate was suspended in 0.2 M ammonium bicarbonate buffer and rotary shadowed. A second portion was resuspended in culture medium containing antibody which recognizes matrix microfibrils, diluted 1:5 in ammonium bicarbonate and reacted for 120 minutes at room temperature. Antibody labeled precipitate was washed by repeated pelleting and resuspension in buffer and then incubated in Janssen GAM 5 nm gold conjugate for 60 minutes at room temperature.

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