Rodolfo Franco-Márquez

The amniotic membrane is widely recognized in regenerative medicine due to its rich content of extracellular matrix proteins and growth factors that confer anti-inflammatory and pro-regenerative properties. However, its rapid degradation restricts its standalone clinical use. To overcome these limitations, we developed biofilms by incorporating decellularized human amniotic membrane matrix (dHAM) into polycaprolactone (PCL) and polyvinylpyrrolidone (PVP) matrices using spin-coating. Bone marrow-derived mesenchymal stem cells (BM-MSCs) were used to evaluate film biocompatibility through cell viability, proliferation, and wound healing migration assays. Surface characterization was performed using contact angle measurements, Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy, and scanning electron microscopy. Soluble dHAM extracts (4–6 mg/mL) significantly enhanced BM-MSC proliferation at 48 h compared to controls (p ≤ 0.01 and p ≤ 0.0001). Both PCL-dHAM and PVP-dHAM biofilms exhibited high cell viability (>90%) and improved initial adhesion. Notably, dHAM incorporation significantly increased wound closure rates at 24 h, reaching 98.47% for PCL-dHAM and 93.13% for PVP-dHAM, compared to 76.56% and 64.20% for pure polymers (p = 0.0001). All scaffolds maintained hydrophilic surfaces (<90°), favorable for cell interaction. The integration of dHAM into PCL and PVP by spin-coating produces biofilms biocompatible with enhanced regenerative potential, representing promising candidates for wound healing applications. In conclusion, these coatings support BM-MSC adhesion, proliferation, and migration, while significantly accelerating wound closure, underscoring their value as advanced bioactive coatings for regenerative medicine.

Amniotic membrane (AM) has gained wide application in regenerative medicine due to its biocompatibility and extracellular matrix (ECM) composition. Effective decellularization is essential to minimize immunogenicity while preserving tissue architecture. This study standardized AM procurement and compared a simplified alkaline-based decellularization protocol with a conventional detergent–alkaline method, emphasizing practicality, histological integrity, and collagen preservation. Methods: Human AM was aseptically obtained from placental tissue and processed using either method. Histological analysis with hematoxylin eosin and Masson’s trichrome staining quantified nuclear content and collagen integrity. Results: The alkaline method achieved the greatest nuclear clearance but retained epithelial outlines, indicating partial persistence of cellular structures. In contrast, the detergent method achieved complete morphological decellularization but showed slightly higher residual nuclear signal. Masson’s trichrome staining revealed that the detergent-based method preserved collagen intensity most closely to native tissue (mean gray values: 128.3 ± 28.2 vs. 140.2 ± 23.4), while the alkaline group exhibited significantly reduced staining (177.8 ± 17.2; p < 0.001). Conclusions: the simplified alkaline method provided efficient decellularization with reduced cost, time, and cytotoxic risk, making it a practical approach for AM processing. However, partial ECM alteration suggests that detergent-based methods remain preferable when optimal structural preservation is required.

Fibrin hydrogels are biocompatible but often lack instructive cues needed to sustain chondrocyte phenotype and cartilage-like matrix formation; therefore, we investigated whether a tricomposite fibrin hydrogel incorporating decellularized articular cartilage matrix (dACM) and decellularized amniotic membrane matrix (dAMM) enhances human articular chondrocyte performance in vitro. Human articular chondrocytes were encapsulated in tricomposite or fibrin-only hydrogels and cultured for 28 days, evaluating degradation kinetics, viability and cell density, histological remodeling (H&E, Masson’s trichrome, Safranin O), immunohistochemistry for type II collagen, aggrecan, and type I collagen, and qPCR of SOX9, COL2A1, ACAN, RUNX2, COL1A2, and COL10A1. The tricomposite remained cytocompatible (~99% viability), supported marked cell expansion (~250% by day 28), and degraded more slowly than fibrin controls. It increased chondrogenic gene expression (SOX9 >3-fold vs. control by day 28; sustained COL2A1 at 1.5–2-fold; early ACAN at 3–5-fold) while attenuating off-target transcriptional programs (RUNX2 ~50% of control, reduced COL1A2, and negligible COL10A1). Consistently, histology showed progressive lacuna-like morphology and proteoglycan-rich matrix accumulation, accompanied by strong type II collagen and aggrecan immunoreactivity and reduced type I collagen. Overall, adding dACM and dAMM to fibrin improved hydrogel biofunctionality and promoted hyaline-like extracellular matrix assembly, supporting further evaluation of this cell-instructive platform for focal articular cartilage repair.

Articular cartilage lesions are challenging to regenerate, prompting the investigation of novel biomaterial-based therapeutic approaches. Extracellular matrix (ECM)-derived biomaterials are a promising option for this purpose; however, to date, the combination of amniotic membrane (AMM) and articular cartilage (ACM) has not been tested. This study evaluated different concentrations of soluble extracts from the decellularized ECM of amniotic membrane (dAMM) and articular cartilage (dACM), both individually and in combination, to determine their ability to maintain the chondrogenic phenotype in human chondrocytes. After the decellularization process 90–99% of the cellular components were removed, it retains nearly 100% of type 2 collagen and 70% of aggrecan (ACAN) for dACM, and approximately 90% of type IV collagen and 75% of ACAN for dAMM. The biological activity of soluble extracts from dACM and dAMM were evaluated on human chondrocytes. After 72 h, 1.5 mg/mL of dACM and 6 mg/mL of dAMM significantly increased (p < 0.05) the proliferation and expression of SOX9 and ACAN. Also, the combination of both (1.5 mg/mL dACM and 6 mg/mL dAMM) showed synergistic effects, enhancing chondrocyte proliferation, maintaining chondrogenic lineage, and increasing the production of cartilage ECM components, such as COLII (1.5-fold), SOX9 (2-fold), and ACAN (2-fold). These results suggest that the combined use of dACM and dAMM has potential for cartilage regeneration.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug reaction commonly related to eosinophilia, from uncertain epidemiology, and without consensus for diagnosis and treatment globally. It presents a great challenge in its management and is characterized by fever, lymphadenopathy, skin rash, and multisystemic involvement. An aggressive and difficult-to-manage clinical case is presented in a 50-year-old man with chronic kidney disease due to diabetes mellitus type 2 and systemic arterial hypertension, who developed an unusual variant similar to DRESS and Stevens–Johnson syndrome (SJS) overlap secondary to allopurinol, with skin manifestations without eosinophilia, but fulfilling clinical and laboratory criteria for DRESS and SJS syndrome.