Matías Fabián Rotela

Airborne particulate matter (PM₂.₅) contributes to oxidative damage of the ocular surface, particularly under dry eye-related hyperosmolar conditions. We evaluated the protective effects of a soluble extract derived from lyophilized human amniotic membrane patches (hAM-Te) in human corneal and conjunctival epithelial cells and THP-1 macrophages exposed to hyperosmolarity, industrial PM₂.₅, or both. Cell viability, migration, reactive oxygen species, nitrite production, total antioxidant capacity, and antioxidant enzyme activities were assessed. Combined hyperosmolarity and PM₂.₅ markedly impaired cell viability and migration while increasing oxidative and nitrosative stress. hAM-Te significantly improved cell viability and wound closure, reduced reactive oxygen species and nitrite levels, restored antioxidant capacity, and modulated endogenous antioxidant defenses. These findings demonstrate that hAM-Te attenuates redox imbalance and cellular injury induced by combined environmental and hyperosmolar stress, supporting its potential as a protective strategy against pollution-associated ocular surface damage.

Chronic wound management remains a significant clinical challenge, requiring adaptive therapeutic approaches to achieve wound closure that nonetheless frequently prove fruitless. Balancing the initial pro-inflammatory response with debris removal and tissue rebuilding remains elusive in most cases, leading to pain, drastic quality-of-life deterioration, and, eventually, amputation. Meanwhile, patient adherence is an overarching theme. Furthermore, non-surgical alternatives that effectively promote tissue rebuilding are essential for patients seeking to avoid further invasive procedures. We report a patient with a recalcitrant ulcer managed using human amniotic membrane dressing (hAM-pe) and a bovine collagen matrix (BCM) in spatially distinct areas as an intra-patient control. Methodology included clinical monitoring and ad hoc molecular and histological analyses to assess inflammatory markers and tissue architecture. Following 59 days of observation, the superior evolution of the hAM-pe-treated zone led to the clinical decision to extend hAM-pe treatment over the adjacent BCM area, resulting in total wound closure. The hAM-pe-treated site demonstrated accelerated closure and clinical resolution of inflammation without the presence of a granulomatous response. Molecular analysis revealed downregulated pro-inflammatory mediators (IL-1β, TNF-α, CXCL-10) and upregulated markers associated with angiogenesis (VEGF, CD34) and tissue repair (Arginase-1). In this case, the non-surgical hAM-pe treatment was associated with a favorable healing trajectory, characterized by superior inflammation resolution and enhanced tissue organization (collagen type I/III maturation). While these descriptive findings suggest the potential advantages of amniotic membrane dressings in promoting advanced tissue repair, they remain limited to this individual observation. Further research in larger cohorts is required to validate these mechanisms.

This study evaluated the effects of two therapeutic approaches using a Bovine Collagen Matrix (BCM) and an innovative Amniotic Membrane Dressing (hAM-pe) in wound healing, integrating both clinical and mechanistic perspectives. Both treatments are collagen-based biomaterials, which play a crucial role in modulating the wound mi-croenvironment, supporting cellular adhesion, and delivering bioactive molecules. While collagen-based therapies have been extensively studied in vitro and in small animal models, clinical translation remains limited. This study’s approach involved the simul-taneous application of both treatments within a single patient, allowing a direct com-parison of therapeutic outcomes. Clinically, hAM-pe demonstrated superior outcomes, accelerating wound closure, re-ducing inflammation, and eliminating the need for surgical intervention. Its practical advantages, including ease of application in outpatient settings, further enhance its translational potential. Mechanistically, hAM-pe treatment was associated with reduced expression of inflammatory markers (IL-1β, TNF-α, and CXCL-10), enhanced vascular-ization (VEGF, CD34), and a shift toward a regenerative macrophage phenotype (Ar-ginase-1 expression). Conversely, BCM treatment led to prolonged inflammation, de-layed tissue remodeling, and an adverse granulomatous response. These findings underscore the potential of hAM-pe as an alternative, non-invasive therapy for chronic wounds. Further investigations into its immunoregulatory mecha-nisms, particularly its influence on macrophage subsets and extracellular matrix re-modeling, will provide valuable insights for optimizing regenerative wound care strategies.

La membrana amniótica humana (hAM), derivada de la placenta, se ha consolidado como un biomaterial de alto valor terapéutico en medicina regenerativa gracias a sus propiedades antiinflamatorias, inmunomoduladoras, antimicrobianas y regenerativas. Su estructura avascular, su contenido de factores bioactivos (citoquinas, factores de crecimiento, inhibidores de metaloproteinasas) y su matriz extracelular rica en colágeno y laminina, la convierten en un sustrato ideal para promover la cicatrización, reducir la inflamación y actuar como barrera biológica en múltiples contextos clínicos. Este trabajo presenta un estado del arte actualizado sobre los usos médicos de la hAM en Argentina, describiendo sus mecanismos de acción, aplicaciones clínicas, formas de presentación y estado regulatorio. Se detallan sus efectos inmunomoduladores, mediados por células amnióticas epiteliales y mesenquimales, su papel en la reepitelización y angiogénesis, así como su potencial anticancerígeno basado en la secreción de factores como la trombospondina, endostatina e interleuquina 10. Asimismo, se destacan sus capacidades como soporte estructural y su utilidad en la ingeniería de tejidos. En la práctica clínica, la hAM se aplica en especialidades como oftalmología, dermatología, traumatología, cirugía plástica, ginecología y odontología. En oftalmología, por ejemplo, se utiliza para tratar úlceras corneales, defectos epiteliales persistentes y patologías inflamatorias de la superficie ocular. En dermatología y cirugía plástica se emplea para el tratamiento de úlceras crónicas, quemaduras y heridas quirúrgicas complejas. Su aplicación en ortopedia y odontología incluye la regeneración ósea y la prevención de adherencias. En Argentina, existen siete bancos de tejidos habilitados para procesar y distribuir hAM en diferentes formatos (criopreservada, liofilizada, desecada). Destacan instituciones como el Hospital Garrahan, el Laboratorio de Hemoderivados (UNC), el Banco Multitejidos Ecodaic (Córdoba) y Amnios BMA (Buenos Aires), que han desarrollado protocolos estandarizados para su obtención, procesamiento y distribución. Además, se presentan experiencias de investigación traslacional y aplicada en colaboración con CONICET, universidades y hospitales públicos. A pesar del crecimiento en su uso y producción, persisten desafíos regulatorios, logísticos y de concientización sobre la donación placentaria. No obstante, la hAM se perfila como un recurso estratégico con enorme potencial en salud pública, capaz de mejorar significativamente la calidad de vida de pacientes mediante terapias regenerativas accesibles y seguras.