Parmar Uday Pratap Singh, Surico Pier Luigi, Scarabosio Anna, Barone Vincenzo, Singh Rohan Bir, D'Ancona Fabrizio, Zeppieri Marco, Parodi Pier Camillo, Mori Tommaso, Cutrupi Francesco, Ma David Hui-Kang, Di Zazzo Antonio, Coassin Marco
Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, 160030, India.
Department of Organs of Sense, University of Rome La Sapienza, Rome, 00185, Italy.
Stem Cell Rev Rep. 2025 May 14. doi: 10.1007/s12015-025-10892-x.
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.
羊膜移植（AMT）已成为一种多功能治疗方式，在伤口愈合、组织再生和眼科领域有重要应用。本综述全面评估了AMT在急性和慢性伤口处理中的疗效，已证明它能减轻疼痛、降低感染风险并促进上皮形成。在慢性伤口中，AMT通过重新上皮化、血管生成和免疫调节等机制促进愈合。此外，AMT在神经再生方面也显示出前景，通过促进神经恢复和减少瘢痕形成，在周围和中枢神经系统损伤修复中展现出潜力。在眼科，AMT在角膜表面重建、结膜修复以及干眼症和角膜缘干细胞缺乏症的治疗中发挥着重要作用。虽然AMT的益处已有充分记录，但本综述也探讨了重大挑战，包括不同临床情况下成功率的差异、供体组织使用的伦理问题以及影响其更广泛临床应用的监管障碍。此外，我们整合了对AMT分子机制的最新认识——例如其通过Nrf2/HO-1途径的抗氧化作用和通过P2X7受体途径的免疫调节——并强调了创新策略，包括纳米氧化铈纳米颗粒的掺入、维生素D3补充和基因治疗方法，以提高AMT的效果。通过探讨这些方面，本综述不仅突出了AMT的当前状态，还强调了其在推进再生医学方面未来可能发挥的作用，包括在脊髓修复、骨科和组织工程中的新兴应用。这一更新的综述旨在让临床医生和研究人员了解AMT的多方面应用，促进对这种有前景的治疗方法的进一步研究和优化。
