Current medical applications and potential of human amniotic membrane: state of the art in Argentina and future research directions

Abstract

The human amniotic membrane (hAM), derived from the placenta, has been established as a highly valuable biomaterial in regenerative medicine due to its anti-inflammatory, immunomodulatory, antimicrobial, and regenerative properties. Its avascular structure, rich content of bioactive factors (cytokines, growth factors, and matrix metalloproteinase inhibitors), and extracellular matrix composed of collagen and laminin make it an ideal substrate for promoting wound healing, reducing inflammation, and acting as a biological barrier in various clinical settings.

This article presents an updated state-of-the-art overview of the medical uses of hAM in Argentina, describing its mechanisms of action, clinical applications, presentations, and regulatory status. Its immunomodulatory effects, mediated by epithelial and mesenchymal amniotic cells, are detailed, along with its role in re-epithelialization and angiogenesis, and its anticancer potential based on the secretion of bioactive molecules such as thrombospondin, endostatin, and interleukin-10. Additionally, its capacity as a structural scaffold and its usefulness in tissue engineering are highlighted.

In clinical practice, hAM is used across specialties such as ophthalmology, dermatology, traumatology, plastic surgery, gynecology, and dentistry. In ophthalmology, for example, it is applied to treat corneal ulcers, persistent epithelial defects, and inflammatory disorders of the ocular surface. In dermatology and plastic surgery, it is used for chronic ulcers, burns, and complex surgical wounds. Its application in orthopedics and dentistry includes bone regeneration and adhesion prevention.

In Argentina, there are currently seven certified tissue banks that process and distribute hAM in various formats (cryopreserved, lyophilized, and dehydrated). Key institutions include Hospital Garrahan, the Hemoderivados Laboratory at the National University of Córdoba (UNC), the Ecodaic Multitissue Bank in Córdoba, and Amnios BMA in Buenos Aires. These centers have developed standardized protocols for the procurement, processing, and distribution of hAM. Furthermore, several translational and applied research projects are being carried out in collaboration with CONICET, universities, and public hospitals.

Despite its growing use and production, regulatory, logistical, and public awareness challenges regarding placenta donation still remain. Nonetheless, hAM stands out as a strategic resource with enormous potential in public health, offering safe and accessible regenerative therapies that can significantly improve patients' quality of life.