Human Amniotic Membrane-Derived Products in Sports Medicine: Basic Science, Early Results, and Potential Clinical Applications
Human Amniotic Membrane-Derived Products in Sports Medicine: Basic Science, Early Results, and Potential Clinical Applications
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DOI：
10.1177/0363546515612750
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发表时间：
2016-09-01
影响因子：
4.8
通讯作者：
Cole, Brian J.
中科院分区：
文献类型：
--
作者：
Riboh, Jonathan C.;Saltzman, Bryan M.;Cole, Brian J.
背景：羊膜（AM）衍生产品已成功应用于眼科、整形外科和伤口护理，但对其在骨科运动医学中的潜在应用知之甚少。目的：提供支持am衍生产品使用的基础科学、临床前和临床数据的最新综述，并回顾其目前在运动医学中的应用。研究设计：系统评价。方法：采用Medline、EMBASE和Cochrane数据库系统检索文献。搜索词羊膜单独使用，并与干细胞、骨科、组织工程、支架和运动医学一起使用。结果：共检索到6870篇文章，经标题和摘要筛选，其中80篇文章被认为与本研究相关。55篇文章描述了am衍生产品的解剖学、基础科学和非矫形学应用。25篇文章描述了am衍生产品用于骨科运动医学的临床前和临床试验。由于从本研究中获得的证据水平不足以进行系统评价或荟萃分析，因此本文对am衍生产品的解剖学、生理学和临床应用进行了当前的概念回顾。结论：羊膜在运动医学中具有广阔的应用前景。它们是多能细胞、高度组织化胶原蛋白、抗纤维化和抗炎细胞因子、免疫调节剂和基质蛋白的来源。这些特性可能使其在用作组织工程支架时有益，在愈合和治疗关节炎关节时改善组织组织。目前的运动医学证据严重偏向于体外和动物研究，很少甚至没有人体临床数据。尽管如此，仍有14家公司或分销商提供商用AM产品。这些产品的制备和配方改变了它们的生物和机械性能，对这些差异的透彻理解将有助于指导am衍生产品在运动医学研究中的使用。
Background: Amniotic membrane (AM)-derived products have been successfully used in ophthalmology, plastic surgery, and wound care, but little is known about their potential applications in orthopaedic sports medicine.Purpose: To provide an updated review of the basic science and preclinical and clinical data supporting the use of AM-derived products and to review their current applications in sports medicine.Study Design: Systematic review.Methods: A systematic search of the literature was conducted using the Medline, EMBASE, and Cochrane databases. The search term amniotic membrane was used alone and in conjunction with stem cell, orthopaedic, tissue engineering, scaffold, and sports medicine.Results: The search identified 6870 articles, 80 of which, after screening of the titles and abstracts, were considered relevant to this study. Fifty-five articles described the anatomy, basic science, and nonorthopaedic applications of AM-derived products. Twenty-five articles described preclinical and clinical trials of AM-derived products for orthopaedic sports medicine. Because the level of evidence obtained from this search was not adequate for systematic review or meta-analysis, a current concepts review on the anatomy, physiology, and clinical uses of AM-derived products is presented.Conclusion: Amniotic membranes have many promising applications in sports medicine. They are a source of pluripotent cells, highly organized collagen, antifibrotic and anti-inflammatory cytokines, immunomodulators, and matrix proteins. These properties may make it beneficial when applied as tissue engineering scaffolds, improving tissue organization in healing, and treatment of the arthritic joint. The current body of evidence in sports medicine is heavily biased toward in vitro and animal studies, with little to no human clinical data. Nonetheless, 14 companies or distributors offer commercial AM products. The preparation and formulation of these products alter their biological and mechanical properties, and a thorough understanding of these differences will help guide the use of AM-derived products in sports medicine research.