Anatomy and Physiology of the Amniotic Membrane Fig.

01: Origin of the human Amniotic Membrane

The amniotic membrane develops from the extra-embryonic tissue consisting of foetal and maternal components which are kept together by the chorionic villi. The foetal component consists of the amniotic and chorionic foetal membranes, which separates the foetus from the endometrium. The amniotic membrane (AM) is the innermost layer of the foetal membranes of the placenta. It is avascular and has an epithelial layer with a sub-adjacent avascular stromal layer. The amniotic membrane is one of the thickest membranes in the human body. The membrane consists of five layers: (I) the cuboidal epithelium layer; (II) the basement membrane; (III) compact layer; (IV) fibroblast layer; and (V) intermediate (spongy) layer.

Fig. 02: Cross section of the human Amniotic Membrane indicating the biochemical characteristics of the section. The basement membrane is a thin layer composed of reticular fibres, closely adherent to the amniotic epithelium, while the adjacent compact layer is more dense and devoid of cells consisting of a complex reticular network. It has low immunogenic potential and contains bioactive factors that have been shown to be beneficial in wound treatment, such as: collagen, cell-adhesion bio-active factors (fibronectin, laminins, proteoglycans and glycosaminoglycans) and growth factors. The following fibroblastic layer is thickest of the five layers consisting of fibroblasts embedded in a loose reticular network. The outer spongy layer forms the interface between amniotic and chorionic membranes, consisting of wavy reticulum bundles bathed in mucin. Amniotic membrane tissue shows little to no HLA-A, B, C antigens or 2 microglobulins and is therefore immunologically inert.

Mode of Action The amniotic membrane is used for its high concentrations of cytokines and growth factors. Generally the membrane is placed with the epithelial side down in contact with the wound surface in order to efficiently release the growth factors to the wound site. The use of the amniotic membrane to cover inflamed or exposed areas favourably influences the wound healing process, as well as, reducing the levels of pain and discomfort of the patient. AmnioMatrix (d) serves as a potent facilitator in wound healing. By removing the epithelial layer, host cells can more readily interact with the bio-active cell-adhesion factors within the basement membrane, serving as a substrate for cellular growth. The amniotic membrane conforms easily to the wound surface and can be either glued or sutured to the wound surface. The membrane is hydrophilic and naturally absorbs the surrounding fluids. As part of the healing process the amnion resorbs into the wound. General literature suggests that the membranes completely resorb into the wound in about 14 21 days. https://www.netcells.co.za/membrane-about.php Netcells Biosciences is Africa's leading stem cell laboratory and cryogenic biobank based in Johannesburg, South Africa. . Netcells is accredited with the American Association of Blood Banks and the only bank on the continent to process, test and store according to validatedinternational accreditation standards.