Evaluation of the Effectiveness of The Use of Decellularized Human Amniotic Membrane in Combination with Cell Therapy for Local Radiation Injuries

Abstract

Cell therapy is a promising direction in medicine, which can significantly improve the results of treatment of various diseases, including local radiation injuries (LRI). The purpose of the study was to compare the results of using decellularized human amniotic membrane isolated and together with lyophilisates of conditioned media of MSCs from the human gingival mucosa and MSCs from human placental tissue and their effect on tissue regeneration in LRI. Material and methods: The study included 42 laboratory animals (white male rats of the Wistar line), randomly divided into 6 groups: K – control group without therapy, on the 21st day after irradiation, groups using: Am+LD – application of lyophilisate of the conditioned medium of MSCs of the human gingival mucosa (LD) under the decellularized amniotic membrane, Am+LP – application of lyophilisate of the conditioned medium of MSCs of human placental tissue (LP) under the decellularized amniotic membrane, Am – application of the decellularized amniotic membrane, AmCl – application of the decellularized amniotic membrane with medical glue BF-6, Kl – application medical glue BF-6. Modeling of LRI in animals was carried out on an LNK-268 X-ray unit at a dose of 110 Gy and observed until the 112th day after irradiation, monitoring of the ulcerative surface of the skin and the course of the inflammatory process of LRI was carried out with calculation of the area of ​​the total changed skin in the ImageTool software. Planimetric and histological analyzes were performed. Results: It was demonstrated that, when compared with the control, the use of decellularized amniotic membrane in LRI on days 77 and 112 after irradiation increased the healing rate by 4.6 and 18 times, respectively; decellularized amniotic membrane with lyophilisate of placental MSC conditioned medium increased the rate of wound healing by 13.5 and 27 times, respectively; and a dellularized amniotic membrane with lyophilisate of MSCs from the human gingival mucosa to 100 % healing. Healing of the ulcer surface area of the LRI in 83.5 % of animals in the Am group demonstrated the effectiveness of using isolated decellularized amniotic membrane even in the absence of human MSC lyophilisates. At the same time, healing of the ulcer surface area of the LRI in the AmCl group was 20 % of cases, where the decellularized amniotic membrane was fixed with BF-6 medical glue, which was less effective compared to other groups. Conclusion: The proposed combined use of decellularized amniotic membrane with lyophilisates of the conditioned medium of mesenchymal stromal cells (MSCs) of the placenta and mucous tissue of the human gums and the isolated use of decellularized amniotic membrane led to complete epithelization of the ulcer surface, a pronounced favorable course of grade IIIb–IV LRI in laboratory animals and a reduction in healing time , the absence of local or systemic complications can be considered as a promising method of conservative treatment for LRI of the skin and a new therapeutic approach in the treatment of non-healing and chronic wounds.