Amnionmembransuspension und autologes Serum – spielt der Inhalt eine Rolle für die Wundheilung?

Zusammenfassung

Autologes Serum (AS) und Amnionmembrantransplantate (AMT) werden für eine Vielzahl von Oberflächenerkrankungen des Auges eingesetzt. Die Amnionmembrantransplantation ist immer mit einem operativen Eingriff verbunden. Für die Patienten wäre es von Vorteil, wenn durch die Applikation von Augentropfen, die aus Amniongewebehomogenat (AMH) oder Amnionmembransuspension (AMS) gewonnen würden, eine Operation vermieden werden könnte. In einer früheren Studie haben wir nachgewiesen, dass Epidermal Growth Factor (EGF), Fibroblast Growth Factor basic (bFGF), Interleukin-6 (IL-6) und IL-8 in AMS freigesetzt wird. Die EGF- und bFGF-Konzentrationen in den AMS lagen jedoch im Durchschnitt um das 1,7–17-Fache niedriger als in den AMH, und in den AMH konnte im Vergleich zur AMS kein IL-6 und IL-8 nachgewiesen werden. 100 % AMS, 15 und 30 % AMH verlangsamten die Proliferation humaner Epithelzellen im Vergleich zur Kontrolle (p = <0,002 für alle), während 15 und 30 % AMS keinen Einfluss auf die Proliferation hatten. Im Vergleich zu den Kontrollen wurde die Migrationsrate unter Verwendung von 15 und 30 % AMS gesteigert (p < 0,001), zeigte aber keinen Unterschied bei einem Einsatz von 15 und 30 % AMH (p = 0,153 und p = 0,083). Die Proliferationsrate wurde durch den Einsatz von 15 % humanem Serum gegenüber 30 % humanem Serum gesteigert (p < 0,001). Humane korneale Epithelzelllinien (HCECs) migrierten schneller mit einer humanen Serumkonzentration von 30 % im Vergleich zu 5 % humanem Serum (p < 0,01). Zusammengefasst zeigten der Einsatz von 15 und 30 % AMS sowie der Einsatz von 15 und 30 % AS die vorteilhafteste Wirkung auf humane Epithelzellen. Jedoch muss bei der Gabe von AS- und AMS-Augentropfen bedacht werden, dass die individuelle Konzentration der Wachstumsfaktoren einer großen Schwankungsbreite unterliegt.

Abstract

Autologous serum (AS) and amniotic membrane transplantation (AMT) are used in the treatment of several ocular surface diseases. AMT is associated with a surgical intervention. Surgery could be avoided by using eye drops prepared from an amniotic membrane homogenate (AMH) or amniotic membrane suspension (AMS). EGF, bFGF, IL-6 and IL-8 were detected in AMS. However, EGF and bFGF concentrations in AMS were about 1.7–17× lower than in AMH, and IL-6 and IL-8 could not be detected in AMH. 100 % AMS, 15 and 30 % AMH significantly decreased proliferation of human corneal epithelial cells (HCECs) compared to controls (p = <0.002 for all), but 15 and 30 % AMS did not affect proliferation. Migration increased significantly compared to controls with 15 and 30 % AMS (p < 0.001), but did not change significantly with 15 or 30 % AMH (p = 0.153 and p = 0.083). Proliferation of HCECs was significantly greater with 15 % AS than with 30 % AS (p < 0.001). HCEC migration was significantly greater with 30 % AS than with 5 % AS (p < 0.01). In summary, 15 and 30 % AMS and 15 and 30 % AS exhibit the best supportive effect on human corneal epithelial cells. Nevertheless, we always have to keep in mind that individual growth factor concentrations exhibit high inter-individual fluctuations in AS or AMS eye drops.

Schlüsselwörter

autologes Serum - Amnionmembran - Suspension - Homogenate

Key words

autologous serum - amniotic membrane - suspension - homogenate

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