Soluble Factors of Amnion-Derived Cells in Treatment of Inflammatory and Fibrotic Pathologies

Inflammation is a complex defense mechanism characterized by leukocyte migration from the vasculature into damaged tissues and subsequent deposition of extracellular matrix resulting in tissue repair. The inflammatory process is generally categorized into an acute, rapid response, and a persistent but slowly evolving chronic condition, which may progress into inflammatory diseases. An excessive deposition of extracellular matrix leads to overgrowth, hardening, and/or scarring of tissues, defined as fibrosis. The amnion has been used as biomaterial in medicine for over 100 years and has been proven valuable for the treatment of different pathological conditions including wound healing. In light of recent reports, this article will review the effects of the amnion and its cellular components within the inflammatory-fibrotic scenario and the factors described so far that could be involved in these immunomodulatory actions. As proof of principles, we will also discuss pre-clinical and clinical applications of the amnion where advantage has been taken of its anti-inflammatory and anti-fibrotic properties. It is conceivable that the local host environment in which the amnion is placed may have a profound role in influencing the production and function of soluble factors and the shift towards different steps in triggering healing. The healing effect depends on time, dosage, and location of cytokine/growth factor production by the amnion, together with the influence of the host microenvironment. Indeed, determining the specific cascade of events that may define the role of the amnion in a given clinical situation remains a challenge.