Researcher Ankara University/Stem Cell Institute/Graduate School of Health Sciences, Ankara, Turkey
Abstract: The therapeutic effect of amniotic membrane (AM) is a proven treatment method used in the field of medicine, especially in wound healing. Its skin-like properties, angiogenic effect, and ability to promote cell proliferation and differentiation make AM an important material for therapeutic applications. In ophthalmology, AM transplantation is widely used, including corneal, conjunctival and retinal pathologies. Early wound healing deterioration means repeated transplants. Therefore, the use of more easily applicable, durable and off the shelf transplantation products can improve the treatment approach. 3D printing technology has made it easier to fabricate tissue-like structures on demand. In this study, the effect of lyophilized amniotic membrane-based lenses produced via 3D printing, on wound healing purpose in corneal epithelial-stromal defects in rabbits was investigated. For this purpose, AM collected from donors was first decellularized and then lyophilized. In order to make it suitable for 3D printing, powdered AM was mixed with alginate and antibiotics to form a hydrogel. The resulting hydrogel was printed with a 3D bioprinter in the shape of a lens of appropriate size for the rabbit eye. Polycaprolactone (PCL) in the form of a cage, which allows the lenses to be fixed in the damaged eyes, was also printed with the 3D bioprinter and sewed to the eyes of the rabbits to secure the lenses. At the end of the 7th day, there was no statistically significant difference between rabbits which received 3D printed AM and conventional AM transplantation in terms of histologic epithelial formation and keratocyte presence, inflammation and wound healing results. Compared to the control group, the 3D printing group showed 50% more moderate-intensity keratinocyte formation and 16.7% more 2-row epithelial formation. The results indicated that rabbits had similar responses to treatment after both 3D printed AM and conventional AM transplantation. Furthermore, the antibiotic secreted through the hydrogel eliminated the need for regular topical drops. Since AM was decellularized, the proposed strategy reduces the risk of immunological response and enables long-term storage. In conclusion, considering these advantages, 3D printed AM lenses offer an alternative treatment to conventional AM transplantation.
