Decellularized human amniotic membrane engraftment in combination with adipose-derived stem cells transplantation, synergistically improved diabetic wound healing.

BACKGROUND: One of the most important and common complications of diabetes is a disorder and defect in diabetic wound healing. AIMS: The aim of present study was to investigate the synergistic effects of decellularized human amniotic membrane (dHAM) engraftment and adipose-derived stem cells (ADSs) transplantation in the healing of delayed and ischemic diabetic wound. METHODS: Sixty diabetic male rats were randomly divided into four groups (n = 15), including untreated (Control) group, engraftment by dHAM (dHAM) group, transplanted by ADSs (ADS) group, and engraftment by dHAM plus transplanted by ADSs (dHAM + ADS) group. Sampling was performed on Days 7, 14, and 21 after surgery. Evaluation tests included stereology, immunohistochemistry, molecular, and biomechanical. RESULTS: Our results showed that the wound closure rate, volumes of newly formed epidermis and dermis, density of fibroblasts and blood vessels, collagen deposition, density of proliferation cells, expression levels of TGF-ß and VEGF genes, and biomechanical characteristics were significantly higher in all treated groups compared with control group; however, these changes were considerable in the combination group. This is while that the density of neutrophils and expression levels of TNF-α and IL-1ß genes in the treated groups, especially in the combination group, were significantly reduced compared with control group. CONCLUSION: Generally, the simultaneous use of dHAM and ADS accelerates healing and improves the quality of repaired diabetic wounds.