A photo of Marcella Townsend following treatment for severe facial burns using placenta-derived grafts. Credit: Kendrick Brinson/The New York Times/Redux
Millions of placentas are discarded annually around the world. Given the regenerative medical potential demonstrated by placenta-derived tissue over the years, this is quite an unfortunate statistic. First used in 1910, placenta-derived tissue was abandoned in the 1980s for fear of disease transmission; however, its clinical safety was eventually established with controlled protocols. From preclinical data describing the regeneration of damaged hearts, to clinical trials targeting diabetic foot ulcers (here and here), and extensively documented use in ophthalmology, the list of current and potential applications is long. It’s especially useful that placenta-derived tissues are immunologically privileged, meaning they do not generate an immune response in patients, regardless of who the donor might have been.
Last month, 47-year-old Marcella Townsend – who suffered second- and third-degree burns across more than 60 per cent of her body – shared her experience with placenta-derived grafts in the New York Times. I also included her story in the October edition of Regenerative Medicine News Under the Microscope, as it was quite impactful. In 2021, a propane explosion at her mother’s house left Ms. Townsend’s face, in her words, “unrecognizable.” You would never guess this looking at her today, however.
The biomaterial that saved her face was manufactured from placentas donated by healthy, consenting women who delivered by elective C-section. Each donor sample is processed so that the amniotic membrane – that is, the layer facing the fetus – is peeled away and sterilized. The resulting material is then deep-frozen, dehydrated, or freeze-dried so that it’s ready for use.
In Ms. Townsend’s case, the membranes were applied to her face, which then transitioned through a series of healing phases that she and her family classified using colour: “It went from a dark, dark, dark blackish to a brown, and then they said it went to an orange… dark orange. I recall when it was very, very bright. Like the orange had went to a pale yellowish-creamish colour, and I was thinking: when my pigmentation starts to come in, that it’s going to be different colours than my normal skin tone. Lo and behold, it’s the same colour.”
Kate Morgan’s NYT piece is incredibly thorough if you’re looking for more background. There are also compelling before and after photos to provide a deeper appreciation for the degree of healing achieved. While burn treatment isn’t necessarily a new application for amniotic membranes, it’s still important to keep these stories in the spotlight given that these patients rely on donated tissues. There’s a ton of ongoing research on placenta-derived tissue – also published this October, see Nie et al.’s preclinical study investigating placental mesenchymal stem cells in modelled acute lung injury, and this human study by García-Vásquez et al. on amniotic membrane patches in retinal repair. Alternatively, check out this link generated by Kate Morgan listing ongoing or completed clinical trials involving amniotic membranes; there are hundreds of them. Additional study is critical to determine where else placenta-derived tissue can best be applied, but if you’d like to read more about how it’s currently being used, Munoz-Torres et al. wrote a review on current surgical applications just last year.
An important note: Amniotic membranes are not to be confused with products such as amniotic fluid eyedrops, which have recently been the subject of warnings by the U.S. Food & Drug Administration (FDA). You can read more about this in Kristina Fiore’s MedPage Today piece (via ABC News), where you’ll also find comments on the matter from Professor Paul Knoepfler of the University of California, Davis. The product used on Ms. Townsend, called AMNIOBURN, is manufactured by a company registered with the FDA and licensed as a tissue bank across multiple states in the U.S. They are also compliant with tissue bank standards set by the American Association of Tissue Banks (AATB). Full information on their quality assurance can be found here. I was originally hesitant to include the specific name of the product, as my intention isn’t to advertise it; however, AMNIOBURN does serve as a positive example in the regenerative medicine space, as it’s a mainstream product regulated by the appropriate institutions.
I do wonder how amniotic membranes will ultimately compare to other emerging biomaterials being studied for wound healing, such as nanocellulose. It seems like these will be complementary tools, rather than competing ones, as each appears to have a particular set of strengths and weaknesses rendering them suitable for different, but potentially overlapping, indications and settings.
In many cases, women might not be aware that they have the option to donate their placentas, depending on where and how they give birth. Here in Toronto, Mount Sinai Hospital’s tissue bank is Ontario’s only program currently producing amniotic membrane products for wound healing. I also came across two other Canadian programs accepting donations: Manitoba appears to have one through their provincial health authority, and the Eye Bank of Canada does as well; see more information about that at Kensington Health. It can’t hurt to inquire if you or someone that you know is interested in getting involved.
Of course, if you’re in Canada and can’t find a similar program close by, consider seeing if you’re eligible to donate blood stem cells left in the umbilical cord and placenta through the Canadian Blood Services. Cord blood donation can help treat over 80 medical conditions, so it’s certainly worth thinking about.
For more stories like these, make sure to catch up on Regenerative Medicine News Under the Microscope, published monthly here on Signals.
Lyla El-Fayomi
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