Está en la página 1de 11

Rev Hematol Mex 2011;12(4):276-286

Artculo de revisin
Utilidad teraputica potencial de las clulas madre de la membrana
amnitica
Carmen L Insausti,* Miguel Blanquer,* Mara J Majado,* Alfredo Insausti,** Jos M Moraleda*,***

RESUMEN
Desde los primeros estudios de clulas madre obtenidas de la membrana amnitica se ha avanzado mucho en el conocimiento de las
caractersticas de estas clulas, sus mtodos de obtencin y procesamiento, as como de su potencialidad. Numerosos ensayos preclnicos
sugieren que las clulas madre de la membrana amnitica podran ser tiles en la regeneracin de una serie de alteraciones tisulares.
(VWiSRUGLOXFLGDUVHVLHOHIHFWREHQpFRTXHHMHUFHQHVWDVFpOXODVVHGHEHDVXGLIHUHQFLDFLyQSRUFpOXODVGHOWHMLGRDIHFWDGRRVLHV
PHGLDGRSRUVXDFFLyQSDUDFULQDDQWLLQDPDWRULDHQORVWHMLGRVGHOKXpVSHGKLSyWHVLVTXHSDUHFHVHUODPiVIDYRUHFLGD6HUHTXLHUHXQD
estrecha colaboracin entre la investigacin bsica y los clnicos para que la terapia con clulas se haga realidad en la prctica diaria.
Palabras clave: membrana amnitica, clulas madre, clulas de la membrana amnitica, clulas epiteliales, clulas mesenquimales,
terapia celular.

ABSTRACT
6LQFHWKHUVWVWXGLHVRQDPQLRWLFGHULYHGVWHPFHOOVZHUHSXEOLVKHGPXFKNQRZOHGJHKDVEHHQJDLQHGUHJDUGLQJWKHFKDUDFWHULVWLFV
handling methods and potential of these cells. A lot of preclinical evidence suggests that human amniotic derived cells may be useful for
WUHDWLQJDUDQJHRISDWKRORJLFFRQGLWLRQVMRLQLQJWKHOLVWRIVLJQLFDQWFRQWULEXWRUVWRUHJHQHUDWLYHPHGLFLQH:KHWKHUWKHEHQHFLDOHIIHFWV
of amniotic derived cells are due to differentiation of the transplanted cells themselves or to paracrine actions on the surrounding host tissue
LQRUGHUWRUHGXFHLQDPPDWLRQDQGSURPRWHUHJHQHUDWLRQUHPDLQVWREHIXOO\HOXFLGDWHG,QPDNLQJQHZFHOOWKHUDS\EDVHGVWUDWHJLHVD
clinical reality, it is fundamental a close collaboration between basic scientists and clinicians.
Key words: Amnion, amniotic membrane, stem cell, amniotic epithelial stem cell, amniotic mesenchymal stem cell, Cell therapy.

DPHPEUDQDDPQLyWLFDHVODFDSDPiVLQWHUQDGHOD
SODFHQWD&RQMXQWDPHQWHFRQHOFRULRQVHH[WLHQGH
PiV DOOi GH ORV PiUJHQHV GHO GLVFR SODFHQWDULR
SDUDHQYROYHUDOIHWRHQODFDYLGDGDPQLyWLFDEULQGDUOH
SURWHFFLyQGXUDQWHVXGHVDUUROOR\RIUHFHUOHXQDPELHQWH

*
**
***

Servicio de Hematologa y Hemoterapia. Unidad de Terapia


Celular. Hospital Universitario Virgen de la Arrixaca.
Servicio de Oftalmologa. Hospital Universitario La Paz, Madrid.
Universidad de Murcia. Murcia, Madrid.

Correspondencia: Dra. Carmen L Insausti. Servicio de Hematologa


y Hemoterapia, Unidad de Terapia Celular. Hospital Universitario
Virgen de la Arrixaca. Ctra. Madrid-Cartagena. El Palmar 30120,
Murcia. Correo electrnico: caymed@gmail.com
Recibido: octubre 2011. Aceptado: noviembre 2011.
Este artculo debe citarse como: Insausti CL, Blanquer M, Majado
MJ, Insausti A, Moraleda JM. Utilidad teraputica potencial de
las clulas madre de la membrana amnitica. Rev Hematol Mex
2011;12(4):276-286.

276

GHVXVSHQVLyQHQHOTXHSXHGDFUHFHUVLQGLVWRUVLyQSRU
SUHVLyQGHODVHVWUXFWXUDVTXHORURGHDQ,QWHUYLHQHDGHPiVHQHOLQWHUFDPELRGHJDVHV\GHVHFKRV\DFW~DFRPR
EDUUHUD GH GHIHQVD FRQWUD LQIHFFLRQHV WUDXPDWLVPRV \
WR[LQDV1,2
/DPHPEUDQDDPQLyWLFDDWpUPLQRWLHQHXQDVXSHUFLH
GHDFP2SHVRGHDJ\HVSHVRUGHD
P(VWUXFWXUDOPHQWHHVWiFRPSXHVWDSRUHSLWHOLROiPLQD
EDVDOHVWURPDGHWHMLGRFRQHFWLYRDYDVFXODUGHQRPLQDGR
PHVRGHUPRDPQLyWLFR\FDSDHVSRQMRVDTXHODVHSDUDGHO
FRULRQ1-4 (OHSLWHOLRDPQLyWLFRIRUPDXQWDSL]DGRVLPSOH
FRQWLQXRLQLQWHUUXPSLGRGHFpOXODVFLOtQGULFDVFXERLGHV
R SODQDV HQ FRQWDFWR FRQ HO OtTXLGR DPQLyWLFR 5HSRVD
VREUHODOiPLQDEDVDOELHQGHQLGDIRUPDGDSRUXQDPDOOD
GHEUDVGHFROiJHQRVWLSR,,,\,9\JOLFRSURWHtQDV(VWD
OiPLQD HVWi FRQHFWDGD FRQ HO PHVRGHUPR DPQLyWLFR HQ
FX\DSDUWHPiVSUR[LPDOVHGLVWLQJXHXQDFDSDFRPSDFWD
acelular,FRPSXHVWDGHEURQHFWLQDFROiJHQRLQWHUVWLFLDO
WLSR,\,,,GLVSXHVWRVHQIRUPDGHKDFHVSDUDOHORV\FR-

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

Utilidad teraputica potencial de las clulas madre de la membrana amnitica

OiJHQRWLSR9\9,TXHIRUPDQFRQH[LRQHVODPHQWRVDV
HQWUH HO FROiJHQR LQWHUVWLFLDO \ OD PHPEUDQD EDVDO 3RU
fuera de sta se encuentra una capa dispersa de clulas
HVWURPDOHVGHWLSREUREODVWRVHPEHELGRVHQXQDPDOODGH
EUDVUHWLFXODUHV0iVH[WHUQDPHQWHVHHQFXHQWUDODFDSD
LQWHUPHGLDRHVSRQMRVDULFDHQHODVWLQDSURWHRJOLFDQRV
JOLFRSURWHtQDV\EUDVGHFROiJHQRSUHGRPLQDQWHPHQWH
WLSR,,,RUJDQL]DGDVOD[DPHQWHTXHVHSDUDHODPQLRVGHO
FRULRQ3,4(ODPQLRVHVXQRGHORVSRFRVWHMLGRVTXHFDUHFH
GH QHUYLRV P~VFXORV \ YDVRV OLQIiWLFRV 6XV QXWULHQWHV
VRQVXSOLGRVGLUHFWDPHQWHSRUGLIXVLyQGHVGHHOOtTXLGR
DPQLyWLFRRGHVGHODGHFLGXDVXE\DFHQWH
(QORV~OWLPRVDxRVODPHPEUDQDDPQLyWLFDKDGHVSHUWDGR JUDQ LQWHUpV HQ OD FRPXQLGDG FLHQWtFD FRPR
XQD IXHQWH DOWHUQDWLYD GH FpOXODV PDGUH (Q HOOD VH KD
GHPRVWUDGR OD H[LVWHQFLD GH GRV SREODFLRQHV FHOXODUHV
FRQFDUDFWHUtVWLFDVGHFpOXODVPDGUHODVFpOXODVHSLWHOLDOHV
FRQRFLGDVFRPRK$(&human Amniotic Epithelial cells,
FRQ FDUDFWHUtVWLFDV PX\ SDUHFLGDV D ODV GH ODV FpOXODV
HPEULRQDULDVTXHDOLJXDOTXHHOODVH[SUHVDQPDUFDGRUHV DQWLJpQLFRV HPEULRQDULRV IDFWRUHV GH WUDQVFULSFLyQ
SURSLRVGHSOXULSRWHQFLDOLGDG\HYLGHQFLDQGLIHUHQFLDFLyQ
SOXULSRWHQFLDOKDFLDFpOXODVGHODVWUHVFDSDVJHUPLQDOHV
HFWRGHUPR QHXURQDV \ FpOXODV JOLDOHV  HQGRGHUPR
KHSDWRFLWRVFpOXODVSDQFUHiWLFDV \PHVRGHUPR RVWHRFLWRVDGLSRFLWRVFDUGLRPLRFLWRVPLRFLWRVHVTXHOpWLFRV 
EDMR FRQGLFLRQHV GH FXOWLYR DGHFXDGDV< ODV FpOXODV
PHVHQTXLPDOHV REWHQLGDV GHO HVWURPD PHVRGpUPLFR
GHQRPLQDGDV K$06& human Amniotic Mesenchymal
Stem or Stromal cells TXHEiVLFDPHQWHVRQFpOXODVPXOWLSRWHQFLDOHVDXQTXHDOJXQRVLQYHVWLJDGRUHVWDPELpQKDQ
GHPRVWUDGRXQDFDSDFLGDGGHGLIHUHQFLDFLyQPiVDOOiGH
ODOtQHDPHVRGpUPLFD
(VWDV FpOXODV GH PX\ IiFLO REWHQFLyQ HQ FDQWLGDGHV
DEXQGDQWHVDSDUWLUGHXQWHMLGRGHGHVHFKRGHGLVSRQLELOLGDGFDVLLOLPLWDGDKDQUHVXOWDGRPX\DWUDFWLYDVSDUDOD
LQYHVWLJDFLyQGHELGRDTXHSRVHHQXQSRWHQFLDOSUROLIHUDWLYRDSDUHQWHPHQWHPD\RUTXHHOGHODVFpOXODVGHOD02
\HYLGHQFLDQIiFLOPHQWHVXSRWHQFLDOGHGLIHUHQFLDFLyQin
vitroFXDQGRVHXWLOL]DQORVPHGLRVGHFXOWLYRDGHFXDGRV
$GHPiV VHFUHWDQ QHXURWUDQVPLVRUHV \ IDFWRUHV WUyFRV
TXHHVWLPXODQDODVFpOXODVPDGUHHQGyJHQDV\PRGXODQ
SRVLWLYDPHQWHHOPLFURDPELHQWHGHORVWHMLGRVUHFHSWRUHV
GRQGH KDQ VLGR DSOLFDGDV D\XGDQGR D VX UHJHQHUDFLyQ
VLQWHWL]DQ \ OLEHUDQ VXVWDQFLDV ELROyJLFDPHQWH DFWLYDV
FRPRFLWRFLQDV\PROpFXODVGHVHxDOL]DFLyQFRPRHO71)

Tumor Necrosis Factor) 7*) 7*) Transforming


JURZWKIDFWRUDQG E)*) EDVLFEUREODVWLFJURZWK
factor)(*) (Epidermal Growth Factor +*) Hepatic
growth factor .*) Keratinocytes growth factor ,/
,/,/ LQWHUOHXFLQDV LQKLELGRUHVQDWXUDOHVGH
PHWDORSURWHDVDGHIHQVLQDVSURVWUDJODQGLQDVHWFTXH
ODFDSDFLWDQSDUDFXPSOLURWUDVIXQFLRQHVELROyJLFDV
1RH[SUHVDQDQWtJHQRV+/$'5QLPROpFXODVFRHVWLPXODGRUDV\MXHJDQXQSDSHOLPSRUWDQWHHQODPRGXODFLyQGH
ODVUHVSXHVWDVLQPXQHVHLQDPDWRULDVH[SUHVDQDQWtJHQRV
+/$* FRQVLGHUDGRV FODYH HQ OD LQPXQRWROHUDQFLD DO
IHWR SXHV VH FRPSRUWDQ FRPR SpSWLGRV WROHURJpQLFRV \
FRQWULEX\HQFRQHOHIHFWRLQPXQRPRGXODGRUSRUVXXQLyQ
DUHFHSWRUHVLQKLELWRULRVSUHVHQWHVHQODVFpOXODV1.\HQ
ORVPDFUyIDJRVLQKLEHQODSUROLIHUDFLyQGHODVFpOXODV7
&' H LQGXFHQ DSRSWRVLV GH ODV FpOXODV 7 &'
7RGDVHVWDVVRQYHQWDMDVDGLFLRQDOHVVREUHRWURVWLSRVGH
FpOXODVPDGUHGHJUDQLPSRUWDQFLDHQODWHUDSLDFHOXODU\
HQODLQJHQLHUtDWLVXODU
Usos de las hAEC y hAMSC en modelos animales

+DFHSRFRVHSXEOLFDURQGLIHUHQWHVHQVD\RVSUHFOtQLFRV
HQ PRGHORV DQLPDOHV FRQ GLYHUVDV HQIHUPHGDGHV TXH
HYLGHQFLDQ OD KDELOLGDG GH HVWDV FpOXODV SDUD LQMHUWDUVH
HQORVWHMLGRVGHOKXpVSHG\FRQWULEXLUDVXUHJHQHUDFLyQ
&XDGUR $OJXQRVGHHOORVORVFRPHQWDUHPRVHQVHJXLGD
(QIHUPHGDGHVQHXUROyJLFDV

(QHODxR.DNLVKLWD\FRODERUDGRUHVFRQHOXVR
GHXQPRGHORGHHQIHUPHGDGGH3DUNLQVRQHQUDWDVLQMHUWDURQK$(&WUDQVIHFWDGDVFRQHOPDUFDGRU/DF=GHO
JHQGHJDODFRVLGDVD JDO HQHOVWULDWXPGHQHUYDGR
GH GRSDPLQD /DV FpOXODV LQIXQGLGDV IXHURQ FDSDFHV
GHVXSHUYLYLUSURGXFLHQGRPHMRUtDSDUFLDOGXUDQWHGRV
VHPDQDVWUDVHOWUDVSODQWH(QXQDH[WHQVLyQGHOHVWXGLR
UHDOL]DGRHQORVPLVPRVLQYHVWLJDGRUHVGHPRVWUDURQTXHODVK$(&IXHURQFDSDFHVGHVLQWHWL]DU\VHFUHWDU
FDWHFRODPLQDV\IDFWRUHVQHXURWUyFRVGLIXVLEOHV %'1)
Brain derived netrophic factor y NT-3: 1eurotrophin-3)
TXHPHMRUDURQODIXQFLyQ\VXSHUYLYHQFLDGHODVQHXURQDV
GRSDPLQpUJLFDV28
(Q  .RQJ \ VXV FRODERUDGRUHV  UDWLILFDURQ
HO HIHFWR QHXURSURWHFWRU \ QHXURJpQLFR GH ODV K$(&
WUDVSODQWDGDV DO VWULDWXP GH UDWRQHV FRQ HQIHUPHGDG GH
3DUNLQVRQDOREVHUYDUPHMRUtDHQODFRQGXFWDGHORVUDWRQHVWUDVSODQWDGRV

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

277

L Insausti C y col.

Cuadro 1. Trasplante de HAEC o HAMSC en modelos animales de enfermedades


Enfermedad

Animal

Enfermedad de Parkinson

Rata

Contusin del cordn medular

Ratn
Rata
Mono
Rata

Obstruccin arterial cerebral media


Tejido heptico

Rata
Ratn
Conejo
Ratn

Fibrosis heptica
Infarto cardiaco
Diabetes
Fibrosis pulmonar
Tejido cartilaginoso
Enfermedades del odo
Pared abdominal

Isquemia de extremidades

Rata
Ratn
Ratn
Ratn
Rata
Cobayo
Rata
Ratn

Evolucin

Referencias

Supervivencia celular. Sntesis y secrecin de catecolaminas y factores


QHXWUyFRV0HMRUtDGHODIXQFLyQ\VXSHUYLYHQFLDGHODVQHXURQDVGRpaminrgicas.
Efecto neuroprotector y neurognico.
Mejora clnica. Expresin de marcadores neurales
6XSHUYLYHQFLDFHOXODU(IHFWRVDQWLLQDPDWRULRVHLQPXQRPRGXODGRUHV
Integracin celular sin reaccin inmunitaria
Supervivencia celular. Expresin de marcadores neuronales. Disminucin
del rea infartada. Mejora clnica
Integracin en tejido heptico. Expresin de marcadores hepticos.
Integracin heptica. Expresin de receptores.
,QWHJUDFLyQHQWHMLGRKHSiWLFR'LVPLQXFLyQGHODDSRSWRVLVODLQDPDFLyQ
\ODEURVLV
Supervivencia celular. Expresin de marcadores cardiacos. Mejora de
la funcin cardiaca.
Correccin de hiperglucemia. Integracin celular en el hgado y el pncreas
'LVPLQXFLyQGHODLQOWUDFLyQSRUQHXWUyORV5HGXFFLyQGHODEURVLV
Produccin de protenas surfactantes A, B, C y D.
Expresin de genes, receptores, colgeno tipo II y aggrecan
Localizacin en la regin supra-limbal, regin supra-espiral en la scala
vestibuli y en la regin subcentral del ligamento espiral en la scala timpani.
Supervivencia durante 3 semanas. Expresin de marcadores.
Integracin celular. Mejora de cicatrizacin. Reduccin de la incidencia
y tamao de hernias incisionales.
0HMRUtDGHXMRVDQJXtQHR'LVPLQXFLyQGHQHFURVLV$XPHQWRGHFDSLODUHV

(Q HO DxR  <DQJ ; \ VX JUXSR WUDVSODQWDURQ


K$(& DO YHQWUtFXOR ODWHUDO GH UDWDV FRQ XQ PRGHOR GH
HQIHUPHGDG GH 3DUNLQVRQ LQGXFLGR SRU PLFURLQ\HFFLyQ
HVWHUHRWiFWLFD GH  K\GUR[\GRSDPLQD 2+'$  HQ HO
VWULDWXP \ HYDOXDURQ OD VXSHUYLYHQFLD \ GLIHUHQFLDFLyQ
GH ODV K$(& DVt FRPR ORV HIHFWRV SURGXFLGRV SRU HO
LQMHUWR 2EVHUYDURQ TXH OD URWDFLyQ DVLPpWULFD LQGXFLGD
SRUODDSRPRUQDHQODVUDWDVFRQHQIHUPHGDGGH3DUNLQVRQGLVPLQX\yVLJQLFDWLYDPHQWHDODVGRVVHPDQDVGHO
WUDVSODQWHHQHOJUXSRWUDWDGRTXHODVFpOXODVLQMHUWDGDV
H[SUHVDURQQHVWLQD\YLPHQWLQDDODVFLQFRVHPDQDVGHO
WUDVSODQWHTXHODVFpOXODVWLUR[LQDKLGUR[LODVDSRVLWLYDV
GHWHFWDGDV SRU LQPXQRKLVWRTXtPLFD HQ OD VXVWDQFLD QLJUD GHO JUXSR WUDWDGR DXPHQWDURQ VLJQLFDWLYDPHQWH HQ
UHODFLyQFRQHOJUXSRQRWUDWDGR\TXHODGRSDPLQDODV
FRQFHQWUDFLRQHVGH'23$& 3,4-Dihydroxyphenylacetic
acid: FLGR  'LKLGUR[L IHQLO DFpWLFR  \ ODV GH iFLGR
KRPRYDQtOLFR +9$Homovanilic acid) en el striatum del
JUXSRWUDWDGRDXPHQWDURQVLJQLFDWLYDPHQWHHQUHODFLyQ
FRQHOJUXSRQRWUDWDGR

278

27,28,

29
30
31
32
33
5,35,37,39
36
40
41,42
44
45,46
18
47
48
49

6DQNDU\0XWKXVDP\HQHYDOXDURQODXWLOLGDGWHUDSpXWLFDSRWHQFLDOGHODVK$(&HQXQPRGHORGHFRQWXVLyQ
GHODPpGXODHVSLQDOLQGXFLGDHQPRQRVQRLQPXQRVXSULPLGRV31 7UDVSODQWDURQ K$(& PDUFDGDV FRQ FRORUDQWHV
GHQWURGHOiUHDOHVLRQDGD\GHPRVWUDURQTXHHVDVFpOXODV
IXHURQFDSDFHVGHVXSHUYLYLUGXUDQWHPiVGHGtDVVLQ
HYLGHQFLDV GH LQDPDFLyQ R UHFKD]R \ TXH ODV SUXHEDV
GHORFRPRFLyQPHMRUDURQKDVWDXQDSXQWXDFLyQGH 
SXQWRVPHQRVTXHORVDQLPDOHVQRUPDOHV &RQVLGHUDURQ
ODDXVHQFLDGHIRUPDFLyQGHFLFDWUL]JOLDO\GHUHDFFLyQ
LQPXQHFRPRXQDSUXHEDGHTXHODVK$(&WUDVSODQWDGDV
RIUHFLHURQXQDPELHQWHIDYRUDEOHHQHOTXHVXSHUYLYLHURQ
ODVQHXURQDV\FUHFLHURQORVD[RQHVVHFFLRQDGRV
(QHODxR:X=<\VXJUXSR32REWXYLHURQUHVXOWDGRVVLPLODUHVHQUDWDVFRQVHFFLyQGHODPpGXODHVSLQDO
/DV K$(& PDUFDGDV FRQ +RHFKVW  VXSHUYLYLHURQ
GXUDQWHRFKRVHPDQDV\VHLQWHJUDURQVLQUHDFFLyQLQPXQH
DOFRUGyQHVSLQDOGHOKXpVSHG
(QHODxR/LX\VXVFRODERUDGRUHV33 tras el trasSODQWH GH K$(& HQ HO FHUHEUR GH UDWDV FRQ REVWUXFFLyQ

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

Utilidad teraputica potencial de las clulas madre de la membrana amnitica

GHODDUWHULDFHUHEUDOPHGLDGHPRVWUDURQTXHODVK$(&
VXSHUYLYLHURQ\PLJUDURQDOiUHDLVTXpPLFDH[SUHVDQGR
PDUFDGRUHVQHXURQDOHVORTXHVHDFRPSDxyGHPHMRUtD
VLJQLFDWLYDGHODGLVIXQFLyQFRQGXFWXDO\GHUHGXFFLyQ
GHOYROXPHQGHOiUHDLQIDUWDGDHQORVDQLPDOHVWUDWDGRV
FRQFpOXODVHQUHODFLyQFRQORVFRQWUROHV
(QHODxR<X6-\VXVFRDXWRUHV34UHDOL]DURQXQD
UHYLVLyQDFHUFDGHOXVRGHODPHPEUDQDDPQLyWLFDFRPR
fuente de clulas para la terapia celular en ictus, una
HQIHUPHGDGHQODTXHODLQDPDFLyQHVHOFRQWULEX\HQWH
SULQFLSDOGHODFDVFDGDGHPXHUWHFHOXODUVHFXQGDULDTXH
VLJXHDOHSLVRGLRLQLFLDOGHLFWXV\HQODTXHODVFpOXODV
WUDVSODQWDGDVSRGUtDQFRQWURODUORVHIHFWRVGHOHWpUHRVGH
ODLQDPDFLyQ\HYLWDUODSURJUHVLyQGHOLFWXV&RQFOX\HURQFRQEDVHHQORVDUWtFXORVUHYLVDGRVTXHODVK$(&
HMHUFHQXQHIHFWRQHXURSURWHFWRUHQODVIDVHVDJXGDVGHO
GDxR\IDFLOLWDQODQHXURUHJHQHUDFLyQHQODVIDVHVWDUGtDV
$GHPiVTXHHOIDFWRUOLEHUDGRGHVGHHOHVWURPDGXUDQWH
ODLQDPDFLyQVLUYHSDUDJXLDUDODVFpOXODVWUDVSODQWDGDV
KDFLD HO WHMLGR LVTXpPLFR SRU HOOR UHVXOWD HIHFWLYD OD
DGPLQLVWUDFLyQGHODVK$(&SRUYtDSHULIpULFDHQODIDVH
DJXGDGHOLFWXV
(QIHUPHGDGHVKHSiWLFDV

6DNXUDJDZD\VXJUXSRHQHODxRHQXQHVWXGLR
FRQK$(&WUDQVGXFLGDVFRQHOJHQGHODJDOWUDVSODQWDGDVHQHOKtJDGRGHUDWRQHVFRQLQPXQRGHFLHQFLDVHYHUD
FRPELQDGD ,'6& REVHUYDURQLQWHJUDFLyQKHSiWLFDGHODV
FpOXODVWUDVSODQWDGDV\SRVLWLYLGDGSDUDIHWRSURWHtQD\
DOE~PLQDHQODVVHPDQDV\HQVHJXLGDGHODLQ\HFFLyQ
3ODQWHDURQTXHODVK$(&SRGUtDQVHU~WLOHVFRPRSRUWDGRUHVGHJHQHVSDUDSDFLHQWHVFRQHQIHUPHGDGHVKHSiWLFDV
FRQJpQLWDV
7DNDKDVKL6\VXVFRODERUDGRUHV36HQORJUDURQOD
H[SUHVLyQGHXQUHFHSWRUGHOLSRSURWHtQDVGHEDMDGHQVLGDG
/'/5Low density lipoprotein receptor HQODVK$(&D
WUDYpVGHODUHFRPELQDFLyQFRQDGHQRYLUXV\WUDVSODQWDURQ
GLFKDVFpOXODVJHQpWLFDPHQWHPRGLFDGDVHQHOKtJDGRGH
FRQHMRVFRQXQPRGHORGHKLSHUFROHVWHUROHPLDIDPLOLDU
2EVHUYDURQ XQD GLVPLQXFLyQ LPSRUWDQWH GHO FROHVWHURO
VpULFRDVtFRPRODPLJUDFLyQGHODVFpOXODVGHVGHORVVLQXVRLGHVKDFLDHOSDUpQTXLPDKHSiWLFRFRQH[SUHVLyQGH
ORVUHFHSWRUHVGXUDQWHGtDVWUDVHOWUDVSODQWHGHVSXpV
GHHVWRODVFpOXODVGHVDSDUHFLHURQ$WULEX\HURQODWHPSRUDOLGDGGHODUHVSXHVWDDOUHFKD]RGHO[HQRLQMHUWR\DOD
IXQFLyQWUDQVLWRULDGHOYHFWRUDGHQRYLUXV

7DNDKDVKL1\VXJUXSRHQWUDVSODQWDURQK$(&
WUDQVIHFWDGDVFRQHODGHQRYLUXV$GODF=HQHOKtJDGRGH
UDWDVIHWDOHVSRUPDQLSXODFLyQXWHULQD\HYLGHQFLDURQTXH
ODVFpOXODVWUDVSODQWDGDVIRUPDURQXQDPDVDFHOXODUTXH
WXYRXQDVXSHUYLYHQFLDPD\RUGHGtDVWUDVHOQDFLPLHQWRGHORVIHWRV3ODQWHDURQTXHHOXVRGHODVK$(&FRPR
WUDQVSRUWDGRUGHJHQHVSRGUtDUHVXOWDUHQODH[SUHVLyQD
ODUJRSOD]RGHJHQHVH[yJHQRV
7DNDVKLPD 6 \ VXV FROHJDV38 HQ HO DxR  WUDVSODQWDURQ SLH]DV GH DPQLRV HQ OD FDYLGDG SHULWRQHDO GH
UDWRQHVFRQ,'6&\HYDOXDURQODVXSHUYLYHQFLDGHOWHMLGR
\ OD VHFUHFLyQ GH DOE~PLQD 'HWHFWDURQ TXH HO DPQLRV
WXYRXQDGXUDFLyQGHGRVVHPDQDVFRQKDELOLGDGPHWDEROL]DQWHPHGLGDSRU077\TXHWDQWRHQHOVXHURFRPRHQ
HOOtTXLGRSHULWRQHDOVHREVHUYySURGXFFLyQGHDOE~PLQD
KXPDQDGXUDQWHVLHWHGtDVWUDVHOWUDVSODQWH/RVDXWRUHV
SODQWHDURQTXHD~QFXDQGRHOWUDVSODQWHGHDPQLRVRGHODV
K$(&SRGtDVHUXQDHVWUDWHJLDWHUDSpXWLFDQRYHGRVDSDUD
HQIHUPHGDGHVKHSiWLFDVXQRGHORVSUREOHPDVDUHVROYHU
HVODFRUWDVXSHUYLYHQFLDGHOWHMLGRWUDVSODQWDGR
(QORVDxRV\HOJUXSRGH0LNL present
HYLGHQFLDVDGLFLRQDOHVGHTXHODVK$(&VRQFDSDFHVGH
UHDOL]DU IXQFLRQHV KHSiWLFDV DO GHWHFWDU HQ HO VXHUR GH
ORV UDWRQHV FRQ ,'6& WUDVSODQWDGRV FRQ K$(& DQWL
tripsina humana.
(QHODxR0DQXHOSLOODL\VXVFRODERUDGRUHV en
XQPRGHORGHEURVLVKHSiWLFDHQUDWRQHVLQGXFLGDSRUOD
DGPLQLVWUDFLyQGHWHWUDFORUXURGHFDUERQR &&O4), trasplanWDURQK$(&$ODVGRVVHPDQDVGHODLQIXVLyQREVHUYDURQ
ODVK$(&HQHOKtJDGRGHORVUDWRQHVVLQHYLGHQFLDVGH
UHFKD]RDVtFRPRDOE~PLQDKXPDQDHQHOVXHURGHGLFKRV
UDWRQHV$GHPiVWUDVHOWUDVSODQWHREVHUYDURQGLVPLQXFLyQ
HQHOJUDGRGHDSRSWRVLVGHORVKHSDWRFLWRV\UHGXFFLyQ
GH OD LQDPDFLyQ \ OD EURVLV HQ FRPSDUDFLyQ FRQ ORV
DQLPDOHVFRQWUROHV
(QIHUPHGDGHVFDUGLDFDV

=KDR\VXJUXSR41HQHODxRGHPRVWUDURQTXHODV
K$06& [HQRWUDVSODQWDGDV HQ HO PLRFDUGLR LQIDUWDGR
GH UDWDV WXYLHURQ VXSHUYLYLHURQ DO PHQRV GRV PHVHV \
VH GLIHUHQFLDURQ HQ FpOXODV SDUHFLGDV D FDUGLRPLRFLWRV
TXL]i SRU HIHFWR GH DOJXQRV IDFWRUHV HQGyJHQRV (Q HO
HQVD\R GH GLIHUHQFLDFLyQ FDUGLRPLRFtWLFD UHDOL]DGR SRU
ORVFLWDGRVDXWRUHVHOFRFXOWLYRFRQH[SODQWHVGHFRUD]yQ
GHUDWDVQHRQDWDOHVFRQUPyTXHXQSHTXHxRQ~PHURGH
K$06& PDUFDGR FRQ HO FRORUDQWH XRUHVFHQWH 3.+

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

279

L Insausti C y col.

IXH FDSD] GH LQWHJUDUVH \ GLIHUHQFLDUVH HQ FpOXODV SDUHFLGDV D FDUGLRPLRFLWRV &RQVLVWHQWH FRQ HVWH KDOOD]JR
OD HYDOXDFLyQ SRU PLFURVFRSLD GH XRUHVFHQFLD GH ODV
K$06&PDUFDGDVFRQHOFRORUDQWHXRUHVFHQWH3.+H
LQ\HFWDGDVHQHOPLRFDUGLRLQIDUWDGRGHODVUDWDVSHUPLWLy
GHWHFWDUHVDVFpOXODVHQFRUWHVFRQJHODGRVUHDOL]DGRVDODV
\VHPDQDVORTXHVHUDWLFySRU3&5DWUDYpVGHOD
H[SUHVLyQGHJHQHVKXPDQRVHQHOFRUD]yQGHODVUDWDV
XVDQGRVRQGDVGH2PLFURJOREXOLQDHVSHFtFDKXPDQD
$GHPiVODVK$06&PDUFDGDVFRQ3.+\WUDVSODQWDGDV
UHVXOWDURQSRVLWLYDVSDUDHOSpSWLGRQDWULXUpWLFR $13 \
SDUDODFDGHQDSHVDGDGHPLRVLQD 0+& FXDQGRVH
HYDOXDURQSRULQPXQRXUHVFHQFLD$XQTXHDGLIHUHQFLD
GHORREVHUYDGRHQORVFDUGLRPLRFLWRVGHULYDGRVGH(6&
\GHODV06&GHOD02HQHVWRVODVSURSLHGDGHVIXQFLRQDOHVHOHFWURVLROyJLFDVQRVHGHPRVWUDURQ/RVDXWRUHV
FRQVLGHUDQ TXH ORV GDWRV REWHQLGRV VRQ VXFLHQWHV SDUD
VXVWHQWDU OD FDSDFLGDG SRWHQFLDO GH HVWDV FpOXODV \ VXV
SUREDEOHVXVRVFOtQLFRV
9HQWXUD \ VX JUXSR42 HQ HO DxR  GHPRVWUDURQ
PHMRUtD GH OD IXQFLyQ FDUGLDFD GXUDQWH FXDWUR VHPDQDV
WUDVODLQ\HFFLyQLQWUDPLRFiUGLFDGHFpOXODVGHULYDGDVGH
ODPHPEUDQDDPQLyWLFDHQFRUD]RQHVGHUDWDVLQIDUWDGDV
(Q HO DxR  &DUJQRQL \ FRODERUDGRUHV43 GHPRVWUDURQTXHHOXVRGHIUDJPHQWRVGHPHPEUDQDDPQLyWLFD
DSOLFDGRV HQ HO YHQWUtFXOR L]TXLHUGR LVTXpPLFR GH UDWDV
D ODV TXH VH OHV KDEtD SUDFWLFDGR OLJDGXUD GH OD DUWHULD
FRURQDULDGHVFHQGHQWHDQWHULRUSURGXMRPHMRUtDGHODIXQFLyQFDUGLDFD\UHGXFFLyQGHOD]RQDGHLQIDUWRHYDOXDGD
SRUHFRFDUGLRJUDItDSDUiPHWURVFDUGLDFRVIXQFLRQDOHV\
PRUIROyJLFRV/DPHMRUtDIXHDSDUHQWHDORVVLHWHGtDVGH
ODDSOLFDFLyQ\SHUVLVWLySRUDOPHQRVWUHVPHVHV/RVDXWRUHVQRREVHUYDURQLQMHUWRGHODVFpOXODVGHODPHPEUDQD
DPQLyWLFDHQHOWHMLGRFDUGLDFRGHOKXpVSHGFRQORTXH
SODQWHDURQODKLSyWHVLVWDPELpQVXJHULGDSRURWURVGHTXH
HOHIHFWREHQpFRVHGHEHDODVHFUHFLyQSDUDFULQDSRUODV
FpOXODV GH OD PHPEUDQD DPQLyWLFD GH IDFWRUHV VROXEOHV
FDUGLRSURWHFWRUHV TXH SURPXHYHQ OD UHJHQHUDFLyQ GHO
WHMLGRGHOKXpVSHG
(QIHUPHGDGHVSDQFUHiWLFDV

(Q:HL\VXJUXSR44FXOWLYDURQK$(&GXUDQWHD
VHPDQDVHQSUHVHQFLDGHQLFRWLQDPLGDSDUDLQGXFLUGLIHUHQFLDFLyQSDQFUHiWLFD(OWUDVSODQWHVXEVHFXHQWHGHODV
K$(&SURGXFWRUDVGHLQVXOLQDFRUULJLyODKLSHUJOXFHPLDGH
UDWRQHVFRQGLDEHWHVLQGXFLGDSRUHVWUHSWR]RWRFLQDGXUDQWH

280

YDULDVVHPDQDV$GHPiVDODQDOL]DUODGLVWULEXFLyQGHODV
FpOXODVKXPDQDV\GHODVHFUHFLyQGHLQVXOLQDFRQDQWL2
PLFURJOREXOLQD\DQWLLQVXOLQDKXPDQDVFRQWpFQLFDVGH
LQPXQRKLVWRTXtPLFDGHPRVWUDURQVXORFDOL]DFLyQHQORV
VLWLRV DQDWyPLFRV GH SURGXFFLyQ GH LQVXOLQD KtJDGR \
SiQFUHDV GHOUDWyQ(OSURFHVRIXHUHYHUVLEOHHQGH
ORVUDWRQHVORTXHVHDWULEX\yHQSDUWHDODYLGDPHGLD
GHOJUXSRFHOXODULPSODQWDGR
(QIHUPHGDGHVSXOPRQDUHV

&DUJQRQL \ VXV FRODERUDGRUHV   HQ HO DxR 


HVWXGLDURQ ORV HIHFWRV GH ODV FpOXODV HSLWHOLDOHV \ PHVHQTXLPDOHV GHULYDGDVGHPHPEUDQDDPQLyWLFDKXPDQD
\ GH PHPEUDQD DPQLyWLFD  GH UDWyQ HQ XQ PRGHOR GH
EURVLV SXOPRQDU LQGXFLGD HQ UDWRQHV SRU LQVWLODFLyQ
LQWUDWUDTXHDOGHEOHRPLFLQD/DVFpOXODVGHODPHPEUDQD
DPQLyWLFD VH LQIXQGLHURQ  PLQ GHVSXpV GH OD EOHRPLFLQD YtD LQWUDWUDTXHDO R LQWUDSHULWRQHDO HQ ORV FDVRV
[HQRJpQLFRVHLQWUDYHQRVDHQORVFDVRVDORJpQLFRV/DV
FpOXODVWUDVSODQWDGDVVHGHWHFWDURQDORV\GtDV
GHOWUDVSODQWH\FRQFRPLWDQWHPHQWHVHREVHUYyXQDFODUD
GLVPLQXFLyQHQODLQOWUDFLyQSRUQHXWUyORV\UHGXFFLyQ
LPSRUWDQWHHQODVHYHULGDGGHODEURVLVSXOPRQDUHQORV
UDWRQHVWUDWDGRVFRQFpOXODVGHPHPEUDQDDPQLyWLFDLQGHSHQGLHQWHPHQWHGHODIXHQWH [HQRJpQLFDRDORJpQLFD 
RGHODYtDGHDGPLQLVWUDFLyQ/RVDXWRUHVSODQWHDQTXH
ODUHGXFFLyQGHODLQOWUDFLyQSRUQHXWUyORVSRGUtDVHU
PHGLDGDYtDVHFUHFLyQGHIDFWRUHVVROXEOHVDQWLLQDPDWRULRVOLEHUDGRVSRUODVFpOXODV
(Q  0RRGOH\ \ VXV FROHJDV46  GHPRVWUDURQ TXH
ODDGPLQLVWUDFLyQLQWUDYHQRVDGHK$(&HQXQPRGHORGH
GDxRSXOPRQDUSURGXFLGRHQUDWRQHVFRQ,'6&FRQGXMRDO
LQMHUWRSUHFR]GHODVFpOXODV\DODSURGXFFLyQGHSURWHtQDV
VXUIDFWDQWHV$%&\'
(QIHUPHGDGHVGHOFDUWtODJR

:HL \ VX JUXSR18 HQ HO DxR  GHPRVWUDURQ TXH ODV
K$06&FRORFDGDVHQFiPDUDVGHGLIXVLyQFRQLQGXFWRUHV
FRQGURJpQLFRV SURWHtQDPRUIRJpQLFDUHFRPELQDQWHKXPDQDU+X%03 \WUDVSODQWDGDVHQWHMLGRVQRFDUWLODJLQRVRV
HVSDFLRVXEIDFLDOGHOP~VFXORDEGRPLQDO GHUDWRQHVR
LPSODQWDGDVVREUHGHIHFWRVFDUWLODJLQRVRVJHQHUDGRVHQORV
FyQGLORVIHPRUDOHVPHGLDOHVGHUDWDVLQPXQRGHFLHQWHVGH
RFKRVHPDQDVGHHGDGH[SHULPHQWDURQFDPELRVPRUIROyJLFRVFRQGHSyVLWRGHFROiJHQRWLSR,,HQHOFLWRSODVPD\
en la matriz pericelular.

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

Utilidad teraputica potencial de las clulas madre de la membrana amnitica

(QIHUPHGDGHVGHORtGR

(QIHUPHGDGHVYDVFXODUHV


(QHODxR<XJH\VXVFRDXWRUHV HVWXGLDURQODSRVLELOLGDGGHXVDUK$(&SDUDHOWUDWDPLHQWRGHODSpUGLGD
GHODDXGLFLyQ/DVK$(&FXOWLYDGDVin vitroH[SUHVDURQ
FRQH[LQD &[ HQODPHPEUDQDFHOXODU\HQHOQ~FOHR\$73DVDGH1D\.HQODPHPEUDQDFHOXODU\HQ
HO FLWRSODVPD ORV TXH QRUPDOPHQWH VRQ H[SUHVDGRV HQ
ORV EURFLWRV FRFOHDUHV HQFDUJDGRV GH PDQWHQHU OD KRPHRVWDVLVORFDOGHORVLRQHVTXHDVXYH]HVVXPDPHQWH
LPSRUWDQWH SDUD OD DXGLFLyQ 8WLOL]DQGR XQD WpFQLFD GH
WUDQVIHUHQFLDGHFRORUDQWHDPDULOOR/XFLIHUSDUDHYDOXDU
ODFRPXQLFDFLyQLQWHUFHOXODUDWUDYpVGHODVXQLRQHVJDS
HYLGHQFLDURQODFDSDFLGDGGHFRPXQLFDFLyQHQWUHFpOXOD\
FpOXODHQODVK$(&FXOWLYDGDV/DVK$(&WUDVSODQWDGDVin
vivoHQODFyFOHDGHFRED\RVVHORFDOL]DURQSUHGRPLQDQWHPHQWHHQODUHJLyQVXSUDOLPEDOUHJLyQVXSUDHVSLUDOHQ
la scala vestibuli\HQODUHJLyQVXEFHQWUDOGHOOLJDPHQWR
espiral en la scala timpani,TXHHVXQDGHODVFDYLGDGHVGHO
ODEHULQWRFRFOHDU'LFKDVFpOXODVSXGLHURQVREUHYLYLUSRU
DOPHQRVWUHVVHPDQDV/DVK$(&DFWXDURQFRPRFpOXODV
SDUHFLGDVDEURFLWRVIXQFLRQDOHVDXQTXHQRHVWiFODUR
VL ODV FDUDFWHUtVWLFDV GH ODV FpOXODV WUDVSODQWDGDV IXHURQ
HOUHVXOWDGRGHWUDQVGLIHUHQFLDFLyQRIXVLyQFHOXODU/RV
KDOOD]JRVVXJLHUHQTXHHOWUDVSODQWHGHK$(&SRGUtDVHU
XQD HVWUDWHJLD WHUDSpXWLFD SDUD GLIHUHQWHV HQIHUPHGDGHV
GHORtGRLQWHUQR
5HJHQHUDFLyQGHOP~VFXORHVTXHOpWLFR

(QHODxR;LQJ\VXJUXSR48LQ\HFWDURQFpOXODVDPQLyWLFDVPXOWLSRWHQWHVKXPDQDV $03Amniotic multipotent


cells REWHQLGDVFRPHUFLDOPHQWHHQODSDUHGDEGRPLQDOGH
ODUDWD VLWLRGHPD\RUFDUJD SUHYLRDODODSDURWRPtDFRQ
HOREMHWRGHLQFUHPHQWDUODUHFXSHUDFLyQGHODIXHU]DHQORV
P~VFXORVGHODSDUHGDEGRPLQDO\GLVPLQXLUODLQFLGHQFLD
GHKHUQLDVLQFLVLRQDOHV7UDVODODSDURWRPtDPLGLHURQODV
SURSLHGDGHVPHFiQLFDVGHODKHULGD\ODLQFLGHQFLD\VHYHULGDGGHOIUDFDVRHQODFLFDWUL]DFLyQGXUDQWHGtDV/RV
LQYHVWLJDGRUHVREVHUYDURQTXHODVFpOXODVIXHURQYLDEOHV
GXUDQWH DO PHQRV  GtDV \ QR PLJUDURQ D RWURV VLWLRV
TXHODSpUGLGDGHIXHU]DSRUODODSDURWRPtDPHMRUyDORV
VLHWHGtDVGHOSRVRSHUDWRULRWUDVODWHUDSLDFRQODVFpOXODV
$03\TXHGLFKDWHUDSLDPHMRUyODFLFDWUL]DFLyQ\UHGXMR
ODLQFLGHQFLD\HOWDPDxRGHKHUQLDVLQFLVLRQDOHV6HJ~Q
ORVDXWRUHVWRGRVHGHELyDODGLIHUHQFLDFLyQGHODV$03
KDFLDFpOXODVSDUHFLGDVDEUREODVWRVRDODSURGXFFLyQ
GHFLWRFLQDV7*)E)*)DQG*0&6)

(QHODxR3UDWKHU\VXJUXSRLQYHVWLJDURQHOXVRGH
FpOXODVHVWURPDOHVGHULYDGDVGHODSODFHQWDKXPDQDH[SDQGLGDVHQ'GHQRPLQDGDV3/;3$'HQHOWUDWDPLHQWRGH
ODLVTXHPLDFUtWLFDGHH[WUHPLGDGHVLQGXFLGDHQUDWRQHV
/DVFpOXODVVHLQ\HFWDURQYtDLQWUDPXVFXODUFLQFRKRUDV
WUDVODSURGXFFLyQGHODLVTXHPLD\REVHUYDURQTXHGXUDQWH
DGtDVHOXMRVDQJXtQHRHQODH[WUHPLGDGLVTXpPLFD
IXHVLJQLFDWLYDPHQWHPD\RU\ODWDVDGHQHFURVLVFHOXODU
VLJQLFDWLYDPHQWHPHQRUHQORVUDWRQHVWUDWDGRVTXHHQ
ORVQRWUDWDGRV/RVDQiOLVLVLQPXQRKLVWRTXtPLFRVUHYHODURQ XQ DXPHQWR VLJQLFDWLYR HQ HO Q~PHUR GH QXHYRV
FDSLODUHV HQ OD H[WUHPLGDG GH ORV DQLPDOHV WUDWDGRV DVt
FRPRQLYHOHVGLVPLQXLGRVGHQLWURWLURVLQDXQLQGLFDGRU
GHHVWUpVR[LGDWLYR\GH9&$0XQLQGLFDGRUGHLQDPDFLyQHQGRWHOLDO7RGRHOORVLQQLQJ~QHIHFWRDGYHUVR
%DVDGRVHQHVWRVUHVXOWDGRV3/;3$'VHHVWiHYDOXDGR
HQXQHQVD\RFOtQLFRHQLVTXHPLDFUtWLFDGHH[WUHPLGDGHV
HQ(VWDGRV8QLGRV\HQOD8QLyQ(XURSHD
$SHVDUGHTXHVyORDOJXQRVGHORVHQVD\RVUHYLVDGRV
DSRUWDQ SUXHEDV DFHUFD GH OD GLIHUHQFLDFLyQ in vivo de
ODV FpOXODV GH OD PHPEUDQD DPQLyWLFD  KDFLD ODV OtQHDV
FHOXODUHV LQYHVWLJDGDV 18,33,41 \ TXH QLQJXQR VHxDOD XQD
UHFXSHUDFLyQ VRVWHQLGD GH OD DIHFWDFLyQ TXH VH KD SUHWHQGLGR FRUUHJLU WRGRV FRLQFLGHQ HQ VHxDODU TXH GLFKDV
FpOXODVSURGXFHQPHMRUtDIXQFLRQDO\HIHFWRVEHQpFRVD
WUDYpVGHHIHFWRVWUyFRVGLUHFWRVRVREUHODVFpOXODVGHO
KXpVSHGHIHFWRVDQWLLQDPDWRULRVHLQPXQRPRGXODGRUHV
SURGXFFLyQGHFLWRFLQDVGLVPLQXFLyQGHODDSRSWRVLVHVWLPXODFLyQGHODDQJLRJpQHVLVQHXURJpQHVLVVLQDSWRJpQHVLV
ROLJRGHQGURJpQHVLVHWF
8VRGHODVK$(&\K$06&HQKXPDQRV

$SHVDUGHORVGDWRVSURPHWHGRUHVTXHKHPRVFRPHQWDGR
XQDVSHFWRLPSRUWDQWHSDUDHOXVRFOtQLFRGHODVFpOXODV
PDGUHGHODPHPEUDQDDPQLyWLFDHVHOUHODFLRQDGRFRQOD
VHJXULGDGGHGLFKDVFpOXODVXQDYH]TXHVHKDQWUDVSODQWDGRHQXQSDFLHQWH(QHVWHVHQWLGRSRGUtDVHUGHXWLOLGDG
VHxDODU TXH OD PHPEUDQD DPQLyWLFD VH KD XWLOL]DGR HQ
FOtQLFDSUiFWLFDPHQWHGXUDQWHXQVLJORSDUDWUDWDUGLYHUVDV
enfermedades.
6HJ~QODELEOLRJUDItD'DYLV\VXJUXSRIXHURQORVSULPHURVHQXWLOL]DUODVPHPEUDQDVIHWDOHV DPQLRV\FRULRQ 
HQ FOtQLFD HVSHFtFDPHQWH HQ HO WUDVSODQWH GH SLHO$
SDUWLU GH HOORV VH XWLOL]y SDUD HO WUDWDPLHQWR GH TXHPDGXUDVKHULGDVGHGLIHUHQWHVHWLRORJtDV~OFHUDVFXWiQHDV

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

281

L Insausti C y col.

FRPRWHMLGRGHDSR\RSDUDODUHFRQVWLWXFLyQTXLU~UJLFDGH
GLYHUVRVyUJDQRV OHQJXDERFDWtPSDQRPXFRVDQDVDO
YHMLJD XUHWUD YDJLQD VXSHUFLH DUWLFXODU HWF  FRPR
VXVWLWXWRGHOSHULWRQHRHQSURFHGLPLHQWRVH[HQWHUDWLYRV\
UHFRQVWUXFWLYRVSpOYLFRVHQODSUHYHQFLyQGHVLQHTXLDVR
DGKHUHQFLDVHQFLUXJtDSpOYLFD\DEGRPLQDOFRPRUHFXEULPLHQWRELROyJLFRGHRQIDORFHOHVHQODUHFRQVWLWXFLyQ
GH WHQGRQHV HWF DVt FRPR SDUD GLYHUVDV SDWRORJtDV
RIWDOPROyJLFDV
(Q2IWDOPRORJtDVXHPSOHRIXHVHxDODGRSRUSULPHUD
YH] HQ  SRU 'H 5RWWK TXLHQ XWLOL]y ODV PHPEUDQDV
IHWDOHVHQODVXSHUFLHRFXODUFRPRXQDSyVLWRELROyJLFR
SDUDHOWUDWDPLHQWRGHGHIHFWRVFRQMXQWLYDOHV0iVWDUGH
6RUE\\VXJUXSRXWLOL]DURQODPHPEUDQDDPQLyWLFDSUHVHUYDGDFRPRUHFXEULPLHQWRWHPSRUDOHQHOWUDWDPLHQWR
GHOHVLRQHVRFXODUHVFiXVWLFDVDJXGDV&RQHVWDWpFQLFD
ORJUDURQUHVXOWDGRVIDYRUDEOHVVLQHPEDUJRSRUUD]RQHV
SRFR FODUDV VX XVR IXH DEDQGRQDGR R QR IXH SXEOLFDGR
GXUDQWHDSUR[LPDGDPHQWHFLQFRGpFDGDV(QFRQORV
HQVD\RVGHUHFRQVWLWXFLyQFRQPHPEUDQDDPQLyWLFDGHODV
FyUQHDVGHFRQHMRVFRQGHIHFWRVOtPELFRVUHDOL]DGRVSRU
.LP-&\7VHQJUHQDFHXQLQWHUpVJHQHUDOL]DGRSRUHOXVR
GHODPHPEUDQDDPQLyWLFDHQRIWDOPRORJtD
+DFHSRFRDSDUHFLHURQQXPHURVRVDUWtFXORVSXEOLFDGRV
GHVXHFDFLDHQGLVWLQWDVSDWRORJtDVGHODVXSHUFLHRFXODU
TXHUDWRSDWtDVIHQLOFHWRQXULDHQIHUPHGDGFRQMXQWLYDO
GH%RZHQ61SDUDSUHYHQLUODQHRYDVFXODUL]DFLyQFRUQHDO
HQDIHFFLRQHVGHOHSLWHOLRFRUQHDO\HQHOWUDWDPLHQWR
GHODV~OFHUDVWUyFDVSHUVLVWHQWHVGHODFyUQHD'HOD
PLVPDPDQHUDODPHPEUDQDDPQLyWLFDKDVLGRHIHFWLYD
SDUD HO WUDWDPLHQWR GH TXHPDGXUDV FXWiQHDV \ ~OFHUDV
FUyQLFDVGHGLYHUVDVFDXVDVFRQUHVXOWDGRVTXHKDQGHPRVWUDGRTXHVXDSOLFDFLyQHVELHQWROHUDGD\TXHIDYRUHFHOD
HSLWHOL]DFLyQGHORVWHMLGRVGDxDGRV &XDGUR 
&RQVLGHUDPRVTXHHOSHUOGHVHJXULGDGGHPRVWUDGRSRU
ODPHPEUDQDDPQLyWLFDHQWRGDVHVWDVLQGLFDFLRQHVSRGUtD
VHUYLUGHEDVHSDUDTXHVXVFpOXODVSXGLHUDQVHULQYHVWLJDGDVHQHQVD\RVFOtQLFRVIDVH,(QHVWHVHQWLGRGHEHPRV
VHxDODU TXH HQ OD OLVWD GH HQVD\RV FOtQLFRV DFWXDOPHQWH
UHJLVWUDGRVHQZZZFOLQLFDOWULDOJRYDSDUHFHQWUHVHVWXGLRV
TXHPHQFLRQDQHOHPSOHRGHFpOXODVGHODSODFHQWD
1. 8&06&V3ODFHQWD06&V6DIHW\DQG(IILFDF\6WXG\RI8PELOLFDO&RUG3ODFHQWD'HULYHG0HVHQFK\PDO
6WHP&HOOVWR7UHDW6HYHUH$SODVWLF$QHPLD6SRQVRU
6KDQGRQJ8QLYHUVLW\&KLQD1&7$FWLYR
(QIDVHGHUHFOXWDPLHQWRGHSDFLHQWHV

282

(O REMHWLYR GH HVWH HVWXGLR HV HYDOXDU OD VHJXULGDG


\ HFDFLD GH ODV 06& GHULYDGDV GHO FRUGyQ XPELOLFDO
SODFHQWDKXPDQDDODGRVLVGH[606&NJHQSDFLHQWHV
FRQDQHPLDDSOiVLFDVHYHUD
 8&06&V3ODFHQWD06&V 6DIHW\ DQG HIILFDF\ VWXG\ RI XPELOLFDO FRUGSODFHQWDGHULYHG PHVHQFK\PDO
VWHPFHOOVWRWUHDWP\HORG\VSODVWLFV\QGURPHV6SRQVRU6KDQGRQJ8QLYHUVLW\&KLQD1&7$FWLYR(QIDVHGHUHFOXWDPLHQWRGHSDFLHQWHV
(OSURSyVLWRGHHVWHHVWXGLRHVHYDOXDUODVHJXULGDG\
HFDFLDGHODV06&GHULYDGDVGHOFRUGyQXPELOLFDOSODFHQWDKXPDQDDODGRVLVGH[606&NJHQSDFLHQWHVFRQ
VtQGURPHVPLHORGLVSOiVLFRVWLSRDQHPLDUHIUDFWDULD $5 
\DQHPLDUHIUDFWDULDFRQDQLOORVVLGHUREOiVWLFRV $5$6 
 3ODFHQWD06&V 6DIHW\ RI LQWUDPXVFXODU LQMHFWLRQ RI
$OORJHQHLF 3/;3$' FHOOV IRU WKH WUHDWPHQW RI FULWLFDO OLPE LVFKHPLD &/,  6SRQVRU 3OXULVWHP /WG
1&7 $FWLYR 7RGDYtD QR HVWi UHFOXWDQGR
pacientes.
(OSURSyVLWRGHHVWHHVWXGLRHVGHWHUPLQDUODVHJXULGDG
GHXQDGRVLV~QLFD,0GH3/;3$'SDUDHOWUDWDPLHQWR
GHSDFLHQWHVFRQLVTXHPLDFUtWLFDGHH[WUHPLGDGHV &/, 
3/;3$'VRQFpOXODVHVWURPDOHVPHVHQFK\PDOOLNH
GHULYDGDVGHGHFLGXDVREWHQLGDVGHSODFHQWDVKXPDQDVD
WpUPLQRH[SDQGLGDVHQXQELRUUHDFWRU'SURSLHGDGGH
OD&RPSDxtD3OXUL;70
$GHPiVKDVWDGRQGHVDEHPRVH[LVWHXQDUWtFXORSXEOLFDGRHQHODxRHQHOTXHVHGHVFULEHODXWLOL]DFLyQ
GH 06& REWHQLGDV GH SODFHQWDV KXPDQDV VLQ FRUGyQ
XPELOLFDOQLPHPEUDQDVIHWDOHV DODGRVLVGH[6NJ,9
WRWDO[6 KRUDVDQWHVGHXQWUDVSODQWHGHGREOH
GHFRUGyQHQXQSDFLHQWHGHDxRVFRQOHXFHPLDDJXGD
PLHOREOiVWLFDHQVHJXQGDUHPLVLyQFRPSOHWD/DV06&GH
ODSODFHQWD\ODVFpOXODVGHOFRUGyQSURFHGtDQGHGRQDQWHV
QRUHODFLRQDGRV/DLQIXVLyQGHODVFpOXODVVHUHDOL]yHQ
XQDVXVSHQVLyQGHP/HQVLHWHPLQXWRVDWUDYpVGHXQ
OWURGHP(OSDFLHQWHQRSUHVHQWyFRPSOLFDFLRQHV
DJXGDVVXEDJXGDVRFUyQLFDVUHODFLRQDGDVFRQODLQIXVLyQ
GH 06& GH OD SODFHQWD /RV DXWRUHV FRQVLGHUDQ TXH HO
SURFHGLPLHQWRIXHVHJXUR\TXHHOSDFLHQWHUHSUHVHQWDHO
SULPHUFDVRGHXQSURJUDPDGHHQVD\RVFOtQLFRVFRQ06&
GHULYDGDVGHSODFHQWDVKXPDQDV
(QQXHVWURJUXSRGHWHUDSLDFHOXODUFX\RREMHWLYRHV
OD LQYHVWLJDFLyQ WUDVODFLRQDO HO HVWXGLR GH PHPEUDQD
DPQLyWLFD\ODFDUDFWHUL]DFLyQGHVXVFpOXODVKDLQVSLUDGR
OD UHDOL]DFLyQ GH WUHV HQVD\RV HQ DQLPDOHV DFWXDOPHQWH

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

Utilidad teraputica potencial de las clulas madre de la membrana amnitica

Cuadro 2. Publicaciones recientes acerca de la indicacin clnica de la membrana amnitica


Aos

Ttulos

Referencias

2000

Reconstitution of damaged corneas by transplantation of autologous limbal epithelial cells

62

2001

Amniotic membrane graft in ocular surface disease. Prospective study with 31 cases.

68

2003

Successful reconstruction of damaged ocular outer surface in humans using limbal and conjuctival stem cell
culture methods.

69

2004

The Amniotic membrane in ophthalmology

55

2005

Amniotic membrane use in ophthalmology


Amniotic membrane transplantation for ocular surface reconstruction.

56
64

2006

Ultrastructural analysis of in vivo expanded corneal epithelium on amniotic membrane


Amniotic membrane transplantation for treatment of symblepharon in a patient with recessive dystrophic epidermolysis bullosa.
Amniotic Membrane transplantation in palliative treatment of bullous keratopathy
Clinical outcome of autologous cultivated limbal epithelium transplantation

65
63

Amniotic Membrane Transplantation


Use of amniotic membrane graft and corneal transplantation in a patient with bilateral keratomalacia induced
by uncontrolled phenylketonuria
Use of amniotic membrane transplantation in the treatment of venous leg ulcers.
Amnia for intractable skin ulcers with recessive dystrophic epidermolysis bullosa: report of three cases.

57
60

2008

Amniotic membrane transplantation for the management of corneal epithelial defects: an in vivo confocal microscopic study.

66

2009

Manufacturing of human placenta-derived mesenchymal stem cells for clinical trials

75

2010

Amniotic membrane transplantation in the treatment of persistent epithelial defect on the corneal graft.
Use of amniotic membrane transplantation in isolated conjunctival Bowen disease: a case report
Dried irradiated human amniotic membrane as a biological dressing for facial burns--a 7-year case series
Amniotic membrane induces epithelialization in massive posttraumatic wounds.

67
61
73
74

2007

HQ FXUVR XQR UHODFLRQDGR FRQ OD LQGXFFLyQ GH IDFWRU


9,,,WUDVHOWUDVSODQWHGHK$06&RGH$06&REWHQLGDV
GHPHPEUDQDDPQLyWLFDGHUDWRQHVVDQRVHQXQPRGHOR
PXULQRGHKHPROLD$2WURUHODFLRQDGRFRQHOWUDVSODQWH
LQWUDFDUGLDFRGH06&SURFHGHQWHVGHPHPEUDQDDPQLyWLFD
GHFRQHMDVVDQDVHQFRQHMRVFRQFDUGLRPLRSDWtDGLODWDGD
LQGXFLGD SRU DQWUDFLFOLQDV FX\R REMHWLYR HV HYDOXDU VL
OD LQ\HFFLyQ LQWUDFDUGLDFD GH GLFKDV FpOXODV PHMRUD OD
IUDFFLyQ GH H\HFFLyQ \ ORV RWURV SDUiPHWURV SURSLRV GH
ODPLRFDUGLRSDWtDGLODWDGD8QWHUFHURHQHOTXHVHEXVFD
HYDOXDUHQUDWRQHVFRQJUDQGHVKHULGDVFXWiQHDVHOHIHFWR
SURPRWRUGHODHSLWHOL]DFLyQGHODPHPEUDQDDPQLyWLFD
XWLOL]DGDFRPRDSyVLWRELROyJLFR$GHPiVVHWLHQHSUHYLVWR
LQLFLDUXQHVWXGLRGHOHIHFWRLQPXQRPRGXODGRU\DQWLLQ-

59
70

71
72

DPDWRULRGHODVFpOXODVGHODPHPEUDQDDPQLyWLFDHQXQ
PRGHORHQUDWRQHVGHHQIHUPHGDGLQMHUWRFRQWUDKXpVSHG
FUyQLFD3DUDOHODPHQWHDHVWRVHQVD\RVH[SHULPHQWDOHVVH
KDGLVHxDGRXQHQVD\RFOtQLFRSDUDHYDOXDUHOHIHFWRGH
OD PHPEUDQD DPQLyWLFD HQ OD UHJHQHUDFLyQ GHO HSLWHOLR
FXWiQHRHQSDFLHQWHVFRQ~OFHUDVH[WHQVDVSRVWUDXPiWLFDV
\VHKDQREWHQLGRODVSUXHEDVGHFRQFHSWR\ODVSULPHUDV
experiencias en pacientes.
CONCLUSIN
/RVGDWRVH[SXHVWRVLQGLFDQTXHH[LVWHQVXFLHQWHVHYLGHQFLDVTXHDYDODQODXWLOLGDGSRWHQFLDOGHODPHPEUDQD
DPQLyWLFD\VXVFpOXODVHQXQDDPSOLDYDULHGDGGHHQIHU-

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

283

L Insausti C y col.

PHGDGHV&RQVLGHUDPRVTXHHQHOIXWXURFHUFDQRHQOD
PHGLGDTXHVHRSWLPLFHQODVFRQGLFLRQHVGHFXOWLYR\GH
H[SDQVLyQGHGLFKDVFpOXODVSDUDDXPHQWDUVXSRWHQFLDO
SUROLIHUDWLYR \ SURORQJDU VX YLGD PHGLD DVt FRPR ORV
PpWRGRVGHSUHVHUYDFLyQSDUDDVHJXUDUXQDFRQVHUYDFLyQ
HIHFWLYDDODUJRSOD]RVHSRGUiYDOLGDUVXHFDFLDHQGLIHUHQWHVPRGHORVGHHQIHUPHGDGHVHQDQLPDOHV\FRQHOOR
GHVDUUROODUODVHVWUDWHJLDVSDUDVXSURGXFFLyQFRQIRUPHD
ODVH[LJHQFLDV*03 Good Manufacturing Practice OR
TXHHQGHQLWLYDSHUPLWLUtDODWUDVODFLyQGHORVUHVXOWDGRV
SUHOLPLQDUHVSUHVHQWDGRVHQHVWDUHYLVLyQKDFLDDSUR[LPDFLRQHVWHUDSpXWLFDVHIHFWLYDV
Agradecimientos

(VWHWUDEDMRKDVLGRQDQFLDGRHQSDUWHSRUHO,6&,,, ),6
(& 5(7,&6 5' ,17 ),6
3, OD'*7$7; 75$(& OD)XQGDFLyQ'LyJHQHV\OD)XQGDFLyQ6pQHFD 3, 

REFERENCIAS
1.

Bourne G. The Foetal Membranes. A Review of the Anatomy


of Normal Amnion and Chorion and Some Aspects of Their
Function. Postgrad Med J 1962;38:193-201.
2. Benirschke K., Kaufman P. Anatomy and Pathology of the
placental membranes. In: Pathology of the Human Placenta.
4th ed. New York: Springer, 2000;281-334.
3. Niknejad H, Peirovi H, Jorjani M, Ahmadiani A, et al. Properties of the amniotic membrane for potential use in tissue
engineering. European Cells and materials 2008; 15:88-99.
4. Dobreva MP, Pereira PM, Deprest J, Zwijsen A. On the origin of amniotic stem cells: of mice and men. Int J Dev Biol
2010;54:761-777.
5. Miki T, Lehmann T, Cai H, Stolz D, Strom S. Stem cell characteristics of amniotic epithelial cells. Stem Cells 2005;23:15491559.
6. Miki T, Strom SC. Amnion derived pluripotent-multipotent stem
cells. Stem Cell Rev 2006;2:133-142.
7. Ilancheran S, Michalska A, Peh G, Wallace EM, et al. Stem
cell derived from human fetal membranes display multilineage
differentiation potential. Biol Reprod 2007;77(3):577-588.
8. Insausti CL, Blanquer M, Bleda P, Iniesta P, et al. The amniotic membrane as a source of stem cells. Histol Histopathol
2010;25:91-98.
9. Takashima S, Ise H, Zhao P, Akaike T, Nikaido T. Human amniotic epithelial cells possess hepatocyte-like characteristics
and functions. Cell Struct Funct 2004;29:73-83.
10. Niknejad H, Peirovi H, Ahmadiani A, Ghanavi J, Jorjani M. DiIIHUHQWLDWLRQIDFWRUVWKDWLQXHQFHQHXURQDOPDUNHUVH[SUHVVLRQ
in vitro from human amniotic epithelial cells. European Cells
and Materials 2010;19:22-29.

284

11. Bilic G, Zeisberger SM, Mallik AS, Zimmermann R, Zisch AH.


Comparative Characterization of Cultured Human Term Amnion Epithelial and Mesenchymal Stromal Cells for Application
in Cell Therapy. Cell Transplantation 2008;17:955-968.
12. Parolini O, Soncini M. Human Placenta: a source of progenitor/
stem cells? J Reproduktionsmed Endokrinol 2006;3:117-126.
13. Portmann-Lanz CB, Schoeberlein A, Huber A, Sager R, et al.
Placental mesenchymal stem cells as potential autologous
graft for pre and perinatal neuroregeneration. Am J Obstet
Gynecol 2006;194:664-673.
14. Parolini O, Alviano F, Bergwerf I, Boraschi D, et al. Toward cell
therapy using placenta-derived cells: Disease mechanisms,
cell biology, preclinical studies, and regulatory aspects at the
round table. Stem cells and development 2010;19:143-154.
15. Alviano F, Fossati V, Marchionni C, Arpinati M, et al. Term
amniotic membrane is a high throughput source for multipotent mesenchymal stem cells with the ability to differentiate
into endothelial cells in vitro. BMC developmental. Biology
2007; 7:1-14.
16. Soncini M, Vertua E, Gibelli L, Zorzi F, et al. Isolation and
characterization of mesenchymal cells from human fetal membranes. J Tissue Eng Regen Med 2007; 1:296-305.
17. Kim J, Mi Kang H, Kim H, Ran Kim M, et al. Ex vivo characteristics of human amniotic membrane- derived stem cells.
Cloning and stem cells 2007;9:581-594.
18. Wei JP, Nawata M, Wakitani S, Kametani K, et al. Human
amniotic mesenchymal cells differentiate into chondrocytes.
Cloning and Stem Cells 2009;11:19-25.
19. Parolini O, Alviano F, Bagnara G, Bilic G, et al. Concise Review: Isolation and characterization of cells from human term
placenta: outcome of the First International Workshop on
Placenta Derived Stem Cells. Stem Cells 2008;26:300-311.
20. Whittle WL, Gibb W, Challis JRG. Characterization of human
amnion epithelial and mesenchymal cells: the cellular expression, activity and glucocorticoid regulation of prostaglandin
output. Placenta 2000;21:394-401.
21. Li H, Niederkorn J, Neelam S, Mayhew E, et al. Immunosuppressive factors secreted by human amniotic epithelial cells.
Invest Ophthalmol Vis Sci 2005; 46:900-907.
22. Koizumi NJ, Inatomi TJ, Sotozono CJ, Fullwood NJ, et al.
Growth factor mRNA and protein in preserved human amniotic
membrane. Curr Eye Res 2000;20:173-177.
23. +DR<0D'++ZDQJ'*.LP:6=KDQJ),GHQWLFDWLRQ
RI DQWLDQJLRJHQLF DQG DQWLLQDPPDWRU\ SURWHLQV LQ KXPDQ
amniotic membrane. Cornea 2000;19:348-352.
24. Solomon A, Rosenblatt M, Monroy D, Ji Z, et al. Suppression
of interleukin 1 (alpha) and interleukin 1 (beta) in human limbal
epithelial cells cultured on the amniotic membrane stromal
matrix. Br J Ophthalmol 2001;85:444-449.
25. Houlihan JM, Biro PA, Harper HM. The human amnion is a
site of MHC class Ib expression: evidence for the expression
of HLA-E y HLA-G. J Immunol 1995;154:5665-5674.
26. Magatti M, de Munari S, Vertua E, Nassuato C, et al. Amniotic
mesenchymal tissue cell inhibit dendritic cell differentiation of
peripheral blood and amnion resident monocytes. Cell Transplant 2009;18:899-914.
27. Kakishita K, Elwan MA, Nakao N, Itakura T, Sakurawaga N.
Human Amniotic epithelial cells produce dopamine and survive
after implantation into the striatum of a rat model of Parkinsons

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

Utilidad teraputica potencial de las clulas madre de la membrana amnitica

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

42.

43.

disease: a potential source of donor for transplantation therapy.


Exp Neurol 2000;165:27-34.
Kakishita K, Nakao N, Sakurawaga N, Itakura T. Implantation
of human amniotic epithelial cells prevents the degeneration
of nigral dopamine neurons in rats with 6-hydroxydopamine
lesions. Brain Res 2003;980:48-56.
Kong XY, Cai Z, Pan L, Zhang L, et al. Transplantation of human amniotic cells exerts neuroprotection in MPTP-induced
Parkinson disease mice. Brain Res 2008; 1205:108-115.
Yang X, Xue S, Dong W, Kong Y. Therapeutic effect of human amniotic epithelial cell transplantation into the lateral
ventricle of hemiparkinsonian rats. Chinese Medical Journal
2009;122:2449-2454.
Sankar V, Muthusamy R. Role of human amniotic epithelial
cell transplantation in spinal cord injury repair research. Neuroscience 2003;118:1-17.
Wu ZY, Hui GZ, Lu Y, Wu X, Guo LH. Transplantation of human
amniotic epithelial cells improves hindlimb function in rats with
spinal cord injury. Chin Med J (Engl) 2006;119:2101-2107.
Liu Y, Wu J, Huang Q, Hou J, et al. Human Amniotic epithelial
cells ameliorate behavioral dysfunction and reduce infarct
size in the rat middle cerebral artery occlusion model. Shock
2008;29:603-611.
Yu SJ, Soncini M, Kaneko Y, Hess DC, et al. Amnion a potent graft source for cell therapy in stroke: Cell Transplant
2009;18:111-118.
Sakuragawa N, Enosawa S, Ishii T, Thangavel R, et al. Human amniotic epithelial cells are promising transgene carriers
for allogeneic cell transplantation into liver. J Hum Genet
2000;45:171-176.
Takahashi S, Ohsugi K, Yamamoto T, Shiomi M, Sakuragawa
N. A novel approach to ex vivo gene therapy for familiar
hypercholesterolemia using human amniotic epithelial cells
as transgene carrier. Tohoku J Exp Med 2001;193:279-292.
Takahashi N, Enosawa S, Mitani T, Lu H, et al. Transplantation
of amniotic epithelial cells into fetal rat liver by in utero manipulation. Cell Transplant 2002; 11:443-449.
Takashima S, Ise H, Zhao P, Akaike T, Nikaido T. Human amniotic epithelial cells possess hepatocyte-like characteristics
and functions. Cell Struct Funct 2004;29:73-83.
Miki T, Marongiu F, Ellis EC, Dorko K, et al. Production of
hepatocyte-like cells from human amnion. Methods Mol Biol
2009;481:1-14.
Manuelpillai I, Tchongue J, Lourensz D, Vaghjiani V, et al.
Transplantation of human amniotic epithelial cells reduce
KHSDWLFEURVLVLQLPPXQRFRPSHWHQW&&O4-treated mice. Cell
Transplantation 2010;19:1157-1168.
Zhao P, Ise H, Hongo M, Ota M, et al. Human amniotic mesenchymal cells have some characteristics of cardiomyocytes.
Transplantation 2005;79:528-535.
Ventura C, Cantoni S, Bianchi F, Lionetti V, et al. Hyaluronan
mixed esters of butyric and retinoic acid drives cardiac and
endothelial fate in term placenta human mesenchymal stem
cells and enhance cardiac repair in infracted rat hearts. J Biol
Chem 2007;282:14243-14252.
Cargnoni A, Di Marcello M, Campagnol M, Nassuato C, et
al. Amniotic membrane patching promotes ischemic rat heart
repair. Cell Transplant 2009;18:1147-1159.

44. Wei JP, Zhang TS, Kawa S, Aizawa T, et al. Human amnion-isolated cells normalize blood glucose in streptozotocin-induced
diabetic mice. Cell Transplant 2003;12:545-552.
45. Cargnoni A, Gibelli L, Tosini A, Signoroni PB, et al. Transplantation of allogenic and xenogenic placenta derived cells
UHGXFHV EOHRP\FLQLQGXFHG OXQJ EURVLV &HOO 7UDQVSODQW
2009;18:405-422
46. Moodley Y, Ilancheran S, Samuel C, Vaghjiani V, et al. Human
DPQLRWLFHSLWKHOLDOFHOOWUDQVSODQWDWLRQDEURJDWHVOXQJEURVLV
and augment repair. Am J Respi Crit Care Med 2010;182:643651.
47. Yuge I, Takumi Y, Koyabu K, Hashimoto S, et al. Transplanted
human amniotic epithelial express connexin 26 y Na-K-ATPasa
in the inner ear. Transplantation 2004;77:1452-1454.
48. Xing L, Franz MG, Marcelo CL, Smith CA, et al. Amnion-derived
multipotent progenitor cells increase gain of incisional breaking
strength and decrease incidence and severity of acute wound
failure. J Burns and Wounds 2007;7:39-52.
49. 3UDWKHU:57RUHQ$0HLURQ02U5HWDO7KHUROHRISODFHQtal derived adherent stromal cell (PLX-PAD) in the treatment of
critical limb ischemia. Cytotherapy 2009;11:427-434.
50. Davis JW. Skin transplantation with a review of 550 cases at
the John Hopkins Hospital. Johns Hopkins Med J 1910;15:307396.
51. Trefold JD, Trelford-Sauer M. The amnion in surgery, past and
present. Am J Obstet Gynecol 1979;134:833-845.
52. Ganatra MA. Amniotic membrane in surgery. J Pak Med Assoc
2003;53:29-32.
53. De Rotth A. Plastic repair of conjunctival defects with fetal
membranes. Arch Ophthalmol 1940;23(5):22-525.
54. Sorby A, Symons HM. Amniotic membrane grafts in caustic
burns of eye. Br J Ophthalmol 1946;30:337-345.
55. Dua HS, Gomes JA, King AJ, Maharajan S. The Amniotic
membrane in ophthalmology. Survey of Ophthalmology
2004;49:51-77.
56. Gomes JA, Roman A, Santos MS, Dua HS. Amniotic membrane use in ophthalmology. Curr Opin Ophthalmol 2005;16:233240.
57. %DUDGDUDQ5DI $ $JKD\DQ +5 $UMPDQG % -DYDGL 0$
Amniotic membrane transplantation. Iranian J Ophthalmolol
Res 2007;2:58-73.
58. Kim JC y Tseng SC. Transplantation of preserved human
amniotic membrane for surface reconstruction in severely
damaged rabbit corneas. Cornea 1995;14: 473-484.
59. Zemba M, Andrei S, Cucu B, Bratulescu M, et al. Amniotic
Membrane transplantation in palliative treatment of bullous
keratopathy. Oftalmologia 2006;50:51-53.
60. Habot-Wilner Z, Spierer A, Barequet IS, Greenbaum A. Use
of amniotic membrane graft and corneal transplantation in a
patient with bilateral keratomalacia induced by uncontrolled
phenylketonuria. Cornea 2007;26:629-631.
61. Motolese J, Mazzera L, Frezzotti P, Motolese PA, Motolese
E. Use of amniotic membrane transplantation in isolated
conjunctival Bowen disease: a case report. Eur J Ophthalmol
2010; 20:604-607.
62. Tsai RJ, Li LM, Chen JK. Reconstruction of damaged corneas
by transplantation of autologous limbal epithelial cells. N Engl
J Med 2000;343:86-93.

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

285

L Insausti C y col.

63. Altan-Yaycioglu R, Akova YA, Oto S. Amniotic membrane


transplantation for treatment of symblepharon in a patient
with recessive dystrophic epidermolysis bullosa. Cornea
2006; 25:971-973.
64. Fernandes M, Sridhar MS, Sangwan VS, Rao GN. Amniotic
membrane transplantation for ocular surface reconstruction.
Cornea 2005;24:643-653.
65. Ha HS, Song KY, Kim JC. Ultrastructural analysis of in vivo
expanded corneal epithelium on amniotic membrane. J Korean
Med Sci 2006;21:544-549.
66. Nubile M, Dua HS, Evb-M Lanzini T, Carpineto P, et al. Amniotic
membrane transplantation for the management of corneal
epithelial defects: an in vivo confocal microscopic study. Br J
Ophthalmol 2008;92:54-60.
67. Dekaris I, Mravicic I, Barisic A, Draca N, Pauk M. Amniotic
membrane transplantation in the treatment of persistent
epithelial defect on the corneal graft. Cell Antropol 2010;34
Suppl 2:15-19.
68. Muraine M, Descargues G, Franck O, Villeroy F, et al. Amniotic
membrane graft in ocular surface disease. Prospective study
with 31 cases. J Fr Ophtalmol 2001;24:798-812.

286

69. Sangwan VS, Vemuganti GK, Singh S, Balasubramanian D.


Successful reconstruction of damaged ocular outer surface
in humans using limbal and conjunctival stem cell culture
methods. Biosci Rep 2003;23:169-174.
70. Sangwan VS, Matalia HP, Vemuganti GK, Fatima A, et al.
Clinical outcome of autologous cultivated limbal epithelium
transplantation. Indian J Ophthalmol 2006; 54:29-34.
71. Mermet I, Pottier N, Sainthillier JM, Malugani C, et al. Use of
amniotic membrane transplantation in the treatment of venous
leg ulcers. Wound Repair Regen 2007;15: 459-464.
72. Hasegawa T, Mizoguchi M, Haruna K, Mizuno Y, et al. Amnia for
intractable skin ulcers with recessive dystrophic epidermolysis
bullosa: report of three cases. J Dermatol 2007;34:328-332.
73. Bujang-Safawi E, Halim AS, Khoo TL, Dorai AA. Dried irradiated human amniotic membrane as a biological dressing for
facial burns--a 7-year case series. Burns 2010;36: 876-882.
74. Insausti CL, Alcarz A, Garca-Vizcano EM, Mrowiec A, et
al. Amniotic membrane induces epithelialization in massive
posttraumatic wounds. Wound Rep Reg 2010;18:368-377.
75. Brooke G, Rosstti T, Pelekanos R, Ilic N, et al. Manufacturing
of human placenta-derived mesenchymal stem cells for clinical
trials. British J Haematol 2009;144:571-579.

Revista de Hematologa Volumen 12, nm. 4, octubre-diciembre 2011

También podría gustarte