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Human amnion/chorion tissue derived from the placenta is rich in cytokines and growth factors known to promote wound healing; however, preservation of the biological activities of therapeutic allografts during processing remains a challenge. In this study,  PURION ® (MiMedx, Marietta, GA) processed dehydrated human amnion/chorion tissue allografts ( dHACM ,  EpiFix ®, MiMedx) were evaluated for the presence of growth factors, interleukins ( ILs ) and tissue inhibitors of metalloproteinases ( TIMPs ). Enzyme‐linked immunosorbent assays ( ELISA ) were performed on samples of  dHACM  and showed quantifiable levels of the following growth factors: platelet‐derived growth factor‐AA ( PDGF‐AA ),  PDGF‐BB , transforming growth factor α ( TGF α),  TGF β1, basic fibroblast growth factor ( bFGF ), epidermal growth factor ( EGF ), placental growth factor (PLGF) and granulocyte colony‐stimulating factor ( GCSF ). The  ELISA  assays also confirmed the presence of  IL ‐4, 6, 8 and 10, and  TIMP  1, 2 and 4. Moreover, the relative elution of growth factors into saline from the allograft ranged from 4% to 62%, indicating that there are bound and unbound fractions of these compounds within the allograft.  dHACM  retained biological activities that cause human dermal fibroblast proliferation and migration of human mesenchymal stem cells ( MSCs ) in vitro. An in vivo mouse model showed that  dHACM  when tested in a skin flap model caused mesenchymal progenitor cell recruitment to the site of implantation. The results from both the in vitro and in vivo experiments clearly established that  dHACM  contains one or more soluble factors capable of stimulating  MSC  migration and recruitment. In summary,  PURION ® processed  dHACM  retains its biological activities related to wound healing, including the potential to positively affect four distinct and pivotal physiological processes intimately involved in wound healing: cell proliferation, inflammation, metalloproteinase activity and recruitment of progenitor cells. This suggests a paracrine mechanism of action for  dHACM  when used for wound healing applications.

Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing