Table 2.

Amniotic membrane mechanisms that promote the healing and reconstruction of the ocular surface.

Mechanical Protects and shields the epithelium Reduces pain and discomfort

Promotion of epithelium regeneration (epithelialization) Enables migration of epithelial cells Enhancement adhesion of basal epithelial cells Reinforcement of epithelial cell differentiation Prevention of apoptosis

Anti-fibrotic properties Inhibition of fibroblast production Inhibition of differentiation of fibroblasts into myoblasts

Anti-inflammatory properties Expression of anti-inflammatory cytokines (e.g., IL-1a, IL-2, IL-8, TGF-β, interferon)

Anti-angiogenic properties Production of substances such as tissue inhibitors of metalloproteases (TIMP −1, 2, 3, and 4), endostatin and thrombospondin-1

Anti-microbial properties Anti-bacterial effects against pathogens Lack of HLA-A, HLA-B, and HLA-DR major histocompatibility antigens

^*According to references [8,9,19–33].