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The Biology Behind BioXclude ®
The Biology Behind BioXclude®
The Biology Behind BioXclude ®

Epithelial Template
The amnion and chorion layers are composed of a rich combination of extracellular matrix proteins. In addition to creating a dynamic barrier membrane, these proteins provide important cues that direct tissue growth and organization. When incorporated into an allograft tissue, these cues help to direct cellular migration and tissue regeneration, critical aspects of healing.

Cells use integrins that are embedded in their outer membrane to attach to the extracellular matrix (ECM), providing a mechanism for cells to adhere to the ECM and generate force for migration. Integrins are formed as a pairing between alpha and beta subunits, with each alpha-beta combination having a specific binding affinity. Because of this, the binding of integrin pairs also provides critical information to the cell about its local environment. For example, integrin pairs that bind motifs in laminin will only be engaged when laminin is present in the ECM, allowing cells to “see” their local environment.

The idea that soluble growth factors (e.g. PDGF-BB, EGF, TGF-b, BMP-2, etc.) activate cellular pathways to stimulate responses within the cell is commonly understood: a growth factor on the outside of the cell binds to a growth factor receptor, the binding of the growth factor creates a signal in the cell, that signal is propagated within the cell via signaling pathways, and changes in gene expression and cell behavior result.

It should also be recognized that the ECM activates cellular pathways to stimulate responses within the cell; however it is a critical aspect of BioXclude’s success. When integrins bind to the complex ECM of BioXclude, signals are created in the cell that propagate by the similar mechanisms and pathways as growth factor signaling pathways. Moreover, the pathways used by growth factor and integrin signaling often converge, creating important synergies between the soluble factors and ECM present in BioXclude, effectively maximizing the healing response at the treatment site.

Basement membranes are the natural substrate for epithelial cells. In fact, the epithelial layer is responsible for creating and maintaining the basement membrane as a critical barrier between tissue types. When tissues are damaged, local cells must use the signals available to direct wound healing and tissue repair. Re-epithelialization, a critical aspect of wound closure, requires that epithelial cells at the wound margins migrate and proliferate over the wound while simultaneously creating a new basement membrane over the wound. By placing a BioXclude, a membrane with intact basement membranes, over wounds or between distinct tissue types, cells involved in rebuilding damaged tissues are provided a template that directs their activity.