• International Journal of Technology (IJTech)
  • Vol 16, No 5 (2025)

Biomaterial Characterization of Decellularized Human Amniotic Membrane Seeded with Fetal Human Cardiac Fibroblasts for Cardiac Tissue Engineering

Biomaterial Characterization of Decellularized Human Amniotic Membrane Seeded with Fetal Human Cardiac Fibroblasts for Cardiac Tissue Engineering

Title: Biomaterial Characterization of Decellularized Human Amniotic Membrane Seeded with Fetal Human Cardiac Fibroblasts for Cardiac Tissue Engineering
Winda Azwani, Dini Aulia Cahya, Achmad Danny Gazali, Amira Puti Karima, Galuh Oktavya, Rahma Nur Istiqomah, Arleni Bustami, Faiza Aisya Rizqy, Puspita Anggraini Katili, Ujang Purnama, Mulyadi M Djer

Corresponding email:


Cite this article as:
Azwani, W, Cahya, DA, Gazali, AD, Karima, AP, Oktavya, G, Istiqomah, RN, Bustami, A, Rizqy, FA,  Katili, PA, Purnama, U & Djer, MM 2025, ‘Biomaterial characterization of decellularized human amniotic membrane seeded with fetal human cardiac fibroblasts for cardiac tissue engineering’, International Journal of Technology, vol. 16, no. 5, pp. 1651-1664

127
Downloads
Winda Azwani Division of Pediatric Cardiology, RSAB Harapan Kita National Women and Children Health Center, Jakarta, 11420, Indonesia
Dini Aulia Cahya Faculty of Medicine, Universitas Negeri Surabaya, Surabaya, 60213, Indonesia
Achmad Danny Gazali Cell, Tissue Culture, and Bio-imaging Division, Integrated Laboratory, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
Amira Puti Karima Division of Pediatric Cardiology, RSAB Harapan Kita National Women and Children Health Center, Jakarta, 11420, Indonesia
Galuh Oktavya Biobank Research Core Facilities, Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
Rahma Nur Istiqomah Clinical Research Unit, RSAB Harapan Kita National Women and Children Health Center, Jakarta, 11420, Indonesia
Arleni Bustami Cell, Tissue Culture, and Bio-imaging Division, Integrated Laboratory, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
Faiza Aisya Rizqy Division of Pediatric Cardiology, RSAB Harapan Kita National Women and Children Health Center, Jakarta, 11420, Indonesia.
Puspita Anggraini Katili Division of Biomedical Engineering, Department of Electrical Engineering, Faculty of Engineering, Universitas Indonesia, Depok, 16424, Indonesia
Ujang Purnama Global Graduate Program InHouse Consulting, Merck Global, Germany
Mulyadi M Djer Division of Paediatric Cardiology, Department of Paediatric, Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital, Jakarta, 10430, Indonesia
Email to Corresponding Author

Abstract
Biomaterial Characterization of Decellularized Human Amniotic Membrane Seeded with Fetal Human Cardiac Fibroblasts for Cardiac Tissue Engineering

The human amniotic membrane (hAM) is a promising biomaterial in cardiac tissue engineering known for excellent viability, anti-inflammatory properties, and ability to support cellular adhesion. Its potential as a biomaterial, particularly after decellularization, offers a novel approach for myocardial regeneration in conditions such as cardiomyopathy and heart failure. Therefore, this study aimed to characterize the ultrastructure of fetal human cardiac fibroblasts-decellularized hAM (fHCFs-dehAM) using scanning electron microscopy (SEM), identify the functional groups of dehAM through fourier transform infrared (FTIR) spectroscopy, assess vimentin expression in fHCFs-dehAM via immunocytochemistry, and evaluate fHCF cell proliferation to determine cell viability on dehAM. In the process, hAM was successfully decellularized using 0.2% (w/v) trypsin/0.25% (w/v) ethylenediaminetetraacetic acid (EDTA) in phosphate-buffered saline (PBS), confirmed by the removal of the native epithelial layer through hematoxylin-eosin (H&E) staining and ultrastructural analysis. The results showed that fHCFs adhered to the basement membrane of the dehAM and retained the phenotype, as evidenced by the expression of the intermediate filament marker vimentin via immunofluorescence staining. Furthermore, the viability of fibroblasts cultured on dehAM increased in a time-dependent manner, indicating enhanced proliferation. This is a novel study on the viability of hwith human cardiac resident cells. The result shows the potential of dehAM for biomaterial application in cardiac tissue engineering.

Cardiac fibroblasts; cardiac tissue engineering; cell viability; decellularization; human amniotic membrane.

Supplementary Material
FilenameDescription
R1-ME-7808-20250616152302.png ---
R1-ME-7808-20250616152531.jpg ---
References

Arrizabalaga, JH & Nollert, MU 2018, 'Human amniotic membrane: A versatile scaffold for tissue engineering', ACS Biomaterials Science & Engineering, vol. 4, no. 7, pp. 2226–2236, https://doi.org/10.1021/acsbiomaterials.8b00015

Badylak, SF, Taylor, D & Uygun, K 2011, 'Whole-organ tissue engineering: Decellularization and recellularization of three-dimensional matrix scaffolds', Annual Review of Biomedical Engineering, vol. 13, pp. 27–53, https://doi.org/10.1146/annurev-bioeng-071910-124743

Bahrami, N, Ale-Ebrahim, M, Asadi, Y, Barikrow, N, Salimi, A & Roholah, F 2023, 'Combined application of human amniotic membrane mesenchymal stem cells and a modified PGS-co-PCL film in an experimental model of myocardial ischemia-reperfusion injury', Applied Biochemistry and Biotechnology, vol. 195, no. 12, pp. 7502–7519, https://doi.org/10.1007/s12010-023-04446-5

Bray, LJ, Heazlewood, CF, Atkinson, K, Hutmacher, DW & Harkin, DG 2012, 'Evaluation of methods for cultivating limbal mesenchymal stromal cells', Cytotherapy, vol. 14, no. 8, pp. 936-947, https://doi.org/10.3109/14653249.2012.684379

Camelliti, P, Borg, TK & Kohl, P 2005, 'Structural and functional characterisation of cardiac fibroblasts', Cardiovascular Research, vol. 65, pp. 40–51, https://doi.org/10.1016/j.cardiores.2004.08.020

Careta, O, Salicio-Paz, A, Pellicer, E, Ibáñez, E, Fornell, J, García-Lecina, E, Sort, J & Nogués, C 2021, 'Electroless palladium-coated polymer scaffolds for electrical stimulation of osteoblast-like Saos-2 cells', International Journal of Molecular Sciences, vol. 22, no. 2, article 528, https://doi.org/10.3390/ijms22020528

Chen, L, Wu, Z, Zhou, Y, Li, L, Wang, Y, Wang, Z, Chen, Y & Zhang, P 2017, 'Biomimetic porous collagen/hydroxyapatite scaffold for bone tissue engineering', Journal of Applied Polymer Science, vol. 134, no. 37, article 45271, https://doi.org/10.1002/app.45271

Chen, W & Frangogiannis, NG 2013, 'Fibroblasts in post-infarction inflammation and cardiac repair', Biochimica et Biophysica Acta (BBA) - Molecular Cell Research, vol. 1833, no. 4, pp. 945–953, https://doi.org/10.1016/j.bbamcr.2012.08.023

Craig, NA, Scruggs, AM, Berens, JP, Deng, F, Chen, Y, Dvonch, JT & Huang, SK 2024, 'Promotion of myofibroblast differentiation through repeated treatment of fibroblasts to low concentrations of PM2.5', Environmental Toxicology and Pharmacology, vol. 105, article 104329, https://doi.org/10.1016/j.etap.2023.104329

Crapo, P M, Gilbert, T W & Badylak, S F 2011, 'An overview of tissue and whole organ decellularization processes', Biomaterials, vol. 32, no. 12, pp. 3233–3243, https://doi.org/10.1016/j.biomaterials.2011.01.057

Elkhenany, H, El-Derby, A, Abd Elkodous, M, Salah, R A, Lotfy, A & El-Badri, N 2022, 'Applications of the amniotic membrane in tissue engineering and regeneration: The hundred-year challenge', Stem Cell Research & Therapy, vol. 13, no. 1, article 8, https://doi.org/10.1186/s13287-021-02684-0

Fajarani, R, Rahman, SF, Pangesty, AI, Katili, PA & Park, DH 2024, 'Physical and chemical characterization of collagen/alginate/poly(vinyl alcohol) scaffold with the addition of multi-walled carbon nanotube, reduced graphene oxide, titanium dioxide, and zinc oxide materials', International Journal of Technology, vol. 15, no. 2, pp. 332–341, https://doi.org/10.14716/ijtech.v15i2.6693

Faravelli, S, Campioni, M, Palamini, M, Canciani, A, Chiapparino, A & Forneris, F 2021, 'Optimized recombinant production of secreted proteins using human embryonic kidney (HEK293) cells grown in suspension', Bio-protocol, vol. 11, no. 8, pp. 1–15, https://doi.org/10.21769/BioProtoc.3998

Garate-Carrillo, A & Ramirez, I 2018, 'Embryonary mouse cardiac fibroblast isolation', Methods in Molecular Biology, vol. 1752, pp. 71–79, https://doi.org/10.1007/978-1-4939-7714-7_7

Gattazzo, F, De Maria, C, Whulanza, Y, Taverni, G, Ahluwalia, A & Vozzi, G, 2015, 'Realisation and characterization of conductive hollow fibers for neuronal tissue engineering'. Journal of Biomedical Materials Research Part B: Applied Biomaterials, vol.103, no. 5, pp.1107-1119, https://doi.org/10.1002/jbm.b.33297  

González, A, Ravassa, S, Beaumont, J, López, B & Díez, J 2011, 'New targets to treat the structural remodeling of the myocardium', Journal of the American College of Cardiology, vol. 58, no. 18, pp. 1833–1843, https://doi.org/10.1016/j.jacc.2011.06.058

Gordon, B, González-Fernández, V & Dos-Subirà, L 2022, 'Myocardial fibrosis in congenital heart disease', Frontiers in Pediatrics, vol. 10, article 965204, https://doi.org/10.3389/fped.2022.965204

Hall, C, Gehmlich, K, Denning, C & Pavlovic, D 2021, 'Complex relationship between cardiac fibroblasts and cardiomyocytes in health and disease', Journal of the American Heart Association, vol. 10, no. 5, article e019338, https://doi.org/10.1161/JAHA.120.019338

Hasmad, HN, Bt Hj Idrus, R, Sulaiman, N & Lokanathan, Y 2022, 'Electrospun fiber-coated human amniotic membrane: A potential angioinductive scaffold for ischemic tissue repair', International Journal of Molecular Sciences, vol. 23, no. 3, article 1743, https://doi.org/10.3390/ijms23031743

Hsu, DT 2005, 'Chronic heart failure in congenital heart disease', in Pediatric Heart Failure, CRC Press, pp. 567–588, https://doi.org/10.1161/cir.0000000000000352

Hu, Z, Luo, Y, Ni, R, Hu, Y, Yang, F, Du, T & Zhu, Y 2023, 'Biological importance of human amniotic membrane in tissue engineering and regenerative medicine', Materials Today Bio, vol. 22, article 100790, https://doi.org/10.1016/j.mtbio.2023.100790

Irsyad, M, Whulanza, Y, Katili, PA, Antarianto, RD, Jasirwan, COM & Bugtai, N 2022, 'Development of Auto-PIVOT: Automated platform in vitro for cell tissue culture', International Journal of Technology, vol. 13, no. 8, pp. 1651–1662, https://doi.org/10.14716/ijtech.v13i8.6176

Ji, Y, Yang, X, Ji, Z, Zhu, L, Ma, N, Chen, D, Jia, X, Tang, J & Cao, Y 2020, 'DFT-calculated IR spectrum amide I, II, and III band contributions of N-methylacetamide fine components', ACS Omega, vol. 5, no. 15, pp. 8572–8578, https://doi.org/10.1021/acsomega.9b04421

Ketabat, F, Karkhaneh, A, Mehdinavaz Aghdam, R & Hossein Ahmadi Tafti, S 2017, 'Injectable conductive collagen/alginate/polypyrrole hydrogels as a biocompatible system for biomedical applications', Journal of Biomaterials Science, Polymer Edition, vol. 28, no. 8, pp. 794–805, https://doi.org/10.1080/09205063.2017.1302314

Khalili, M, Ekhlasi, A, Solouk, A, Nazarpak, M H & Akbari, S 2025, 'A hybrid scaffold of modified human amniotic membrane with gelatine/dendrimer-protected silver nanoparticles for skin wound healing applications', RSC Advances, vol. 15, no. 9, pp. 6902–6913, https://doi.org/10.1039/d4ra08014a

Khodayari, H, Khodayari, S, Rezaee, M, Rezaeiani, S, Alipour Choshali, M, Erfanian, S, Muhammadnejad, A, Nili, F, Pourmehran, Y, Pirjani, R & Rajabi, S 2024, 'Promotion of cardiac microtissue assembly within G-CSF-enriched collagen I-cardiogel hybrid hydrogel', Regenerative Biomaterials, vol. 11, article rbae072, https://doi.org/10.1093/rb/rbae072

Khosravimelal, S, Momeni, M, Gholipur, M, Kundu, SC & Gholipourmalekabadi, M 2020, 'Protocols for decellularization of human amniotic membrane', Methods in Cell Biology, vol. 157, pp. 37–47, https://doi.org/10.1016/bs.mcb.2019.11.004

Li, W, He, H, Chen, YT, Hayashida, Y & Tseng, SC 2008, 'Reversal of myofibroblasts by amniotic membrane stromal extract', Journal of Cellular Physiology, vol. 215, no. 3, pp. 657–664, https://doi.org/10.1002/jcp.21345

Maleki, SN, Aboutaleb, N, Nazarinia, D, Beik, SA, Qolamian, A & Nobakht, M 2019, 'Conditioned medium obtained from human amniotic membrane-derived mesenchymal stem cell attenuates heart failure injury in rats', Iranian Journal of Basic Medical Sciences, vol. 22, no. 11, article 1253, https://doi.org/10.22038/IJBMS.2019.36617.8722

Mamede, AC, Carvalho, MJ, Abrantes, AM, Laranjo, M, Maia, CJ & Botelho, MF 2012, 'Amniotic membrane: From structure and functions to clinical applications', Cell and Tissue Research, vol. 349, pp. 447–458, https://doi.org/10.1007/s00441-012-1424-6

Moravvej, H, Memariani, H, Memariani, M, Kabir-Salmani, M, Shoae-Hassani, A & Abdollahimajd, F 2021, 'Evaluation of fibroblast viability seeded on acellular human amniotic membrane', BioMed Research International, vol. 1, article  5597758, https://doi.org/10.1155/2021/5597758

Nagpal, V, Rai, R, Place, AT, Murphy, SB, Verma, SK, Ghosh, AK & Vaughan, DE 2016, 'MiR-125b is critical for fibroblast-to-myofibroblast transition and cardiac fibrosis', Circulation, vol. 133, no. 3, pp. 291–301, https://doi.org/10.1161/CIRCULATIONAHA.115.018174

Nishio, K, Inoue, A, Qiao, S, Kondo, H & Mimura, A 2001, 'Senescence and cytoskeleton: Overproduction of vimentin induces senescent-like morphology in human fibroblasts', Histochemistry and Cell Biology, vol. 116, no. 4, pp. 321–327, https://doi.org/10.1007/s004180100325

Nurhayati, R W, Laksono, A L, Salwa, A, Pangesty, A I, Whulanza, Y & Mubarok, W 2023, 'The effect of umbilical cord blood serum and platelet-rich plasma coatings on the characteristics of poly(?-caprolactone) scaffolds for skin tissue engineering applications', International Journal of Technology, vol. 14, no. 7, pp. 1596–1604, https://doi.org/10.14716/ijtech.v14i7.6709

Ostrowska-Podhorodecka, Z, Ding, I, Norouzi, M & McCulloch, C A 2022, 'Impact of vimentin on regulation of cell signaling and matrix remodeling', Frontiers in Cell and Developmental Biology, vol. 10, article 869069, https://doi.org/10.3389/fcell.2022.869069

Pangesty, AI, Dwinovandi, CS, Tarigan, SJAP, Rahman, SF, Katili, PA, Azwani, W, Whulanza, Y & Abdullah, AH 2024, 'PVA/gelatin hydrogel loaded with propolis for the treatment of myocardial infarction', Journal of Science: Advanced Materials and Devices, vol. 9, no. 3, article 100732, https://doi.org/10.1016/j.jsamd.2024.100732

Pangesty, AI, Kamila, RA, Schlumbergerina, ACPB, Faizurrizqi, MD, Fakhri, RW, Sunarso, S, Zakaria, MN, Nuraini, L & Azwani, W 2025, 'Propolis-enhanced alginate-collagen injectable hydrogel crosslinked with calcium gluconate for myocardial infarction therapy', International Journal of Technology, vol. 16, no. 3, pp. 1019-1029, https://doi.org/10.14716/ijtech.v16i3.7366

Pattar, SS, Hassanabad, AF & Fedak, PW 2019, 'Acellular extracellular matrix bioscaffolds for cardiac repair and regeneration', Frontiers in Cell and Developmental Biology, vol. 7, article 63, https://doi.org/10.3389/fcell.2019.00063

Rahyussalim, AJ, Kurniawati, T, Aprilya, D, Anggraini, R, Ramahdita, G & Whulanza, Y, 2017, 'Toxicity and biocompatibility profile of 3D bone scaffold developed by Universitas Indonesia: A preliminary study', AIP Conference Proceedings, Vol. 1817, No. 1, p. 020004, https://doi.org/10.1063/1.4976756  

Rizal, R, Syaidah, R, Evelyn, E, Hafizh, A M & Frederich, J 2020, 'Wharton’s jelly mesenchymal stem cells: Differentiation capacity showing its role in bone tissue engineering', International Journal of Technology, vol. 11, no. 5, pp. 1005–1014, https://doi.org/10.14716/ijtech.v11i5.4309

Salah, R A, Mohamed, I K & El-Badri, N 2018, 'Development of decellularized amniotic membrane as a bioscaffold for bone marrow-derived mesenchymal stem cells: Ultrastructural study', Journal of Molecular Histology, vol. 49, no. 3, pp. 289–301, https://doi.org/10.1007/s10735-018-9768-1

Sarvari, R, Keyhanvar, P, Agbolaghi, S, Roshangar, L, Bahremani, E, Keyhanvar, N, Haghdoost, M, Keshel, S H, Taghikhani, A, Firouzi, N & Valizadeh, A 2022, 'A comprehensive review on methods for promotion of mechanical features and biodegradation rate in amniotic membrane scaffolds', Journal of Materials Science: Materials in Medicine, vol. 33, article 32, https://doi.org/10.1007/S10856-021-06570-2

Savi?, L, Augustyniak, E M, Kastensson, A, Snelling, S, Abhari, R E, Baldwin, M, Price, A, Jackson, W, Carr, A & Mouthuy, P A 2021, 'Early development of a polycaprolactone electrospun augment for anterior cruciate ligament reconstruction', Materials Science and Engineering: C, vol. 129, article 112414, https://doi.org/10.1016/J.MSEC.2021.112414

Skopinska-Wisniewska, J, Michalak, M, Tworkiewicz, J, Tyloch, D, Tuszynska, M & Bajek, A 2023, 'Modification of the human amniotic membrane using different cross-linking agents as a promising tool for regenerative medicine', Materials, vol. 16, no. 20, article 6726, https://doi.org/10.3390/ma16206726

Sliogeryte, K & Gavara, N 2019, 'Vimentin plays a crucial role in fibroblast ageing by regulating biophysical properties and cell migration', Cells, vol. 8, no. 10, article 1164, https://doi.org/10.3390/cells8101164

Solarte David, VA, Güiza-Argüello, VR, Arango-Rodríguez, ML, Sossa, CL & Becerra-Bayona 2022, 'Decellularized tissues for wound healing: Towards closing the gap between scaffold design and effective extracellular matrix remodeling', Frontiers in Bioengineering and Biotechnology, vol. 10, article 821852, https://doi.org/10.3389/fbioe.2022.821852

Solecki, L, Fenelon, M, Kerdjoudj, H, Di Pietro, R, Stati, G, Gaudet, C, Bertin, E, Nallet, J, Louvrier, A, Gualdi, T & Schiavi-Tritz, J 2025, 'Perspectives on the use of decellularized/devitalized and lyophilized human perinatal tissues for bone repair: Advantages and remaining challenges', Materials Today Bio, vol. 30, article 101364, https://doi.org/10.1016/j.mtbio.2024.101364

Sripriya, R & Kumar, R 2016, 'Denudation of human amniotic membrane by a novel process and its characterisations for biomedical applications', Progress in Biomaterials, vol. 5, no. 3, pp. 161–172, https://doi.org/10.1007/s40204-016-0053-7

Susilo, R I, Wahyuhadi, J, Sudiana, I K & Rantam, F A 2021, 'Cytotoxicity test for the use of freeze-dried amniotic membranes against viability, proliferation, and apoptosis on brain cell culture: An in vitro study', Interdisciplinary Neurosurgery, vol. 23, article 100947, https://doi.org/10.1016/J.INAT.2020.100947

Svystonyuk, D A, Mewhort, H E, Hassanabad, A F, Heydari, B, Mikami, Y, Turnbull, J D, Teng, G, Belke, D D, Wagner, K T, Tarraf, S A & DiMartino, E S 2020, 'Acellular bioscaffolds redirect cardiac fibroblasts and promote functional tissue repair in rodents and humans with myocardial injury', Scientific Reports, vol. 10, no. 1, article 9459, https://doi.org/10.1038/s41598-020-66327-9

Syuhada, G, Ramahdita, G, Rahyussalim, AJ & Whulanza, Y, 2018, 'Multi-material poly (lactic acid) scaffold fabricated via fused deposition modeling and direct hydroxyapatite injection as spacers in laminoplasty'. AIP Conference Proceedings, Vol. 1933, No. 1, p. 020008), https://doi.org/0.1063/1.5023942 

Taghiabadi, E, Nasri, S, Shafieyan, S, Firoozinezhad, SJ & Aghdami, N 2015, 'Fabrication and characterization of spongy denuded amniotic membrane based scaffold for tissue engineering', Cell Journal (Yakhteh), vol. 16, no. 4, pp. 476-487, https://doi.org/10.22074/cellj.2015.493

Wang, C, Chai, Y, Wen, X, Ai, Y, Zhao, H, Hu, W, Yang, X, Ding, M Y, Shi, X, Liu, Q & Liang, Q 2021, 'Stretchable and anisotropic conductive composite hydrogel as therapeutic cardiac patches', ACS Materials Letters, vol. 3, no. 8, pp. 1238–1248, https://doi.org/10.1021/ACSMATERIALSLETT.1C00146/SUPPL_FILE/TZ1C00146_SI_001.PDF

Wang, X, Yu, S, Xie, L, Xiang, M & Ma, H 2025, 'The role of the extracellular matrix in cardiac regeneration', Heliyon, vol. 11, no. 1, article e41157, https://doi.org/10.1016/j.heliyon.2024.e41157

Whulanza, Y, Ucciferri, N, Domenici, C, Vozzi, G & Ahluwalia, A, 2011, 'Sensing scaffolds to monitor cellular activity using impedance measurements', Biosensors and Bioelectronics, vol. 26, no. 7, pp.3303-3308, https://doi.org/10.1016/j.bios.2011.01.002  

Wilshaw, S P, Kearney, J, Fisher, J & Ingham, E 2008, 'Biocompatibility and potential of acellular human amniotic membrane to support the attachment and proliferation of allogeneic cells', Tissue Engineering - Part A, vol. 14, no. 4, pp. 463–472, https://doi.org/10.1089/tea.2007.0145

Zhang, T, Yam, G H F, Riau, AK, Poh, R, Allen, JC, Peh, GS, Beuerman, R W, Tan, DT & Mehta, JS 2013, 'The effect of amniotic membrane de-epithelialization method on its biological properties and ability to promote limbal epithelial cell culture', Investigative Ophthalmology and Visual Science, vol. 54, no. 4, pp. 3072–3081, https://doi.org/10.1167/iovs.12-10805

Zhou, H, Wang, L, Zhang, C, Hu, J, Chen, J, Du, W, Liu, F, Ren, W, Wang, J & Quan, R 2019, 'Feasibility of repairing full-thickness skin defects by iPSC-derived epithelial stem cells seeded on a human acellular amniotic membrane', Stem Cell Research and Therapy, vol. 10, no. 1, pp. 1–13, https://doi.org/10.1186/s13287-019-1234-9