Cartilage is an important yet vulnerable tissue with limited self-healing capacity, where damage often progresses to joint degeneration, which eventually leads to severe osteoarthritis (OA). Current tissue engineering strategies focus on biocompatible scaffolds for cartilage regeneration, particularly amnion (or amniotic membrane), emerging as a promising biomaterial due to its wide availability, low immunogenicity, and naturally derived microenvironment that is advantageous for cartilage regeneration. This systematic review aims to evaluate the existing evidence on the efficacy of amnion as a tissue scaffolding material for cartilage regeneration in both preclinical and clinical studies. Using terms such as “cartilage damage”, “cartilage injuries”, “amnion” and “amniotic membrane”, 19 relevant studies were identified across three major databases (PubMed, Scopus and Web of Science) until 25 December 2025. All preclinical and clinical studies that utilized amnion for cartilage repair or as cartilage tissue engineering scaffolding materials were included. Evidence quality was assessed using the OHAT and MINORS risk of bias tool. This study is prospectively registered in the PROSPERO database under the ID 1178444. The findings consistently indicate that amniotic scaffolds, regardless of processing methods or cell seeding, yield favorable outcomes without adverse effects across different species. In vitro analysis revealed that treatment groups with amnion show better cell attachment, viability, and proliferation, and higher content of cartilage-related markers expressed by the seeded cells, either chondrocyte, bone marrow-derived mesenchymal stem cells (MSCs), adipose tissue-derived MSCs, placenta-derived MSCs, umbilical cord-derived MSCs, amniotic MSCs or amniotic epithelial cells. In in vivo and ex vivo studies, amnion-treated groups demonstrated improved quality of the treated cartilage, with better integration, as indicated by higher histological scores and the presence of type II collagen (COL-II). There was an inconsistency in the reporting of cartilage defect dimensions in the in vivo models across the different studies. Nevertheless, the outcome measurements were consistently reported with histological analysis, with or without International Cartilage Repair Society (ICRS) scoring and immunohistochemistry (IHC) analysis, across the studies. Clinically, most subjects show improvement in the Knee Injury and Osteoarthritis Outcome Score (KOOS) Sports and Recreation score and KOOS Quality of Life score, as well as reduced Visual Analogue Scale (VAS) average and maximum pain scores. In conclusion, preclinical and clinical studies support amnion as an ideal scaffold material for cartilage tissue engineering and regeneration. Future research should focus on optimizing and standardizing amnion scaffold preparation at a production scale to facilitate the translation of these positive outcomes into clinical applications. This study is funded by the Ministry of Higher Education Malaysia via Prototype Research Grant Scheme (PRGS/1/2021/SKK01/UM/02/1) and UM International Collaboration Grant—2023 SATU Joint Research Scheme Program: ST007-2024.

Cardiovascular disease is the primary cause of death in Malaysia, with post-menopausal women at higher risk due to oestrogen deficiency. Consequently, researchers are exploring alternative approaches to minimize cardiovascular injury in post-menopausal women. S-Allylcysteine (SAC), a compound in aged garlic extract has demonstrated cardioprotective effects through mitochondrial preservation and the CSE/hydrogen sulfide (H₂S) pathway. This study investigated the impact of SAC in ovariectomised rats with isoprenaline-induced myocardial injury. Ovariectomy surgery was performed on 32 female Wistar rats, while eight rats underwent sham surgery. After three weeks, all rats received subcutaneous administration of either normal saline (Sham OVX) or isoprenaline 85 mg/kg (OVXM) for two days to induce myocardial injury. Then distilled water (Sham, OVX, OVXM) or SAC 100 mg/kg (OVXS, OVXMS) were orally given for one week. Blood pressure was monitored before and after treatment and cardiac function was measured using Langendorff’s system after treatment. Structural changes and fibrosis of the heart were assessed by histological analysis. Biochemical analysis were conducted using colorimetric methods and Western blot for protein expression. Histological observation indicated that SAC limit hypertrophy and collagen deposition in the OVXMS group. Although SAC did not reduce TBARS levels, it increased GSH and SOD antioxidants levels. CSE enzyme activity and protein expression showed a trend of increment in SAC-treated group. In summary, this study demonstrates SAC's potential in preserving cardiac function and structure under oestrogen-deficient conditions. However, further in-depth study is warranted to understand the antioxidant and CSE enzyme signalling pathways.