Use of adipose tissue-derived stromal cells for prevention of esophageal stricture after circumferential EMR in a canine model

作者：Honda Michitaka^*; Hori Yoshio; Nakada Akira; Uji Masato; Nishizawa Yuji; Yamamoto Kazumichi; Kobayashi Takeshi; Shimada Hidenori; Kida Naoki; Sato Toshihiko; Nakamura Tatsuo

来源：Gastrointestinal Endoscopy, 2011, 73(4): 777-784.

DOI：10.1016/j.gie.2010.11.008

Background: EMR is an accepted treatment for early esophageal carcinoma. However, resection of a large mucosal area often causes postoperative esophageal stricture.
Objective: To investigate the efficacy of autologous adipose tissue-derived stromal cells (ADSCs) for prevention of stricture formation after EMR in dogs.
Design: Animal study.
Setting: University research center.
Intervention: Ten beagle dogs were randomized into a control group and an ADSCs-injected (ADSC) group. The ADSCs were isolated from autologous adipose tissue. Immediately after circumferential esophageal EMR, about 5 x 10(6) ADSCs suspended in 8 mL of phosphate-buffered saline solution were injected endoscopically into the residual submucosa of the ADSC group, whereas the control group received only 8 mL. of phosphate-buffered saline solution.
Main Outcome Measurements: Dysphagia score, weight loss, rate of mucosal constriction, and histologic assessments.
Results: In the control and ADSC groups, the median dysphagia scores were 4 and 1 (P < .043), the mean degrees of mucosal constriction were 75.7% and 45.3% (P < .008), and the numbers of nascent microvessels in the submucosal layer were 7.4 and 16.2 per unit area (P = .007), respectively. Atrophy and fibrosis of the muscularis propria layer were observed in the control group.
Limitations: Animal study, small sample size.
Conclusion: Injection therapy with autologous ADSCs suppresses constriction of the esophageal mucosa and improves clinical symptoms after circumferential EMR in this canine model. (Gastrointest Enclose 2011;73: 777-84.)

• 出版日期2011-4