1. Cell Sheet Transplantation for Esophageal Stricture Prevention after Endoscopic Submucosal Dissection in a Porcine Model
- Author
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Sophie Camilleri, Thomas Viel, Laetitia Pidial, Amaury Casanova, Guillaume Perrod, Gabriel Rahmi, Christophe Cellier, Alexandre Bellucci, Bertrand Tavitian, and Olivier Clément
- Subjects
0301 basic medicine ,Esophageal Neoplasms ,Sus scrofa ,Cell Culture Techniques ,lcsh:Medicine ,Pathology and Laboratory Medicine ,Endoscopy, Gastrointestinal ,Postoperative Complications ,0302 clinical medicine ,Pig Models ,Medicine and Health Sciences ,lcsh:Science ,Animal Signaling and Communication ,Immune Response ,Cells, Cultured ,Ulcers ,Stenosis ,Multidisciplinary ,Animal Behavior ,medicine.diagnostic_test ,Dissection ,Animal Models ,Esophageal stricture ,Esophageal Stenosis ,Female ,030211 gastroenterology & hepatology ,Anatomy ,Research Article ,medicine.medical_specialty ,Histology ,Stromal cell ,Immunology ,Abdominal Fat ,Surgical and Invasive Medical Procedures ,Dissection (medical) ,Research and Analysis Methods ,03 medical and health sciences ,Esophagus ,Signs and Symptoms ,Model Organisms ,medicine ,Animals ,Cell sheet ,Inflammation ,Behavior ,business.industry ,lcsh:R ,Biology and Life Sciences ,Endoscopy ,Endoscopic submucosal dissection ,medicine.disease ,Fibrosis ,Surgery ,Radiography ,Transplantation ,030104 developmental biology ,lcsh:Q ,business ,Zoology ,Stem Cell Transplantation ,Developmental Biology - Abstract
BACKGROUND & AIMS:Extended esophageal endoscopic submucosal dissection (ESD) is highly responsible for esophageal stricture. We conducted a comparative study in a porcine model to evaluate the effectiveness of adipose tissue-derived stromal cell (ADSC) double cell sheet transplantation. METHODS:Twelve female pigs were treated with 5 cm long hemi-circumferential ESD and randomized in two groups. ADSC group (n = 6) received 4 double cell sheets of allogenic ADSC on a paper support membrane and control group (n = 6) received 4 paper support membranes. ADSC were labelled with PKH-67 fluorophore to allow probe-based confocal laser endomicroscopie (pCLE) monitoring. After 28 days follow-up, animals were sacrificed. At days 3, 14 and 28, endoscopic evaluation with pCLE and esophagography were performed. RESULTS:One animal from the control group was excluded (anesthetic complication). Animals from ADSC group showed less frequent alimentary trouble (17% vs 80%; P = 0.08) and higher gain weight on day 28. pCLE demonstrated a compatible cell signal in 4 animals of the ADSC group at day 3. In ADSC group, endoscopy showed that 1 out of 6 (17%) animals developed a severe esophageal stricture comparatively to 100% (5/5) in the control group; P = 0.015. Esophagography demonstrated a decreased degree of stricture in the ADSC group on day 14 (44% vs 81%; P = 0.017) and day 28 (46% vs 90%; P = 0.035). Histological analysis showed a decreased fibrosis development in the ADSC group, in terms of surface (9.7 vs 26.1 mm²; P = 0.017) and maximal depth (1.6 vs 3.2 mm; P = 0.052). CONCLUSION:In this model, transplantation of allogenic ADSC organized in double cell sheets after extended esophegeal ESD is strongly associated with a lower esophageal stricture's rate.
- Published
- 2016