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Oral administration of conditioned medium obtained from mesenchymal stem cell culture prevents subsequent stricture formation after esophageal submucosal dissection in pigs

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Title: Oral administration of conditioned medium obtained from mesenchymal stem cell culture prevents subsequent stricture formation after esophageal submucosal dissection in pigs
Authors: Mizushima, Takeshi Browse this author
Ohnishi, Shunsuke Browse this author →KAKEN DB
Hosono, Hidetaka Browse this author
Yamahara, Kenichi Browse this author →KAKEN DB
Tsuda, Momoko Browse this author
Shimizu, Yuichi Browse this author →KAKEN DB
Kato, Mototsugu Browse this author →KAKEN DB
Asaka, Masahiro Browse this author →KAKEN DB
Sakamoto, Naoya Browse this author →KAKEN DB
Keywords: Endoscopic submucosal dissection
Esophageal stricture
Mesenchymal stem cells
Conditioned medium
Amnion
Issue Date: Sep-2017
Publisher: Elsevier
Journal Title: Gastrointestinal endoscopy
Volume: 86
Issue: 3
Start Page: 542
End Page: 552
Publisher DOI: 10.1016/j.gie.2017.01.024
PMID: 28153569
Abstract: Background and Aims: Endoscopic submucosal dissection (ESD) for esophageal cancer often causes postoperative stricture when more than three fourths of the circumference of the esophagus is dissected. Mesenchymal stem cells are a valuable cell source in regenerative medicine, and conditioned medium (CM) obtained from mesenchymal stem cells reportedly inhibits inflammation. In this study we evaluated whether CM could prevent esophageal stricture after ESD. Methods: We resected a semi-circumference of pig esophagus by ESD. We prepared CM gel by mixing with 5% carboxymethyl cellulose and endoscopically applied it onto the wound bed immediately after ESD and on days 8 and 15 (weekly CM group) or administered it orally from days 1 to 4 (daily CM group). We also injected triamcinolone acetonide into the remaining submucosa immediately after ESD (steroid group). We killed the pigs on day 8 or day 22 to measure the stricture rate and to perform histologic analysis. Results: Stricture rate in weekly and daily CM groups and steroid groups were significantly lower than in the control group on day 22. Moreover, CM significantly attenuated the number of activated myofibroblasts and fiber thickness on day 22. CM also significantly decreased the infiltration of neutrophils and macrophages compared with the control group on day 8. Conclusions: CM gel prevents esophageal stricture formation by suppressing myofibroblast activation and fibrosis after the infiltration of neutrophils and macrophages. Oral administration of CM gel is a promising treatment for the prevention of post-ESD stricture.
Rights: © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/71410
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 大西 俊介

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