1
|
Li Z, Lu X, Wu K, Wang J, Li Y, Li Y, Ren K, Han X. Graphene oxide-loaded rapamycin coating on airway stents inhibits stent-related granulation tissue hyperplasia. Eur J Cardiothorac Surg 2024; 66:ezae270. [PMID: 38980196 DOI: 10.1093/ejcts/ezae270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/24/2024] [Accepted: 07/09/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVES Our objective was to explore the safety and efficacy of a graphene oxide-loaded rapamycin-coated self-expandable metallic airway stent (GO@RAPA-SEMS) in a rabbit model. METHODS The dip coating method was used to develop a GO@RAPA-SEMS and a poly(lactic-co-glycolic)-acid loaded rapamycin-coated self-expandable metallic airway stent (PLGA@RAPA-SEMS). The surface structure was evaluated using a scanning electronic microscope. The in vitro drug-release profiles of the 2 stents were explored and compared. In the animal study, a total of 45 rabbits were randomly divided into 3 groups and underwent 3 kinds of stent placements. Computed tomography was performed to evaluate the degree of stenosis at 1, 2 and 3 months after the stent operation. Five rabbits in each group were sacrificed after the computed tomography scan. The stented trachea and blood were collected for further pathological analysis and laboratory testing. RESULTS The in vitro drug-release study revealed that GO@RAPA-SEMS exhibited a sudden release on the first day and maintained a certain release rate on the 14th day. The PLGA@RAPA-SEMS exhibited a longer sustained release time. All 45 rabbits underwent successful stent placement. Pathological results indicated that the granulation tissue thickness in the GO@RAPA-SEMS group was less than that in the PLGA@RAPA-SEMS group. The TUNEL and hypoxia-inducible factor-1α staining results support the fact that the granulation inhibition effect in the GO@RAPA-SEMS group was greater than that in the PLGA@RAPA-SEMS group. CONCLUSIONS GO@RAPA-SEMS effectively inhibited stent-related granulation tissue hyperplasia.
Collapse
Affiliation(s)
- Zongming Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Institute of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, Henan, China
| | - Xin Lu
- School of Chemical Engineering, Zhengzhou University, Zhengzhou, China
| | - Kunpeng Wu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Institute of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, Henan, China
| | - Jing Wang
- School of Chemical Engineering, Zhengzhou University, Zhengzhou, China
| | - Yahua Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Institute of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, Henan, China
| | - Yifan Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Institute of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, Henan, China
| | - Kewei Ren
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Institute of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, Henan, China
| | - Xinwei Han
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Institute of Zhengzhou University, Zhengzhou, Henan, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, Henan, China
| |
Collapse
|
2
|
Sirolimus-eluting cobalt-chrome alloy stent suppresses stent-induced tissue hyperplasia in a porcine Eustachian tube model. Sci Rep 2022; 12:3436. [PMID: 35236923 PMCID: PMC8891339 DOI: 10.1038/s41598-022-07471-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/11/2022] [Indexed: 11/09/2022] Open
Abstract
Various preclinical studies with developed Eustachian tube (ET) stents are in progress but have not yet been clinically applied. ET stent is limited by stent-induced tissue hyperplasia in preclinical studies. The effectiveness of sirolimus-eluting cobalt–chrome alloy stent (SES) in suppressing stent-induced tissue hyperplasia after stent placement in the porcine ET model was investigated. Six pigs were divided into two groups (i.e., the control and the SES groups) with three pigs for each group. The control group received an uncoated cobalt–chrome alloy stent (n = 6), and the SES group received a sirolimus-eluting cobalt–chrome alloy stent (n = 6). All groups were sacrificed 4 weeks after stent placement. Stent placement was successful in all ETs without procedure-related complications. None of the stents was able to keep its round shape as original, and mucus accumulation was observed inside and around the stent in both groups. On histologic analysis, the tissue hyperplasia area and the thickness of submucosal fibrosis were significantly lower in the SES group than in the control group. SES seems to be effective in suppressing stent-induced tissue hyperplasia in porcine ET. However, further investigation was required to verify the optimal stent materials and antiproliferative drugs.
Collapse
|
3
|
Huang Z, Wei P, Gan L, Li W, Zeng T, Qin C, Chen Z, Liu G. Protective effects of different anti‑inflammatory drugs on tracheal stenosis following injury and potential mechanisms. Mol Med Rep 2021; 23:314. [PMID: 34240225 PMCID: PMC7974317 DOI: 10.3892/mmr.2021.11953] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 07/07/2020] [Indexed: 01/17/2023] Open
Abstract
Tracheal stenosis following injury cannot be effectively treated. The current study compared the protective effects of different anti-inflammatory drugs on tracheal stenosis and investigated their possible mechanisms. Rabbit tracheal stenosis models following injury were constructed and confirmed using hematoxylin and eosin (H&E) staining. A total of 30 rabbits were divided into the control (CON), penicillin (PEN), erythromycin (ERY), budesonide (BUD) and PEN + ERY + BUD groups (n=6). Stenotic tracheal tissue, serum and bronchoalveolar lavage fluid (BALF) were collected 10 days after continuous treatment. Pathological changes in the tracheas were observed by H&E staining. Histone deacetylase 2 (HDAC2) expression in tracheal tissues was detected by immunofluorescence. Immunohistochemistry was performed to detect collagen I (Col-I) and collagen III (Col-III) levels in tracheal tissues. Transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF) and interleukin 8 (IL-8) levels in serum and BALF samples were determined using ELISA kits. Western blotting detected HDAC2, IL-8, TGF-β1 and VEGF levels in tracheal tissues. H&E staining demonstrated that tracheal epithelial hyperplasia and fibroblast proliferation in the ERY and PEN + ERY + BUD groups markedly improved compared with the CON group. Furthermore, in tracheal tissues, HDAC2 expression was significantly increased and IL-8, TGF-β1, VEGF, Col-I and Col-III levels were significantly decreased in the ERY and PEN + ERY + BUD groups compared with the CON group. Additionally, the results for the PEN + ERY + BUD were more significant compared with the ERY group. In serum and BALF samples, IL-8, TGF-β1 and VEGF levels in the ERY and PEN + ERY + BUD groups were significantly lower compared with the CON group, with the results of the PEN + ERY + BUD group being more significant compared with the ERY group. There were no significant differences between the PEN, BUD and CON groups. ERY inhibited tracheal granulation tissue proliferation and improved tracheal stenosis following injury and synergistic effects with PEN and BUD further enhanced these protective effects. The mechanism may involve HDAC2 upregulation and inhibition of local airway and systemic inflammatory responses.
Collapse
Affiliation(s)
- Zhenjie Huang
- Department of Respiratory Medicine, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| | - Peng Wei
- Department of Respiratory Medicine, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| | - Luoman Gan
- School of Medicine, Qinghai University, Xining, Qinghai 810000, P.R. China
| | - Wentao Li
- Department of Respiratory Medicine, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| | - Tonghua Zeng
- Department of Respiratory Medicine, Beihai People's Hospital, Beihai, Guangxi 536000, P.R. China
| | - Caicheng Qin
- Department of Respiratory Medicine, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| | - Zhiyu Chen
- Department of Respiratory Medicine, Beihai People's Hospital, Beihai, Guangxi 536000, P.R. China
| | - Guangnan Liu
- Department of Respiratory Medicine, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| |
Collapse
|
4
|
Role of Erythromycin-Regulated Histone Deacetylase-2 in Benign Tracheal Stenosis. Can Respir J 2020; 2020:4213807. [PMID: 32051729 PMCID: PMC6995498 DOI: 10.1155/2020/4213807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/24/2019] [Indexed: 11/24/2022] Open
Abstract
Objective This study aims to explore the role of erythromycin-regulated histone deacetylase-2 in benign tracheal stenosis. Methods The rabbit model of tracheal stenosis was established. The rabbits were randomly divided into 8 groups. Histone deacetylase-2 (HDAC2) expression was detected by immunofluorescence. The expression of type I collagen and type III collagen was detected by immunohistochemical method. The expression of TGF-β1, VEGF and IL-8 in serum and alveolar lavage fluid was detected by ELISA. The expression of HDAC2, TGF-β1, VEGF and IL-8 in serum and alveolar lavage fluid was detected by ELISA. The expression of HDAC2, TGF- Results In Erythromycin (ERY) group, ERY + Budesonide group, ERY + Vorinostat group and ERY + Budesonide + Vorinostat group, the degree of bronchial stenosis was alleviated, and the mucosal epithelium was still slightly proliferated. The effect of ERY combined with other drugs was more obvious. The HDAC2 protein expression increased significantly in ERY group, ERY + Budesonide group and ERY + Budesonide + Vorinostat group and decreased significantly in Vorinostat group, the expression of collagen I and III decreased significantly in ERY group, ERY + Budesonide group and ERY + Budesonide + Vorinostat group (P < 0.05). The TGF-β1, VEGF and IL-8 in serum and alveolar lavage fluid was detected by ELISA. The expression of HDAC2, TGF-P < 0.05). The TGF- Conclusions Erythromycin inhibited inflammation and excessive proliferation of granulation tissue after tracheobronchial mucosal injury by up-regulating the expression of HDAC2, it promoted wound healing and alleviated tracheobronchial stenosis. When combined with budesonide, penicillin and other glucocorticoids and antibiotics, it had a good synergistic effect. However, vorinostat could attenuate erythromycin's effect by down-regulating the expression of HDAC2. It may have good clinical application prospects in the treatment of tracheal stenosis.
Collapse
|
5
|
Han K, Park JH, Yang SG, Lee DH, Tsauo J, Kim KY, Kim MT, Gang SG, Kim DK, Kim DH, Song HY. EW-7197 eluting nano-fiber covered self-expandable metallic stent to prevent granulation tissue formation in a canine urethral model. PLoS One 2018; 13:e0192430. [PMID: 29447198 PMCID: PMC5813937 DOI: 10.1371/journal.pone.0192430] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 01/11/2018] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To evaluate an EW-7197-eluting nanofiber-covered stent (NFCS) for suppressing granulation tissue formation after stent placement in a canine urethral model. MATERIALS AND METHODS All experiments were approved by the committee of animal research. A total of 12 NFCSs were placed in the proximal and distal urethras of six dogs. Dogs were divided into two groups with 3 dogs each. The control stent (CS) group received NFCSs and the drug stent (DS) group received EW-7197 (1000 μg)-eluting NFCSs. All dogs were sacrificed 8 weeks after stent placement Histologic findings of the stented urethra were compared using the Mann-Whitney U test. RESULTS Stent placement was technically successful in all dogs without procedure-related complications. On urethrographic analysis, the mean luminal diameter was significantly larger in the DS group than in the CS group at 4 and 8 weeks after stent placement (all p < 0.001). On histological examination, mean thicknesses of the papillary projection, thickness of submucosal fibrosis, number of epithelial layers, and degree of collagen deposition were significantly lower in the DS group than in the CS group (all p < 0.001), whereas the mean degree of inflammatory cell infiltration was not significantly different (p > 0.05). CONCLUSION The EW-7197-eluting NFCS is effective and safe for suppressing granulation tissue formation after stent placement in a canine urethral model.
Collapse
Affiliation(s)
- Kichang Han
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea
| | - Jung-Hoon Park
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Engineering Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Su-Geun Yang
- Department of New Drug Development and WCSL, Inha University College of Medicine, Incheon, Republic of Korea
- * E-mail: (SGY); (DHL)
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- * E-mail: (SGY); (DHL)
| | - Jiaywei Tsauo
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kun Yung Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Tae Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Gwon Gang
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dae-Kee Kim
- College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea
| | - Dong-Hyun Kim
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Ho-Young Song
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
6
|
Recent developments in drug eluting devices with tailored interfacial properties. Adv Colloid Interface Sci 2017; 249:181-191. [PMID: 28532663 DOI: 10.1016/j.cis.2017.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/02/2017] [Accepted: 05/02/2017] [Indexed: 11/23/2022]
Abstract
Drug eluting devices have greatly evolved during past years to become fundamental products of great marketing importance in the biomedical field. There is currently a large diversity of highly specialized devices for specific applications, making the development of these devices an exciting field of research. The replacement of the former bare metal devices by devices loaded with drugs allowed the sustained and controlled release of drugs, to achieve the desired local therapeutic concentration of drug. The newer devices have been "engineered" with surfaces containing micro- and nanoscale features in a well-controlled manner, that have shown to significantly affect cellular and subcellular function of various biological systems. For example, the topography can be structured to form an antifouling surface mimicking the defense mechanisms found in nature, like the skin of the shark. In the case of bone implants, well-controlled nanostructured interfaces can promote osteoblast differentiation and matrix production, and enhance short-term and long-term osteointegration. In any case, the goal of current research is to design implants that induce controlled, guided, and rapid healing. This article reviews recent trends in the development of drug eluting devices, as well as recent developments on the micro/nanotechnology scales, and their future challenges. For this purpose medical devices have been divided according to the different systems of the body they are focused to: orthopedic devices, breathing stents, gastrointestinal and urinary systems, devices for cardiovascular diseases, neuronal implants, and wound dressings.
Collapse
|
7
|
Kim KY, Park JH, Kim DH, Tsauo J, Kim MT, Son WC, Kang SG, Kim DH, Song HY. Sirolimus-eluting Biodegradable Poly-l-Lactic Acid Stent to Suppress Granulation Tissue Formation in the Rat Urethra. Radiology 2017; 286:140-148. [PMID: 28787263 DOI: 10.1148/radiol.2017170414] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To investigate the use of sirolimus-eluting biodegradable stents (SEBSs) to suppress granulation tissue formation after stent placement in a rat urethral model. Materials and Methods All experiments were approved by the animal research committee. A total of 36 male Sprague-Dawley rats were randomized into three equal groups after biodegradable stent placement. Group A received control biodegradable stents. Groups B and C received stents coated with 90 µg/cm2 and 450 µg/cm2 sirolimus, respectively. Six rats in each group were sacrificed after 4 weeks; the remaining rats were sacrificed after 12 weeks. The therapeutic effectiveness of SEBSs was assessed by comparing the results of retrograde urethrography and histologic examination. Analysis of variance with post hoc comparisons was used to evaluate statistical differences. Results SEBS placement was technically successful in all rats. Urethrographic and histologic examinations revealed significantly less granulation tissue formation at both time points in the rats receiving SEBSs (groups B and C) compared with those that received control stents (group A) (P < .05 for all). There were no significant differences in urethrographic and histologic findings between groups B and C (P > .05 for all). However, the mean number of epithelial layers in group B was higher than that in group C at 4 weeks after stent placement (P < .001). Apoptosis increased in group C compared with groups A and B (P < .05 for all). Conclusion The use of SEBSs suppressed granulation tissue formation secondary to stent placement in a rat urethral model; local therapy with SEBSs may be used to decrease stent-related granulation tissue formation. © RSNA, 2017.
Collapse
Affiliation(s)
- Kun Yung Kim
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Jung-Hoon Park
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Do Hoon Kim
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Jiaywei Tsauo
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Min Tae Kim
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Woo-Chan Son
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Sung-Gwon Kang
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Dong-Hyun Kim
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| | - Ho-Young Song
- From the Department of Radiology and Research Institute of Radiology (K.Y.K., J.H.P., J.T., M.T.K., S.G.K., H.Y.S.), Biomedical Engineering Research Center (J.H.P.), Department of Gastroenterology (Do Hoon Kim), and Department of Pathology (W.C.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.H.P., Dong-Hyun Kim)
| |
Collapse
|
8
|
Jun EJ, Park JH, Tsauo J, Yang SG, Kim DK, Kim KY, Kim MT, Yoon SH, Lim YJ, Song HY. EW-7197, an activin-like kinase 5 inhibitor, suppresses granulation tissue after stent placement in rat esophagus. Gastrointest Endosc 2017; 86:219-228. [PMID: 28137596 DOI: 10.1016/j.gie.2017.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/10/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Self-expanding metallic stent (SEMS) placement is a well-established method for treating malignant esophageal strictures; however, this procedure has not gained widespread acceptance for treating benign esophageal strictures because of granulation tissue formation. The aim of the present study was to investigate whether EW-7197, a novel per-oral transforming growth factor-β type I receptor kinase inhibitor, suppressed granulation tissue formation after SEMS placement in the rat esophagus. METHODS Sixty rats underwent SEMS placement and were randomly divided into 4 groups. Group A (n = 20) received vehicle-treated control for 4 weeks. Group B (n = 20) received 20 mg/kg/day EW-7197 for 4 weeks. Group C (n = 10) received 20 mg/kg/day EW-7197 for 4 weeks followed by vehicle-treated control for 4 weeks. Group D (n = 10) received 20 mg/kg/day EW-7197 for 8 weeks. RESULTS SEMS placement was technically successful in all rats. Eleven rats, however, were excluded because of stent migration (n = 9) and procedure-related death (n = 2). The luminal diameter in group A was significantly smaller than those in groups B, C, and D (all P < .001). The percentage of granulation tissue area, number of epithelial layers, thickness of submucosal fibrosis, percentage of connective tissue area, and degree of collagen deposition were significantly higher in group A than in groups B, C, and D (all P < .001); however, there were no significant differences among groups B, C, and D. EW-7197 decreased the expression levels of phospho-Smad 3, N-cadherin, fibronectin, α-smooth muscle actin, and transforming growth factor-β1 and increased the expression level of E-cadherin (all P < .01). CONCLUSIONS EW-7197 suppressed granulation tissue formation after SEMS placement in the rat esophagus.
Collapse
Affiliation(s)
- Eun Jung Jun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jung-Hoon Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Biomedical Engineering Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiaywei Tsauo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Su-Geun Yang
- Department of New Drug Development and NCEED, School of Medicine, Inha University, Incheon, Republic of Korea
| | - Dae-Kee Kim
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Women's University, Seoul, Republic of Korea
| | - Kun Yung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Tae Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Hwan Yoon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Je Lim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho-Young Song
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
9
|
Choi JS, Lim JY, Park IS, Seo SY, Joung YK, Han DK, Kim YM. Surface-modified silicone T-tubes for prevention of tracheal stenosis in a rabbit model. Laryngoscope 2014; 125:1465-71. [DOI: 10.1002/lary.25044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 10/10/2014] [Accepted: 10/28/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Jeong-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery; Korea Institute of Science and Technology; Seoul Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology-Head and Neck Surgery; Korea Institute of Science and Technology; Seoul Republic of Korea
| | - In S. Park
- Department of Pathology; Inha University School of Medicine, Incheon; Korea Institute of Science and Technology Seoul, Republic of Korea
| | - Si Y. Seo
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology; Seoul Republic of Korea
| | - Yoon K. Joung
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology; Seoul Republic of Korea
| | - Dong K. Han
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology; Seoul Republic of Korea
| | - Young-Mo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery; Korea Institute of Science and Technology; Seoul Republic of Korea
| |
Collapse
|
10
|
Park JH, Kim JH, Kim EY, Kim J, Song HY, Kim WJ, Lee D, Park J, Kim S. Bioreducible polymer-delivered siRNA targeting MMP-9: suppression of granulation tissue formation after bare metallic stent placement in a rat urethral model. Radiology 2013; 271:87-95. [PMID: 24475825 DOI: 10.1148/radiol.13130980] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the effectiveness of small interfering RNA (siRNA) targeting matrix metalloproteinase 9 (MMP-9) in suppressing granulation tissue formation caused by bare metallic stent placement in a rat urethral model. MATERIALS AND METHODS All experiments were approved by the committee of animal research. In 20 Sprague-Dawley male rats (weight range, 300-350 g), a self-expanding metallic bare stent was inserted in the urethra with fluoroscopic guidance. One group of 10 rats (group A) was treated with MMP-9 siRNA/bioreducible branched polyethylenimine-disulfide cross-linked-indocyanine green (bioreducible BPEI-SS-ICG), while the other group of 10 rats (group B) received control siRNA/bioreducible BPEI-SS-ICG treatment. All rats were sacrificed at 4 weeks. The therapeutic effectiveness of the MMP-9 siRNA/bioreducible BPEI-SS-ICG complex was assessed by comparing the two results of retrograde urethrography, histologic examination, and quantification of MMP-9 by using zymography and Western blot analysis between the two groups. The Mann-Whitney U test was used to evaluate differences. RESULTS Stent placement was successful in all rats without a single case of migration at follow-up. Retrograde urethrography performed 4 weeks after stent placement demonstrated significantly larger luminal diameters of the urethra within the stents in group A compared with those in group B (P = .011). Histologic analysis revealed that the mean percentage of granulation tissue area (P < .001), mean number of epithelial layers (P < .001), and mean thickness of submucosal fibrosis (P < .001) were significantly decreased in group A compared with group B. Meanwhile, the mean density of inflammatory cell infiltration did not significantly differ between the two groups (P = .184). Quantitative analysis disclosed MMP-9 levels to be lower in group A relative to group B, indicating positive inhibition of MMP-9 by MMP-9 siRNA/bioreducible BPEI-SS-ICG. CONCLUSION MMP-9 siRNA/bioreducible BPEI-SS-ICG is effective for inhibiting granulation tissue formation after bare metallic stent placement in a rat urethral model.
Collapse
Affiliation(s)
- Jung-Hoon Park
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea (J.H.P., J.H.K., H.Y.S., J.P., S.K.); Medical Device Development Center, Osong Medical Innovation Foundation, Chungbuk, Korea (E.Y.K.); Department of Radiology, Hanyang University Guri Hospital, Guri, Korea (J.K.); and Center for Self-assembly and Complexity, Institute for Basic Science, and Department of Chemistry, Pohang University of Science and Technology, Pohang, Korea (W.J.K., D.L.)
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Non-vascular drug eluting stents as localized controlled drug delivery platform: Preclinical and clinical experience. J Control Release 2013; 172:105-117. [DOI: 10.1016/j.jconrel.2013.08.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 08/03/2013] [Accepted: 08/05/2013] [Indexed: 01/10/2023]
|
12
|
Kim EY, Song HY, Kim JH, Fan Y, Park S, Kim DK, Lee EW, Na HK. IN-1233–eluting Covered Metallic Stent to Prevent Hyperplasia: Experimental Study in a Rabbit Esophageal Model. Radiology 2013; 267:396-404. [DOI: 10.1148/radiol.12120361] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
13
|
Ernst A, Anantham D. Update on interventional bronchoscopy for the thoracic radiologist. J Thorac Imaging 2012; 26:263-77. [PMID: 22009080 DOI: 10.1097/rti.0b013e318221ec03] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Interventional bronchoscopy, together with other domains of interventional pulmonology, has experienced tremendous technological advances. Diagnostic applications include endobronchial ultrasound, which enables endoscopists to see through airway walls. White light videobronchoscopy, autofluorescence imaging, and narrow band imaging have enhanced the ability to detect early lung cancer at a preinvasive stage. Electromagnetic navigational bronchoscopy, ultrathin bronchoscopy, and virtual bronchoscopy increase the diagnostic yield of biopsy of small peripheral lung lesions. The options that are currently available for the relief of central airway obstruction are also numerous, with both flexible and rigid bronchoscopic applications. Stents, although dichotomized to silicone and metal, come in various sizes and shapes to suit the requirements of the pathology being treated. Ablative techniques are categorized into those with an immediate effect and those with a delayed effect. Laser, electrocautery, and argon plasma coagulation can immediately relieve obstruction and control hemoptysis, whereas cryosurgery, brachytherapy, and photodynamic therapy have established roles in subacute airway obstruction and in the treatment of early lung cancer. Microdebriders have recently been added to the armamentarium of modalities for mechanical debulking of tumor. Distal airway obstruction has also been targeted with bronchial thermoplasty treatment of refractory asthma and with bronchoscopic lung volume reduction for the management of severe emphysema. This array of new technology has fostered collaborative work with a wide range of other medical specialties to deliver safer, more effective, minimally invasive treatment.
Collapse
Affiliation(s)
- Armin Ernst
- Pulmonary, Critical Care and Sleep Medicine, St Elizabeth Medical Center, Tufts University School of Medicine, Boston, MA, USA.
| | | |
Collapse
|
14
|
Lei L, Guo SR, Chen WL, Rong HJ, Lu F. Stents as a platform for drug delivery. Expert Opin Drug Deliv 2011; 8:813-31. [DOI: 10.1517/17425247.2011.572068] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
15
|
Shin JH, Sung KB, Kim EY, Shin DH, Song HY. A Rat Tracheal Model to Investigate Stent-induced Tissue Hyperplasia: A Pilot Study. J Vasc Interv Radiol 2010; 21:1878-83. [DOI: 10.1016/j.jvir.2010.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 08/08/2010] [Accepted: 09/01/2010] [Indexed: 11/28/2022] Open
|
16
|
Lee SS, Shin JH, Woo CW, Hwang JC, Park CS, Kim HJ, Kim EY, Kim TH, Song HY. A New Model of Tracheal Stenosis in Dogs Using Combined Bronchoscopic Electrocautery and Ethanol Injection. J Vasc Interv Radiol 2008; 19:764-9. [DOI: 10.1016/j.jvir.2008.01.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 01/25/2008] [Accepted: 01/28/2008] [Indexed: 11/29/2022] Open
|
17
|
Li YD, Li MH, Han XW, Wu G, Li WB. Gastrotracheal and gastrobronchial fistulas: management with covered expandable metallic stents. J Vasc Interv Radiol 2007; 17:1649-56. [PMID: 17057007 DOI: 10.1097/01.rvi.0000236609.33842.50] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The present study evaluated the clinical results of covered tracheobronchial metallic stent placement in the management of gastrotracheal fistulas (GTFs) and gastrobronchial fistulas (GBFs). MATERIALS AND METHODS Sixteen patients with GTFs or GBFs after esophagogastrectomy were treated with one of two types of covered tracheobronchial metallic stents: a hinged stent or a straight stent. These included 12 GTFs and four GBFs. Thirteen hinged stents and three straight stents were placed during the initial procedure. Data regarding the technical success of stent placement, initial clinical success and failure, fistula reopening, and complications were obtained. RESULTS Stent placement was technically successful in all patients. The stent completely sealed off the fistula in 12 of 16 patients (75% initial clinical success rate), whereas the remaining four patients (25%) had persistent aspiration symptoms as a result of incomplete GTF or GBF closure (ie, initial clinical failure). During follow-up, the fistula reopened in three of the 12 patients in whom initial clinical success was achieved (25%). Two reopened fistulas were sealed off with stent placement, and one was treated with a nasoenteric feeding tube and a nasogastric decompression tube. All patients died during the 1-year follow-up period; mean survival time was 17 +/- 3.02 weeks (range, 1-42 weeks) after stent placement. Mean survival in patients in whom initial clinical success was achieved was significantly longer than in patients with initial clinical failure (P = .003; log-rank test). CONCLUSION Use of covered metallic stents appears to be a safe and moderately effective procedure to occlude GTFs and GBFs.
Collapse
Affiliation(s)
- Yong-Dong Li
- Department of Radiology, Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600 Yi Shan Road, Shanghai 200233, ROC.
| | | | | | | | | |
Collapse
|