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Cazelles A, Collard MK, Lalatonne Y, Doblas S, Zappa M, Labiad C, Cazals-Hatem D, Maggiori L, Treton X, Panis Y, Jarry U, Desvallées T, Eliat PA, Pineau R, Motte L, Letourneur D, Simon-Yarza T, Ogier-Denis E. A Preclinical Validation of Iron Oxide Nanoparticles for Treatment of Perianal Fistulizing Crohn's Disease. Int J Mol Sci 2022; 23:8324. [PMID: 35955465 PMCID: PMC9368411 DOI: 10.3390/ijms23158324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
Fistulizing anoperineal lesions are severe complications of Crohn's disease (CD) that affect quality of life with a long-term risk of anal sphincter destruction, incontinence, permanent stoma, and anal cancer. Despite several surgical procedures, they relapse in about two-thirds of patients, mandating innovative treatments. Ultrasmall particles of iron oxide (USPIO) have been described to achieve in vivo rapid healing of deep wounds in the skin and liver of rats thanks to their nanobridging capability that could be adapted to fistula treatment. Our main purpose was to highlight preclinical data with USPIO for the treatment of perianal fistulizing CD. Twenty male Sprague Dawley rats with severe 2,4,6-trinitrobenzenesulfonic acid solution (TNBS)-induced proctitis were operated to generate two perianal fistulas per rat. At day 35, two inflammatory fistulas were obtained per rat and perineal magnetic resonance imaging (MRI) was performed. After a baseline MRI, a fistula tract was randomly drawn and topically treated either with saline or with USPIO for 1 min (n = 17 for each). The rats underwent a perineal MRI on postoperative days (POD) 1, 4, and 7 and were sacrificed for pathological examination. The primary outcome was the filling or closure of the fistula tract, including the external or internal openings. USPIO treatment allowed the closure and/or filling of all the treated fistulas from its application until POD 7 in comparison with the control fistulas (23%). The treatment with USPIO was safe, permanently closed the fistula along its entire length, including internal and external orifices, and paved new avenues for the treatment of perianal fistulizing Crohn's disease.
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Affiliation(s)
- Antoine Cazelles
- Département of Chirurgie Colorectale, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France; (A.C.); (M.K.C.); (C.L.); (L.M.); (Y.P.)
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
| | - Maxime K. Collard
- Département of Chirurgie Colorectale, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France; (A.C.); (M.K.C.); (C.L.); (L.M.); (Y.P.)
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
| | - Yoann Lalatonne
- Laboratory for Vascular Translational Science, Université Paris Cité, Université Sorbonne Paris Nord, LVTS, INSERM, UMR 1148, 75018 Paris, France; (Y.L.); (L.M.); (D.L.); (T.S.-Y.)
- Départements of Biochimie and de Médecine Nucléaire, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, 93009 Bobigny, France
| | - Sabrina Doblas
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Laboratory of Imaging Biomarkers, Université Paris Cité, BP 416, 75018 Paris, France; (S.D.); (M.Z.)
| | - Magaly Zappa
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Laboratory of Imaging Biomarkers, Université Paris Cité, BP 416, 75018 Paris, France; (S.D.); (M.Z.)
- Département of Radiologie, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France
| | - Camélia Labiad
- Département of Chirurgie Colorectale, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France; (A.C.); (M.K.C.); (C.L.); (L.M.); (Y.P.)
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
| | - Dominique Cazals-Hatem
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
- Département of Pathologie, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France
| | - Léon Maggiori
- Département of Chirurgie Colorectale, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France; (A.C.); (M.K.C.); (C.L.); (L.M.); (Y.P.)
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
| | - Xavier Treton
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
- Département Gastroentérologie, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France
| | - Yves Panis
- Département of Chirurgie Colorectale, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, CEDEX, 92110 Clichy, France; (A.C.); (M.K.C.); (C.L.); (L.M.); (Y.P.)
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
| | - Ulrich Jarry
- Université Rennes, CNRS, INSERM, BIOSIT UAR 3480, US_S 018, Oncotrial, 35000 Rennes, France; (U.J.); (T.D.)
- Biotrial Pharmacology, Unité De Pharmacologie Préclinique, 35000 Rennes, France
| | - Thomas Desvallées
- Université Rennes, CNRS, INSERM, BIOSIT UAR 3480, US_S 018, Oncotrial, 35000 Rennes, France; (U.J.); (T.D.)
| | - Pierre-Antoine Eliat
- Université Rennes, CNRS, INSERM, BIOSIT UAR 3480, US_S 018, PRISM, 35000 Rennes, France;
- INRAE, INSERM, Institute NUMECAN, UMR_A 1341, Université Rennes, UMR_S 1241, 35000 Rennes, France
| | - Raphaël Pineau
- INSERM, CLCC Eugène Marquis, Oncogenesis, Stress Signaling, Université Rennes, UMR_S 1242, 35000 Rennes, France;
| | - Laurence Motte
- Laboratory for Vascular Translational Science, Université Paris Cité, Université Sorbonne Paris Nord, LVTS, INSERM, UMR 1148, 75018 Paris, France; (Y.L.); (L.M.); (D.L.); (T.S.-Y.)
| | - Didier Letourneur
- Laboratory for Vascular Translational Science, Université Paris Cité, Université Sorbonne Paris Nord, LVTS, INSERM, UMR 1148, 75018 Paris, France; (Y.L.); (L.M.); (D.L.); (T.S.-Y.)
| | - Teresa Simon-Yarza
- Laboratory for Vascular Translational Science, Université Paris Cité, Université Sorbonne Paris Nord, LVTS, INSERM, UMR 1148, 75018 Paris, France; (Y.L.); (L.M.); (D.L.); (T.S.-Y.)
| | - Eric Ogier-Denis
- Centre de Recherche sur l’Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France; (D.C.-H.); (X.T.)
- INSERM, CLCC Eugène Marquis, Oncogenesis, Stress Signaling, Université Rennes, UMR_S 1242, 35000 Rennes, France;
- INSERM U1242, Centre Eugène Marquis, Rue de la Bataille de Flandres-Dunkerque, 35042 Rennes, France
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Lu SS, Liu WJ, Niu QY, Huo CY, Cheng YQ, Wang EJ, Li RN, Feng FF, Cheng YM, Liu R, Huang J. Establishing a rabbit model of perianal fistulizing Crohn’s disease. World J Gastroenterol 2022; 28:1536-1547. [PMID: 35582134 PMCID: PMC9048459 DOI: 10.3748/wjg.v28.i15.1536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/18/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Crohn's disease (CD) is a chronic nonspecific intestinal inflammatory disease. The aetiology and pathogenesis of CD are still unclear. Anal fistula is the main complication of CD and is a difficult problem to solve at present. The main limitation of developing new therapies is bound up with the short of preclinical security and effectiveness data. Therefore, an ideal animal model is needed to establish persistent anal fistula and an inflamed rectal mucosa.
AIM To improve the induction method of colitis and establish a reliable and reproducible perianal fistulizing Crohn’s disease animal model to evaluate new treatment strategies.
METHODS Twenty male New Zealand rabbits underwent rectal enema with different doses of 2,4,6-trinitrobenzene sulfonic acid to induce proctitis. Group A was treated with an improved equal interval small dose increasing method. The dosage of group B was constant. Seven days later, the rabbits underwent surgical creation of a transsphincteric fistula. Then, three rabbits were randomly selected from each group every 7 d to remove the seton from the fistula. The rabbits were examined by endoscopy every 7 days, and biopsy forceps were used to obtain tissue samples from the obvious colon lesions for histological analysis. The disease activity index (DAI), colonoscopy and histological scores were recorded. Perianal endoscopic ultrasonography (EUS) was used to evaluate the healing of fistulas.
RESULTS Except for the DAI score, the colonoscopy and histological scores in group A were significantly higher than those in group B (P < 0.05). In the ideal model rabbit group, on the 7th day after the removal of the seton, all animals had persistent lumens on EUS imaging, showing continuous full-thickness high signals. Histological inspection of the fistula showed acute and chronic inflammation, fibrosis, epithelialization and peripheral proctitis of the adjoining rectum.
CONCLUSION The improved method of CD colitis induction successfully established a rabbit perianal fistula CD preclinical model, which was confirmed by endoscopy and pathology.
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Affiliation(s)
- Shuang-Shuang Lu
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Wen-Jia Liu
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Qiu-Ya Niu
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Chun-Yan Huo
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Yu-Qing Cheng
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - En-Jing Wang
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
| | - Rong-Nan Li
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Fang-Fang Feng
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Yi-Ming Cheng
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Rong Liu
- Medical Statistics Center, Changzhou University, Changzhou 213000, Jiangsu Province, China
| | - Jin Huang
- Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
- Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China
- Medical Statistics Center, Changzhou University, Changzhou 213000, Jiangsu Province, China
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Flacs M, Collard M, Doblas S, Zappa M, Cazals-Hatem D, Maggiori L, Panis Y, Treton X, Ogier-Denis E. Preclinical Model of Perianal Fistulizing Crohn's Disease. Inflamm Bowel Dis 2020; 26:687-696. [PMID: 31774918 DOI: 10.1093/ibd/izz288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fistulizing anoperineal lesions (FAPLs) are common and severe complications of Crohn's disease (CD), exposing patients to the risk of anal sphincter alteration and permanent stoma. Due to the limited efficacy of current treatments, identifying new local therapies is mandatory. However, testing new treatments is currently limited because no relevant preclinical model of Crohn's-like FAPL is available. Thus, a reliable and reproducible experimental model of FAPLs is needed to assess new therapeutic strategies. METHODS Twenty-one rats received a rectal enema of 2,4,6-trinitrobenzensulfonic acid (TNBS) to induce proctitis. Seven days later, a transsphincteric fistula tract was created with a surgical thread, instilled with TNBS twice a week until its removal at day 7 (group 1), day 14 (group 2), or day 28 (group 3). In each rat, pelvic MRI was performed just before and 7 days after thread removal. Rats were sacrificed 7 days after thread removal for pathological assessment of the fistula tract. RESULTS The optimal preclinical model was obtained in group 3. In this group, 7 days after thread removal, all animals (9 of 9) had a persistent fistula tract visible on MRI with T2-hypersignal (normalized T2 signal intensity: 2.36 ± 0.39 arbitrary units [a.u.] [2.08-2.81]) and elevation of the apparent diffusion coefficient (1.33 ± 0.16 10-3 millimeter squared per seconds [1.18-1.49]). The pathological examination of the fistula tract revealed acute and chronic inflammation, granulations, fibrosis, epithelialization, and proctitis in the adjacent rectum. CONCLUSIONS This reproducible preclinical model could be used to assess the effectiveness of innovative treatments in perianal fistulizing CD.
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Affiliation(s)
- Meredith Flacs
- Department of Colorectal Surgery, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Clichy la Garenne, Clichy Cedex, France.,Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Team Gut Inflammation, Paris, France
| | - Maxime Collard
- Department of Colorectal Surgery, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Clichy la Garenne, Clichy Cedex, France.,Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Team Gut Inflammation, Paris, France
| | - Sabrina Doblas
- Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Laboratory of Imaging Biomarkers, Paris, France
| | - Magaly Zappa
- Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Laboratory of Imaging Biomarkers, Paris, France.,Department of Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Clichy la Garenne, Clichy Cedex, France
| | - Dominique Cazals-Hatem
- Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Team Gut Inflammation, Paris, France.,Department of Pathology, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Clichy la Garenne, Clichy Cedex, France
| | - Léon Maggiori
- Department of Colorectal Surgery, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Clichy la Garenne, Clichy Cedex, France.,Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Team Gut Inflammation, Paris, France
| | - Yves Panis
- Department of Colorectal Surgery, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Clichy la Garenne, Clichy Cedex, France.,Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Team Gut Inflammation, Paris, France
| | - Xavier Treton
- Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Team Gut Inflammation, Paris, France.,Department of Gastroenterology, Assistance Publique Hôpitaux de Paris, Hôpital Beaujon, Clichy la Garenne, Clichy Cedex, France
| | - Eric Ogier-Denis
- Université de Paris, Centre de Recherche sur l'Inflammation, INSERM, CNRS, Team Gut Inflammation, Paris, France
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