1
|
Dave H, Vithalani H, Singh H, Yadav I, Jain A, Kumar S, Bhatia Z, Seshadri S, Hassan S, Dhanka M. Easily injectable gelatin-nonanal hydrogel for endoscopic resectioning of gastrointestinal polyps. Int J Biol Macromol 2024; 279:135405. [PMID: 39245110 DOI: 10.1016/j.ijbiomac.2024.135405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 08/29/2024] [Accepted: 09/05/2024] [Indexed: 09/10/2024]
Abstract
The use of submucosal injection is crucial for satisfactory submucosal elevation in the early resection of flat polyps originating from the gastrointestinal tract (GIT). Injectable hydrogels derived from natural polypeptides are attractive candidates due to their excellent biocompatibility and easy gelation properties. However, most of the reported hydrogels are not the class of catheter delivery materials due to quick gelation, high inherent viscosity, and injection clogging. This study presents a novel injectable shear-thinning hydrogel platform of small molecules (nonanal) modified gelatin polymer, which offers a promising submucosal injection for effective removal of polyps from GIT. Physicochemical characterizations of hydrogel demonstrate the suitable features as an effective submucosal injection, including shear thinning property, self-assembly, methylene blue dye encapsulation, flow behavior, stability, syringeability (18 G, 21 G, and 24 G needles) and fibrous morphology. Ex vivo investigations of developed submucosal formulation on goat intestines demonstrate the enhanced visibility of cushions and the ability to produce stable, long-lasting cushions of about 8.07 mm up to ∼60 min of submucosal injection. The rapid blood clotting behavior of hydrogel was observed in about 120 s without compromising hemocompatibility with the hemolysis of about 3.77 % only. In vitro biocompatibility of the hydrogel was also verified using the HepG2 and nHDF cells. In vivo study depicts desirable biocompatibility, a non-toxic organ profile, and optimal cushion height in mice models. Studies established the foundation of novel submucosal fluid to improve the therapeutic outcomes of early resection for gastrointestinal polyps.
Collapse
Affiliation(s)
- Harshil Dave
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
| | - Hitasha Vithalani
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
| | - Hemant Singh
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India; Biological Sciences, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Indu Yadav
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
| | | | - Sunny Kumar
- Institute of Science, Nirma University, Ahmedabad, Gujarat, India
| | - Zeel Bhatia
- Institute of Science, Nirma University, Ahmedabad, Gujarat, India
| | - Sriram Seshadri
- Institute of Science, Nirma University, Ahmedabad, Gujarat, India
| | - Shabir Hassan
- Biological Sciences, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Mukesh Dhanka
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India.
| |
Collapse
|
2
|
Xie R, Yan X, Yu J, Shen K, Zhang M, Li M, Lv Z, Zhang Y, Zhang Z, Lyu Y, Cheng Y, Chu D. pH-responsive bioadhesive with robust and stable wet adhesion for gastric ulcer healing. Biomaterials 2024; 309:122599. [PMID: 38703409 DOI: 10.1016/j.biomaterials.2024.122599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
Development of bioadhesives that can be facilely delivered by endoscope and exhibit instant and robust adhesion with gastric tissues to promote gastric ulcer healing remains challenging. In this study, an advanced bioadhesive is prepared through free radical polymerization of ionized N-acryloyl phenylalanine (iAPA) and N-[tris (hydroxymethyl) methyl] acrylamide (THMA). The precursory polymer solution exhibits low viscosity with the capability for endoscope delivery, and the hydrophilic-hydrophobic transition of iAPA upon exposure to gastric acid can trigger gelation through phenyl groups assisted multiple hydrogen bonds formation and repel water molecules on tissue surface to establish favorable environment for interfacial interactions between THMA and functional groups on tissues. The in-situ formed hydrogel features excellent stability in acid environment (14 days) and exhibits firm wet adhesion to gastric tissue (33.4 kPa), which can efficiently protect the wound from the stimulation of gastric acid and pepsin. In vivo studies reveal that the bioadhesive can accelerate the healing of ulcers by inhibiting inflammation and promoting capillary formation in the acetic acid-induced gastric ulcer model in rats. Our work may provide an effective solution for the treatment of gastric ulcers clinically.
Collapse
Affiliation(s)
- Ruilin Xie
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, PR China; Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Xueli Yan
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, PR China
| | - Jing Yu
- Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Kaixiang Shen
- Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Mengyuan Zhang
- Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Meng Li
- Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Zhuting Lv
- Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Yuchen Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Zixi Zhang
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, PR China
| | - Yi Lyu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, PR China
| | - Yilong Cheng
- Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, PR China.
| | - Dake Chu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, PR China.
| |
Collapse
|
3
|
Wang Y, Su Y, Zhu Y, Ni P, Yu T, Yuan T, Sun X, Shan J. Research on triamcinolone-loaded thermosensitive chitosan hydrogels for preventing esophageal stricture induced by endoscopic submucosal dissection. Int J Biol Macromol 2024; 261:129679. [PMID: 38286381 DOI: 10.1016/j.ijbiomac.2024.129679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/31/2024]
Abstract
Early-stage esophageal cancer is primarily treated by endoscopic submucosal dissection (ESD). However, extensive mucosal dissection creates a significant risk of postoperative esophageal stricture. Clinically, postoperative stricture can be prevented by glucocorticoids; however, there are drawbacks to both systemic and local administration of glucocorticoids, and improving drug administration methods is crucial. In this study, we developed a chitosan-based thermosensitive hydrogel for triamcinolone (TA) delivery. Our results indicated that the hydrogel remains liquid at low temperatures and can be injected into the esophageal wound site through an endoscopic biopsy channel. Upon reaching body temperature, the hydrogel undergoes spontaneous gelation and firmly adheres to the wound surface. The liquid phase enables convenient and precise delivery, while the gel phase achieves remarkable adhesion, tensile strength, and resistance to degradation. Moreover, the hydrogel exhibited an extended release duration of >10 days when loaded with a 10 mg dose. In vitro studies revealed that the hydrogel suppresses the proliferation and fibrogenesis of human scar fibroblasts (HKF). In a rat skin dermal defect model, the hydrogel attenuated keloid formation during the healing process. Consequently, the chitosan-based thermosensitive hydrogel developed in this study for triamcinolone delivery may be an effective tool for preventing post-ESD esophageal stricture.
Collapse
Affiliation(s)
- Yi Wang
- North Sichuan Medical College, Nanchong 637000, Sichuan, China
| | - Yang Su
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China; Department of Gastroenterology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China
| | - Yuchun Zhu
- North Sichuan Medical College, Nanchong 637000, Sichuan, China
| | - Panxianzhi Ni
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan 610064, China; Sichuan Testing Centre for Biomaterials and Medical Devices, Chengdu, Sichuan 610064, China
| | - Tai Yu
- North Sichuan Medical College, Nanchong 637000, Sichuan, China
| | - Tun Yuan
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan 610064, China; Sichuan Testing Centre for Biomaterials and Medical Devices, Chengdu, Sichuan 610064, China
| | - Xiaobin Sun
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China
| | - Jing Shan
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China.
| |
Collapse
|
4
|
Jung KU, Lee YJ, Jang JY, Cho JY. Efficacy and safety of a submucosal injection solution of sodium alginate for endoscopic resection in a porcine model. Sci Rep 2024; 14:4592. [PMID: 38409310 PMCID: PMC10897473 DOI: 10.1038/s41598-024-55226-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
Endoscopic resection techniques require the use of submucosal injection. Normal saline and sodium hyaluronate solutions are mainly used for this purpose, but an ideal solution has not yet been developed. The aim of this study was to assess a new solution, MC-003-a novel submucosal injection solution developed with sodium alginate as the main ingredient. Normal saline, a commercial sodium hyaluronate solution (Endo-Ease), and MC-003 were examined. A total of 18 gastric submucosal cushions were created in the stomachs of six pigs. The height of mucosal elevation was measured sequentially using endoscopic sonography. After euthanizing the animals either 2 h or 5 days after the procedure, pathologic examination was performed for each injection site. Although not statistically significant over the entire study period, MC-003 showed a superior result to normal saline and an equivalent result to Endo-Ease in the submucosal cushion height and its rate of decrease. There were no adverse outcomes after injection of the three solutions and there was no pathologically identified detrimental change in the resected specimens. MC-003 creates a sufficient submucosal fluid cushion without apparent tissue damage. It can be considered as an effective submucosal injection material.
Collapse
Affiliation(s)
- Kyung Uk Jung
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
| | - Yeon Jae Lee
- Research and Development Center of Mcnulty Pharma Co., Ltd., Seoul, Republic of Korea
| | - Jae-Young Jang
- Departments of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Joo Young Cho
- Departments of Gastroenterology, Cha Gangnam Medical Center, Cha University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
5
|
Ohya Y, Yoshida Y, Kumagae T, Kuzuya A. Gelation upon the Mixing of Amphiphilic Graft and Triblock Copolymers Containing Enantiomeric Polylactide Segments through Stereocomplex Formation. Gels 2024; 10:139. [PMID: 38391469 PMCID: PMC10887654 DOI: 10.3390/gels10020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
Biodegradable injectable polymer (IP) systems that form hydrogels in situ when injected into the body have considerable potential as medical materials. In this paper, we report a new two-solution mixed biodegradable IP system that utilizes the stereocomplex (SC) formation of poly(l-lactide) (PLLA) and poly(d-lactide) (PDLA). We synthesized triblock copolymers of PLLA and poly(ethylene glycol), PLLA-b-PEG-b-PLLA (tri-L), and a graft copolymer of dextran (Dex) attached to a PDLA-b-PEG diblock copolymer, Dex-g-(PDLA-b-PEG) (gb-D). We found that a hydrogel can be obtained by mixing gb-D solution and tri-L solution via SC formation. Although it is already known that graft copolymers attached to enantiomeric PLLA and PDLA chains can form an SC hydrogel upon mixing, we revealed that hydrogels can also be formed by a combination of graft and triblock copolymers. In this system (graft vs. triblock), the gelation time was shorter, within 1 min, and the physical strength of the resulting hydrogel (G' > 100 Pa) was higher than when graft copolymers were mixed. Triblock copolymers form micelles (16 nm in diameter) in aqueous solutions and hydrophobic drugs can be easily encapsulated in micelles. In contrast, graft copolymers have the advantage that their molecular weight can be set high, contributing to improved mechanical strength of the obtained hydrogel. Various biologically active polymers can be used as the main chains of graft copolymers, and chemical modification using the remaining functional side chain groups is also easy. Therefore, the developed mixing system with a graft vs. triblock combination can be applied to medical materials as a highly convenient, physically cross-linked IP system.
Collapse
Affiliation(s)
- Yuichi Ohya
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate, Suita 564-8680, Osaka, Japan
- Kansai University Medical Polymer Research Center (KUMP-RC), Organization for Research and Development of Innovative Science and Technology (ORDIST), Kansai University, 3-3-35 Yamate, Suita 564-8680, Osaka, Japan
| | - Yasuyuki Yoshida
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate, Suita 564-8680, Osaka, Japan
| | - Taiki Kumagae
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate, Suita 564-8680, Osaka, Japan
| | - Akinori Kuzuya
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate, Suita 564-8680, Osaka, Japan
- Kansai University Medical Polymer Research Center (KUMP-RC), Organization for Research and Development of Innovative Science and Technology (ORDIST), Kansai University, 3-3-35 Yamate, Suita 564-8680, Osaka, Japan
| |
Collapse
|
6
|
Sarangi M, Padhi S, Rath G. Non-Invasive Delivery of Insulin for Breaching Hindrances against Diabetes. Crit Rev Ther Drug Carrier Syst 2024; 41:1-64. [PMID: 38608132 DOI: 10.1615/critrevtherdrugcarriersyst.2023048197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Insulin is recognized as a crucial weapon in managing diabetes. Subcutaneous (s.c.) injections are the traditional approach for insulin administration, which usually have many limitations. Numerous alternative (non-invasive) slants through different routes have been explored by the researchers for making needle-free delivery of insulin for attaining its augmented absorption as well as bioavailability. The current review delineating numerous pros and cons of several novel approaches of non-invasive insulin delivery by overcoming many of their hurdles. Primary information on the topic was gathered by searching scholarly articles from PubMed added with extraction of data from auxiliary manuscripts. Many approaches (discussed in the article) are meant for the delivery of a safe, effective, stable, and patient friendly administration of insulin via buccal, oral, inhalational, transdermal, intranasal, ocular, vaginal and rectal routes. Few of them have proven their clinical efficacy for maintaining the glycemic levels, whereas others are under the investigational pipe line. The developed products are comprising of many advanced micro/nano composite technologies and few of them might be entering into the market in near future, thereby garnishing the hopes of millions of diabetics who are under the network of s.c. insulin injections.
Collapse
Affiliation(s)
| | - Sasmita Padhi
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University, Malhaur Railway Station Road, Gomti Nagar, Lucknow, Uttar Pradesh, Pin-201313, India
| | - Goutam Rath
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan University, Bhubaneswar-751030, Odisha, India
| |
Collapse
|
7
|
Guo H, Shen H, Ma J, Wang P, Yao Z, Zhang W, Tan X, Chi B. Versatile Injectable Carboxymethyl Chitosan Hydrogel for Immediate Hemostasis, Robust Tissue Adhesion Barrier, and Antibacterial Applications. ACS APPLIED MATERIALS & INTERFACES 2023. [PMID: 37922211 DOI: 10.1021/acsami.3c12027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
Iatrogenic ulcers resulting from endoscopic submucosal dissection surgery remain a significant clinical concern due to the risk of uncontrolled bleeding. Herein, we have developed an injectable shear-thinning hydrogel cross-linked through electrostatic interactions and hydrogen bonding. The hydrogel underwent comprehensive characterization, focusing on rheological behavior, injectability, microstructure, film-forming capability, adhesion, swelling behavior, degradation kinetics, antibacterial efficacy, hemostatic performance, and biocompatibility. The incorporation of poly(vinyl alcohol) notably enhanced the internal structural stability and injection pressure, while the Laponite content influenced self-healing ability, modulus, and viscosity. Additionally, the hydrogel exhibited pH sensitivity, appropriate degradation, and swelling rates and displayed favorable film-forming and adhesion properties. Notably, it demonstrated excellent resistance against Escherichia coli and Staphylococcus aureus, highlighting its potential to create an optimal wound environment. In vivo studies further confirmed the hydrogel's exceptional hemostatic performance, positioning it as an optimal material for endoscopic submucosal dissection (ESD) surgery. Moreover, cell experiments and hemolysis tests revealed high biocompatibility, supporting their potential to facilitate the healing of iatrogenic ulcers post-ESD surgery. In conclusion, our hydrogels hold great promise as endoscopic treatment materials for ESD-induced ulcers given their outstanding properties.
Collapse
Affiliation(s)
- Hao Guo
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Haifeng Shen
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Juping Ma
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Penghui Wang
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Zheng Yao
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing 210019, P. R. China
| | - Wenjie Zhang
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Xiaoyan Tan
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
- National Synergetic Innovation Center for Advanced Materials, Nanjing Tech University, Nanjing 211816, China
| | - Bo Chi
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
- National Synergetic Innovation Center for Advanced Materials, Nanjing Tech University, Nanjing 211816, China
| |
Collapse
|
8
|
Chen Z, Ding J, Wu C, Wei D, Sun J, Fan H, Guo Z. A review of hydrogels used in endoscopic submucosal dissection for intraoperative submucosal cushions and postoperative management. Regen Biomater 2023; 10:rbad064. [PMID: 37501677 PMCID: PMC10368804 DOI: 10.1093/rb/rbad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023] Open
Abstract
Endoscopic submucosal dissection (ESD) has been clinically proved to have prominent advantages in the treatment of early gastrointestinal cancers over traditional surgery, including less trauma, fewer complications, a quicker recovery and lower costs. During the procedure of ESD, appropriate and multifunctional submucosal injected materials (SIMs) as submucosal cushions play an important role, however, even with many advances in design strategies of SIMs over the past decades, the performance of the submucosal cushions with postoperative management function seems to be still unsatisfactory. In this review, we gave a brief historical recount about the clinical development of SIMs, then some common applications of hydrogels used as SIMs in ESD were summarized, while an account of the universal challenges during ESD procedure was also outlined. Going one step further, some cutting-edge functional strategies of hydrogels for novel applications in ESD were exhibited. Finally, we concluded the advantages of hydrogels as SIMs for ESD as well as the treatment dilemma clinicians faced when it comes to deeply infiltrated lesions, some technical perspectives about linking the clinical demand with commercial supply were also proposed. Encompassing the basic elements of SIMs used in ESD surgery and the corresponding postoperative management requirements, this review could be a good reference for relevant practitioners in expanding the research horizon and improving the well-being index of patients.
Collapse
Affiliation(s)
| | | | - Chengheng Wu
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan 610064, China
- Institute of Regulatory Science for Medical Devices, Sichuan University, Chengdu, Sichuan 610064, China
| | - Dan Wei
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan 610064, China
| | - Jing Sun
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan 610064, China
| | | | | |
Collapse
|
9
|
Ma J, Wang P, Tang C, Liao H, Zhang W, Yang R, Shi T, Tan X, Chi B. Injectable shear-thinning sodium alginate hydrogels with sustained submucosal lift for endoscopic submucosal dissection. Int J Biol Macromol 2022; 223:939-949. [PMID: 36395937 DOI: 10.1016/j.ijbiomac.2022.11.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 11/15/2022]
Abstract
Endoscopic submucosal dissection (ESD) is one of the most effective approaches for the minimally invasive treatment of early gastrointestinal cancers. Submucosal injections help safely and successfully remove lesions during ESD by elevating the mucosa and separating the submucosal muscle layer. Herein, we report dynamic injectable sodium alginate hydrogels (ISAHs) with shear-thinning for ESD surgery, which were easily fabricated by the sulfhydryl group of GSH-modified sodium alginate (SA-GSH) reacting with the aldehyde group of oxidized sodium alginate (OSA) at room temperature. ISAHs have advantageous self-healing abilities and antioxidant activity. Additionally, according to an in vitro test on porcine colorectal submucosal lifting, the submucosal elevation heights created by ISAHs were 13 % -18 % greater than those created by commercial ESD solutions (0.4 w/v% sodium hyaluronate). These properties and biocompatibility were confirmed in vitro and in vivo experiments. ISAHs will hopefully become a novel submucosal injectable hydrogel to assist ESD surgery.
Collapse
Affiliation(s)
- Juping Ma
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Penghui Wang
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Chuanfei Tang
- Jiangsu Yangtze River Medical Technology Corp, Taizhou 225300, China
| | - Huiyun Liao
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing 210019, China
| | - Wenjie Zhang
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Rong Yang
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Tianqi Shi
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China
| | - Xiaoyan Tan
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China; National Synergetic Innovation Center for Advanced Materials, Nanjing Tech University, Nanjing 211816, China
| | - Bo Chi
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Biotechnology and Pharmaceutical Engineering, College of Food Science and Light Industry, Nanjing Tech University, Nanjing 211816, China; National Synergetic Innovation Center for Advanced Materials, Nanjing Tech University, Nanjing 211816, China.
| |
Collapse
|
10
|
Zhang Y, Wen J, Zhang S, Liang X, Ren L, Wang L, Sun Y, Li S, Wang K, Lv S, Qiao X. Clinical study of submucosal tunneling endoscopic resection and endoscopic submucosal dissection in the treatment of submucosal tumor originating from the muscularis propria layer of the esophagus. Medicine (Baltimore) 2022; 101:e32380. [PMID: 36595766 PMCID: PMC9794317 DOI: 10.1097/md.0000000000032380] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Herein, we aimed to evaluate the clinical value and safety of transendoscopic submucosal tunnel tumor resection (STER) and endoscopic submucosal dissection (ESD) for the resection of esophageal submucosal intrinsic muscle tumors. We retrospectively analyzed the clinical data of 68 patients with esophageal submucosal intrinsic muscle tumors treated with STER (STER group, n = 38, March 2018 to January 2020) or ESD (ESD group, n = 30, January 2017 to January 2020) at the First People's Hospital of Lianyungang to compare the treatment efficacy, hospitalization time and costs, and postoperative complications between the 2 groups. All 68 cases were of single lesions. The mean operative duration was shorter in the STER group (53.39 ± 11.57 min) than in the ESD group (68.33 ± 18.52 min, P < .05). The postoperative hospital stay duration was significantly shorter in the STER group (5.86 ± 1.01 days; P < .05) than in the ESD group (8.2 ± 3.4 days, P < .05). The mean hospitalization cost was significantly lower in the STER group than in the ESD group (12,468.8 + 4966.8 yuan vs 17,033.3 ± 4547.2 yuan; P < .05). Only 1 case of intraoperative perforation occurred in ESD group. There were no other complications in both groups. The wound healed in both groups, and no residual or recurrent tumors were detected during the follow-up period. Both STER and ESD can be used for the treatment of esophageal intrinsic muscular layer (MP) tumors, and STER is safer and more efficient for lesions with a diameter <3.5 cm.
Collapse
Affiliation(s)
- Yue Zhang
- Jinzhou Medical University, Jiangsu, China
| | - Jing Wen
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Shuxian Zhang
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Xuyang Liang
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Ling Ren
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Lu Wang
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Yunliang Sun
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Shouying Li
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Kun Wang
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Shengxiang Lv
- Department of Gastroenterology, Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
- * Correspondence: Shengxiang Lv, Department of Gastroenterology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, No. 6 Zhenhua East Road, Lianyungang 222000, China (e-mail: ) and Xiao Qiao, Department of Gastroenterology, Huai'an Hospital, Xuzhou Medical University, Huai'an, Jiangsu 223002, China (e-mail: )
| | - Xiao Qiao
- Department of Gastroenterology, Huai’an Hospital of Xuzhou Medical University, Jiangsu, China
- * Correspondence: Shengxiang Lv, Department of Gastroenterology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, No. 6 Zhenhua East Road, Lianyungang 222000, China (e-mail: ) and Xiao Qiao, Department of Gastroenterology, Huai'an Hospital, Xuzhou Medical University, Huai'an, Jiangsu 223002, China (e-mail: )
| |
Collapse
|
11
|
Loss of multipotency in adipose-derived stem cells after culture in temperature-responsive injectable polymer hydrogels. Polym J 2022. [DOI: 10.1038/s41428-022-00739-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AbstractAdipose-derived stem cells (AdSCs), a type of mesenchymal stem cell, are expected to be applicable to regenerative medicine and cellular delivery systems. The maintenance of cell multipotency and control of the differentiation direction are important for these applications. However, the differentiation direction of these cells is widely believed to depend on the physical properties of their scaffold. In this study, we explored whether the multipotency of AdSCs, that is, their ability to differentiate into multiple cells, is maintained when they are removed from injectable polymer (IP) hydrogels with various degrees of cross-linking and induced to differentiate into osteoblasts and adipocytes. We confirmed that AdSCs cultured in IP hydrogels maintained an undifferentiated state. However, their differentiation into osteoblasts and adipocytes cannot be ensured; specifically, the multipotency of AdSCs may decrease when they are cultured in IP hydrogels. When cultured in an IP hydrogel with extreme softness and poor cell adhesion properties, the AdSCs remained in an undifferentiated state, but their multipotency was reduced. These results provide important insights into stem cell delivery systems using IP hydrogels.
Collapse
|
12
|
Cao D, Ding J. Recent advances in regenerative biomaterials. Regen Biomater 2022; 9:rbac098. [PMID: 36518879 PMCID: PMC9745784 DOI: 10.1093/rb/rbac098] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 07/22/2023] Open
Abstract
Nowadays, biomaterials have evolved from the inert supports or functional substitutes to the bioactive materials able to trigger or promote the regenerative potential of tissues. The interdisciplinary progress has broadened the definition of 'biomaterials', and a typical new insight is the concept of tissue induction biomaterials. The term 'regenerative biomaterials' and thus the contents of this article are relevant to yet beyond tissue induction biomaterials. This review summarizes the recent progress of medical materials including metals, ceramics, hydrogels, other polymers and bio-derived materials. As the application aspects are concerned, this article introduces regenerative biomaterials for bone and cartilage regeneration, cardiovascular repair, 3D bioprinting, wound healing and medical cosmetology. Cell-biomaterial interactions are highlighted. Since the global pandemic of coronavirus disease 2019, the review particularly mentions biomaterials for public health emergency. In the last section, perspectives are suggested: (i) creation of new materials is the source of innovation; (ii) modification of existing materials is an effective strategy for performance improvement; (iii) biomaterial degradation and tissue regeneration are required to be harmonious with each other; (iv) host responses can significantly influence the clinical outcomes; (v) the long-term outcomes should be paid more attention to; (vi) the noninvasive approaches for monitoring in vivo dynamic evolution are required to be developed; (vii) public health emergencies call for more research and development of biomaterials; and (viii) clinical translation needs to be pushed forward in a full-chain way. In the future, more new insights are expected to be shed into the brilliant field-regenerative biomaterials.
Collapse
Affiliation(s)
- Dinglingge Cao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| |
Collapse
|
13
|
Yoon HJ, Lee S, Kim TY, Yu SE, Kim HS, Chung YS, Chung S, Park S, Shin YC, Wang EK, Noh J, Kim HJ, Ku CR, Koh H, Kim CS, Park JS, Shin YM, Sung HJ. Sprayable nanomicelle hydrogels and inflammatory bowel disease patient cell chips for development of intestinal lesion-specific therapy. Bioact Mater 2022; 18:433-445. [PMID: 35415304 PMCID: PMC8971598 DOI: 10.1016/j.bioactmat.2022.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/07/2022] [Accepted: 03/20/2022] [Indexed: 12/16/2022] Open
Abstract
All-in-one treatments represent a paradigm shift in future medicine. For example, inflammatory bowel disease (IBD) is mainly diagnosed by endoscopy, which could be applied for not only on-site monitoring but also the intestinal lesion-targeted spray of injectable hydrogels. Furthermore, molecular conjugation to the hydrogels would program both lesion-specific adhesion and drug-free therapy. This study validated this concept of all-in-one treatment by first utilizing a well-known injectable hydrogel that underwent efficient solution-to-gel transition and nanomicelle formation as a translatable component. These properties enabled spraying of the hydrogel onto the intestinal walls during endoscopy. Next, peptide conjugation to the hydrogel guided endoscopic monitoring of IBD progress upon adhesive gelation with subsequent moisturization of inflammatory lesions, specifically by nanomicelles. The peptide was designed to mimic the major component that mediates intestinal interaction with Bacillus subtilis flagellin during IBD initiation. Hence, the peptide-guided efficient adhesion of the hydrogel nanomicelles onto Toll-like receptor 5 (TLR5) as the main target of flagellin binding and Notch-1. The peptide binding potently suppressed inflammatory signaling without drug loading, where TLR5 and Notch-1 operated collaboratively through downstream actions of tumor necrosis factor-alpha. The results were produced using a human colorectal cell line, clinical IBD patient cells, gut-on-a-chip, a mouse IBD model, and pig experiments to validate the translational utility. Injectable nanomicelle hydrogel for all-in-one treatment of intestinal inflammation. Spraying of the hydrogel onto the intestinal walls during endoscopy. Peptide-guided detection and moisturization of inflammatory lesions.
Collapse
Affiliation(s)
- Hyo-Jin Yoon
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Songhyun Lee
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, 31116, Republic of Korea
| | - Tae Young Kim
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- School of Electrical and Electronic Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Seung Eun Yu
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hye-Seon Kim
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Young Shin Chung
- Department of Obstetrics and Gynecology, Institution of Women's Life Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Seyong Chung
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Suji Park
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Yong Cheol Shin
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Eun Kyung Wang
- Department of Internal Medicine, Endocrinology, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jihye Noh
- Department of Pediatrics, Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hyun Jung Kim
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Cheol Ryong Ku
- Department of Internal Medicine, Endocrinology, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hong Koh
- Department of Pediatrics, Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Chang-Soo Kim
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Numais Co., Ltd., Korea Seoul 04799, Republic of Korea
| | - Joon-Sang Park
- Department of Computer Engineering, Hongik University, Seoul, 04066, Republic of Korea
- Corresponding author.
| | - Young Min Shin
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Corresponding author.
| | - Hak-Joon Sung
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Corresponding author.
| |
Collapse
|
14
|
Sabbagh F, Muhamad II, Niazmand R, Dikshit PK, Kim BS. Recent progress in polymeric non-invasive insulin delivery. Int J Biol Macromol 2022; 203:222-243. [PMID: 35101478 DOI: 10.1016/j.ijbiomac.2022.01.134] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/04/2022] [Accepted: 01/20/2022] [Indexed: 12/12/2022]
Abstract
The design of carriers for insulin delivery has recently attracted major research attentions in the biomedical field. In general, the release of drug from polymers is driven via a variety of polymers. Several mechanisms such as matrix release, leaching of drug, swelling, and diffusion are usually adopted for the release of drug through polymers. Insulin is one of the most predominant therapeutic drugs for the treatment of both diabetes mellitus; type-I (insulin-dependent) and type II (insulin-independent). Currently, insulin is administered subcutaneously, which makes the patient feel discomfort, pain, hyperinsulinemia, allergic responses, lipodystrophy surrounding the injection area, and occurrence of miscarried glycemic control. Therefore, significant research interest has been focused on designing and developing new insulin delivery technologies to control blood glucose levels and time, which can enhance the patient compliance simultaneously through alternative routes as non-invasive insulin delivery. The aim of this review is to emphasize various non-invasive insulin delivery mechanisms including oral, transdermal, rectal, vaginal, ocular, and nasal. In addition, this review highlights different smart stimuli-responsive insulin delivery systems including glucose, pH, enzymes, near-infrared, ultrasound, magnetic and electric fields, and the application of various polymers as insulin carriers. Finally, the advantages, limitations, and the effect of each non-invasive route on insulin delivery are discussed in detail.
Collapse
Affiliation(s)
- Farzaneh Sabbagh
- Department of Chemical Engineering, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - Ida Idayu Muhamad
- Universiti Teknologi Malaysia, Department of Chemical Engineering, 81310, Johor, Malaysia
| | - Razieh Niazmand
- Department of Food Chemistry, Research Institute of Food Science and Technology, Mashhad, Iran
| | - Pritam Kumar Dikshit
- Department of Biotechnology, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Guntur 522 502, Andhra Pradesh, India
| | - Beom Soo Kim
- Department of Chemical Engineering, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea.
| |
Collapse
|
15
|
Jeon HJ, Choi HS, Bang EJ, Lee KW, Kim SH, Lee JM, Kim ES, Keum B, Tae Jeen Y, Lee HS, Chun HJ, Jeong S, Kim JH. Efficacy and safety of a thermosensitive hydrogel for endoscopic submucosal dissection: An in vivo swine study. PLoS One 2021; 16:e0260458. [PMID: 34882721 PMCID: PMC8659419 DOI: 10.1371/journal.pone.0260458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Injectable thermo-sensitive chitosan hydrogels have recently been developed for the use of submucosal fluids in endoscopic submucosal dissections (ESD). This study aimed to investigate the efficacy and safety of chitosan hydrogels during ESD. Submucosal fluids were administered as follows: 0.9% normal saline (NS), 0.4% hyaluronic acid (HA) and chitosan/β-glycerophosphate (CS/GP) hydrogel. Each solution was administered twice into the stomach and colon of a pig, with a total of 72 ESD procedures performed on 12 pigs. The injected volume and procedure-related parameters were recorded and analyzed. ESDs that created ulcers after 7 days were histologically compared. All ESD specimens were resected en bloc. The total injected volumes during ESD of the stomach (NS, 16.09±3.27 vs. HA, 11.17±2.32 vs. CS/GP, 9.44±2.33; p<0.001) and colon (NS, 9.17±1.80 vs. HA, 6.67±1.50 vs. CS/GP, 6.75±1.57; p = 0.001) were significantly different. Hydrogel showed significant differences from normal saline in terms of fluid power (mm2/vol; NS, 35.70±9.00 vs. CS/GP 57.48±20.77; p = 0.001) and consumption rate (vol/min; NS, 2.59±0.86 vs. CS/GP, 1.62±0.65; p = 0.013) in the stomach. Histological examination revealed preserved muscularis propria, although the chitosan hydrogel resulted in a partial inflammatory response, with a hypertrophied submucosal layer. Chitosan hydrogel was found to be superior to normal saline, with an efficacy similar to that of hyaluronic acid. Nonetheless, long-term histological changes should be evaluated before clinical implementation.
Collapse
Affiliation(s)
- Han Jo Jeon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyuk Soon Choi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- * E-mail:
| | - Eun Ju Bang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kang Won Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sang Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae Min Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eun Sun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Bora Keum
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoon Tae Jeen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hong Sik Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hoon Jai Chun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seung Jeong
- Department of Biosystems & Biomaterials Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Jong Hyuk Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America
| |
Collapse
|
16
|
Tang Y, Hu M, Tang F, Huang R, Wang H, Wu D, Lan P. Easily-injectable shear-thinning hydrogel provides long-lasting submucosal barrier for gastrointestinal endoscopic surgery. Bioact Mater 2021; 15:44-52. [PMID: 35386335 PMCID: PMC8940951 DOI: 10.1016/j.bioactmat.2021.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 12/22/2022] Open
Abstract
Submucosal injection material has shown protective effect against gastrointestinal injury during endoscopic surgery in clinic. However, the protective ability of existing submucosal injection material is strictly limited by their difficult injectability and short barrier time. Herein, we report a shear-thinning gellan gum hydrogel that simultaneously has easy injectability and long-lasting barrier function, together with good hemostatic property and biocompatibility. Shear-thinning property endows our gellan gum hydrogel with excellent endoscopic injection performance, and the injection pressure of our gellan gum hydrogel is much lower than that of the small molecule solution (50 wt% dextrose) when injected through the endoscopic needle. More importantly, our gellan gum hydrogel shows much stronger barrier retention ability than normal saline and sodium hyaluronate solution in the ex vivo and in vivo models. Furthermore, our epinephrine-containing gellan gum hydrogel has a satisfactory hemostatic effect in the mucosal lesion resection model of pig. These results indicate an appealing application prospect for gellan gum hydrogel utilizing as a submucosal injection material in endoscopic surgery. Submucosal injection materials are widely used in endoscopic surgery to protect against gastrointestinal injury. Gellan gum hydrogel with shear-thinning character is a novel submucosal injection material. Gellan gum hydrogel simultaneously has easy injectability and long-lasting barrier performance in vivo. Epinephrine-containing gellan gum hydrogel has a satisfactory hemostatic effect.
Collapse
|
17
|
Shi J, Yu L, Ding J. PEG-based thermosensitive and biodegradable hydrogels. Acta Biomater 2021; 128:42-59. [PMID: 33857694 DOI: 10.1016/j.actbio.2021.04.009] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/09/2021] [Accepted: 04/01/2021] [Indexed: 02/07/2023]
Abstract
Injectable thermosensitive hydrogels are free-flowing polymer solutions at low or room temperature, making them easy to encapsulate the therapeutic payload or cells via simply mixing. Upon injection into the body, in situ forming hydrogels triggered by body temperature can act as drug-releasing reservoirs or cell-growing scaffolds. Finally, the hydrogels are eliminated from the administration sites after they accomplish their missions as depots or scaffolds. This review outlines the recent progress of poly(ethylene glycol) (PEG)-based biodegradable thermosensitive hydrogels, especially those composed of PEG-polyester copolymers, PEG-polypeptide copolymers and poly(organophosphazene)s. The material design, performance regulation, thermogelation and degradation mechanisms, and corresponding applications in the biomedical field are summarized and discussed. A perspective on the future thermosensitive hydrogels is also highlighted. STATEMENT OF SIGNIFICANCE: Thermosensitive hydrogels undergoing reversible sol-to-gel phase transitions in response to temperature variations are a class of promising biomaterials that can serve as minimally invasive injectable systems for various biomedical applications. Hydrophilic PEG is a main component in the design and fabrication of thermoresponsive hydrogels due to its excellent biocompatibility. By incorporating hydrophobic segments, such as polyesters and polypeptides, into PEG-based systems, biodegradable and thermosensitive hydrogels with adjustable properties in vitro and in vivo have been developed and have recently become a research hotspot of biomaterials. The summary and discussion on molecular design, performance regulation, thermogelation and degradation mechanisms, and biomedical applications of PEG-based thermosensitive hydrogels may offer a demonstration of blueprint for designing new thermogelling systems and expanding their application scope.
Collapse
|
18
|
Injectable Thermosensitive Chitosan Solution with β-Glycerophosphate as an Optimal Submucosal Fluid Cushion for Endoscopic Submucosal Dissection. Polymers (Basel) 2021; 13:polym13111696. [PMID: 34067377 PMCID: PMC8196954 DOI: 10.3390/polym13111696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/16/2021] [Accepted: 05/19/2021] [Indexed: 01/27/2023] Open
Abstract
Endoscopic submucosal dissection (ESD) is a surgical procedure to remove early neoplastic lesions in the gastrointestinal tract with the critical issue of perforation. A submucosal fluid cushion, such as normal saline, is used as a cushioning agent to prevent perforation; however, its cushioning maintenance is insufficient for surgery. In this study, we introduce an injectable thermosensitive chitosan solution (CS) with β-glycerophosphate (β-GP) as a submucosal injection agent for ESD. The CS/β-GP system with optimal β-GP concentration showed drastic viscosity change near body temperature while other commercial products did not. Additionally, the injectability of the solution was similar to or greater than other commercial products. The solution with low β-GP concentration showed low cytotoxicity similar to other products. An in vivo preclinical study illustrated maintenance of the high cushioning of the thermosensitive solutions. These results indicate that a CS/β-GP system with optimal β-GP concentration might be used as a submucosal injection agent in ESD, and further studies are needed to validate the effectiveness of the solutions in vivo.
Collapse
|
19
|
Cui S, Wei Y, Bian Q, Zhu Y, Chen X, Zhuang Y, Cai M, Tang J, Yu L, Ding J. Injectable Thermogel Generated by the "Block Blend" Strategy as a Biomaterial for Endoscopic Submucosal Dissection. ACS APPLIED MATERIALS & INTERFACES 2021; 13:19778-19792. [PMID: 33881817 DOI: 10.1021/acsami.1c03849] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Endoscopic submucosal dissection is an established method for the removal of early cancers and large lesions from the gastrointestinal tract but is faced with the risk of perforation. To decrease this risk, a submucosal fluid cushion (SFC) is needed clinically by submucosal injection of saline and so on to lift and separate the lesion from the muscular layer. Some materials have been tried as the SFC so far with disadvantages. Here, we proposed a thermogel generated by the "block blend" strategy as an SFC. This system was composed of two amphiphilic block copolymers in water, so it was called a "block blend". We synthesized two non-thermogellable copolymers poly(d,l-lactide-co-glycolide)-b-poly(ethylene glycol)-b-poly(d,l-lactide-co-glycolide) and blended them in water to achieve a sol-gel transition upon heating in both pure water and physiological saline. We explored the internal structure of the resultant thermogel with transmission electron microscopy, three-dimensional light scattering, 13C NMR, fluorescence resonance energy transfer, and rheological measurements, which indicated a percolated micelle network. The biosafety of the synthesized copolymer was preliminarily confirmed in vitro. The main necessary functions as an SFC, namely, injectability of a sol and the maintained mucosal elevation as a gel after injection, were verified ex vivo. This study has revealed the internal structure of the block blend thermogel and illustrated its potential application as a biomaterial. This work might be stimulating for investigations and applications of intelligent materials with both injectability and thermogellability of tunable phase-transition temperatures.
Collapse
Affiliation(s)
- Shuquan Cui
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Yiman Wei
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Qiao Bian
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Yan Zhu
- Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Shanghai 200032, China
| | - Xiaobin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Yaping Zhuang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Mingyan Cai
- Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Shanghai 200032, China
| | - Jingyu Tang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
- Zhuhai Fudan Innovation Institute, Zhuhai, Guangdong 519000, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
- Zhuhai Fudan Innovation Institute, Zhuhai, Guangdong 519000, China
| |
Collapse
|
20
|
Yao X, Wang X, Ding J. Exploration of possible cell chirality using material techniques of surface patterning. Acta Biomater 2021; 126:92-108. [PMID: 33684535 DOI: 10.1016/j.actbio.2021.02.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/10/2021] [Accepted: 02/19/2021] [Indexed: 02/07/2023]
Abstract
Consistent left-right (LR) asymmetry or chirality is critical for embryonic development and function maintenance. While chirality on either molecular or organism level has been well established, that on the cellular level has remained an open question for a long time. Although it remains unclear whether chirality exists universally on the cellular level, valuable efforts have recently been made to explore this fundamental topic pertinent to both cell biology and biomaterial science. The development of material fabrication techniques, surface patterning, in particular, has afforded a unique platform to study cell-material interactions. By using patterning techniques, chirality on the cellular level has been examined for cell clusters and single cells in vitro in well-designed experiments. In this review, we first introduce typical fabrication techniques of surface patterning suitable for cell studies and then summarize the main aspects of preliminary evidence of cell chirality on patterned surfaces to date. We finally indicate the limitations of the studies conducted thus far and describe the perspectives of future research in this challenging field. STATEMENT OF SIGNIFICANCE: While both biomacromolecules and organisms can exhibit chirality, it is not yet conclusive whether a cell has left-right (LR) asymmetry. It is important yet challenging to study and reveal the possible existence of cell chirality. By using the technique of surface patterning, the recent decade has witnessed progress in the exploration of possible cell chirality within cell clusters and single cells. Herein, some important preliminary evidence of cell chirality is collected and analyzed. The open questions and perspectives are also described to promote further investigations of cell chirality in biomaterials.
Collapse
|
21
|
Degradation of thermoresponsive laponite/PEG-b-PLGA nanocomposite hydrogels controlled by blending PEG-b-PLGA diblock copolymers with different PLGA molecular weights. Polym Degrad Stab 2021. [DOI: 10.1016/j.polymdegradstab.2021.109535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
22
|
Ni P, Li R, Ye S, Shan J, Yuan T, Liang J, Fan Y, Zhang X. Lactobionic acid-modified chitosan thermosensitive hydrogels that lift lesions and promote repair in endoscopic submucosal dissection. Carbohydr Polym 2021; 263:118001. [PMID: 33858584 DOI: 10.1016/j.carbpol.2021.118001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 03/05/2021] [Accepted: 03/25/2021] [Indexed: 02/07/2023]
Abstract
To develop a biomaterial to lift the lesion and promote wound healing in endoscopic submucosal dissection (ESD), we used lactobionic acid (LA) to improve the water solubility of chitosan (CS) and prepared a new three-phase hydrogel system with lactobionic acid-modified chitosan/chitosan/β-glycerophosphate (CSLA/CS/GP). The results indicated that the hydrogel retains temperature-sensitive properties, and CSLA obviously improved the low-temperature fluidity of the hydrogel precursor solution, enabling injection of the hydrogel by endoscopic needle. The mechanical strength and bio-adhesion of the hydrogels were also improved by the addition of CSLA and the hydrogels could be maintained in acidic environment for a few days and exhibit greater protection of cells. The CSLA/CS/GP hydrogels show good cytocompatibility. The heights of cushions elevated by CSLA/CS/GP hydrogels remained ∼ 60 % 2 h post-injection in porcine stomach models. Given the unique characteristics of these materials, the CSLA/CS/GP thermo-sensitive hydrogel is a promising intraoperative biomaterial in ESD.
Collapse
Affiliation(s)
- Panxianzhi Ni
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu, Sichuan, China
| | - Renpeng Li
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu, Sichuan, China
| | - Sheng Ye
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu, Sichuan, China
| | - Jing Shan
- Department of Gastroenterology, the 3rd People's Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, 82# Qinglong Street, Qingyang District, Chengdu, Sichuan, China
| | - Tun Yuan
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu, Sichuan, China.
| | - Jie Liang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu, Sichuan, China.
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu, Sichuan, China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu, Sichuan, China
| |
Collapse
|
23
|
Zhao LM, Gong M, Wang R, Yuan QJ, Zhang Y, Pi JK, Lv XH, Xie Y, Xie HQ. Accelerating ESD-induced gastric ulcer healing using a pH-responsive polyurethane/small intestinal submucosa hydrogel delivered by endoscopic catheter. Regen Biomater 2021; 8:rbaa056. [PMID: 33732501 PMCID: PMC7947578 DOI: 10.1093/rb/rbaa056] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 02/05/2023] Open
Abstract
Endoscopic submucosal dissection (ESD) is the standard treatment for early-stage gastric cancer, but the large post-operative ulcers caused by ESD often lead to serious side effects. Post-ESD mucosal repair materials provide a new option for the treatment of post-ESD ulcers. In this study, we developed a polyurethane/small intestinal submucosa (PU/SIS) hydrogel and investigated its efficacy for accelerating ESD-induced ulcer healing in a canine model. PU/SIS hydrogel possessed great biocompatibility and distinctive pH-sensitive swelling properties and protected GES-1 cells from acid attack through forming a dense film in acidic conditions in vitro. Besides, PU/SIS gels present a strong bio-adhesion to gastric tissues under acidic conditions, thus ensuring the retention time of PU/SIS gels in vivo. In a canine model, PU/SIS hydrogel was easily delivered via endoscopy and adhered to the ulcer sites. PU/SIS hydrogel accelerated gastric ulcer healing at an early stage with more epithelium regeneration and slight inflammation. Our findings reveal PU/SIS hydrogel is a promising and attractive candidate for ESD-induced ulcer repair.
Collapse
Affiliation(s)
- Long-Mei Zhao
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Keyuan Road 4, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Mei Gong
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Keyuan Road 4, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Rui Wang
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Keyuan Road 4, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Qi-Juan Yuan
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Keyuan Road 4, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Yi Zhang
- Research Core Facility, West China Hospital, Sichuan University, Keyuan Road 4, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Jin-Kui Pi
- Research Core Facility, West China Hospital, Sichuan University, Keyuan Road 4, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Xiu-He Lv
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Yan Xie
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Hui-Qi Xie
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Keyuan Road 4, Gaopeng Street, Chengdu, Sichuan 610041, China
| |
Collapse
|
24
|
Chen C, Liu XY, Cheng CE, Xiong YJ, Sun YB, Tan CH, Liu YT, Feng J, Ma YF, Shi DT, Li R. Efficacy and safety of a novel submucosal injection solution for endoscopic resection in porcine models. J Dig Dis 2021; 22:49-56. [PMID: 33236832 DOI: 10.1111/1751-2980.12963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/17/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A submucosal injection is usually required to improve the efficacy and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR). This study aimed to evaluate the performance of 3.3% sodium carboxymethyl starch (Na-CMS) solution, a novel submucosal injection solution, for ESD and EMR. METHODS Na-CMS, normal saline (NS) and two commercially available agents (sigMAVisc and Eleview) were injected into the esophageal submucosa of randomly grouped pigs. The level of submucosal elevation was examined. Subsequently, ESD or EMR procedures using 3.3% Na-CMS or NS as submucosal injections were performed in the gastrointestinal tract of the pigs. RESULTS Submucosal elevation was significantly higher and more sustained in the 3.3% Na-CMS group than in the controls (P < 0.05). The volume required for ESD or EMR was significantly lower in the 3.3% Na-CMS group than in the NS group (ESD: 12.21 ± 4.09 mL vs 28.25 ± 8.02 mL, P < 0.001; EMR: 3.99 ± 1.98 mL vs 7.15 ± 3.67 mL, P = 0.001). The ESD resection time was significantly shorter in the 3.3% Na-CMS group than in the NS group (16.58 ± 7.30 min vs 25.29 ± 11.89 min, P = 0.004). Hemorrhage after ESD in the 3.3% Na-CMS group was less severe than that in the NS group (P = 0.006). CONCLUSION 3.3% Na-CMS is an effective, safe and low-cost submucosal injection solution and holds promise as preferable agent for submucosal injection in ESD and EMR procedures.
Collapse
Affiliation(s)
- Chen Chen
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Xiao Yu Liu
- Department of Gastroenterology, Yulin No. 2 Hospital, Yulin, Shaanxi Province, China
| | - Cui E Cheng
- Department of Gastroenterology, Changshu No. 2 People's Hospital, Changshu, Jiangsu Province, China
| | - Yu Jia Xiong
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yi Bin Sun
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Chen Huan Tan
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yi Ting Liu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Ji Feng
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yi Fan Ma
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Dong Tao Shi
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Rui Li
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| |
Collapse
|
25
|
Xie Y, Liu J, Cai S, Bao X, Li Q, Xu G. Setting Characteristics and High Compressive Strength of an Anti-washout, Injectable Calcium Phosphate Cement Combined with Thermosensitive Hydrogel. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5779. [PMID: 33348902 PMCID: PMC7766756 DOI: 10.3390/ma13245779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/11/2022]
Abstract
In this work, a thermosensitive poly(D,L-lactide-co-glycolide)-poly(ethylene glycol)-poly(D,L-lactide-co-glycolide) (PLGA-PEG-PLGA) hydrogel was introduced into calcium phosphate cement (CPC) to enhance the anti-washout property of CPC. The effects of the hydrogel on the setting time, injectability, anti-washout property and compressive strength of CPC were thoroughly investigated. The results showed that the hydrogel significantly increased the injectability and anti-washout property of CPC, meanwhile maintained the setting time with an acceptable range. Moreover, the hydrogel improved the initial compressive strength of CPC. The composite cement with 20% v/v hydrogel in the liquid phase showed fine crystals of hydration product, a more compact microstructure and lower porosity compared with control CPC. The analysis of X-ray diffraction (XRD), infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) indicated that suitable volume ratio of hydrogel (20% v/v) in the setting liquid of CPC could promote the formation of hydroxyapatite in the early hydration period. The degradation behavior of the cement was characterized by immersion tests in simulated body fluid. The hydrogel had no adverse effect on the degradation rate of CPC over the immersion period of 23 days. This study indicated that incorporating PLGA-PEG-PLGA hydrogel could be a promising strategy to reinforce the handing properties and initial compressive strength of calcium phosphate cement.
Collapse
Affiliation(s)
- Yao Xie
- Key Laboratory for Advanced Ceramics and Machining Technology of Ministry of Education, Tianjin University, Tianjin 300072, China; (Y.X.); (Q.L.)
| | - Jia Liu
- Department of Orthopedic Surgery, Spine Center, Naval Medical University, Shanghai 200003, China; (J.L.); (X.B.)
| | - Shu Cai
- Key Laboratory for Advanced Ceramics and Machining Technology of Ministry of Education, Tianjin University, Tianjin 300072, China; (Y.X.); (Q.L.)
| | - Xiaogang Bao
- Department of Orthopedic Surgery, Spine Center, Naval Medical University, Shanghai 200003, China; (J.L.); (X.B.)
| | - Qianqian Li
- Key Laboratory for Advanced Ceramics and Machining Technology of Ministry of Education, Tianjin University, Tianjin 300072, China; (Y.X.); (Q.L.)
| | - Guohua Xu
- Department of Orthopedic Surgery, Spine Center, Naval Medical University, Shanghai 200003, China; (J.L.); (X.B.)
| |
Collapse
|
26
|
Cui S, Yu L, Ding J. Strategy of “Block Blends” to Generate Polymeric Thermogels versus That of One-Component Block Copolymer. Macromolecules 2020. [DOI: 10.1021/acs.macromol.0c02488] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Shuquan Cui
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
- Zhuhai Fudan Innovation Institute, Zhuhai Guangdong, 519000, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
- Zhuhai Fudan Innovation Institute, Zhuhai Guangdong, 519000, China
| |
Collapse
|
27
|
Viscosity and degradation controlled injectable hydrogel for esophageal endoscopic submucosal dissection. Bioact Mater 2020; 6:1150-1162. [PMID: 33134608 PMCID: PMC7588753 DOI: 10.1016/j.bioactmat.2020.09.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 12/16/2022] Open
Abstract
Endoscopic submucosal dissection (ESD) is a common procedure to treat early and precancerous gastrointestinal lesions. Via submucosal injection, a liquid cushion is created to lift and separate the lesion and malignant part from the muscular layer where the formed indispensable space is convenient for endoscopic incision. Saline is a most common submucosal injection liquid, but the formed liquid pad lasts only a short time, and thus repeated injections increase the potential risk of adverse events. Hydrogels with high osmotic pressure and high viscosity are used as an alternate; however, with some drawbacks such as tissue damage, excessive injection resistance, and high cost. Here, we reported a nature derived hydrogel of gelatin-oxidized alginate (G-OALG). Based on the rheological analysis and compare to commercial endoscopic mucosal resection (EMR) solution (0.25% hyaluronic acid, HA), a designed G-OALG hydrogel of desired concentration and composition showed higher performances in controllable gelation and injectability, higher viscosity and more stable structures. The G-OALG gel also showed lower propulsion resistance than 0.25% HA in the injection force assessment under standard endoscopic instruments, which eased the surgical operation. In addition, the G-OALG hydrogel showed good in vivo degradability biocompatibility. By comparing the results acquired via ESD to normal saline, the G-OALG shows great histocompatibility and excellent endoscopic injectability, and enables create a longer-lasting submucosal cushion. All the features have been confirmed in the living both pig and rat models. The G-OALG could be a promising submucosal injection agent for esophageal ESD. Injectable gel with controlled viscosity. Injectable gel with controlled degradation. Making esophageal submucosal liquid cushion. Potential treatment for early esophageal cancer. Big animal in-situ imaging.
Collapse
|
28
|
Cui S, Chen L, Yu L, Ding J. Synergism among Polydispersed Amphiphilic Block Copolymers Leading to Spontaneous Physical Hydrogelation upon Heating. Macromolecules 2020. [DOI: 10.1021/acs.macromol.0c01430] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Shuquan Cui
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Liang Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
- Zhuhai Fudan Innovation Institute, Zhuhai, Guangdong 519000, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
- Zhuhai Fudan Innovation Institute, Zhuhai, Guangdong 519000, China
| |
Collapse
|
29
|
Chen X, Nishiguchi A, Taguchi T. Adhesive Submucosal Injection Material Based on the Nonanal Group-Modified Poly(vinyl alcohol)/α-Cyclodextrin Inclusion Complex for Endoscopic Submucosal Dissection. ACS APPLIED BIO MATERIALS 2020; 3:4370-4379. [DOI: 10.1021/acsabm.0c00384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Xi Chen
- Polymer-Bio Field, Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
| | - Akihiro Nishiguchi
- Polymer-Bio Field, Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
| | - Tetsushi Taguchi
- Polymer-Bio Field, Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
| |
Collapse
|
30
|
Ren P, Li J, Zhao L, Wang A, Wang M, Li J, Jian H, Li X, Yan X, Bai S. Dipeptide Self-assembled Hydrogels with Shear-Thinning and Instantaneous Self-healing Properties Determined by Peptide Sequences. ACS APPLIED MATERIALS & INTERFACES 2020; 12:21433-21440. [PMID: 32319760 DOI: 10.1021/acsami.0c03038] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Dipeptide self-assembled hydrogels have potential biomedical applications because of their great biocompatibility, bioactivity, and tunable physicochemical properties, which can be modulated in the molecular level by design of amino acid sequences. Herein, a series of dipeptides (Fmoc-FL, -YL, -LL, and -YA) are designed to form shear-thinning hydrogels with self-healing and tunable mechanical properties by adjusting the synergetic effect of hydrophobic interactions (π-π stacking and hydrophobic effect) and hydrogen bonds of peptides through substitution of amino acid residues. The enhancement of hydrophobic interactions is a primary factor to promote mechanical rigidity of hydrogels, and strong hydrogen-bonding interactions between molecules contribute to the instantaneous self-healing property, which is supported by experimental studies (FTIR, CD, SEM, AFM, and rheology) and molecular dynamics simulations. The injectable dipeptide hydrogels were certified as an ideal endoscopic submucosal dissection filler to make operation convenient and secure in mice and living mini-pig's experiments with a longer duration time, higher stiffness, and lower inflammatory response than commercial clinical fillers.
Collapse
Affiliation(s)
- Peng Ren
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jingtao Li
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Luyang Zhao
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Anhe Wang
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Meiyue Wang
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jieling Li
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Honglei Jian
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Xiaoou Li
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Xuehai Yan
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Shuo Bai
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| |
Collapse
|
31
|
Hoang Thi TT, Sinh LH, Huynh DP, Nguyen DH, Huynh C. Self-Assemblable Polymer Smart-Blocks for Temperature-Induced Injectable Hydrogel in Biomedical Applications. Front Chem 2020; 8:19. [PMID: 32083052 PMCID: PMC7005785 DOI: 10.3389/fchem.2020.00019] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/08/2020] [Indexed: 12/29/2022] Open
Abstract
Self-assembled temperature-induced injectable hydrogels fabricated via self-assembly of polymer smart-blocks have been widely investigated as drug delivery systems and platforms for tissue regeneration. Polymer smart-blocks that can be self-assembly play an important role in fabrication of hydrogels because they can self-assemble to induce the gelation of their copolymer in aqueous solution. The self-assembly occurs in response to an external stimulus change, such as temperature, pH, glucose, ionic strength, light, magnetic field, electric field, or their combination, which results in property transformations like hydrophobicity, ionization, and conformational change. The self-assembly smart-block based copolymers exist as a solution in aqueous media at certain conditions that are suitable for mixing with bioactive molecules and/or cells. However, this solution turns into a hydrogel due to the self-assembly of the smart-blocks under exposure to an external stimulus change in vitro or injection into the living body for a controllable release of loaded bioactive molecules or serving as a biomaterial scaffold for tissue regeneration. This work reports current scenery in the development of these self-assembly smart-blocks for fabrication of temperature-induced injectable physically cross-linked hydrogels and their potential application as drug delivery systems and platforms for tissue engineering.
Collapse
Affiliation(s)
- Thai Thanh Hoang Thi
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Le Hoang Sinh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
| | - Dai Phu Huynh
- Faculty of Materials Technology and Polymer Research Center, Ho Chi Minh City University of Technology, VNU HCM, Ho Chi Minh City, Vietnam
| | - Dai Hai Nguyen
- Institute of Applied Materials Science, Vietnam Academy of Science and Technology, Ho Chi Minh City, Vietnam
| | - Cong Huynh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
| |
Collapse
|
32
|
Maeda T. Structures and Applications of Thermoresponsive Hydrogels and Nanocomposite-Hydrogels Based on Copolymers with Poly (Ethylene Glycol) and Poly (Lactide- Co-Glycolide) Blocks. Bioengineering (Basel) 2019; 6:E107. [PMID: 31766313 PMCID: PMC6955967 DOI: 10.3390/bioengineering6040107] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 01/04/2023] Open
Abstract
Thermoresponsive hydrogels showing biocompatibility and degradability have been under intense investigation for biomedical applications, especially hydrogels composed of hydrophilic poly(ethylene glycol) (PEG) and hydrophobic poly(lactic acid-co-glycolic acid) (PLGA) as first-line materials. Even though various aspects such as gelation behavior, degradation behavior, drug-release behavior, and composition effect have been studied for 20 years since the first report of these hydrogels, there are still many outputs on parameters affecting their gelation, structure, and application. In this review, the current trends of research on linear block copolymers composed of PEG and PLGA during the last 5 years (2014-2019) are summarized. In detail, this review stresses newly found parameters affecting thermoresponsive gelation, findings from structural analysis by simulation, small-angle neutron scattering (SANS), etc., progress in biomedical applications including drug delivery systems and regeneration medicine, and nanocomposites composed of block copolymers with PEG and PLGA and nanomaterials (laponite).
Collapse
Affiliation(s)
- Tomoki Maeda
- Frontier Research Center for Applied Atomic Sciences, Ibaraki University, 162-1 Shirakata, Tokai, Ibaraki 319-1106, Japan;
- Department of Mechanical Engineering, Keio University, 3-14-1, Hiyoshi, Kohoku-ku, Yokohama 223-8522, Japan
| |
Collapse
|
33
|
Hirose R, Yoshida N, Naito Y, Yoshida T, Bandou R, Daidoji T, Inoue K, Dohi O, Konishi H, Nakaya T, Itoh Y. Development of Sodium Polyacrylate-Based High-Performance Submucosal Injection Material with Pseudoplastic Fluid Characteristics. ACS Biomater Sci Eng 2019; 5:6794-6800. [PMID: 33423472 DOI: 10.1021/acsbiomaterials.9b01373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
34
|
Development of chitosan/glycerophosphate/collagen thermo-sensitive hydrogel for endoscopic treatment of mucosectomy-induced ulcer. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 103:109870. [DOI: 10.1016/j.msec.2019.109870] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 12/14/2022]
|
35
|
EndoClot ®SIS Polysaccharide Injection as a Submucosal Fluid Cushion for Endoscopic Mucosal Therapies: Results of Ex Vivo and In Vivo Studies. Dig Dis Sci 2019; 64:2955-2964. [PMID: 31165380 DOI: 10.1007/s10620-019-05686-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 05/25/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are many studies on submucosal injection materials, but their clinical use is restricted for various reasons. The objective of this study was to compare the feasibility and safety of injected EndoClot®SIS polysaccharide as a submucosal injection material (SFC) in ESD in the pig stomach to that of injected sigMAVisc™ or Eleview™. METHODS Four pig stomachs were used for the ex vivo study. Eighteen pigs were used for the in vivo study. In the ex vivo study, four injections were made in the gastric submucosa to induce submucosal uplift and extend its duration. Tissue change was observed. The in vivo study was performed in 2 steps. First, 3 injections were made in the esophageal mucosa to induce submucosal uplift and extend its duration. Histological change was observed. Second, ESD was performed in the stomach by injecting EndoClot®SIS polysaccharide, sigMAVisc™, or Eleview™ (each, n = 6) as an SFC. The effects of these agents on wound healing were examined. We evaluated the efficacy and safety of endoscopic surgery after EndoClot®SIS polysaccharide injection. RESULTS EndoClot®SIS polysaccharide produced a longer-lasting elevation with clearer margins than was achieved by sigMAVisc™, Eleview™, or 0.9% NaCl and thereby enabled precise ESD without complications, such as bleeding and perforation. No obvious histopathological damage was observed at the injection site on endoscopy and histology. CONCLUSION Submucosally injected EndoClot®SIS polysaccharide increased the effective separation of the mucosa and submucosa and reduced surgical complications. Hence, EndoClot®SIS polysaccharide injection is a safe and effective submucosal injection material.
Collapse
|
36
|
Temperature-responsive biodegradable injectable polymer systems with conveniently controllable properties. Polym J 2019. [DOI: 10.1038/s41428-019-0217-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
37
|
Cui S, Yu L, Ding J. Thermogelling of Amphiphilic Block Copolymers in Water: ABA Type versus AB or BAB Type. Macromolecules 2019. [DOI: 10.1021/acs.macromol.9b00534] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Shuquan Cui
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| |
Collapse
|
38
|
Peng W, Tan S, Huang S, Ren Y, Li H, Peng Y, Fu X, Tang X. Efficacy and safety of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors with more than 1-year' follow-up: a systematic review and meta-analysis. Scand J Gastroenterol 2019; 54:397-406. [PMID: 30925071 DOI: 10.1080/00365521.2019.1591500] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objectives: Submucosal tunneling endoscopic resection (STER) is a novel therapeutic approach for upper gastrointestinal submucosal tumors (SMTs) especially for tumors originating from the muscularis propria layer. Presently, several studies have reported the efficacy and safety of STER for SMTs. Therefore, we conducted this study to review the clinical outcomes of STER with more than 1-year' follow-up duration. Materials and methods: Medline, Embase and Cochrane databases were searched on November 2018 to identify studies reporting STER for SMTs. Weighted pooled rates were calculated for en bloc resection, complete resection and adverse event (AE). Risk ratios (RR) were calculated and pooled to compare STER with thoracoscopic enucleation (TE). Results: A total of 701 patients with 728 lesions from 12 original studies were review. Pooled WPR for en bloc resection of STER was 86.3% (95% CI: 74.5-93.1%), (I2=82.5). Pooled WPR for complete resection of STER was 97.7% (95% CI: 92.8-99.3%), (I2=77.6). WPR for AE was 18.3% (95% CI: 9.7-31.6%), (I2=90.6%). Two studies with 292 patients compared the performance of STER with TE. Pooled RR for en bloc resection was 1.02 (95% CI: 0.95-1.09). Pooled RR for complete resection was 1.0 (95% CI: 0.98-1.03). Pooled RR for AE was 0.82 (95% CI: 0.33-2.05). Conclusions: Our study showed that STER has relatively long-term efficacy for treating upper gastrointestinal SMTs, and the incidence of AE was not low for STER, but all of them can be managed conservatively.
Collapse
Affiliation(s)
- Wei Peng
- a Department of Gastroenterology , Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Shali Tan
- a Department of Gastroenterology , Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Shu Huang
- b Department of Gastroenterology , the People's Hospital of Lianshui , Huaian , China
| | - Yutang Ren
- c Departmemt of Gastroenterology , Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University , Beijing , China
| | - Huan Li
- a Department of Gastroenterology , Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Yan Peng
- a Department of Gastroenterology , Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Xiangsheng Fu
- d Department of Gastroenterology , the Affiliated Hospital of North Sichuan Medical College , Nanchong , China
| | - Xiaowei Tang
- a Department of Gastroenterology , Affiliated Hospital of Southwest Medical University , Luzhou , China
| |
Collapse
|
39
|
Wang M, Wang K, Chen Y, Liu W, Liu L, Wang X, Zhao L, Fan Z. Thermoresponsive aerification and tissue vacuolization for facilitating endoscopic submucosal resection. Dig Endosc 2018; 30:741-749. [PMID: 29992627 DOI: 10.1111/den.13235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/09/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS Mucosal lifting and its persistence are critical for maintaining the operational space and preventing perforation in endoscopic operation. Although numerous agents have been investigated, optimization is still required for improving their clinical performance. In the present study, we proposed a novel concept of thermoresponsive aerification and tissue vacuolization for submucosal injection. METHODS Lifting performance and operational condition were first evaluated in porcine stomachs in vitro and rabbits in vivo. Dodecafluoropentane (DDFP) injection dosage, lifting persistency and operational assistance were quantitatively recorded. Gross and histological pathology were also analyzed to identify DDFP acute toxicity and long-term safety. The endoscopic submucosal dissection (ESD) procedure with DDFP was carried out on pigs in vivo to confirm its operational feasibility, efficacy, and safety. RESULTS Dodecafluoropentane aerification could achieve better mucosal lift with lower dosage (1% of normal saline dosage). Thermoresponsive DDFP aerification could provide continuous replenishment and longer persistence. Meanwhile, its tissue vacuolization effect significantly facilitated submucosal tissue dissection in in vitro study. Similar performance was verified in vivo. The particular vacuole-like submucosal structure was seen after DDFP onset, which also promoted reepithelization and wound healing. No tissue damage, gas embolism, biotoxicity, and physicochemical risk were observed. CONCLUSION Bioinert DDFP was feasible, efficient, and safe as the novel submucosal lifting candidate.
Collapse
Affiliation(s)
- Min Wang
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Kuangjing Wang
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yingtong Chen
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Wenjie Liu
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Li Liu
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiang Wang
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lili Zhao
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Zhining Fan
- Digestive Endoscopy Department, Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| |
Collapse
|
40
|
Alonci G, Fiorini F, Riva P, Monroy F, López-Montero I, Perretta S, De Cola L. Injectable Hybrid Hydrogels, with Cell-Responsive Degradation, for Tumor Resection. ACS APPLIED BIO MATERIALS 2018; 1:1301-1310. [DOI: 10.1021/acsabm.8b00189] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Giuseppe Alonci
- Institut de Science et d’Ingénierie Supramoléculaires, CNRS, UMR 7006, Université de Strasbourg, 8 rue Gaspard Monge, 67000 Strasbourg, France
| | - Federica Fiorini
- Institut de Science et d’Ingénierie Supramoléculaires, CNRS, UMR 7006, Université de Strasbourg, 8 rue Gaspard Monge, 67000 Strasbourg, France
| | - Pietro Riva
- IHU, Strasbourg 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Francisco Monroy
- Universidad Complutense de Madrid, Avda. Complutense s/n, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Avda. Córdoba s/n, 28041 Madrid, Spain
| | - Ivan López-Montero
- Universidad Complutense de Madrid, Avda. Complutense s/n, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Avda. Córdoba s/n, 28041 Madrid, Spain
| | | | - Luisa De Cola
- Institut de Science et d’Ingénierie Supramoléculaires, CNRS, UMR 7006, Université de Strasbourg, 8 rue Gaspard Monge, 67000 Strasbourg, France
| |
Collapse
|
41
|
Hirose R, Nakaya T, Naito Y, Daidoji T, Dohi O, Yoshida N, Yasuda H, Konishi H, Itoh Y. Identification of the critical viscoelastic factor in the performance of submucosal injection materials. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 94:909-919. [PMID: 30423779 DOI: 10.1016/j.msec.2018.10.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 10/08/2018] [Accepted: 10/11/2018] [Indexed: 12/17/2022]
Abstract
High-performance submucosal injection materials (SIMs) contribute to the success of endoscopic therapy for early-stage gastrointestinal neoplasms. This study aimed to identify the most important factor (viscoelastic parameter) that determines SIM performance and the ease of injection. To determine the ideal viscoelastic parameters of SIMs, submucosal elevation heights (SEHs) and the ease of submucosal injection [characterized by injection pressures (IPs)] were evaluated using a newly developed ex vivo model, in which a constant tension was applied to the studied specimen. The strongest positive correlation was observed between the loss modulus determined at an oscillation frequency of 0.1 rad/s and SEH (correlation coefficient > 0.9) and between the loss modulus at 10 rad/s and IP (correlation coefficient > 0.9). SIMs with high loss moduli (0.1 rad/s) also contributed to maintenance of the submucosal elevation. Moreover, the SEHs of pseudoplastic fluid SIMs (whose loss moduli increased slightly with increasing angular frequency) were greater than those of Newtonian fluid SIMs (whose loss modulus increased drastically with increasing angular frequency). In this study, the ideal viscoelastic SIM parameters were clarified. The loss modulus (0.1 rad/s) was the most important viscoelastic factor affecting SIM performance. Additionally, the development of pseudoplastic fluid SIMs may lead to the creation of next-generation SIMs, with a performance superior to that of sodium hyaluronate, which is currently used widely in endoscopic treatments.
Collapse
Affiliation(s)
- Ryohei Hirose
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Takaaki Nakaya
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Naito
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomo Daidoji
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Yasuda
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideyuki Konishi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
42
|
Luan J, Zhang Z, Shen W, Chen Y, Yang X, Chen X, Yu L, Sun J, Ding J. Thermogel Loaded with Low-Dose Paclitaxel as a Facile Coating to Alleviate Periprosthetic Fibrous Capsule Formation. ACS APPLIED MATERIALS & INTERFACES 2018; 10:30235-30246. [PMID: 30102023 DOI: 10.1021/acsami.8b13548] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Medical-grade silicones as implants have been utilized for decades. However, the postoperative complications, such as capsular formation and contracture, have not yet been fully controlled and resolved. The aim of the present study is to elucidate whether the capsular formation can be alleviated by local and sustained delivery of low-dose paclitaxel (PTX) during the critical phase after the insertion of silicone implants. A biocompatible and thermogelling poly(lactic acid- co-glycolic acid)- b-poly(ethylene glycol)- b-poly(lactic acid- co-glycolic acid) triblock copolymer was synthesized by us. The micelles formed by the amphiphilic polymers in water could act as a reservoir for the solubilization of PTX, a very hydrophobic drug. The concentrated polymer aqueous solution containing PTX exhibited a sol-gel transition upon heating and formed a thermogel depot at body temperature. In vitro release tests demonstrated that the entrapped microgram-level PTX displayed a sustained release manner up to 57 days without a significant initial burst effect. Customized silicone implants coated with the PTX-loaded thermogels at various drug concentrations were inserted into the pockets of the subpanniculus carnosus plane of rats. The histological observations performed 1 month postoperation showed that the sustained release of PTX with an appropriate dose significantly reduced the peri-implant capsule thickness, production and deposition of collagen, and expression of contracture-mediating factors compared with bare silicone implants. More importantly, such an optimum dose had an excellent repeatability for the suppression of the capsular formation. Therefore, this study provides a strategic foothold regarding the sustained release of low-dose PTX to alleviate fibrotic capsule formation after implantation, and the microgram-level PTX-loaded thermogel holds great potential as an "all-purpose antifibrosis coating" for veiling the surfaces of various implantable medical devices.
Collapse
Affiliation(s)
- Jiabin Luan
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
| | - Zheng Zhang
- Department of Breast Surgery, Obstetrics and Gynecology Hospital , Fudan University , Shanghai 200011 , China
| | - Wenjia Shen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
| | - Yipei Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
| | - Xiaowei Yang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
| | - Xiaobin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
| | - Jian Sun
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
- Department of Breast Surgery, Obstetrics and Gynecology Hospital , Fudan University , Shanghai 200011 , China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science , Fudan University , Shanghai 200438 , China
| |
Collapse
|
43
|
Cui S, Yu L, Ding J. Semi-bald Micelles and Corresponding Percolated Micelle Networks of Thermogels. Macromolecules 2018. [DOI: 10.1021/acs.macromol.8b01014] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Shuquan Cui
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| |
Collapse
|
44
|
Yoshida Y, Takai H, Kawahara K, Mitsumune S, Takata K, Kuzuya A, Ohya Y. Biodegradable injectable polymer systems exhibiting a longer and controllable duration time of the gel state. Biomater Sci 2018; 5:1304-1314. [PMID: 28594018 DOI: 10.1039/c7bm00357a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Here, we report biodegradable temperature-triggered covalent gelation systems exhibiting a longer and controllable duration time of the gel state by a "mixing strategy" utilizing a thiol-ene reaction. We synthesized a tri-block copolymer of poly(caprolactone-co-glycolic acid) and PEG (tri-PCG) as a temperature-responsive injectable polymer (IP) and attached acryloyl groups on both termini (tri-PCG-Acryl). A tri-PCG micelle solution containing hydrophobic hexa-functional polythiol (Solution-A) and a tri-PCG-Acryl micelle solution (Solution-B) were mixed together. After mixing, the solution was still in the sol state at r.t., but exhibited an irreversible sol-to-gel transition in response to temperature. The duration time of the gel state while soaking in PBS could be altered from 1 day to 93 days by changing the mixing ratio of Solution-A/B. The physical strengths of the hydrogels were also controllable by changing the mixing ratio. The IP system showed good biocompatibility and a long duration time of the gel state after subcutaneous implantation.
Collapse
Affiliation(s)
- Yasuyuki Yoshida
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, 3-3-35 Yamate, Suita, Osaka 564-8680, Japan.
| | | | | | | | | | | | | |
Collapse
|
45
|
Hirose R, Nakaya T, Naito Y, Daidoji T, Yasuda H, Konishi H, Itoh Y. Development of a new ex vivo model for evaluation of endoscopic submucosal injection materials performance. J Mech Behav Biomed Mater 2018; 79:219-225. [PMID: 29329031 DOI: 10.1016/j.jmbbm.2018.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/28/2017] [Accepted: 01/02/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Development of high-performance submucosal injection materials (SIMs) contribute to the advancement of endoscopic therapy for early-stage gastrointestinal neoplasms. This study aimed to develop a new ex vivo model that mimics the human gastrointestinal tract to evaluate the performance (the height and duration of the submucosal elevation) of various SIMs in detail. METHODS A new ex vivo model that applies a constant tension to the tested specimen (the porcine gastric specimen) was developed. SIMs were injected into the submucosa at the center or edge of the tested specimen, and submucosal elevation heights (SEHs) were measured over time. RESULTS The average value and standard deviation of SEH determined using the conventional model (the tested specimen was fixed with pins) were higher than those obtained using the new model, which showed that the new model could precisely measure the SEH of a given SIM. In addition, the performance (SEH) of SIMs decreased with increasing tension applied to the specimen, suggesting that the performance of SIMs deteriorates with the over-expansion of the gastrointestinal tract. The submucosal elevation formed at the specimen edge disappeared faster than that formed at the specimen's center. CONCLUSIONS The proposed new ex vivo model allows accurate SEH measurement under uniform conditions and detailed comparison of the performances of various types of SIMs and can contribute to the development of high-performance materials.
Collapse
Affiliation(s)
- Ryohei Hirose
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Takaaki Nakaya
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Naito
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomo Daidoji
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Yasuda
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hideyuki Konishi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| |
Collapse
|
46
|
Liu W, Wang M, Zhao L, Wang M, Wang X, Fan Z, Liu L. Thermo-sensitive isopentane aerification for mucosal lift during endoscopic resection in animal models (with video). Gastrointest Endosc 2017; 86:1168-1175.e3. [PMID: 28288842 DOI: 10.1016/j.gie.2017.02.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 02/27/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Mucosal lift is critical for successful endoscopic treatment. Normal saline (NS) solution is widely used as the submucosal filler, but its short persistency restricts clinical endoscopic submucosal dissection (ESD). In this study, thermo-sensitive isopentane was introduced for submucosal injection. With a boiling point at 27.8°C, liquid isopentane can be easily applied, and gasification inflation can provide great support for submucosal lifting at body temperature. The feasibility and efficiency of isopentane were evaluated in this study. METHODS Porcine stomachs were used for in vitro evaluation. A 37°C water bath was used to mimic body temperature. Compared with NS, isopentane was studied for its lifting performance, including injection dosage, persistence of lifting strength, and efficacy for assisting submucosal dissection. The changes in submucosal tissue were also compared. For in vivo evaluation, rats were used to further compare the differences between isopentane and NS, including lifting efficacy, pathologic effect, and safety. RESULTS Compared with NS, the maximum lifting height was achieved with less isopentane (2% NS volume). Longer persistency and faster operation for submucosal dissection were also recorded for isopentane during the in vitro study. Aerification resulted in vacuolization of submucosal connective tissue, which facilitates EMR and postoperative recovery. The same results were confirmed in the rat model. With the same dosage, isopentane produced better mucosal elevation and larger range than NS. According to the histologic examination, no tissue injury was observed with isopentane application. CONCLUSIONS As a submucosal injection agent, the feasibility, efficacy, and safety of isopentane has been demonstrated. Thermo-sensitive aerification may be a promising approach to facilitate ESD.
Collapse
Affiliation(s)
- Wenjie Liu
- Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Min Wang
- Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Lili Zhao
- Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Min Wang
- Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Xiang Wang
- Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Zhining Fan
- Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Li Liu
- Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| |
Collapse
|
47
|
Cheng B, Qian L, Qian HJ, Lu ZY, Cui S. Effects of stereo-regularity on the single-chain mechanics of polylactic acid and its implications on the physical properties of bulk materials. NANOSCALE 2017; 9:14312-14316. [PMID: 28936502 DOI: 10.1039/c7nr06483g] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The material properties of polylactic acid (PLA) are largely determined by its stereo-regularity (tacticity). To find out the origin at the molecular level, the single-chain mechanics of poly-l-lactic acid (PLLA) and poly-d,l-lactide (PDLLA) were comparatively investigated by single-molecule atomic force microscopy (AFM). At a low concentration, PLLA adopted a random-coil conformation in a good solvent. At a high concentration, however, the PLLA chain can be induced into a helix, which consumed additional energy during unfolding by further stretching. Due to the random arrangement of l- and d-repeating units in the PDLLA chain, PDLLA adopts a random-coil conformation at all concentrations. The difference in single-chain mechanics of PLLA and PDLLA at high concentrations may be the cause of their different macroscopic properties. This is the first report to reveal the stereo-regularity-dependent mechanics of a polymer at the single-molecule level, which may help to bridge the gap between understanding single-molecule and materials properties.
Collapse
Affiliation(s)
- Bo Cheng
- Key Lab of Advanced Technologies of Materials, Ministry of Education of China, Southwest Jiaotong University, Chengdu 610031, P. R. China.
| | | | | | | | | |
Collapse
|
48
|
Takata K, Kawahara K, Yoshida Y, Kuzuya A, Ohya Y. Analysis of the sol-to-gel transition behavior of temperature-responsive injectable polymer systems by fluorescence resonance energy transfer. Polym J 2017. [DOI: 10.1038/pj.2017.33] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
49
|
Non-invasive monitoring of in vivo degradation of a radiopaque thermoreversible hydrogel and its efficacy in preventing post-operative adhesions. Acta Biomater 2017; 55:396-409. [PMID: 28363786 DOI: 10.1016/j.actbio.2017.03.042] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 03/07/2017] [Accepted: 03/27/2017] [Indexed: 01/19/2023]
Abstract
In vivo behavior of hydrogel-based biomaterials is very important for rational design of hydrogels for various biomedical applications. Herein, we developed a facile method for in situ fabrication of radiopaque hydrogel. An iodinated functional diblock copolymer of poly(ethylene glycol) and aliphatic polyester was first synthesized by coupling the hydroxyl end of the diblock copolymer with 2,3,5-triiodobenzoic acid (TIB) and then a radiopaque thermoreversible hydrogel was obtained by mixing it with the virgin diblock copolymer. A concentrated aqueous solution of the copolymer blend was injectable at room temperature and spontaneously turned into an in situ hydrogel at body temperature after injection. The introduction of TIB moieties affords the capacity of X-ray opacity, enabling in vivo visualization of the hydrogel using Micro-CT. A rat model with cecum and abdominal defects was utilized to evaluate the efficacy of the radiopaque hydrogel in the prevention of post-operative adhesions, and a significant reduction of the post-operative adhesion formation was confirmed. Meanwhile, the maintenance of the radiopaque hydrogel in the abdomen after administration was non-destructively detected via Micro-CT scanning. The reconstructed three-dimensional images showed that the radiopaque hydrogel with an irregular morphology was located on the injured abdominal wall. The time-dependent profile of the volume of the radiopaque hydrogel determined by Micro-CT imaging was well consistent with the trend obtained from the dissection observation. Therefore, the radiopaque thermoreversible hydrogel can serve as a potential visualized biomedical implant and this practical mixing approach is also useful for further extension into the in vivo monitoring of other biomaterials. STATEMENT OF SIGNIFICANCE While a variety of biomaterials have been extensively studied, it is rare to monitor in vivo degradation and medical efficacy of a material after being implanted deeply into the body. Herein, the radiopaque thermoreversible hydrogel developed by us not only holds desirable performance on the prevention of post-operative abdominal adhesions, but also allows non-invasive monitoring of its in vivo degradation with CT imaging in a real-time, quantitative and three-dimensional manner. The methodology based on CT imaging provides important insights into the in vivo fate of the hydrogel after being deeply implanted into mammals for different biomedical applications and significantly reduces the amount of animals sacrificed.
Collapse
|
50
|
Jang JY. Future Development of Endoscopic Accessories for Endoscopic Submucosal Dissection. Clin Endosc 2017; 50:242-249. [PMID: 28609819 PMCID: PMC5475511 DOI: 10.5946/ce.2017.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 05/18/2017] [Accepted: 05/23/2017] [Indexed: 12/27/2022] Open
Abstract
Endoscopic submucosal dissection (ESD) has recently been accepted as a standard treatment for patients with early gastric cancer (EGC), without lymph node metastases. Given the rise in the number of ESDs being performed, new endoscopic accessories are being developed and existing accessories modified to facilitate the execution of ESD and reduce complication rates. This paper examines the history underlying the development of these new endoscopic accessories and indicates future directions for the development of these accessories.
Collapse
Affiliation(s)
- Jae-Young Jang
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| |
Collapse
|