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Martel RD, Hoyos NA, Tapia-Laliena MÁ, Herrmann I, Herrmann M, Khasanov R, Schäfer KH. Intra-arterial delivery of neurospheres into isolated perfused porcine colons: a proof of concept. Biol Methods Protoc 2024; 9:bpae022. [PMID: 38628556 PMCID: PMC11018533 DOI: 10.1093/biomethods/bpae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/21/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024] Open
Abstract
Cell replacement in aganglionic intestines is a promising, yet merely experimental tool for the therapy of congenital dysganglionosis of the enteric nervous system like Hirschsprung disease. While the injection of single cells or neurospheres to a defined and very restricted location is trivial, the translation to the clinical application, where large aganglionic or hypoganglionic areas need to be colonized (hundreds of square centimetres), afford a homogeneous distribution of multiple neurospheres all over the affected tissue areas. Reaching the entire aganglionic area in vivo is critical for the restoration of peristaltic function. The latter mainly depends on an intact nervous system that extends throughout the organ. Intra-arterial injection is a common method in cell therapy and may be the key to delivering cells or neurospheres into the capillary bed of the colon with area-wide distribution. We describe an experimental method for monitoring the distribution of a defined number of neurospheres into porcine recta ex vivo, immediately after intra-arterial injection. We designed this method to localize grafting sites of single neurospheres in precise biopsies which can further be examined in explant cultures. The isolated perfused porcine rectum allowed us to continuously monitor the perfusion pressure. A blockage of too many capillaries would lead to an ischaemic situation and an increase of perfusion pressure. Since we could demonstrate that the area-wide delivery of neurospheres did not alter the overall vascular resistance, we showed that the delivery does not significantly impair the local circulation.
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Affiliation(s)
- Richard D Martel
- Department of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Nicolas A Hoyos
- Department of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
| | - María Ángeles Tapia-Laliena
- Department of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
| | - Irmgard Herrmann
- Department of Medicine 3, Universitäts-Klinikum Erlangen, Erlangen, Germany
| | - Martin Herrmann
- Department of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
- Department of Medicine 3, Universitäts-Klinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie DZI, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Rasul Khasanov
- Department of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
| | - Karl-Herbert Schäfer
- Enteric Nervous System Group, University of Applied Sciences Kaiserslautern, Zweibrücken, Germany
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Cvetkoska A, Maček-Lebar A, Polajžer T, Reberšek M, Upchurch W, Iaizzo PA, Sigg DC, Miklavčič D. The Effects of Interphase and Interpulse Delays and Pulse Widths on Induced Muscle Contractions, Pain and Therapeutic Efficacy in Electroporation-Based Therapies. J Cardiovasc Dev Dis 2023; 10:490. [PMID: 38132658 PMCID: PMC10744272 DOI: 10.3390/jcdd10120490] [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: 11/05/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Electroporation is used in medicine for drug and gene delivery, and as a nonthermal ablation method in tumor treatment and cardiac ablation. Electroporation involves delivering high-voltage electric pulses to target tissue; however, this can cause effects beyond the intended target tissue like nerve stimulation, muscle contractions and pain, requiring use of sedatives or anesthetics. It was previously shown that adjusting pulse parameters may mitigate some of these effects, but not how these adjustments would affect electroporation's efficacy. We investigated the effect of varying pulse parameters such as interphase and interpulse delay while keeping the duration and number of pulses constant on nerve stimulation, muscle contraction and assessing pain and electroporation efficacy, conducting experiments on human volunteers, tissue samples and cell lines in vitro. Our results show that using specific pulse parameters, particularly short high-frequency biphasic pulses with short interphase and long interpulse delays, reduces muscle contractions and pain sensations in healthy individuals. Higher stimulation thresholds were also observed in experiments on isolated swine phrenic nerves and human esophagus tissues. However, changes in the interphase and interpulse delays did not affect the cell permeability and survival, suggesting that modifying the pulse parameters could minimize adverse effects while preserving therapeutic goals in electroporation.
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Affiliation(s)
- Aleksandra Cvetkoska
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia; (A.C.); (A.M.-L.); (T.P.); (M.R.)
| | - Alenka Maček-Lebar
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia; (A.C.); (A.M.-L.); (T.P.); (M.R.)
| | - Tamara Polajžer
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia; (A.C.); (A.M.-L.); (T.P.); (M.R.)
| | - Matej Reberšek
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia; (A.C.); (A.M.-L.); (T.P.); (M.R.)
| | - Weston Upchurch
- Visible Heart® Laboratories, Department of Surgery and the Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (W.U.); (P.A.I.)
| | - Paul A. Iaizzo
- Visible Heart® Laboratories, Department of Surgery and the Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (W.U.); (P.A.I.)
| | - Daniel C. Sigg
- Cardiac Ablation Solutions, Medtronic, Inc., Minneapolis, MN 55432, USA;
| | - Damijan Miklavčič
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia; (A.C.); (A.M.-L.); (T.P.); (M.R.)
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Smith TJ, Wang EJ, Loprinzi CL. Cutaneous Electroanalgesia for Relief of Chronic and Neuropathic Pain. N Engl J Med 2023; 389:158-164. [PMID: 37437145 DOI: 10.1056/nejmra2110098] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Affiliation(s)
- Thomas J Smith
- From the Harry J. Duffey Family Patient and Family Services Program, Sidney Kimmel Comprehensive Cancer Program, and the Department of Medicine, Division of General Internal Medicine (T.J.S.), and the Pain Medicine Division, Department of Anesthesiology and Critical Care Medicine (E.J.W.), Johns Hopkins Medical Institutions, Baltimore; and the Mayo Clinic, Rochester, MN (C.L.L.)
| | - Eric J Wang
- From the Harry J. Duffey Family Patient and Family Services Program, Sidney Kimmel Comprehensive Cancer Program, and the Department of Medicine, Division of General Internal Medicine (T.J.S.), and the Pain Medicine Division, Department of Anesthesiology and Critical Care Medicine (E.J.W.), Johns Hopkins Medical Institutions, Baltimore; and the Mayo Clinic, Rochester, MN (C.L.L.)
| | - Charles L Loprinzi
- From the Harry J. Duffey Family Patient and Family Services Program, Sidney Kimmel Comprehensive Cancer Program, and the Department of Medicine, Division of General Internal Medicine (T.J.S.), and the Pain Medicine Division, Department of Anesthesiology and Critical Care Medicine (E.J.W.), Johns Hopkins Medical Institutions, Baltimore; and the Mayo Clinic, Rochester, MN (C.L.L.)
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