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Gaba RC, Elkhadragy L, Pennix T, Schachtschneider KM, Bolt CR, Anderson A, Majumdar S, Weber D, Whiteley HE, Regan DP, Schook LB, Sutton BP. Magnetic Resonance Elastography for Staging Liver Fibrosis in the Oncopig. Diagnostics (Basel) 2024; 14:1880. [PMID: 39272665 PMCID: PMC11394206 DOI: 10.3390/diagnostics14171880] [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: 07/10/2024] [Revised: 08/19/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024] Open
Abstract
This pilot study investigated the feasibility of using magnetic resonance elastography (MRE) for the non-invasive detection and quantification of liver fibrosis in the Oncopig cancer model. Seven 8-week-old Oncopigs underwent alcoholic liver fibrosis induction and serial MRE imaging and liver biopsy at 1, 2, and 3 months post procedure. MRE was utilized to quantify liver stiffness, and liver fibrosis was histologically graded using the METAVIR system. The primary outcome measure was the capability to detect and quantify liver fibrosis using MRE with radiologic-pathologic correlation. Liver fibrosis induction, MRE imaging, and liver biopsy were successfully performed. MRE liver fibrosis was evident in 57% (4/7), 50% (3/6), and 40% (2/5) animal subjects 1, 2, and 3 months after fibrosis induction, with mean liver stiffness of 2.94, 3.25, and 2.91 kPa, respectively. Histological liver fibrosis was noted in 71% (5/7), 100% (5/5), and 100% (5/5) of animal subjects with available tissue samples. There was no significant statistical correlation between the MRE-measured liver stiffness and the METAVIR fibrosis scores. In conclusion, quantifiable liver fibrosis may be induced in the Oncopig. MRE has potential utility in non-invasively detecting liver stiffness in this large-animal preclinical model, though tissue biopsy was more sensitive in demonstrating disease.
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Affiliation(s)
- Ron C Gaba
- Department of Radiology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Lobna Elkhadragy
- Department of Radiology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Thomas Pennix
- Department of Radiology, University of Texas, Houston, TX 77058, USA
| | - Kyle M Schachtschneider
- Department of Radiology, University of Illinois at Chicago, Chicago, IL 60612, USA
- Sus Clinicals Inc., Cincinnati, OH 45242, USA
| | - Courtni R Bolt
- Sus Clinicals Inc., Cincinnati, OH 45242, USA
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Aaron Anderson
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Shreyan Majumdar
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Denise Weber
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Herbert E Whiteley
- College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Daniel P Regan
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO 80523, USA
| | - Lawrence B Schook
- Department of Radiology, University of Illinois at Chicago, Chicago, IL 60612, USA
- Sus Clinicals Inc., Cincinnati, OH 45242, USA
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Bradley P Sutton
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
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2
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Kuhn TN, Kahl VH, Wang Y, Berz AM, Shewarega A, Santana JG, Antoch G, Chapiro J, Schlachter T, Madoff DC. Hepatic Hypertrophy in Normal and Cirrhotic Livers Following Portal Vein Embolization: Comparative Assessment of 2 Different Embolic Regimens in a Large Animal Model. J Vasc Interv Radiol 2023; 34:2162-2172.e2. [PMID: 37634850 DOI: 10.1016/j.jvir.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/29/2023] [Accepted: 08/17/2023] [Indexed: 08/29/2023] Open
Abstract
PURPOSE To compare the mechanistic effects and hypertrophy outcomes using 2 different portal vein embolization (PVE) regimens in normal and cirrhotic livers in a large animal model. METHODS AND MATERIALS The Institutional Animal Care and Use Committee approved all experiments conducted in this study. Fourteen female Yorkshire pigs were separated into a cirrhotic group (CG, n = 7) and non-cirrhotic group (NCG, n = 7) and further subgrouped into those using microspheres and coils (MC, n = 3) or n-butyl cyanoacrylate (nBCA, n = 3) and their corresponding controls (each n = 1). A 3:1 ethiodized oil and ethanol mixture was administered intra-arterially in the CG to induce cirrhosis 4 weeks before PVE. Animals underwent baseline computed tomography (CT), PVE including pre-PVE and post-PVE pressure measurements, and CT imaging at 2 and 4 weeks after PVE. Immunofluorescence stainings for CD3, CD16, Ki-67, and caspase 3 were performed to assess immune cell infiltration, hepatocyte proliferation, and apoptosis. Statistical significance was tested using the Student's t test. RESULTS Four weeks after PVE, the percentage of future liver remnant (FLR%) increased by 18.8% (standard deviation [SD], 3.6%) vs 10.9% (SD, 0.95%; P < .01) in the NCG vs CG. The baseline percentage of standardized future liver remnant (sFLR%) for the controls were 41.6% for CG vs 43.6% for NCG. Based on the embolic agents used, the sFLR% two weeks after PVE was 58.4% (SD, 3.7%) and 52.2% (SD, 0.9%) (P < .01) for MC and 46.0% (SD, 2.2%) and 47.2% (SD, 0.4%) for nBCA in the NCG and CG, respectively. Meanwhile, the sFLR% 4 weeks after PVE was 60.5% (SD, 3.9%) and 54.9% (SD, 0.8%) (P < .01) and 60.4% (SD, 3.5%) and 54.2% (SD, 0.95%) (P < .01), respectively. Ki-67 signal intensity increased in the embolized lobe in both CG and NCG (P < .01). CONCLUSIONS This preclinical study demonstrated that MC could be the preferred embolic of choice compared to nBCA when a substantial and rapid FLR increase is needed for resection, in both cirrhotic and non-cirrhotic livers.
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Affiliation(s)
- Tom N Kuhn
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Vinzent H Kahl
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Yifan Wang
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Antonia M Berz
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Department of Radiology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Annabella Shewarega
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Jessica G Santana
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Todd Schlachter
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - David C Madoff
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Section of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut; Section of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
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3
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Pirasteh A, Periyasamy S, Meudt JJ, Liu Y, Lee LM, Schachtschneider KM, Schook LB, Gaba RC, Mao L, Said A, McMillan AB, Laeseke PF, Shanmuganayagam D. Staging Liver Fibrosis by Fibroblast Activation Protein Inhibitor PET in a Human-Sized Swine Model. J Nucl Med 2022; 63:1956-1961. [PMID: 35450958 PMCID: PMC9730920 DOI: 10.2967/jnumed.121.263736] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/07/2022] [Indexed: 01/11/2023] Open
Abstract
Current methods of staging liver fibrosis have notable limitations. We investigated the utility of PET in staging liver fibrosis by correlating liver uptake of 68Ga-labeled fibroblast activation protein inhibitor (FAPI) with histology in a human-sized swine model. Methods: Five pigs underwent baseline 68Ga-FAPI-46 (68Ga-FAPI) PET/MRI and liver biopsy, followed by liver parenchymal embolization, 8 wk of oral alcohol intake, endpoint 68Ga-FAPI PET/MRI, and necropsy. Regions of interest were drawn on baseline and endpoint PET images, and SUVmean was recorded. At the endpoint, liver sections corresponding to regions of interest were identified and cut out. Fibrosis was histologically evaluated using a modified METAVIR score for swine liver and quantitatively using collagen proportionate area (CPA). Box-and-whisker plots and linear regression were used to correlate SUVmean with METAVIR score and CPA, respectively. Results: Liver 68Ga-FAPI uptake strongly correlated with CPA (r = 0.89, P < 0.001). 68Ga-FAPI uptake was significantly and progressively higher across F2 and F3/F4 fibrosis stages, with a respective median SUVmean of 2.9 (interquartile range [IQR], 2.7-3.8) and 7.6 (IQR, 6.7-10.2) (P < 0.001). There was no significant difference between 68Ga-FAPI uptake of baseline liver and endpoint liver sections staged as F0/F1, with a respective median SUVmean of 1.7 (IQR, 1.3-2.0) and 1.7 (IQR, 1.5-1.8) (P = 0.338). Conclusion: The strong correlation between liver 68Ga-FAPI uptake and the histologic stage of liver fibrosis suggests that 68Ga-FAPI PET can play an impactful role in noninvasive staging of liver fibrosis, pending validation in patients.
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Affiliation(s)
- Ali Pirasteh
- Radiology and Medical Physics, University of Wisconsin–Madison, Madison, Wisconsin
| | - Sarvesh Periyasamy
- Radiology and Biomedical Engineering, University of Wisconsin–Madison, Madison, Wisconsin
| | - Jennifer Jean Meudt
- Animal and Dairy Sciences, University of Wisconsin–Madison, Madison, Wisconsin
| | - Yongjun Liu
- Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin
| | - Laura M. Lee
- Research Animal Resources and Compliance, University of Wisconsin–Madison, Madison, Wisconsin
| | - Kyle M. Schachtschneider
- Radiology and Biochemistry and Molecular Genetics, University of Illinois at Chicago, Chicago, Illinois;,National Center for Supercomputing Applications, University of Illinois at Urbana–Champaign, Champaign, Illinois
| | - Lawrence B. Schook
- Animal Sciences, University of Illinois at Chicago, Chicago, Illinois;,Radiology/Interventional Radiology, University of Illinois at Chicago, Chicago, Illinois
| | - Ron C. Gaba
- Radiology/Interventional Radiology, University of Illinois at Chicago, Chicago, Illinois
| | - Lu Mao
- Biostatistics and Medical Informatics, University of Wisconsin–Madison, Madison, Wisconsin
| | - Adnan Said
- Medicine, Gastroenterology, and Hepatology, University of Wisconsin–Madison, Madison, Wisconsin;,William S. Middleton VA Medical Center, Madison, Wisconsin
| | - Alan Blair McMillan
- Radiology and Medical Physics, University of Wisconsin–Madison, Madison, Wisconsin
| | - Paul F. Laeseke
- Radiology and Biomedical Engineering, University of Wisconsin–Madison, Madison, Wisconsin
| | - Dhanansayan Shanmuganayagam
- Animal and Dairy Sciences, University of Wisconsin–Madison, Madison, Wisconsin;,Surgery, University of Wisconsin–Madison, Madison, Wisconsin; and,Center for Biomedical Swine Research and Innovation, University of Wisconsin–Madison, Madison, Wisconsin
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4
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Maluf-Filho F, Meyer A, Martins PPM, Galvão FHF, D’Albuquerque LAC. Experimental model of portal hypertension and esophagogastric varices in minipigs: pressure and endoscopic pilot study. Acta Cir Bras 2022; 37:e370103. [PMID: 35262597 PMCID: PMC8901138 DOI: 10.1590/acb370103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/05/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Portal hypertension still represents an important health problem worldwide. In the search for knowledge regarding this syndrome, experimental studies with animal models have proven to be useful to point the direction to be taken in future randomized clinical trials. PURPOSE To validate the experimental model of portal hypertension and esophagogastric varices in a medium-sized animal. METHODS This study included five minipigs br1. Midline laparotomy with dissection of the portal vein and production of a calibrated stenosis of this vein was performed. Measurement of pressure in the portal venous and digestive endoscopic were performed before and five weeks after the production of a stenosis. RESULTS All animals were 8 months old, average weight of 17 ± 2.5 kg. The mean pressure of the portal vein immediately before the partial ligation of the portal vein was 8.9 + 1.6 mm Hg, with 26.6 + 5.4 mm Hg in the second measurement five weeks later (p < 0.05). No gastroesophageal varices or hypertensive portal gastropathy were seen at endoscopy procedures in our sample at any time in the study. CONCLUSION Portal vein ligation in minipigs has been validated in the production of portal hypertension, but not in the formation of esophageal varices.
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Affiliation(s)
| | - Alberto Meyer
- Liver and Abdominal Organs Transplantation Division, Brazil
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5
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Novel imaging-based approaches for predicting the hepatic venous pressure gradient in a porcine model of liver cirrhosis and portal hypertension. Life Sci 2020; 264:118710. [PMID: 33144188 DOI: 10.1016/j.lfs.2020.118710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/21/2020] [Accepted: 10/30/2020] [Indexed: 01/06/2023]
Abstract
AIMS Hepatic venous pressure gradient (HVPG) is critical for staging and prognosis prediction of portal hypertension (PH). However, HVPG measurement has limitations (e.g., invasiveness). This study examined the value of non-invasive, imaging-based approaches including magnetic resonance elastography (MRE) and intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for the prediction of HVPG in a porcine model of liver cirrhosis and PH. MAIN METHODS Male Bama miniature pigs were used to establish a porcine model of liver cirrhosis and PH induced by embolization. They were randomly assigned to an experimental group (n = 12) and control group (n = 3). HVPG was examined before and after transjugular intrahepatic portosystemic shunt (TIPS). MRE and IVIM-DWI were performed to obtain quantitative parameters including liver stiffness (LS) in MRE, tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) in IVIM-DWI. The correlation between HVPG and the parameters was assessed. KEY FINDINGS LS values were significantly greater in the experimental group, while f values were significantly decreased at 4, 8, and 12 weeks after embolization compared to the control group. Furthermore, HVPG was significantly lower immediately after versus before TIPS. In parallel, LS and f values showed significant alterations after TIPS, and these changes were consistent with a reduction in HVPG. Spearman analysis revealed a significant correlation between the parameters (LS and f) and HVPG. The equation was eventually generated for prediction of HVPG. SIGNIFICANCE The findings show a good correlation between HVPG and the quantitative parameters; thus, imaging-based techniques have potential as non-invasive methods for predicting HVPG.
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6
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Kjærgaard K, Weber B, Alstrup AKO, Petersen JBB, Hansen R, Hamilton-Dutoit SJ, Mortensen FV, Sørensen M. Hepatic regeneration following radiation-induced liver injury is associated with increased hepatobiliary secretion measured by PET in Göttingen minipigs. Sci Rep 2020; 10:10858. [PMID: 32616907 PMCID: PMC7331737 DOI: 10.1038/s41598-020-67609-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 05/26/2020] [Indexed: 12/11/2022] Open
Abstract
Normal liver tissue is highly vulnerable towards irradiation, which remains a challenge in radiotherapy of hepatic tumours. Here, we examined the effects of radiation-induced liver injury on two specific liver functions and hepatocellular regeneration in a minipig model. Five Göttingen minipigs were exposed to whole-liver stereotactic body radiation therapy (SBRT) in one fraction (14 Gy) and examined 4–5 weeks after; five pigs were used as controls. All pigs underwent in vivo positron emission tomography (PET) studies of the liver using the conjugated bile acid tracer [N-methyl-11C]cholylsarcosine ([11C]CSar) and the galactose-analogue tracer [18F]fluoro-2-deoxy-d-galactose ([18F]FDGal). Liver tissue samples were evaluated histopathologically and by immunohistochemical assessment of hepatocellular mitosis, proliferation and apoptosis. Compared with controls, both the rate constant for secretion of [11C]CSar from hepatocytes into intrahepatic bile ducts as well as back into blood were doubled in irradiated pigs, which resulted in reduced residence time of [11C]CSar inside the hepatocytes. Also, the hepatic systemic clearance of [18F]FDGal in irradiated pigs was slightly increased, and hepatocellular regeneration was increased by a threefold. In conclusion, parenchymal injury and increased regeneration after whole-liver irradiation was associated with enhanced hepatobiliary secretion of bile acids. Whole-liver SBRT in minipigs ultimately represents a potential large animal model of radiation-induced liver injury and for testing of normal tissue protection methods.
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Affiliation(s)
- Kristoffer Kjærgaard
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, 8200, Aarhus N, Denmark. .,Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8200, Aarhus N, Denmark.
| | - Britta Weber
- Department of Oncology, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | | | | | - Rune Hansen
- Department of Oncology, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | | | | | - Michael Sørensen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, 8200, Aarhus N, Denmark.,Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8200, Aarhus N, Denmark
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7
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Mik P, Tonar Z, Malečková A, Eberlová L, Liška V, Pálek R, Rosendorf J, Jiřík M, Mírka H, Králíčková M, Witter K. Distribution of Connective Tissue in the Male and Female Porcine Liver: Histological Mapping and Recommendations for Sampling. J Comp Pathol 2018; 162:1-13. [PMID: 30060837 DOI: 10.1016/j.jcpa.2018.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/17/2018] [Accepted: 05/25/2018] [Indexed: 02/07/2023]
Abstract
The pig is a large animal model that is often used in experimental medicine. The aim of this study was to assess, in normal pig livers, sexual dimorphism in the normal fraction of hepatic interlobular and intralobular connective tissue (CT) in six hepatic lobes and in three macroscopical regions of interest (ROIs) with different positions relative to the liver vasculature. Using stereological point grids, the fractions of CT were quantified in histological sections stained with aniline blue and nuclear fast red. Samples (415 tissue blocks) were collected from healthy piglets, representing paracaval, paraportal and peripheral ROIs. There was considerable variability in the CT fraction at all sampling levels. In males the mean fraction of interlobular CT was 4.7 ± 2.4% (mean ± SD) and ranged from 0% to 11.4%. In females the mean fraction of the interlobular CT was 3.6 ± 2.2% and ranged from 0% to 12.3%. The mean fraction of intralobular (perisinusoidal summed with pericentral) CT was <0.2% in both sexes. The interlobular CT represented >99.8% of the total hepatic CT and the fractions were highly correlated (Spearman r = 0.998, P <0.05). The smallest CT fraction was observed in the left medial lobe and in the paracaval ROI and the largest CT fraction was detected in the quadrate lobe and in the peripheral ROI. For planning experiments involving the histological quantification of liver fibrosis and requiring comparison between the liver lobes, these data facilitate the power analysis for sample size needed to detect the expected relative increase or decrease in the fraction of CT.
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Affiliation(s)
- P Mik
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, Pilsen, Czech Republic
| | - Z Tonar
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, Pilsen, Czech Republic.
| | - A Malečková
- European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Univerzitní 22, Pilsen, Czech Republic
| | - L Eberlová
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, Pilsen, Czech Republic
| | - V Liška
- Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, Pilsen, Czech Republic
| | - R Pálek
- Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, Pilsen, Czech Republic
| | - J Rosendorf
- Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, Pilsen, Czech Republic
| | - M Jiřík
- European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Univerzitní 22, Pilsen, Czech Republic
| | - H Mírka
- Department of Imaging Methods and Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, University Hospital in Pilsen, Czech Republic
| | - M Králíčková
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, Pilsen, Czech Republic
| | - K Witter
- Institute of Anatomy, Histology and Embryology, Department for Pathobiology, University of Veterinary Medicine Vienna, Veterinärplatz 1, Vienna, Austria
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8
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Gaba RC, Mendoza-Elias N, Regan DP, Garcia KD, Lokken RP, Schwind RM, Eichner M, Thomas FM, Rund LA, Schook LB, Schachtschneider KM. Characterization of an Inducible Alcoholic Liver Fibrosis Model for Hepatocellular Carcinoma Investigation in a Transgenic Porcine Tumorigenic Platform. J Vasc Interv Radiol 2018; 29:1194-1202.e1. [PMID: 29887183 DOI: 10.1016/j.jvir.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/03/2018] [Accepted: 03/07/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study used the Oncopig Cancer Model (OCM) to develop alcohol-induced fibrosis in a porcine model capable of developing hepatocellular carcinoma. MATERIALS AND METHODS Liver injury was induced in 8-week-old Oncopigs (n = 10) via hepatic transarterial infusion of 0.75 mL/kg ethanol-ethiodized oil (1:3 v/v). Feasibility was assessed in an initial Oncopig cohort (n = 5) by histologic analysis at 8 weeks after induction, and METAVIR results were compared to age- and sex-matched healthy controls (n = 5). Liver injury was then induced in a second OCM cohort (n = 5) for a time-course study, with post-induction disease surveillance via biweekly physical exam, lab analysis, and liver biopsies until 20 weeks after induction. RESULTS In Cohort 1, 8-week post-induction liver histologic analysis revealed median METAVIR F3 (range, F3-F4) fibrosis, A2 (range, A2-A3) inflammation, and 15.3% (range, 5.0%-22.9%) fibrosis. METAVIR and inflammation scores were generally elevated compared to healthy controls (F0-F1, P = 0.0013; A0-A1, P = .0013; median percent fibrosis 8.7%, range, 5.8%-12.1%, P = .064). In Cohort 2, histologic analysis revealed peak fibrosis severity of median METAVIR F3 (range, F2-F3). However, lack of persistent alcohol exposure resulted in liver recovery, with median METAVIR F2 (range, F1-F2) fibrosis at 20 weeks after induction. No behavioral or biochemical abnormalities were observed to indicate liver decompensation. CONCLUSIONS This study successfully validated a protocol to develop METAVIR F3-F4 fibrosis within 8 weeks in the OCM, supporting its potential to serve as a model for hepatocellular carcinoma in a fibrotic liver background. Further investigation is required to determine if repeated alcohol liver injury is required to develop an irreversible METAVIR grade F4 porcine cirrhosis model.
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Affiliation(s)
- Ron C Gaba
- Department of Radiology, University of Illinois Health, 1740 West Taylor Street, MC 931, Chicago, Illinois, 60612
| | | | - Daniel P Regan
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Kelly D Garcia
- Biological Resources Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - R Peter Lokken
- Department of Radiology, University of Illinois Health, 1740 West Taylor Street, MC 931, Chicago, Illinois, 60612
| | - Regina M Schwind
- Department of Radiology, University of Illinois Health, 1740 West Taylor Street, MC 931, Chicago, Illinois, 60612
| | - Michael Eichner
- Biological Resources Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - Faith M Thomas
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana and Champaign, Illinois
| | - Lauretta A Rund
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana and Champaign, Illinois
| | - Lawrence B Schook
- Department of Radiology, University of Illinois Health, 1740 West Taylor Street, MC 931, Chicago, Illinois, 60612; Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana and Champaign, Illinois
| | - Kyle M Schachtschneider
- Department of Radiology, University of Illinois Health, 1740 West Taylor Street, MC 931, Chicago, Illinois, 60612.
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Obeid M, Khabbaz RC, Garcia KD, Schachtschneider KM, Gaba RC. Translational Animal Models for Liver Cancer. ACTA ACUST UNITED AC 2018. [DOI: 10.25259/ajir-11-2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Animal models have become increasingly important in the study of hepatocellular carcinoma (HCC), as they serve as a critical bridge between laboratory-based discoveries and human clinical trials. Developing an ideal animal model for translational use is challenging, as the perfect model must be able to reproduce human disease genetically, anatomically, physiologically, and pathologically. This brief review provides an overview of the animal models currently available for translational liver cancer research, including rodent, rabbit, non-human primate, and pig models, with a focus on their respective benefits and shortcomings. While small animal models offer a solid starting point for investigation, large animal HCC models are becoming increasingly important for translation of preclinical results to clinical practice.
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Affiliation(s)
- Michele Obeid
- Department of Radiology, University of Illinois, 1740 West Taylor Street MC 931, Chicago, IL, 60612, United States
| | - Ramzy C. Khabbaz
- Department of Radiology, University of Illinois, 1740 West Taylor Street MC 931, Chicago, IL, 60612, United States
| | - Kelly D. Garcia
- College of Medicine, University of Illinois, 1740 West Taylor Street MC 931, Chicago, IL, 60612, United States
| | - Kyle M. Schachtschneider
- Department of Biological Resources Laboratory, University of Illinois, 1740 West Taylor Street MC 931, Chicago, IL, 60612, United States
| | - Ron C. Gaba
- Department of Radiology, University of Illinois, 1740 West Taylor Street MC 931, Chicago, IL, 60612, United States
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10
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Bosch J, Iwakiri Y. The portal hypertension syndrome: etiology, classification, relevance, and animal models. Hepatol Int 2017; 12:1-10. [PMID: 29064029 DOI: 10.1007/s12072-017-9827-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 09/26/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Portal hypertension is a key complication of portal hypertension, which is responsible for the development of varices, ascites, bleeding, and hepatic encephalopathy, which, in turn, cause a high mortality and requirement for liver transplantation. AIM This review deals with the present day state-of-the-art preventative treatments of portal hypertension in cirrhosis according to disease stage. Two main disease stages are considered, compensated and decompensated cirrhosis, the first having good prognosis and being mostly asymptomatic, and the second being heralded by the appearance of bleeding or non-bleeding complications of portal hypertension. RESULTS The aim of treatment in compensated cirrhosis is preventing clinical decompensation, the more frequent event being ascites, followed by variceal bleeding and hepatic encephalopathy. Complications are mainly driven by an increase of hepatic vein pressure gradient (HVPG) to values ≥10 mmHg (defining the presence of Clinically Significant Portal Hypertension, CSPH). Before CSPH, the treatment is limited to etiologic treatment of cirrhosis and healthy life style (abstain from alcohol, avoid/correct obesity…). When CSPH is present, association of a non-selective beta-blocker (NSBB), including carvedilol should be considered. NSBBs are mandatory if moderate/large varices are present. Patients should also enter a screening program for hepatocellular carcinoma. In decompensated patients, the goal is to prevent further bleeding if the only manifestation of decompensation was a bleeding episode, but to prevent liver transplantation and death in the common scenario where patients have manifested first non-bleeding complications. Treatment is based on the same principles (healthy life style..) associated with administration of NSBBs in combination if possible with endoscopic band ligation if there has been variceal bleeding, and complemented with simvastatin administration (20-40 mg per day in Child-Pugh A/B, 10-20 mg in Child C). Recurrence shall be treated with TIPS. TIPS might be indicated earlier in patients with: 1) Difficult/refractory ascites, who are not the best candidates for NSBBs, 2) patients having bleed under NSBBs or showing no HVPG response (decrease in HVPG of at least 20% of baseline or to values equal or below 12 mmHg). Decompensated patients shall all be considered as potential candidates for liver transplantation. CONCLUSION Treatment of portal hypertension has markedly improved in recent years. The present day therapy is based on accurate risk stratification according to disease stage.
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Affiliation(s)
- Jaime Bosch
- Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic-IDIBAPS, University of Barcelona, C.Villarroel 170, 08036, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Barcelona, Spain. .,Swiss Liver Center, Hepatology, UVCM, Inselspital, University of Bern, Bern, Switzerland.
| | - Yasuko Iwakiri
- Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, 06520, USA
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11
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Schachtschneider KM, Schwind RM, Darfour-Oduro KA, De AK, Rund LA, Singh K, Principe DR, Guzman G, Ray CE, Ozer H, Gaba RC, Schook LB. A validated, transitional and translational porcine model of hepatocellular carcinoma. Oncotarget 2017; 8:63620-63634. [PMID: 28969016 PMCID: PMC5609948 DOI: 10.18632/oncotarget.18872] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 06/05/2017] [Indexed: 12/29/2022] Open
Abstract
Difficult questions are confronting clinicians attempting to improve hepatocellular carcinoma (HCC) outcomes. A large animal model with genetic, anatomical, and physiological similarities to humans is required to transition from mouse models to human clinical trials to address unmet clinical needs. To validate our previously reported inducible porcine cancer model (Oncopig) as a transitional HCC model, Oncopig hepatocyte cultures were transformed using Cre recombinase. The resulting porcine HCC cells (pHCC) expressed oncogenic TP53R167H and KRASG12D, and displayed nuclear pleomorphisms with pale to granular cytoplasm arranged in expanded plates similar to human HCC histopathology. Human HCC transcriptional hallmarks were detected in pHCC cells using RNA-seq, including TERT reactivation, apoptosis evasion, angiogenesis activation, and Wnt signaling activation. Master regulators of gene expression were conserved across Oncopig and 18 human HCC cell lines. pHCC injection into SCID mice resulted in tumors recapitulating human HCC characteristics, including thick trabeculae formation, pseudoacini patterning, and sheets of well-vascularized stroma. Finally, autologous injection of pHCC cells subcutaneously yielded a tumor histologically characterized as Edmondson Steiner (HCC nuclear grade assessment system) grade 2 HCC with trabecular patterning and T-lymphocyte infiltration. These data demonstrate the Oncopig HCC model's utility for improving detection, treatment, and biomarker discovery relevant to human HCC.
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Affiliation(s)
- Kyle M. Schachtschneider
- Department of Animal Sciences, University of Illinois, Urbana, IL, USA
- Animal Breeding and Genomics Centre, Wageningen University, Wageningen, The Netherlands
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Regina M. Schwind
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Arun K. De
- Department of Animal Sciences, University of Illinois, Urbana, IL, USA
| | - Lauretta A. Rund
- Department of Animal Sciences, University of Illinois, Urbana, IL, USA
| | - Kuldeep Singh
- Veterinary Diagnostic Laboratory, University of Illinois, Urbana, IL, USA
| | - Daniel R. Principe
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Grace Guzman
- Department of Pathology, University of Illinois at Chicago, Chicago, IL, USA
| | - Charles E. Ray
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Medicine, Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Howard Ozer
- Department of Medicine, Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Ron C. Gaba
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Lawrence B. Schook
- Department of Animal Sciences, University of Illinois, Urbana, IL, USA
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
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12
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Lee KS, Santagostino SF, Li D, Ramjit A, Serrano K, Ginsberg MD, Ding BS, Rafii S, Madoff DC. Catheter-directed Intraportal Delivery of Endothelial Cell Therapy for Liver Regeneration: A Feasibility Study in a Large-Animal Model of Cirrhosis. Radiology 2017; 285:114-123. [PMID: 28498793 DOI: 10.1148/radiol.2017162617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose To demonstrate the feasibility of imaging-guided catheter-directed delivery of endothelial cell therapy in a porcine model of cirrhosis for liver regeneration. Materials and Methods After approval from the institutional animal care and use committee, autologous liver endothelial cells were grown from core hepatic specimens from swine. Cirrhosis was induced in swine by means of transcatheter infusion of ethanol and iodized oil into the hepatic artery. Three weeks after induction of cirrhosis, the swine were randomly assigned to receive autologous cell therapy (endothelial cells, n = 4) or control treatment (phosphate-buffered saline, n = 4) by means of imaging-guided transhepatic intraportal catheterization. Fluorescence-activated cell sorting analysis was performed on biopsy samples 1 hour after therapy. Three weeks after intraportal delivery of endothelial cells, the swine were euthanized and the explanted liver underwent quantitative pathologic examination. Statistical analysis was performed with an unpaired t test by using unequal variance. Results Liver endothelial cells were successfully isolated, cultured, and expanded from eight 20-mm, 18-gauge hepatic core samples to 50 × 106 autologous cells per pig. Intraportal delivery of endothelial cell therapy or saline was technically successful in all eight swine, with no complications. Endothelial cells were present in the liver for a minimum of 1 hour after intraportal infusion. Swine treated with endothelial cell therapy showed mean levels of surrogate markers of hepatobiliary injury that were consistent with decreases in hepatic fibrosis and biliary ductal damage relative to the control animals, although statistical significance was not met in this pilot study: The mean percentage of positive pixels at Masson trichrome staining was 7.28% vs 5.57%, respectively (P = .20), the mean proliferation index with cytokeratin wide-spectrum was 2.55 vs 1.13 (P = .06), and the mean proliferation index with Ki67 was 7.08 vs 4.96 (P = .14). Conclusion The results confirm the feasibility of imaging-guided catheter-directed endothelial cell therapy with an intraportal technique for the treatment of cirrhosis in a porcine model. A trend toward decreased liver fibrosis with endothelial cell therapy was observed. Larger animal studies and human studies are necessary to confirm significance. © RSNA, 2017.
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Affiliation(s)
- Kyungmouk Steve Lee
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - Sara F Santagostino
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - David Li
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - Amit Ramjit
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - Kenneth Serrano
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - Michael D Ginsberg
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - Bi-Sen Ding
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - Shahin Rafii
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
| | - David C Madoff
- From the Department of Radiology (K.S.L., D.L., A.R., K.S., D.C.M.), Laboratory of Comparative Pathology (S.F.S.), and Department of Genetic Medicine (B.S.D., S.R.), Weill Cornell Medicine, 525 E 68th St, Payson Pavilion 5, New York, NY 10065; and Angiocrine Bioscience, San Diego, Calif (M.D.G.)
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Poincloux L, Chabrot P, Mulliez A, Genes J, Boyer L, Abergel A. Interventional endoscopic ultrasound: A new promising way for intrahepatic portosystemic shunt with portal pressure gradient. Endosc Ultrasound 2017; 6:394-401. [PMID: 29251274 PMCID: PMC5752762 DOI: 10.4103/eus.eus_42_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background and Objectives: Interventional endoscopic ultrasound (EUS) is a promising novel approach for intravascular interventions. The aim of this study was to assess the feasibility and safety of a EUS-guided intrahepatic portosystemic shunt (EGIPS) with portal pressure gradient measurement in a live porcine model. Methods: The left hepatic vein (LHV) or the inferior vena cava (IVC) was punctured with a needle that advanced into the portal vein (PV). A guidewire was then inserted into the PV, and a needle knife was used to create an intrahepatic fistula between LHV and PV. Portal pressure was recorded. The fistula was dilated with a balloon and a biliary metal stent was deployed between LHV and PV under sonographic and fluoroscopic observation. A portocavography validated the patency of the stent. Necropsies were realized after euthanasia. Results: Portosystemic stenting was achieved in 19/21 pigs. Final portocavography confirmed stent patency between PV and LHV or IVC in 17 pigs (efficacy of 81%): Four stents were dysfunctional as two were thrombosed and two were poor positioned. Portal pressure was documented before and after shunting in 20/21 pigs. Necropsies revealed that 19/21 procedures were transesophageal and two were transgastric. Hemoperitoneum and pneumothorax were found in one pig and hemothorax was found in two pigs. Morbidity was 14.2% (3/21 animals). Conclusion: EGIPS was feasible in 91% of cases, functional in 81%, with 14.2% per procedure morbidity. EGIPS still needs to be assessed in portal hypertension pig models with longer follow-up before being considered as an alternative when the transjugular intrahepatic portosystemic shunt fails.
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Affiliation(s)
- Laurent Poincloux
- Department of Digestive and Hepatobiliary Diseases, CHU Estaing; Auvergne University Department/CNRS 6284 Image Sciences for Innovations Techniques, France
| | - Pascal Chabrot
- Auvergne University Department/CNRS 6284 Image Sciences for Innovations Techniques; Department of Radiology, CHU Gabriel Montpied, France
| | - Aurélien Mulliez
- Department of Biostatistics, DRCI, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Julien Genes
- Department of Digestive and Hepatobiliary Diseases, CHU Estaing, France
| | - Louis Boyer
- Auvergne University Department/CNRS 6284 Image Sciences for Innovations Techniques; Department of Radiology, CHU Gabriel Montpied, France
| | - Armando Abergel
- Department of Digestive and Hepatobiliary Diseases, CHU Estaing; Auvergne University Department/CNRS 6284 Image Sciences for Innovations Techniques, France
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14
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Huang SY, Abdelsalam ME, Harmoush S, Ensor JE, Chetta JA, Hwang KP, Stafford RJ, Madoff DC, Avritscher R. Evaluation of liver fibrosis and hepatic venous pressure gradient with MR elastography in a novel swine model of cirrhosis. J Magn Reson Imaging 2014; 39:590-7. [PMID: 24532376 DOI: 10.1002/jmri.24189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 04/03/2013] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess the correlation among MR elastography (MRE) measured liver stiffness (LS), liver fibrosis, and hepatic venous pressure gradient (HVPG) in a swine model of cirrhosis. MATERIALS AND METHODS Three swine served as controls, and liver fibrosis was induced in eight swine by transarterial embolization. LS and HVPG were obtained at baseline and 4 weeks (prenecropsy) following induction of liver fibrosis. RESULTS Four weeks following the induction of liver cirrhosis, experimental animals developed an increase in HVPG of 8.0±6.4 mmHg compared with 0.3±1.2 mmHg for controls (P=0.08). Over the same timeframe, mean MRE-measured LS increased 0.82±0.39 kPa for experimental swine and 0.1±0.05 kPa for controls (P=0.01). A positive correlation was observed between increases in HVPG and LS (ρ=0.682; P=0.02). Liver fibrosis was measured on explanted livers at 4 weeks and yielded mean fibrosis scores of 2.8 for experimental animals and 0 for controls (P=0.0016). A positive correlation was observed between higher LS and liver fibrosis (ρ=0.884; P=0.0003). CONCLUSION MRE is a reliable noninvasive technique to measure LS in a swine model of cirrhosis. Significant positive correlations were observed between LS and HVPG as well as LS and fibrosis.
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Affiliation(s)
- Steven Y Huang
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Avritscher R, Abdelsalam ME, Javadi S, Ensor J, Wallace MJ, Alt E, Madoff DC, Vykoukal JV. Percutaneous intraportal application of adipose tissue-derived mesenchymal stem cells using a balloon occlusion catheter in a porcine model of liver fibrosis. J Vasc Interv Radiol 2013; 24:1871-8. [PMID: 24144538 DOI: 10.1016/j.jvir.2013.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 08/22/2013] [Accepted: 08/26/2013] [Indexed: 02/09/2023] Open
Abstract
PURPOSE To investigate the safety and effectiveness of a novel endovascular approach for therapeutic cell delivery using a balloon occlusion catheter in a large animal model of liver fibrosis. MATERIALS AND METHODS Transcatheter arterial embolization with ethiodized oil (Ethiodol) and ethanol was used to induce liver damage in 11 pigs. Mesenchymal stem cells (MSCs) were harvested from adipose tissue and engineered to express green fluorescent protein (GFP). A balloon occlusion catheter was positioned in the bilateral first-order portal vein branches 2 weeks after embolization to allow intraportal application of MSCs in six experimental animals. MSCs were allowed to dwell for 10 minutes using prolonged balloon inflation. Five control animals received a sham injection of normal saline in a similar fashion. Hepatic venous pressure gradient (HVPG) was measured immediately before necropsy. Specimens from all accessible lobes were obtained with ultrasound-guided percutaneous 18-gauge biopsy 2 hours after cell application. All animals were euthanized within 4 weeks. Fluorescent microscopy was used to assess the presence and distribution of cells. RESULTS Liver injury and fibrosis were successfully induced in all animals. MSCs (6-10 × 10(7)) were successfully delivered into the portal vein in the six experimental animals. Cell application was not associated with vascular complications. HVPG showed no instances of portal hypertension. GFP-expressing MSCs were visualized in biopsy specimens and were distributed primarily within the sinusoidal spaces; however, 4 weeks after implantation, MSCs could not be identified in histologic specimens. CONCLUSIONS A percutaneous endovascular approach for cell delivery using a balloon occlusion catheter proved safe for intraportal MSC application in a large animal model of liver fibrosis.
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Affiliation(s)
- Rony Avritscher
- Department of Diagnostic Radiology, Interventional Radiology Section, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471 Houston, TX 77030.
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Catheter-based stem cell delivery for liver repair: getting it there is half the battle. J Vasc Interv Radiol 2013; 24:1879. [PMID: 24267523 DOI: 10.1016/j.jvir.2013.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 09/24/2013] [Accepted: 09/25/2013] [Indexed: 11/22/2022] Open
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Abstract
Liver fibrogenesis refers to a dynamic process involving complex cellular and molecular mechanisms, resulting in the chronic activation of tissue repair mechanisms and reiterated liver tissue injury. Regardless of the etiology, hepatic fibrosis is a characteristic feature of chronic liver disease. Advanced liver fibrosis results in cirrhosis, portal hypertension, and eventually hepatic cancer and liver failure. Liver fibrosis represents a significant health problem worldwide, and no acceptable therapy exists. Blocking of liver fibrosis formation has become a key problem in the therapy of chronic liver disease. Animal models of liver fibrosis and cirrhosis have been applied to study the occurrence of liver fibrosis and evaluate the potential and possibility of anti-fibrosis treatments for several decades. This article reviews recent advances in the development of large animal models (e.g., rabbits, dogs, monkeys, and pigs) of liver fibrosis and cirrhosis.
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