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Li J, Jiang Y, Yu H, Liu L, Wang Q, Ju H, Zhang X, Wang W, Yin X, Wu Q, Xiao J, Miao J, Ye X, Li T, Tian H, Xue W. Effects of UCMSCs Delivered through Different Transplantation Approaches on Acute Radiation Enteritis in Rats. Cell Transplant 2021; 30:9636897211025230. [PMID: 34318709 PMCID: PMC8323445 DOI: 10.1177/09636897211025230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Radiation enteritis is the most common and serious complication of abdominal or
pelvic radiation therapy. Mesenchymal stem cells (MSCs), as well as cell
protection agents, inhibit apoptosis and promote the proliferation of injured
tissues. 3 human umbilical cords MSCs (UCMSCs) were injected into the tail vein
or peritoneal cavity of a rat model of radiation enteritis. The temporary
protective effect was assessed by identification of donor cells, detection of
cellular immune parameters and inflammatory cytokine levels, quantitation of
jejunum mucosal preservation and examination of the rat remaining life. Only the
rats in the intraperitoneal injection group exhibited a few positive donor cells
7 days after transplantation. CD4+/CD8+ T cells, a cellular immune parameter, decreased in the abdominal
exudate of intraperitoneal injection group, compared with the model-only control
and tail vein groups (both P < .05). Both serum and
abdominal exudate TNF-α and IL-6 levels in the intraperitoneally injected rats
rapidly decreased and were significantly different from those in the model-only
control and tail vein injection groups (all P < .05).
Mucosal surface area and survival time increased in the intraperitoneal
injection group compared with the vehicle and tail vein injection groups (all
P = .000). Therefore, the administration of UCMSCs with
intraperitoneal injection approach postponed death in a rat model of radiation
enteritis, which was associated with reduced serum levels of proinflammatory
cytokines (TNF-α, IL-6). However, UCMSCs injected via the tail vein triggered an
intense cellular immune response in the serum that adversely affects their
survival. This treatment failed to suppress circulating serum and abdominal
exudate levels of TNF-α and IL-6 and could not provide a therapeutic benefit for
prolonging life against acute radiation enteritis.
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Affiliation(s)
- Jun Li
- Medical School of Ningde Normal University, Ningde, China.,Medical School of Kunming University, Kunming, China
| | | | - Hua Yu
- Medical School of Kunming University, Kunming, China
| | - Lejiang Liu
- Medical School of Kunming University, Kunming, China
| | - Qiang Wang
- Cell Biological Therapy Center, and Transfer Medicine Key Laboratory of Cell Therapy Technology of Yunan Province, and National and Local Joint Engineering Laboratory of Stem Cell and Immunocyte Biomedical Technology, 920th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Kunming, China
| | - Hongpin Ju
- Medical School of Kunming University, Kunming, China
| | - Xuemei Zhang
- Medical School of Kunming University, Kunming, China
| | - Wenqi Wang
- Medical School of Kunming University, Kunming, China
| | - Xudong Yin
- School of Agriculture and Life Science, Kunming University, Kunming, China
| | - Qiong Wu
- School of Chemistry and Chemical Engineering, Kunming University, Kunming, China
| | - Jianzhong Xiao
- Medical School of Ningde Normal University, Ningde, China
| | - Jianrong Miao
- Medical School of Ningde Normal University, Ningde, China
| | - Xiao Ye
- Medical School of Ningde Normal University, Ningde, China
| | - Tianyu Li
- Class 1, Grade 2019, postgraduate student majoring in physics, School of Physical Science and Technology, Kunming University, Kunming, China
| | - Hui Tian
- Class 1, Grade 2018, Undergraduate majoring in chemistry teacher education, School of Chemistry and Chemical Engineering, Kunming University, Kunming, China
| | - Wei Xue
- Medical School of Kunming University, Kunming, China
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Cai Y, Ma T, Zhong Q, Qin Q, Cao W, Liu Z, Ke J, Wang H. Quantitative CT measurement of left colonic and pelvic mesenteric adipose volume in radiation proctitis. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:882. [PMID: 32793726 DOI: 10.21037/atm-20-5102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The edema of left colonic and pelvic mesenteric adipose tissues has long been recognized in surgery as a characteristic feature of radiation proctitis (RP). However, the correlation between mesenteric adipose volume and RP has not been extensively clarified. The purpose of this study was thus to assess the variation of left colonic and pelvic mesenteric adipose volume in RP. Methods From March 2013 to June 2015, the data of 52 patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy, including 23 patients with RP and 29 with non-RP (nRP), were retrieved. The mesenteric adipose volume was quantified via a computed tomography (CT) reconstruction method. Corresponding analyses were conducted to observe the correlation between the relative change of mesenteric adipose volume and the thickening degree of the rectal wall. Results The baseline data of the RP group and the nRP group were comparable. There was no significant difference in the relative change of the left colonic mesenteric adipose volume in each vertebral space from the third lumbar vertebra to the first sacral vertebra before and after radiotherapy. The relative change of pelvic mesenteric adipose volume (ΔVp%) was notably higher in the RP group compared to the nRP group. With a ΔVp% cutoff value of 3.67%, the sensitivity and specificity for the diagnosis of RP were 65.2% and 86.2%, respectively. According to the correlation analysis, ΔVp% in the RP group was significantly correlated with the thickening degree of the rectal wall after radiotherapy (r=0.47, P=0.024). Conclusions The increment of the relative change of pelvic mesenteric adipose volume quantitatively measured by CT can be clinically useful in identifying RP.
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Affiliation(s)
- Yonghua Cai
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Tenghui Ma
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qinghua Zhong
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiyuan Qin
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wuteng Cao
- Department of Radiology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhanzhen Liu
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia Ke
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hui Wang
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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The efficacy of new oral contrast mixture for computed tomography enterography. Pol J Radiol 2020; 84:e403-e412. [PMID: 31969958 PMCID: PMC6964335 DOI: 10.5114/pjr.2019.89684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose To show the reliabilities of the new mixture (composed of water, methylcellulose, lactulose, locust bean gum, and sorbitol) and to compare the luminal distension and radiological confidence scores of this solution with water-lactulose mixture. Material and methods Computed tomography enterography (CTE) images in a three-year period were included randomly in our institutional review board-approved and retrospective study. Ninety-one patients drank a lactulose and water mixture (Group 1), and 54 patients drank the new mixture (Group 2). Patients who drank the oral contrast agent were taken to a 64-detector row multiple detector computed tomography machine. Coronal and sagittal reformatted images were also formed. The gastrointestinal tract was divided into 11 segments for scoring. Each segment was graded for distensional and radiological confidence. CTE images were evaluated by two radiologists. Results Inter- and intra-reader reliabilities were good or excellent for all gastrointestinal segments in both groups (p < 0.001). The best κ values were obtained in sigmoid colon assessments. Lower agreement values were detected in duodenum and jejunum scores. The new mixture group (Group 2) showed better results than Group 1 for ileum and colonic segments according to distension and confidence scorings. Conclusions Inter- and intra-reader reliabilities of the new mixture were good or excellent for CTE. The new mixture seems to be more efficient and reliable for ileum and colon. The new mixture can increase bowel distention, radiological confidence, and quality in CTE evaluations.
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Abstract
Radiotherapy not only plays a pivotal role in the cancer care pathways of many patients with pelvic malignancies, but can also lead to significant injury of normal tissue in the radiation field (pelvic radiation disease) that is sometimes as challenging to treat as the neoplasms themselves. Acute symptoms are usually self-limited and respond to medical therapy. Chronic symptoms often require operative intervention that is made hazardous by hostile surgical planes and unforgiving tissues. Management of these challenging patients is best guided by the utmost caution and humility.
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Affiliation(s)
- Jean H Ashburn
- Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Matthew F Kalady
- Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic Foundation, Cleveland, Ohio
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Cai Z, Cai D, Yao D, Chen Y, Wang J, Li Y. Associations between body composition and nutritional assessments and biochemical markers in patients with chronic radiation enteritis: a case-control study. Nutr J 2016; 15:57. [PMID: 27233356 PMCID: PMC4884391 DOI: 10.1186/s12937-016-0177-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/24/2016] [Indexed: 12/15/2022] Open
Abstract
Background Chronic radiation enteritis (CRE) is defined as loss of absorptive capacity after irradiation due to chronic inflammation and damage of intestinal mucosa, which may lead to varying degrees of malnutrition. The aim of this study was to evaluate the potential correlation between the nutritional status and systemic inflammation in patients with CRE. Methods Medical records of 92 patients with CRE and 184 age- and sex-matched controls in a single center from January 2010 to October 2015 were retrospectively reviewed. All enrolled subjects underwent nutritional status analysis, including three different nutritional indices: Nutritional Risk Screening-2002 (NRS-2002), Patient-generated Subjective Global Assessment (PG-SGA) and Controlling Nutritional Status (CONUT), bioelectrical impedance spectroscopy (BIS), and biochemical markers, within 24 h of admission. Results The results showed that NRS-2002, PG-SGA and CONUT were all positively correlated with neutrophil/lymphocyte ratio (NLR) (r = 0.304, 0.384 and 0.425, all p < 0.001) and C-reactive protein (CRP) (r = 0.357, 0.479 and 0.230, all p < 0.001), while negatively correlated with albumin (r = −0.612, −0.727 and −0.792, all p < 0.001) and total cholesterol (TC) (r = −0.485, −0.545 and −0.473, all p < 0.001) in patients with CRE, respectively. Body cell mass (BCM) has been deemed a key body composition parameter. It was positively correlated with albumin (r = 0.489, p < 0.001) and TC (r = 0.237, p < 0.001), while negatively correlated with NLR (r = −0.140, p = 0.02) and CRP (r = −0.215, p < 0.001). A multivariate linear regression analysis showed that values of intracellular water (β coefficient = 0.760, p < 0.001), extracellular water (β coefficient = 0.006, p = 0.011), protein (β coefficient = 0.235, p < 0.001) and CRP (β coefficient = 0.001, p = 0.009) were independent determinants of BCM. Conclusion This study revealed that BIS combined with nutritional assessments and biochemical markers were appropriate methods to assess the nutritional and inflammatory status in patients with CRE. Furthermore, the nutritional status was verified to be significantly correlated with systemic inflammation.
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Affiliation(s)
- Zhongliang Cai
- Department of Surgery, Nanjing Clinical College of the Secondary Military Medical University, Nanjing, Jiangsu, 210002, China.,Department of Surgery, Jinling hospital, 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, China
| | - Da Cai
- Department of Radiology, Hangzhou Sanatorium of Nanjing Command, PLA, Hangzhou, Zhejiang, 310007, China
| | - Danhua Yao
- Department of Surgery, Jinling hospital, 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, China
| | - Yong Chen
- Department of Surgery, Nanjing Clinical College of the Secondary Military Medical University, Nanjing, Jiangsu, 210002, China
| | - Jian Wang
- Department of Surgery, Jinling hospital, 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, China
| | - Yousheng Li
- Department of Surgery, Jinling hospital, 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, China.
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Abstract
Radiation enteritis continues to be a major health concern in recipients of radiation therapy. The incidence of radiation enteritis is expected to continue to rise during the coming years paralleling the unprecedented use of radiotherapy in pelvic cancers. Radiation enteritis can present as either an acute or chronic syndrome. The acute form presents within hours to days of radiation exposure and typically resolves within few weeks. The chronic form may present as early as 2 months or as long as 30 years after exposure. Risk factors can be divided into patient and treatment-related factors. Chronic radiation enteritis is characterized by progressive obliterative endarteritis with exaggerated submucosal fibrosis and can manifest by stricturing, formation of fistulae, local abscesses, perforation, and bleeding. In the right clinical context, diagnosis can be confirmed by cross-sectional imaging, flexible or video capsule endoscopy. Present treatment strategies are directed primarily towards symptom relief and management of emerging complications. Recently, however, there has been a shift towards rational drug design based on improved understanding of the molecular basis of disease in an effort to limit the fibrotic process and prevent organ damage.
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Affiliation(s)
- Ali H Harb
- Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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