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Jun EJ, Song HY, Park JH, Bae YS, Paulson B, Lee S, Cho YC, Tsauo J, Kim MT, Kim KY, Yang SG, Kim JK. In Vivo Fluorescence Microendoscopic Monitoring of Stent-Induced Fibroblast Cell Proliferation in an Esophageal Mouse Model. J Vasc Interv Radiol 2018; 29:1756-1763. [PMID: 30266211 DOI: 10.1016/j.jvir.2018.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/25/2018] [Accepted: 06/29/2018] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To evaluate the feasibility of self-expanding metal stent (SEMS) placement and fluorescence microendoscopic monitoring for determination of fibroblast cell proliferation after stent placement in an esophageal mouse model. MATERIALS AND METHODS Twenty fibroblast-specific protein (FSP)-1 green fluorescent protein (GFP) transgenic mice were analyzed. Ten mice (Group A) underwent SEMS placement, and fluoroscopic and fluorescence microendoscopic images were obtained biweekly until 8 weeks thereafter. Ten healthy mice (Group B) were used for control esophageal values. RESULTS SEMS placement was technically successful in all mice. The relative average number of fibroblast GFP cells and the intensities of GFP signals in Group A were significantly higher than in Group B after stent placement. The proliferative cellular response, including granulation tissue, epithelial layer, submucosal fibrosis, and connective tissue, was increased in Group A. FSP-1-positive cells were more prominent in Group A than in Group B. CONCLUSIONS SEMS placement was feasible and safe in an esophageal mouse model, and proliferative cellular response caused by fibroblast cell proliferation after stent placement was longitudinally monitored using a noninvasive fluorescence microendoscopic technique. The results have implications for the understanding of proliferative cellular response after stent placement in real-life patients and provide initial insights into new clinical therapeutic strategies for restenosis.
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Affiliation(s)
- Eun Jung Jun
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Ho-Young Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Jung-Hoon Park
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea; Department of Biomedical Engineering Research Center, and Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Yoon Sung Bae
- Department of Biomedical Engineering Research Center, and Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Bjorn Paulson
- Department of Biomedical Engineering Research Center, and Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea; Department of Physics, College of Science, Yonsei University, Seoul, Republic of Korea
| | - Sanghwa Lee
- Department of Biomedical Engineering Research Center, and Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Young Chul Cho
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Jiaywei Tsauo
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Min Tae Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Kun Yung Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Su-Geun Yang
- Department of New Drug Development and NCEED, School of Medicine, Inha University, Incheon, Republic of Korea
| | - Jun Ki Kim
- Department of Biomedical Engineering Research Center, and Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
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Kim EY, Shin JH, Jung YY, Shin DH, Song HY. A rat esophageal model to investigate stent-induced tissue hyperplasia. J Vasc Interv Radiol 2010; 21:1287-91. [PMID: 20656225 DOI: 10.1016/j.jvir.2010.04.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2009] [Revised: 02/24/2010] [Accepted: 04/03/2010] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To evaluate the feasibility of stent placement and the formation of tissue hyperplasia caused by stent placement in a rat esophageal model. MATERIALS AND METHODS Twenty Sprague-Dawley rats were divided into four groups to assess differing stent diameters and design (group I, 4 mm diameter and a large mesh gap; group II, 5 mm diameter and a large mesh gap; group III, 5 mm diameter and a small mesh gap; and group IV, barbs added to the group III stents). Follow-up, 1-week, and 3-week esophagograms were obtained. Rats were euthanized 3 weeks after stent placement. Microscopic findings were evaluated in groups with an incidence of less than 50% stent migration. RESULTS Stent placement was technically successful in all rats, and there were no procedure-related complications. No esophageal perforation occurred during follow-up. The incidence of stent migration was 100%, 60%, 40%, and 0% in groups I through IV, respectively. The esophagi with stent migration showed only a small amount of tissue hyperplasia; however, esophagi without stent migration showed gross tissue hyperplasia through the mesh. The microscopic findings were evaluated in groups III and IV. The degree of inflammatory cell infiltration, papillary projection thickness, granulation tissue area, and percentage of the granulation tissue area were higher in group IV than in group III; however, there was no statistical significance. CONCLUSIONS Esophageal stent placement was feasible in a rat model, and formation of tissue hyperplasia was evident in rats without stent migration. With barbed stents, there was the least incidence of stent migration without esophageal perforation.
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Affiliation(s)
- Eun-Young Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Korea
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