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Khosrawipour C, Nicpoń J, Kiełbowicz Z, Prządka P, Liszka B, Al-Jundi S, Khosrawipour V, Li S, Lau H, Kulas J, Diakun A, Kielan W, Chabowski M, Mikolajczyk-Martinez A. Intraoperative parameters and postoperative follow-up of foam-based intraperitoneal chemotherapy (FBIC). Front Pharmacol 2023; 14:1276759. [PMID: 38035016 PMCID: PMC10682065 DOI: 10.3389/fphar.2023.1276759] [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: 08/12/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Background: For decades, intraperitoneal chemotherapy (IPC) has been delivered into the abdominal cavity as a liquid solution. Recently the concept of foam as a carrier-solution for IPC was suggested. This in-vivo swine study aims to evaluate the safety, intraoperative parameters, limitations and postoperative complications of foam-based intraperitoneal chemotherapy (FBIC). Methods: Three 65-day-old swine received FBIC with doxorubicin in a laparoscopy setting. Intraoperative parameters were monitored throughout the procedure and an extensive postoperative laboratory monitoring was conducted for 7 days. At day seven an autopsy was performed for further evaluation. Results: The insufflation of FBIC caused a temporary rise in blood pressure and a simultaneous drop in heart rate. Capnography detected a continuous increase in end-tital CO2 levels. A temporary drop of intraabdominal temperature was noted. Postoperative blood and serum laboratory results did not indicate any organ failure. No indication of intraperitoneal infections was noted and no structural tissue changes were visible in the autopsy. Discussion: The application of FBIC appears to be a feasible approach regarding intraoperative anesthesiology and postoperative surgical management. A lack of postoperative structural changes on the seventh day were a promising sign of safety and biocompatibility. Surgical reintervention would have been possible. To discuss a possible clinical application, further studies are required to investigate long-term safety, pharmacodynamics and the antitumoral potential of FBIC.
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Affiliation(s)
| | - Jakub Nicpoń
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Przemysław Prządka
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Bartłomiej Liszka
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Said Al-Jundi
- Department of Surgery, Petrus-Hospital Wuppertal, Teaching Hospital of the Medical University Düsseldorf, Wuppertal, Germany
| | - Veria Khosrawipour
- Department of Surgery, Petrus-Hospital Wuppertal, Teaching Hospital of the Medical University Düsseldorf, Wuppertal, Germany
| | - Shiri Li
- Division of Colon and Rectal Surgery, Department of Surgery, New York Presbyterian Hospital, Weill-Cornell College of Medicine, New York, NY, United States
| | - Hien Lau
- Department of Surgery, University of California-Irvine (UCI), Irvine, CA, United States
| | - Joanna Kulas
- Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Agata Diakun
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Wojciech Kielan
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Mariusz Chabowski
- Department of Surgery, 4th Military Hospital, Wroclaw, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
| | - Agata Mikolajczyk-Martinez
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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Thelen S, Mikolajczyk-Martinez A, Diakun A, Khosrawipour T, Zielinski K, Nicpoń J, Kiełbowicz Z, Prządka P, Liszka B, Kuropka P, Li S, Lau H, Kielan W, Khosrawipour V. Evaluating the concept of gas‑based intraperitoneal hyperthermia beyond 43˚C in the treatment of peritoneal metastasis: A pilot study. Exp Ther Med 2022; 24:752. [PMID: 36561969 PMCID: PMC9748640 DOI: 10.3892/etm.2022.11687] [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] [Received: 06/06/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
While hyperthermic intraperitoneal applications have demonstrated high efficacy in treating peritoneal metastases (PM), these applications are limited to temperatures of 41-43˚C to prevent a harmful increase in core temperature. However, since gaseous substances display low specific heat capacities, gas-based hyperthermia could potentially increase surface temperatures without affecting the body's core temperature. To the best of our knowledge, the present study is the first to explore the in vivo feasibility of gas-based hyperthermia via spatial and time-based distribution. In the present study, a temperature-isolated, abdominal box model was created with fresh peritoneal tissue exposed to continuous high-volume airflow temperatures ranging between 47 and 69˚C. Heat conduction within the peritoneal tissues was measured using temperature microsensors. Temperature build-up at different time points during the procedure was calculated and the safest option to perform gas-based intraperitoneal hyperthermia beyond 43˚C was identified using an in vivo swine model. In subsequent experiments, viability and cytotoxicity of HT-29 colon cancer cells were measured following short-term hyperthermia. The present study demonstrated that the application of gas-based intraperitoneal hyperthermia with temperatures up to 50˚C is possible without increasing the core temperature to harmful levels. Gas-based intraperitoneal hyperthermia can induce a histological reaction on the peritoneal surface, and it can also result in decreased viability and increased cytotoxicity of HT-29 cells. The concept of extreme hyperthermia may be of great clinical importance as it could significantly increase local cytotoxicity in PM without increasing the body's core temperature. Further studies are required to investigate the benefits, as well as the restrictions, of this novel concept.
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Affiliation(s)
- Simon Thelen
- Department of Orthopedics and Trauma Surgery, Medical Faculty, Heinrich-Heine University Dusseldorf, D-40225 Duesseldorf, Germany
| | - Agata Mikolajczyk-Martinez
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Agata Diakun
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Tanja Khosrawipour
- Department of Surgery (A), University-Hospital Düsseldorf, Medical Faculty, Heinrich-Heine University Dusseldorf, D-40225 Düsseldorf, Germany,Correspondence to: Dr Tanja Khosrawipour, Department of Surgery (A), University-Hospital Düsseldorf, Medical Faculty, Heinrich-Heine University Düsseldorf, 5 Moorenstrasse, D-40225 Düsseldorf, Germany
| | - Kacper Zielinski
- Department of Anesthesiology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Jakub Nicpoń
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, 50-366 Wroclaw, Poland
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, 50-366 Wroclaw, Poland
| | - Przemysław Prządka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, 50-366 Wroclaw, Poland
| | - Bartłomiej Liszka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, 50-366 Wroclaw, Poland
| | - Piotr Kuropka
- Department of Biostructure and Animal Physiology, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Shiri Li
- Division of Colon and Rectal Surgery, Department of Surgery, New York Presbyterian Hospital-Weill Cornell College of Medicine, New York, NY 10065, USA
| | - Hien Lau
- Department of Surgery, University of California, Irvine, CA 92868, USA
| | - Wojciech Kielan
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Veria Khosrawipour
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, 50-367 Wroclaw, Poland,Department of Surgery, Petrus-Hospital Wuppertal, D-42283 Wuppertal, Germany
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3
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Diakun A, Khosrawipour T, Mikolajczyk-Martinez A, Nicpoń J, Thelen S, Kiełbowicz Z, Prządka P, Liszka B, Kulas J, Zielinski K, Li S, Lau H, Kielan W, Khosrawipour V. Safety, feasibility, and application of intraperitoneal gas-based hyperthermia beyond 43°C in the treatment of peritoneal metastasis: An in-vivo pilot study. Front Oncol 2022; 12:953920. [PMID: 36303827 PMCID: PMC9592704 DOI: 10.3389/fonc.2022.953920] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/26/2022] [Indexed: 10/29/2023] Open
Abstract
Background 43°Celsius (C) is currently the highest temperature used in the treatment of peritoneal metastasis (PM). Despite sufficient data on water- based hyperthermic solutions in PM treatment, there is currently no information on gas-based hyperthermia extending beyond 43°C. This study is the first to provide in-vivo data on different organ systems during and after intraperitoneal gas-based hyperthermia beyond 43°C. The aim of this study is to explore in-vivo feasibility, safety, and efficacy of this novel concept from a biological perspective. Methods For this study, three swine were subjected to laparoscopy and subsequent gas-based intraperitoneal hyperthermia at 48°, 49° and 50°C under a high-flow air stream. Intraoperative data from multiple temperature sensors were analysed. Additionally, intraoperative anaesthesiologic and gasometrical data was analysed. Postoperatively, swine were monitored for one week and laboratory work-up was performed on postoperative days 1, 3 and 7. Results During gas-based intraperitoneal hyperthermia, anesthesiologic parameters did not exhibit critical values. No intra- or postoperative complications were observed. Distinct temperature measurements on the skin, cystohepatic triangle and esophagus did not display any temperature increase. Postoperative laboratory workup did not show any changes in hemoglobin, white blood cell count, platelets, or kidney function. Discussion Based on our data, there are no safety concerns for the application of gas-based hyperthermia between 48 - 50°C. In fact, no critical systemic temperature increase was observed. With respect to possible limitations, further in-vivo studies are required to evaluate whether gas-based intraperitoneal hyperthermia may be a therapeutic option for PM patients.
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Affiliation(s)
- Agata Diakun
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Tanja Khosrawipour
- Department of Surgery (A), University-Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
- Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Agata Mikolajczyk-Martinez
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jakub Nicpoń
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Simon Thelen
- Department of Orthopedics and Trauma Surgery, Medical Faculty, Heinrich-Heine University, Duesseldorf, Germany
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Przemysław Prządka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Bartłomiej Liszka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Joanna Kulas
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Kacper Zielinski
- Department of Anaesthesiology, Wroclaw Medical University, Wroclaw, Poland
| | - Shiri Li
- Division of Colon and Rectal Surgery, Department of Surgery, New York Presbyterian Hospital- Weill Cornell College of Medicine, New York, NY, United States
| | - Hien Lau
- Department of Surgery, University of California, Irvine, Irvine, CA, United States
| | - Wojciech Kielan
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Veria Khosrawipour
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
- Department of Surgery, Petrus-Hospital Wuppertal, Wuppertal, Germany
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4
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Diakun A, Khosrawipour T, Mikolajczyk-Martinez A, Kuropka P, Nicpoń J, Kiełbowicz Z, Prządka P, Liszka B, Li S, Lau H, Kielan W, Khosrawipour V. In-vivo thermodynamic exploration of gas-based intraperitoneal hyperthermia. Front Oncol 2022; 12:925724. [PMID: 36106116 PMCID: PMC9464870 DOI: 10.3389/fonc.2022.925724] [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: 04/21/2022] [Accepted: 07/28/2022] [Indexed: 12/14/2022] Open
Abstract
Background While hyperthermic intraperitoneal (i.p) applications are highly efficient in treating peritoneal metastases (PM), they are currently limited to temperatures of 41 – 43° Celsius (C). First data on gas-based i.p. hyperthermia is promising, as this novel method allows a significant temperature rise in superficial peritoneal layers without increasing core temperatures. Until now, key mechanisms of this novel tool, e.g. thermodynamic energy transfer, have not been investigated. This study aims to explore the volume of thermodynamic energy transfer during gas-based i.p. hyperthermia at 48-50°C and its peritoneal effects. Methods For this study, three swine were subjected to gas-based i.p. hyperthermia at varying temperatures (48°, 49° and 50°C) in a diagnostic laparoscopy setting with a high-flow air stream. Temperatures of the i.p. cavity, in- and outflow airstream at the trocar were measured and the thermodynamic energy transfer was calculated. Tissue samples were collected on postoperative day 7 for histopathologic analyses. Results According to our data, temperatures within the intraabdominal cavity and at the outflow site remain relatively stable at < 40°C. An increase in thermodynamic energy transfer is observed with increasing applied temperatures. Gas-based i.p. hyperthermia induced capillary coagulation and white blood cell infiltration within peritoneal layers. Conclusions Gas-based i.p. hyperthermia is an innovative approach which enables the i.p. delivery of specific amounts of thermodynamic energy. Following this procedure, our data indicate remarkable histologic changes on the superficial peritoneal layer most likely attributable to the applied thermodynamic energy. Further studies are required to investigate how these findings can be applied in PM management.
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Affiliation(s)
- Agata Diakun
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
- *Correspondence: Tanja Khosrawipour, ; Agata Diakun,
| | - Tanja Khosrawipour
- Department of Surgery (A), University-Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
- *Correspondence: Tanja Khosrawipour, ; Agata Diakun,
| | - Agata Mikolajczyk-Martinez
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Piotr Kuropka
- Department of Biostructure and Animal Physiology, Wroclaw University, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jakub Nicpoń
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Przemysław Prządka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Bartłomiej Liszka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Shiri Li
- Division of Colon and Rectal Surgery, Department of Surgery, New York Presbyterian Hospital- Weill Cornell College of Medicine, New York, NY, United States
| | - Hien Lau
- Department of Surgery, University of California, Irvine, CA, United States
| | - Wojciech Kielan
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Veria Khosrawipour
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
- Department of Surgery, Petrus-Hospital Wuppertal, Wuppertal, Germany
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5
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Diakun A, Khosrawipour T, Mikolajczyk-Martinez A, Nicpoń J, Kiełbowicz Z, Prządka P, Liszka B, Kielan W, Zielinski K, Migdal P, Lau H, Li S, Khosrawipour V. The Onset of In-Vivo Dehydration in Gas -Based Intraperitoneal Hyperthermia and Its Cytotoxic Effects on Colon Cancer Cells. Front Oncol 2022; 12:927714. [PMID: 35847916 PMCID: PMC9278806 DOI: 10.3389/fonc.2022.927714] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Peritoneal metastasis (PM) is an ongoing challenge in surgical oncology. Current therapeutic options, including intravenous and intraperitoneal (i.p.) chemotherapies display limited clinical efficacy, resulting in an overall poor prognosis in affected patients. Combined hyperthermia and dehydration induced by a high-flow, gas-based i.p. hyperthermic procedure could be a novel approach in PM treatment. Our study is the first to evaluate the therapeutic potential of i.p. dehydration, hyperthermia, as well as the combination of both mechanisms in an in-vivo setting. Methods For this study, three swine were subjected to diagnostic laparoscopy under a high-flow air stream at 48°, 49° and 50°Celsius (C). Hygrometry of the in- and outflow airstream was measured to calculate surface evaporation and i.p. dehydration. To analyze the effects of this concept, in vitro colon cancer cells (HT-29) were treated with hyperthermia and dehydration. Cytotoxicity and cell viability were measured at different time intervals. Additionally, structural changes of dehydrated cells were analyzed using scanning electron microscopy. Results According to our results, both dehydration and hyperthermia were cytotoxic to HT-29 cells. However, while dehydration reduced cell viability, hyperthermia did not. However, dehydration effects on cell viability were significantly increased when combined with hyperthermia (p<0.01). Conclusions Changes to the physiological milieu of the peritoneal cavity could significantly reduce PM. Therefore, limited dehydration of the abdominal cavity might be a feasible, additional tool in PM treatment. Further studies are required to investigate dehydration effects and their applicability in PM management.
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Affiliation(s)
- Agata Diakun
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Tanja Khosrawipour
- Department of Surgery (A), University-Hospital Düsseldorf, Düsseldorf, Germany.,Medical faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Agata Mikolajczyk-Martinez
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jakub Nicpoń
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Przemysław Prządka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Bartłomiej Liszka
- Department of Surgery, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Wojciech Kielan
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Kacper Zielinski
- Department of Anesthesiology, Wroclaw Medical University, Wroclaw, Poland
| | - Pawel Migdal
- Department of Environment, Hygiene and Animal Welfare, University of Environmental and Life Sciences, Wroclaw, Poland
| | - Hien Lau
- Department of Surgery, University of California, Irvine, Irvine, CA, United States
| | - Shiri Li
- Division of Colon and Rectal Surgery, Department of Surgery, New York Presbyterian Hospital- Weill Cornell College of Medicine, New York, NY, United States
| | - Veria Khosrawipour
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Sciences, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.,Department of Surgery, Petrus-Hospital Wuppertal, Wuppertal, Germany
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Wedlich N, Figl J, Liebler-Tenorio EM, Köhler H, von Pückler K, Rissmann M, Petow S, Barth SA, Reinhold P, Ulrich R, Grode L, Kaufmann SHE, Menge C. Video Endoscopy-Guided Intrabronchial Spray Inoculation of Mycobacterium bovis in Goats and Comparative Assessment of Lung Lesions With Various Imaging Methods. Front Vet Sci 2022; 9:877322. [PMID: 35591868 PMCID: PMC9113525 DOI: 10.3389/fvets.2022.877322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Bovine tuberculosis (bTB) not only poses a zoonotic threat to humans but also has a significant economic impact on livestock production in many areas of the world. Effective vaccines for humans, livestock, and wildlife are highly desirable to control tuberculosis. Suitable large animal models are indispensable for meaningful assessment of vaccine candidates. Here, we describe the refinement of an animal model for bTB in goats. Intrabronchial inoculation procedure via video-guided endoscopy in anesthetized animals, collection of lungs after intratracheal fixation in situ, and imaging of lungs by computed tomography (CT) were established in three goats using barium sulfate as surrogate inoculum. For subsequent infection experiments, four goats were infected with 4.7 × 102 colony-forming units of M. bovis by intrabronchial inoculation using video-guided endoscopy with spray catheters. Defined amounts of inoculum were deposited at five sites per lung. Four age-matched goats were mock-inoculated. None of the goats developed clinical signs until they were euthanized 5 months post infection, but simultaneous skin testing confirmed bTB infection in all goats inoculated with M. bovis. In tissues collected at necropsy, M. bovis was consistently re-isolated from granulomas in lymph nodes, draining the lungs of all the goats infected with M. bovis. Further dissemination was observed in one goat only. Pulmonary lesions were quantified by CT and digital 2D radiography (DR). CT revealed mineralized lesions in all the infected goats ranging from <5 mm to >10 mm in diameter. Small lesions <5 mm predominated. The DR failed to detect small lesions and to determine the exact location of lesions because of overlapping of pulmonary lobes. Relative volume of pulmonary lesions was low in three but high in one goat that also had extensive cavitation. CT lesions could be correlated to gross pathologic findings and histologic granuloma types in representative pulmonary lobes. In conclusion, video-guided intrabronchial inoculation with spray catheters, mimicking the natural way of infection, resulted in pulmonary infection of goats with M. bovis. CT, but not DR, presented as a highly sensitive method to quantify the extent of pulmonary lesions. This goat model of TB may serve as a model for testing TB vaccine efficacy.
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Affiliation(s)
- Nadine Wedlich
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (FLI), Jena, Germany
| | - Julia Figl
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (FLI), Jena, Germany
| | - Elisabeth M. Liebler-Tenorio
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (FLI), Jena, Germany
- *Correspondence: Elisabeth M. Liebler-Tenorio
| | - Heike Köhler
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (FLI), Jena, Germany
| | - Kerstin von Pückler
- Clinic for Small Animals – Radiology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Melanie Rissmann
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institute, Greifswald-Insel Riems, Germany
| | - Stefanie Petow
- Institute for Animal Welfare and Animal Husbandry, Friedrich-Loeffler-Institute, Celle, Germany
| | - Stefanie A. Barth
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (FLI), Jena, Germany
| | - Petra Reinhold
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (FLI), Jena, Germany
| | - Reiner Ulrich
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institute, Greifswald-Insel Riems, Germany
| | | | - Stefan H. E. Kaufmann
- Director Emeritus, Max Planck Institute for Infection Biology, Berlin, Germany
- Emeritus Group for Systems Immunology, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
- Hagler Institute for Advanced Study, Texas A&M University, College Station, TX, United States
| | - Christian Menge
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (FLI), Jena, Germany
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7
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Lau H, Khosrawipour T, Li S, Alexander M, Frelkiewicz P, Labbé MK, Stieglitz S, Lakey JRT, Kielan W, Khosrawipour V. Exploring Insulin Production Following Alveolar Islet Transplantation (AIT). Int J Mol Sci 2021; 22:ijms221910185. [PMID: 34638521 PMCID: PMC8508311 DOI: 10.3390/ijms221910185] [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] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022] Open
Abstract
Recent studies have demonstrated the feasibility of islet implantation into the alveoli. However, until today, there are no data on islet behavior and morphology at their transplant site. This study is the first to investigate islet distribution as well insulin production at the implant site. Using an ex vivo postmortem swine model, porcine pancreatic islets were isolated and aerosolized into the lung using an endoscopic spray-catheter. Lung tissue was explanted and bronchial airways were surgically isolated and connected to a perfusor. Correct implantation was confirmed via histology. The purpose of using this new lung perfusion model was to measure static as well as dynamic insulin excretions following glucose stimulation. Alveolar islet implantation was confirmed after aerosolization. Over 82% of islets were correctly implanted into the intra-alveolar space. The medium contact area to the alveolar surface was estimated at 60 +/− 3% of the total islet surface. The new constructed lung perfusion model was technically feasible. Following static glucose stimulation, insulin secretion was detected, and dynamic glucose stimulation revealed a biphasic insulin secretion capacity during perfusion. Our data indicate that islets secrete insulin following implantation into the alveoli and display an adapted response to dynamic changes in glucose. These preliminary results are encouraging and mark a first step toward endoscopically assisted islet implantation in the lung.
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Affiliation(s)
- Hien Lau
- Department of Surgery, University of California, Irvine (UCI), Orange, CA 92868, USA; (M.A.); (J.R.T.L.); (V.K.)
- Correspondence: (H.L.); (T.K.)
| | - Tanja Khosrawipour
- Department of Surgery (A), University-Hospital Düsseldorf, Heinrich-Heine University, Moorenstrasse 5, D-40225 Duesseldorf, Germany
- Correspondence: (H.L.); (T.K.)
| | - Shiri Li
- Department of Surgery, Weill Medical College of Cornell University, New York, NY 10065, USA;
| | - Michael Alexander
- Department of Surgery, University of California, Irvine (UCI), Orange, CA 92868, USA; (M.A.); (J.R.T.L.); (V.K.)
| | - Piotr Frelkiewicz
- Center for Experimental Diagnostics and Biomedical Innovations, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland;
| | - Maya Karine Labbé
- School of Dentistry, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Sven Stieglitz
- Department Pulmonary Medicine, Petrus-Hospital Wuppertal, University of Witten-Herdecke, D-42283 Wuppertal, Germany;
| | - Jonathan Robert Todd Lakey
- Department of Surgery, University of California, Irvine (UCI), Orange, CA 92868, USA; (M.A.); (J.R.T.L.); (V.K.)
| | - Wojciech Kielan
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Veria Khosrawipour
- Department of Surgery, University of California, Irvine (UCI), Orange, CA 92868, USA; (M.A.); (J.R.T.L.); (V.K.)
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
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