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Mo1998 Endoscopic Injection of Adipose-Derived Mesenchymal Stem Cells Enhanced Healing of Ulcers After Esd
Abstracts
treated with aspirin. As of November 2016, 40 of 41 patients completed 3 month follow-up endoscopy. 35/40 patients (87.5%) showed endoscopic and histologic CR. Five patients had residual USL and were ablated again. No strictures were noted on follow-up. Conclusion: Early results of our multicenter cohort study suggest that FCBA of ESCIN is safe, well-tolerated and highly effective in inducing endoscopic and histologic remission. Longer term (12 month) follow-up data is pending.
Mo1998 Endoscopic Injection of Adipose-Derived Mesenchymal Stem Cells Enhanced Healing of Ulcers After Esd Xian Feng Xia*, Philip Wai Yan W. Chiu, Ping Keun Lam, Baldwin P. Yeung, Gerald Tsz Yau Wong, Enders K. Ng The Chinese University of Hong Kong, Hong Kong, Hong Kong Background & Aim: Our previous study showed that adipose-derived mesenchymal stem cells (ADMSCs) enhanced healing of perforated gastric ulcers in rat model. This study aimed to investigate the effect of endoscopic injection of ADMSCs on healing of NSAID related ulcers after endoscopic submucosal dissection (ESD) and its feasibility as an adjuvant to prevent ulcer complications. Methods: Indomethacin (15mg/kg) was administered in all porcine models 10 days prior to ESD. We performed ESD at body and antrum of stomach in each pig under general anesthesia to create ulcer model. After ESD, one of the ulcers was treated by endoscopic injection of ADMSCs (1.0107) at the submucosa, while the other ulcer was injected with PBS as control. Further endoscopic injection of ADMSCs and PBS was performed at respective ulcer one week after ESD. Indomethacin was continued after ESD till euthanasia as adjunctive agent to delay natural ulcer healing. Endoscopic surveillance was performed every 7 days to measure the ulcer size by an endoscopy ruler. The ulcer index was calculated as the product of the longest and shortest diameters of each lesion. Results: Endoscopic surveillance demonstrated that ulcers receiving submucosal injection of ADMSCs had significantly faster healing than control; ulcer index was significantly reduced to 41% of the original size on day7 and 14% on day14 after ADMSCs injection therapy (Fig. A, B). Histological examination revealed good granulation and mucosal morphology in ulcer treated with ADMSCs on day 21 (Fig. C). Moreover, ADMSCs treatment significantly enhanced angiogenesis (Fig. D, E) and cellular proliferation (Fig. D, F) as well as increasing the expression of COX2 and VEGF in ulcer tissues (Fig. G, H). Conclusion: Endoscopic submucosal injection of ADMSCs served as a novel approach to improve healing of large ulcers after ESD and indomethacin therapy.
Fig.1. Focal cryoballoon ablation (Focal CBA) system is comprised of a balloon catheter, handle, and a small cartridge containing the cryogen (nitrous oxide).
Fig.2. Pictures of a typical case in our study. (A) Pretreatment picture after Lugol’s staining showing a flat-type unstained lesion (USL) from the 6 o’clock position to the 8 o’clock position; (B) Ice patch visible during cryoablation using the focal cryoballoon ablation system; (C) Lesion immediately after ablation; (D) 3 month follow-up visit: regenerated esophageal squamous mucosa, normally stained after Lugol’s and with biopsies confirming absence of ESCIN.
AB514 GASTROINTESTINAL ENDOSCOPY Volume 85, No. 5S : 2017
www.giejournal.org
treated with aspirin. As of November 2016, 40 of 41 patients completed 3 month follow-up endoscopy. 35/40 patients (87.5%) showed endoscopic and histologic CR. Five patients had residual USL and were ablated again. No strictures were noted on follow-up. Conclusion: Early results of our multicenter cohort study suggest that FCBA of ESCIN is safe, well-tolerated and highly effective in inducing endoscopic and histologic remission. Longer term (12 month) follow-up data is pending.
Mo1998 Endoscopic Injection of Adipose-Derived Mesenchymal Stem Cells Enhanced Healing of Ulcers After Esd Xian Feng Xia*, Philip Wai Yan W. Chiu, Ping Keun Lam, Baldwin P. Yeung, Gerald Tsz Yau Wong, Enders K. Ng The Chinese University of Hong Kong, Hong Kong, Hong Kong Background & Aim: Our previous study showed that adipose-derived mesenchymal stem cells (ADMSCs) enhanced healing of perforated gastric ulcers in rat model. This study aimed to investigate the effect of endoscopic injection of ADMSCs on healing of NSAID related ulcers after endoscopic submucosal dissection (ESD) and its feasibility as an adjuvant to prevent ulcer complications. Methods: Indomethacin (15mg/kg) was administered in all porcine models 10 days prior to ESD. We performed ESD at body and antrum of stomach in each pig under general anesthesia to create ulcer model. After ESD, one of the ulcers was treated by endoscopic injection of ADMSCs (1.0107) at the submucosa, while the other ulcer was injected with PBS as control. Further endoscopic injection of ADMSCs and PBS was performed at respective ulcer one week after ESD. Indomethacin was continued after ESD till euthanasia as adjunctive agent to delay natural ulcer healing. Endoscopic surveillance was performed every 7 days to measure the ulcer size by an endoscopy ruler. The ulcer index was calculated as the product of the longest and shortest diameters of each lesion. Results: Endoscopic surveillance demonstrated that ulcers receiving submucosal injection of ADMSCs had significantly faster healing than control; ulcer index was significantly reduced to 41% of the original size on day7 and 14% on day14 after ADMSCs injection therapy (Fig. A, B). Histological examination revealed good granulation and mucosal morphology in ulcer treated with ADMSCs on day 21 (Fig. C). Moreover, ADMSCs treatment significantly enhanced angiogenesis (Fig. D, E) and cellular proliferation (Fig. D, F) as well as increasing the expression of COX2 and VEGF in ulcer tissues (Fig. G, H). Conclusion: Endoscopic submucosal injection of ADMSCs served as a novel approach to improve healing of large ulcers after ESD and indomethacin therapy.
Fig.1. Focal cryoballoon ablation (Focal CBA) system is comprised of a balloon catheter, handle, and a small cartridge containing the cryogen (nitrous oxide).
Fig.2. Pictures of a typical case in our study. (A) Pretreatment picture after Lugol’s staining showing a flat-type unstained lesion (USL) from the 6 o’clock position to the 8 o’clock position; (B) Ice patch visible during cryoablation using the focal cryoballoon ablation system; (C) Lesion immediately after ablation; (D) 3 month follow-up visit: regenerated esophageal squamous mucosa, normally stained after Lugol’s and with biopsies confirming absence of ESCIN.
AB514 GASTROINTESTINAL ENDOSCOPY Volume 85, No. 5S : 2017
www.giejournal.org