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Jonas E, Sjöqvist S, Elbe P, et al. Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus. United European Gastroenterol J. 2016;4(6):741-753doi: 10.1177/2050640616631205.
Jonas, E., Sjöqvist, S., Elbe, P., Kanai, N., Enger, J., Haas, S. L., Mohkles-Barakat, A., Okano, T., Takagi, R., Ohki, T., Yamamoto, M., Kondo, M., Markland, K., Lim, M. L., Yamato, M., Nilsson, M., Permert, J., Blomberg, P., & Löhr, J. M. (2016). Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus. United European gastroenterology journal, 4(6), 741-753. https://doi.org/10.1177/2050640616631205
Jonas, Eduard, et al. "Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus." United European gastroenterology journal vol. 4,6 (2016): 741-753. doi: https://doi.org/10.1177/2050640616631205
Jonas E, Sjöqvist S, Elbe P, Kanai N, Enger J, Haas SL, Mohkles-Barakat A, Okano T, Takagi R, Ohki T, Yamamoto M, Kondo M, Markland K, Lim ML, Yamato M, Nilsson M, Permert J, Blomberg P, Löhr JM. Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus. United European Gastroenterol J. 2016 Dec;4(6):741-753. doi: 10.1177/2050640616631205. Epub 2016 Feb 19. PMID: 28408991; PMCID: PMC5386228.
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United European Gastroenterol J. 2016 Dec;4(6):741-753. doi: 10.1177/2050640616631205. Epub 2016 Feb 19.

Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus.

United European gastroenterology journal

Eduard Jonas, Sebastian Sjöqvist, Peter Elbe, Nobuo Kanai, Jenny Enger, Stephan L Haas, Ammar Mohkles-Barakat, Teruo Okano, Ryo Takagi, Takeshi Ohki, Masakazu Yamamoto, Makoto Kondo, Katrin Markland, Mei Ling Lim, Masayuki Yamato, Magnus Nilsson, Johan Permert, Pontus Blomberg, J-Matthias Löhr

Affiliations

  1. Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
  2. Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
  3. Advanced Centre for Translational Regenerative Medicine (ACTREM), Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
  4. Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.
  5. Vecura, Clinical Research Centre, Karolinska University Hospital, Stockholm, Sweden.
  6. Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
  7. Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden.
  8. Innovation Office, Karolinska University Hospital, Stockholm, Sweden.
  9. Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

PMID: 28408991 PMCID: PMC5386228 DOI: 10.1177/2050640616631205

Abstract

BACKGROUND AND OBJECTIVE: Endoscopic mucosal dissection (ESD) is a treatment option for oesophagus tumours localized to the mucosa enabling en bloc removal of large lesions. The resulting larger mucosal defects have resulted in an increase in the occurrence of post-treatment strictures. Transplantation of autologous cell sheets, cultured from oral mucosa, has been shown to prevent post-ESD strictures. The aim of the study was to assess the efficacy and safety of cell sheet transplantation after oesophageal ESD in a Western patient population where reflux-associated pre-malignant and malignant conditions predominate.

METHODS: Patients with Barrett's oesophagus associated high-grade dysplasia or early adenocarcinoma where ESD entailed a resection >3 cm in length and ≥75% of the circumference were eligible for treatment under hospital exemption. Cell sheets were cultured from buccal mucosa according to Good Manufacturing Practice and were endoscopically applied to the post-ESD defect directly after resection. Patients were followed with weekly endoscopy examinations, including confocal laser microscopy, for a total of four weeks.

RESULTS: Five patients were treated. ESD was extensive with resections being circumferential in three patients and 9-10 cm in length in two. The number of transplanted cell sheets ranged from two to six. Three patients developed strictures requiring two to five dilatation sessions.

CONCLUSIONS: Cell sheet transplantation shows to be safe and feasible in a Western population. Results suggest that transplantation has a protective effect on the mucosal defect after ESD, decreasing both the risk for and extent of stricture formation.

Keywords: Barrett’s oesophagus; cell sheets; early oesophageal cancer; endoscopic submucosal dissection; oesophagus stricture prevention

References

  1. Clin Gastroenterol Hepatol. 2005 Jul;3(7 Suppl 1):S67-70 - PubMed
  2. Lancet Oncol. 2015 Feb;16(2):e84-92 - PubMed
  3. Clin Endosc. 2014 Nov;47(6):516-22 - PubMed
  4. Endoscopy. 2011 Mar;43(3):184-9 - PubMed
  5. Ann Surg. 2011 Feb;253(2):271-8 - PubMed
  6. Tissue Eng Part A. 2011 Jun;17(11-12):1643-50 - PubMed
  7. Medicine (Baltimore). 2015 Jan;94(1):e373 - PubMed
  8. BMC Gastroenterol. 2015 Jan 22;15:1 - PubMed
  9. BMC Gastroenterol. 2011 May 04;11:46 - PubMed
  10. J Gastrointest Surg. 2004 Nov;8(7):890-7; discussion 897-8 - PubMed
  11. Endoscopy. 2009 Aug;41(8):661-5 - PubMed
  12. Gastrointest Endosc. 2010 Apr;71(4):715-21 - PubMed
  13. Dig Dis Sci. 2014 Mar;59(3):658-63 - PubMed
  14. Gastrointest Endosc. 2009 Nov;70(5):860-6 - PubMed
  15. Gastrointest Endosc. 2010 Dec;72(6):1253-9 - PubMed
  16. N Engl J Med. 2014 Dec 25;371(26):2499-509 - PubMed
  17. J Gastrointest Oncol. 2015 Feb;6(1):20-30 - PubMed
  18. Dis Esophagus. 2009;22(7):626-31 - PubMed
  19. Gastroenterology. 2012 Sep;143(3):582-8.e1-2 - PubMed
  20. World J Surg. 2013 Oct;37(10):2372-8 - PubMed
  21. Int J Surg. 2010;8(6):417-22 - PubMed
  22. J Gastrointest Surg. 2010 Feb;14 Suppl 1:S108-14 - PubMed
  23. Gastrointest Endosc. 2013 Aug;78(2):250-7 - PubMed
  24. Br J Surg. 2014 Mar;101(4):321-38 - PubMed
  25. Gastrointest Endosc. 2011 Jun;73(6):1115-21 - PubMed
  26. Gut. 2006 Dec;55(12):1704-10 - PubMed
  27. J Clin Gastroenterol. 2011 Mar;45(3):222-7 - PubMed

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