Adipose Stem Cells Prevent Esophageal Strictures After Extensive Endoscopic Submucosal Dissection-Experimental Research

Jie Liu; Yuting Jiang; Xianzeng Chen; Xujin Wei; Xiangyu Wang; Zeliang Yang; Jie Yang; Jianhui Zhang; Yunyi Peng; Caihao Lin; Qilin Chen; Genmiao Yu; Yangyang Chen; Qingqing Wei; Xiaoling Zheng; Shengwu Zheng

doi:10.1097/JS9.0000000000002148

Adipose Stem Cells Prevent Esophageal Strictures After Extensive Endoscopic Submucosal Dissection-Experimental Research

Int J Surg. 2024 Dec 20. doi: 10.1097/JS9.0000000000002148. Online ahead of print.

Authors

Jie Liu^{1

2}, Yuting Jiang^{1

2}, Xianzeng Chen^{3

4}, Xujin Wei⁵, Xiangyu Wang^{1

2}, Zeliang Yang^{1

2}, Jie Yang^{1

2}, Jianhui Zhang^{1

2}, Yunyi Peng^{1

2}, Caihao Lin^{1

2}, Qilin Chen^{1

2}, Genmiao Yu^{6

7}, Yangyang Chen^{1

2}, Qingqing Wei^{1

2}, Xiaoling Zheng^{1

2}, Shengwu Zheng^{6

7}

Affiliations

¹ Department of Endoscopy, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
² Department of Endoscopy, Fujian Provincial Hospital, Fuzhou, Fujian, China.
³ Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
⁴ Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, Fujian, China.
⁵ The Graduate School of Fujian Medical University, Fuzhou, China.
⁶ Department of Plastic Surgery and Burns, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
⁷ Department of Plastic Surgery and Burns, Fujian Provincial Hospital, Fuzhou, Fujian, China.

PMID: 39693486
DOI: 10.1097/JS9.0000000000002148

Abstract

Background and aims: Endoscopic submucosal dissection (ESD) is a pivotal technique for excision of early-stage esophageal tumors. However, its primary complication, postoperative esophageal stricture, is a significant challenge owing to the absence of effective preventive measures. Adipose-derived stem cells (ADSCs) have emerged as a promising treatment modality to address this concern. In this study, we aimed to investigate, for the first time, the efficacy of allogenic ADSC injections in preventing esophageal stenosis after ESD.

Methods: We administered allogeneic ADSC injections ((same-species but different individual)) to a porcine model of ESD as a way to observe the role of ADSC in preventing esophageal stricture. We also co-cultured rats ADSCs with rats esophageal fibroblasts and esophageal mucosal epithelial cells to investigate the mechanism.

Results: ADSCs notably facilitated epithelial-mesenchymal transition (EMT) of epithelial cells. Furthermore, ADSC-conditioned medium exhibited a substantial inhibitory effect on fibroblast proliferation and migration, which was mediated by the transforming growth factor-beta pathway.

Conclusions: Our findings underscore the potential of ADSC injections as a promising therapeutic intervention to enhance recovery and prevent post-ESD complications.