1
|
Vélez-Pinto JF, Garcia-Arranz M, García-Bernal D, García Gómez-Heras S, Villarejo-Campos P, García-Hernández AM, Vega-Clemente L, Jiménez-Galanes S, Guadalajara H, Moraleda JM, García-Olmo D. Therapeutic effect of adipose-derived mesenchymal stem cells in a porcine model of abdominal sepsis. Stem Cell Res Ther 2023; 14:365. [PMID: 38087374 PMCID: PMC10717819 DOI: 10.1186/s13287-023-03588-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The term sepsis refers to a complex and heterogeneous syndrome. Although great progress has been made in improving the diagnosis and treatment of this condition, it continues to have a huge impact on morbidity and mortality worldwide. Mesenchymal stem cells are a population of multipotent cells that have immunomodulatory properties, anti-apoptotic effects, and antimicrobial activity. We studied these capacities in a porcine model of peritoneal sepsis. METHODS We infused human adipose-derived mesenchymal stem cells (ADSCs) into a porcine model of peritoneal sepsis. Twenty piglets were treated with antibiotics alone (control group) or antibiotics plus peritoneal infusion of ADSCs at a concentration of 2 × 106 cells/kg or 4 × 106 cells/kg (low- and high-dose experimental groups, respectively). The animals were evaluated at different time points to determine their clinical status, biochemical and hematologic parameters, presence of inflammatory cytokines and chemokines in blood and peritoneal fluid, and finally by histologic analysis of the organs of the peritoneal cavity. RESULTS One day after sepsis induction, all animals presented peritonitis with bacterial infection as well as elevated C-reactive protein, haptoglobin, IL-1Ra, IL-6, and IL-1b. Xenogeneic ADSC infusion did not elicit an immune response, and peritoneal administration of the treatment was safe and feasible. One day after infusion, the two experimental groups showed a superior physical condition (e.g., mobility, feeding) and a significant increase of IL-10 and TGF-β in blood and a decrease of IL-1Ra, IL-1b, and IL-6. After 7 days, all animals treated with ADSCs had better results concerning blood biomarkers, and histopathological analysis revealed a lower degree of inflammatory cell infiltration of the organs of the peritoneal cavity. CONCLUSIONS Intraperitoneal administration of ADSCs as an adjuvant therapy for sepsis improves the outcome and diminishes the effects of peritonitis and associated organ damage by regulating the immune system and reducing intra-abdominal adhesions in a clinically relevant porcine model of abdominal sepsis.
Collapse
Affiliation(s)
- J F Vélez-Pinto
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
| | - M Garcia-Arranz
- New Therapy Laboratory, Health Research Institute of the Jimenez Diaz Foundation (Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz), Avda Reyes Católicos 2, 28040, Madrid, Spain.
- Department of Surgery, Faculty of Medicine, Universidad Autónoma de Madrid, 28029, Madrid, Spain.
| | - D García-Bernal
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
- Biochemistry, Molecular Biology and Immunology Department, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - S García Gómez-Heras
- Department of Basic Health Science, Faculty of Health Sciences, Rey Juan Carlos University, 28922, Alcorcón, Madrid, Spain
| | - P Villarejo-Campos
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
| | - A M García-Hernández
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - L Vega-Clemente
- New Therapy Laboratory, Health Research Institute of the Jimenez Diaz Foundation (Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz), Avda Reyes Católicos 2, 28040, Madrid, Spain
| | - S Jiménez-Galanes
- Department of Surgery, Infanta Elena University Hospital, 28342, Valdemoro, Madrid, Spain
| | - H Guadalajara
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
- Department of Surgery, Faculty of Medicine, Universidad Autónoma de Madrid, 28029, Madrid, Spain
| | - J M Moraleda
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - D García-Olmo
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
- New Therapy Laboratory, Health Research Institute of the Jimenez Diaz Foundation (Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz), Avda Reyes Católicos 2, 28040, Madrid, Spain
- Department of Surgery, Faculty of Medicine, Universidad Autónoma de Madrid, 28029, Madrid, Spain
| |
Collapse
|
2
|
Heinz J, Walshaw J, Kwan JY, Long J, Carradice D, Totty J, Kontouli KM, Lainas P, Hitchman L, Smith G, Huo B, Guadalajara H, Garcia-Olmo D, Sharma D, Biyani CS, Tomlinson J, Loubani M, Galli R, Lathan R, Chetter I, Yiasemidou M. PRESS survey: PREvention of surgical site infection-a global pan-specialty survey of practice protocol. Front Surg 2023; 10:1251444. [PMID: 37818209 PMCID: PMC10560728 DOI: 10.3389/fsurg.2023.1251444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/15/2023] [Indexed: 10/12/2023] Open
Abstract
Background Surgical site infections (SSI) complicate up to 40% of surgical procedures, leading to increased patient morbidity and mortality. Previous research identified disparities in SSI prevention guidelines and clinical practices across different institutions. The study aims to identify variations in SSI prevention practices within and between specialties and financial systems and provide a representation of existing SSI preventative measures to help improve the standardization of SSI prevention practices. Methods This collaborative cross-sectional survey will be aimed at pan-surgical specialties internationally. The study has been designed and will be reported in line with the CROSS and CHERRIES standards. An international study steering committee will design and internally validate the survey in multiple consensus-based rounds. This will be based on SSI prevention measures outlined in the CDC (2017), WHO (2018), NICE (2019), Wounds UK (2020) and the International Surgical Wound Complications Advisory Panel (ISWCAP) guidelines. The questionnaire will include demographics, SSI surveillance, preoperative, peri-operative and postoperative SSI prevention. Data will be collected on participants' surgical specialty, operative grade, of practice and financial healthcare system of practice. The online survey will be designed and disseminated using QualtricsXM Platform™ through national and international surgical colleges and societies, in addition to social media and snowballing. Data collection will be open for 3 months with reminders, and raking will be used to ascertain the sample. Responses will be analyzed, and the chi-square test used to evaluate the impact of SSI prevention variables on responses. Discussion Current SSI prevention practice in UK Vascular surgery varies considerably, with little consensus on many measures. Given the inconsistency in guidelines on how to prevent SSIs, there is a need for standardization. This survey will investigate the disparity in SSI preventative measures between different surgical fields and countries.
Collapse
Affiliation(s)
- J Heinz
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - J Walshaw
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
- Department of Health Sciences, University of York, York, United Kingdom
| | - J Y Kwan
- Leeds Vascular Institute, Leeds Teachings Hospitals NHS Trust, Leeds, United Kingdom
| | - J Long
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - D Carradice
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - J Totty
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - K M Kontouli
- Department of Mathematics, University of Ioannina, Ioannina, Greece
| | - P Lainas
- Department of Digestive Surgery, Metropolitan Hospital, HEAL Academy, Athens, Greece
- Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Partis-Saclay University, Clamart, France
| | - L Hitchman
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - G Smith
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - B Huo
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - H Guadalajara
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - D Garcia-Olmo
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - D Sharma
- Department of Surgery, Government NSCB Medical College, Jabalpur, India
| | - C S Biyani
- Department of Urology, St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - J Tomlinson
- Trauma and Orthopedics, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - M Loubani
- Department of Cardiothoracic Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - R Galli
- Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland
| | - R Lathan
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
- Department of Health Sciences, University of York, York, United Kingdom
| | - I Chetter
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - M Yiasemidou
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Department of General Surgery, Bradford Teaching Hospitals NHS Trust, Bradford, United Kingdom
| |
Collapse
|
3
|
Garcia-Arranz M, Villarejo-Campos P, Barambio J, Garcia Gomez-Heras S, Vega-Clemente L, Guadalajara H, García-Olmo D. Toxicity study in a pig model of intraperitoneal collagenase as an "enzymatic scalpel" directed to break stroma in order to generate a new perspective for peritoneal carcinomatosis approach: an experimental research. World J Surg Oncol 2022; 20:53. [PMID: 35216593 PMCID: PMC8881860 DOI: 10.1186/s12957-022-02524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/05/2022] [Indexed: 11/22/2022] Open
Abstract
Background This study aimed to measure the toxicity resulting from collagenase administration to the peritoneal cavity in a pig model as a preliminary step to break down the stroma surrounding tumors. Methods Eight pigs were treated with 2 different collagenase concentrations previously tested in rats by our group. Time and temperature were controlled using a peritoneal lavage system (PRS System, Combat Medical Ltd.) identical to that used in human surgeries through hyperthermic intraperitoneal chemotherapy (HIPEC); 2 additional pigs were treated with peritoneal lavage only. Samples of blood and peritoneal fluid were collected pre-treatment, immediately after treatment, and 24 h postoperatively. In addition, histological studies and blood collagenase levels were measured. Results No complications were observed during the surgeries. Intraoperative images evidenced the release of peritoneal tissue during collagenase treatment. After surgery, the animals showed no signs of pain. Diet and mobility were normal at 4 h postoperatively, and there were no significant differences in hematologic or biochemical parameters. Quantification of MMP1 and MMP2 in all samples as measured by absorbance showed no differences in blood collagenase levels between pre-treatment, post-treatment, and 24 h postoperatively. None of the animals treated with collagenase showed peritoneal adhesions during the second surgery. Histologically, peritoneal organs and serous structures did not show any microscopic alterations associated with collagenase treatment in any group. Conclusion Lavage of the peritoneal cavity with doses of up to 100,000 collagen digestion units/animal for 30 min is safe and removes connective tissue from the peritoneal cavity.
Collapse
Affiliation(s)
- M Garcia-Arranz
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain. .,Department of Surgery, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo s/n, 28034, Madrid, Spain.
| | - P Villarejo-Campos
- Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - J Barambio
- Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - S Garcia Gomez-Heras
- Department of Human Histology, Universidad Rey Juan Carlos, Avda de Atenas s/n, 28922, Alcorcón, Spain
| | - L Vega-Clemente
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - H Guadalajara
- Department of Surgery, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo s/n, 28034, Madrid, Spain.,Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - D García-Olmo
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain.,Department of Surgery, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo s/n, 28034, Madrid, Spain.,Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| |
Collapse
|
4
|
Guadalajara H, Muñoz de Nova JL, Fernandez Gonzalez S, Yiasemidou M, Recarte Rico M, Juez LD, García Septiem J, Galindo Jara P, García Virosta M, Lobo Martínez E, Martín-Pérez E, García-Olmo D. Author response to: Comment on: Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO Study): surgery may be the best treatment option. Br J Surg 2021; 108:e42-e43. [PMID: 33640951 PMCID: PMC7929292 DOI: 10.1093/bjs/znaa022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/19/2020] [Indexed: 11/14/2022]
Affiliation(s)
- H Guadalajara
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | - J L Muñoz de Nova
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - S Fernandez Gonzalez
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | - M Yiasemidou
- ST6 Colorectal Surgery, Leeds Teaching Hospitals, University of Hull, Hull, UK
| | - M Recarte Rico
- Department of General and Digestive Surgery, Tajo University Hospital, Madrid, Spain
| | - L D Juez
- Department of General and Digestive Surgery, Ramon y Cajal University Hospital, Madrid, Spain
| | - J García Septiem
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - P Galindo Jara
- Department of General and Digestive Surgery, Torrejon University Hospital, Madrid, Spain
| | - M García Virosta
- Department of General and Digestive Surgery, Infanta Sofia University Hospital, Madrid, Spain
| | - E Lobo Martínez
- Department of General and Digestive Surgery, Ramon y Cajal University Hospital, Madrid, Spain
| | - E Martín-Pérez
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - D García-Olmo
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | | |
Collapse
|
5
|
García-Olmo D, Villarejo Campos P, Barambio J, Gomez-Heras SG, Vega-Clemente L, Olmedillas-Lopez S, Guadalajara H, Garcia-Arranz M. Intraperitoneal collagenase as a novel therapeutic approach in an experimental model of colorectal peritoneal carcinomatosis. Sci Rep 2021; 11:503. [PMID: 33436728 PMCID: PMC7803982 DOI: 10.1038/s41598-020-79721-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/07/2020] [Indexed: 01/07/2023] Open
Abstract
The usefulness of local collagenase in therapeutic approaches to solid tumors has been tested recently. In this study, we evaluate the safety and efficacy of intraperitoneal collagenase associated or not to mitomycin for treatment of colorectal peritoneal metastases in an experimental rat model. Using a fixed-dose procedure, we found that a dose of collagenase of 37 IU/mL administered for 15 min with a hyperthermia pump at 37.5 °C, both in isolation or associated to sequential treatment with intraperitoneal mitomycin, led to a macroscopic decrease in tumor volume as evaluated by the modified peritoneal cancer index (mPCI). Concerning the safety of the procedure, the animals showed no physiological or behavioral disorders during 8 weeks of follow-up. Local treatment for peritoneal metastases of colorectal origin with intraperitoneal collagenase has proved safe and effective in an experimental murine model. Therefore, the stroma-first approach by enzymatic breakdown of collagen from the tumor's extracellular matrix provides a new therapeutic target for colorectal peritoneal metastases.
Collapse
Affiliation(s)
- D García-Olmo
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain.,Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain.,Department of Surgery, Universidad Autónoma de Madrid, C/Arzobispo Morcillo s/n, 28034, Madrid, Spain
| | - P Villarejo Campos
- Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain.
| | - J Barambio
- Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - S Garcia Gomez-Heras
- Department of Human Histology, Universidad Rey Juan Carlos, Avda de Atenas s/n, 28922, Alcorcón, Spain
| | - L Vega-Clemente
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - S Olmedillas-Lopez
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - H Guadalajara
- Department of Surgery, Fundación Jiménez Díaz University Hospital, Avda. Reyes Católicos, 2, 28040, Madrid, Spain.,Department of Surgery, Universidad Autónoma de Madrid, C/Arzobispo Morcillo s/n, 28034, Madrid, Spain
| | - M Garcia-Arranz
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain.,Department of Surgery, Universidad Autónoma de Madrid, C/Arzobispo Morcillo s/n, 28034, Madrid, Spain
| |
Collapse
|
6
|
Guadalajara H, Muñoz de Nova JL, Fernandez Gonzalez S, Yiasemidou M, Recarte Rico M, Juez LD, García Septiem J, Galindo Jara P, García Virosta M, Lobo Martínez E, Martín-Pérez E, García-Olmo D. Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO Study): Surgery may be the best treatment option. Br J Surg 2020; 107:e494-e495. [PMID: 32820826 PMCID: PMC7461068 DOI: 10.1002/bjs.11950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/02/2020] [Indexed: 11/16/2022]
Affiliation(s)
- H Guadalajara
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | - J L Muñoz de Nova
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - S Fernandez Gonzalez
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | - M Yiasemidou
- ST6 colorectal surgery, Leeds Teaching Hospitals, Clinical lecturer, University of Hull, Madrid, Spain
| | - M Recarte Rico
- Department of General and Digestive Surgery, Tajo University Hospital, Madrid, Spain
| | - L D Juez
- Department of General and Digestive Surgery, Ramon y Cajal University Hospital, Madrid, Spain
| | - J García Septiem
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - P Galindo Jara
- Department of General and Digestive Surgery, Torrejon University Hospital, Madrid, Spain
| | - M García Virosta
- Department of General and Digestive Surgery, Infanta Sofia University Hospital, Madrid, Spain
| | - E Lobo Martínez
- Department of General and Digestive Surgery, Ramon y Cajal University Hospital, Madrid, Spain
| | - E Martín-Pérez
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - D García-Olmo
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | | |
Collapse
|
7
|
Georgiev-Hristov T, Guadalajara H, Herreros MD, Lightner AL, Dozois EJ, García-Arranz M, García-Olmo D. A Step-By-Step Surgical Protocol for the Treatment of Perianal Fistula with Adipose-Derived Mesenchymal Stem Cells. J Gastrointest Surg 2018; 22:2003-2012. [PMID: 30066070 DOI: 10.1007/s11605-018-3895-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 07/20/2018] [Indexed: 01/31/2023]
Abstract
Anal fistula is a challenging condition both for surgeons and patients. Recurrent fistula, Crohn's disease, or autoimmune disorders add further complexity to this situation. Numerous clinical trials have now demonstrated that cell-based therapy appears to be a good complement to fistulous surgery. As in any new treatment, especially that involving living cells, appropriate application is paramount to achieve optimal outcomes. As stem cell-based treatments are gaining a strong foothold in fistula management worldwide, we herein aim to share our mesenchymal stem cell surgical protocol. With the goal of optimizing results of this emerging therapy, we have improved and refined our protocol over the past 17 years of working with stem cells in clinical trials. The protocol consists of nine reproducible steps for mesenchymal stem cell application inside the fistulous tract, and has proven to be safe and effective in several studies, including international phase III clinical trials.
Collapse
Affiliation(s)
- Tihomir Georgiev-Hristov
- Department of Surgery, Hospital General de Villalba, Carretera de Alpedrete a Moralzarzal, M-608, Km. 41, 28400 Collado Villalba, Madrid, Spain.
| | - H Guadalajara
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Avda Reyes Católicos 2, 28040, Madrid, Spain
| | - M D Herreros
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Avda Reyes Católicos 2, 28040, Madrid, Spain
| | - A L Lightner
- Department of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - E J Dozois
- Department of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - M García-Arranz
- New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos 2, 28040, Madrid, Spain
| | - D García-Olmo
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Avda Reyes Católicos 2, 28040, Madrid, Spain
- New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos 2, 28040, Madrid, Spain
| |
Collapse
|
8
|
Sendagorta E, Herranz P, Guadalajara H, Zamora F. Early Detection of Anal Intraepithelial Neoplasia in High-Risk Patients. Actas Dermo-Sifiliográficas (English Edition) 2011. [DOI: 10.1016/j.adengl.2012.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|