Injection of porous polycaprolactone beads containing autologous myoblasts in a dog model of fecal incontinence
Injection of porous polycaprolactone beads containing autologous myoblasts in a dog model of fecal incontinence
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DOI：
10.4174/jkss.2013.84.4.216
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发表时间：
2013-04-01
影响因子：
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通讯作者：
Lee, Jin Ho
中科院分区：
文献类型：
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作者：
Kang, Sung-Bum;Lee, Hye Seung;Lee, Jin Ho
目的：很少有研究探讨生物工程是否可以改善大便失禁。本研究旨在确定注射含有自体成肌细胞的多孔聚己内酯微球是否能改善狗大便失禁模型的括约肌功能。方法：取损伤犬肛门括约肌，分别在损伤部位注射含自体成肌细胞的多孔聚己内酯微球和不注射（n = 5）。从腓肠肌中纯化的自体成肌细胞被转移到小珠上。治疗3个月后测定阴部神经复合肌动作电位（CMAP）、肛门括约肌压力及组织病理学。结果：损伤后括约肌CMAP振幅明显低于损伤前（1.22 mV vs. 3.00 mV, P = 0.04）。注射与未注射自体成肌细胞珠后，其振幅差异无统计学意义（P = 0.49）。接受自体成肌细胞珠治疗的狗的静息和挤压压力更高（2.00 mmHg vs. 1.80 mmHg; 6.13 mmHg vs. 4.02 mmHg），尽管这些差异在基线值调整后的协方差分析中并不显著。注射部位平滑肌肌动蛋白染色，但显示异物炎症反应的证据。结论：这是第一个研究生物工程是否可以改善大便失禁的研究。虽然结果没有明确的证据表明注射自体成肌细胞珠可以改善括约肌功能，但我们发现狗模型适合和可靠地研究大便失禁的潜在治疗方式的效果。
Purpose: Few studies have examined whether bioengineering can improve fecal incontinence. This study designed to determine whether injection of porous polycaprolactone beads containing autologous myoblasts improves sphincter function in a dog model of fecal incontinence. Methods: The anal sphincter of dogs was injured and the dogs were observed without and with (n = 5) the injection of porous polycaprolactone beads containing autologous myoblasts into the site of injury. Autologous myoblasts purified from the gastrocnemius muscles were transferred to the beads. Compound muscle action potentials (CMAP) of the pudendal nerve, anal sphincter pressure, and histopathology were determined 3 months after treatment. Results: The amplitudes of the CMAP in the injured sphincter were significantly lower than those measured before injury (1.22 mV vs. 3.00 mV, P = 0.04). The amplitudes were not different between dogs with and without the injection of autologous myoblast beads (P = 0.49). Resting and squeezing pressures were higher in dogs treated with autologous myoblast beads (2.00 mmHg vs. 1.80 mmHg; 6.13 mmHg vs. 4.02 mmHg), although these differences were not significant in analyses of covariance adjusted for baseline values. The injection site was stained for smooth muscle actin, but showed evidence of foreign body inflammatory reactions. Conclusion: This was the first study to examine whether bioengineering could improve fecal incontinence. Although the results did not show definite evidence that injection of autologous myoblast beads improves sphincter function, we found that the dog model was suitable and reliable for studying the effects of a potential treatment modality for fecal incontinence.