Management of radiation-induced proctitis using submucosal endoscopic injections of autologous adipose-derived stromal vascular fraction: a case report.

Autor: Smirnov AV; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682., Sychev VI; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682., Kuznetsova SM; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682.; Federal Center for Brain and Neurotechnologies, Federal Medical and Biological Agency of Russia, Moscow, Russia, 117513., Kalsin VA; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682.; Federal Center for Brain and Neurotechnologies, Federal Medical and Biological Agency of Russia, Moscow, Russia, 117513.; Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia, 117997., Vasilyev VS; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682.; Institute of Plastic Surgery and Cosmetology, Moscow, Russia, 105066., Ivanov YV; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682., Stankevich VR; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682., Sazonov DV; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682., Zabozlaev FG; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682., Konoplyannikov MA; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682. mkonopl@mail.ru.; Institute of Molecular Theranostics, Sechenov First Moscow State Medical University, Moscow, Russia, 119991. mkonopl@mail.ru., Baklaushev VP; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682.; Federal Center for Brain and Neurotechnologies, Federal Medical and Biological Agency of Russia, Moscow, Russia, 117513.; Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia, 117997.; Pulmonology Research Institute, Federal Medical and Biological Agency of Russia, Moscow, Russia, 115682., Troitsky AV; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682.
Jazyk: angličtina
Zdroj: Stem cell research & therapy [Stem Cell Res Ther] 2024 Nov 09; Vol. 15 (1), pp. 410. Date of Electronic Publication: 2024 Nov 09.
DOI: 10.1186/s13287-024-04017-3
Abstrakt: Background: Standard approaches to the treatment of chronic post-radiation proctitis are associated with a high risk of complications and a high percentage of unsatisfactory results due to the reduced regenerative potential of irradiated tissues. Regenerative surgery techniques using the stromal-vascular cell fraction (SVF) based on the patient's autologous adipose tissue are a promising direction for study.
Clinical Case Description: A 76-year-old patient suffering from chronic post-radiation erosive-ulcerative proctitis, grade 4 according to RTOG-EORTC, complicated by recurrent profuse rectal bleeding, underwent local autotransplantation of SVF into the submucosal layer of the rectum and pararectal connective tissue. The follow-up colonoscopies 1 and 6 months after the surgery and histological examination showed the complete epithelialization of ulcerative defects and a decrease in proctitis activity. There were no bleeding episodes during the 12-month postoperative observation period.
Conclusion: The proangiogenic, wound-healing, and anti-apoptotic effects of the SVF cell suspension provided reduction of inflammation activity, epithelialization of ulcers, and elimination of defecation-associated hemorrhage, following the SVF injection into the submucosal layer of the rectal wall and pararectal connective tissue in a patient with post-radiation proctitis with ulcers and recurrent bleeding.
(© 2024. The Author(s).)
Databáze: MEDLINE
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