Helpful, albeit hazardous! Esophageal stem-cell injection in systemic sclerosis
Autor: | Florentine Moazedi-Fuerst, Angelika Lackner, F Durchschein, Horst Koch, Maria Wiedner, Andreas Eherer, Ivo Justich, Sonja Kielhauser |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
030203 arthritis & rheumatology
medicine.medical_specialty systemic sclerosis business.industry gastroesophageal reflux Life quality Reflux Diseases of the musculoskeletal system stems cell injection Gastroenterology 03 medical and health sciences 0302 clinical medicine Rheumatology RC925-935 Internal medicine medicine Case Series Orthopedics and Sports Medicine 030212 general & internal medicine Stem cell business Esophageal motility |
Zdroj: | Therapeutic Advances in Musculoskeletal Disease, Vol 11 (2019) Therapeutic Advances in Musculoskeletal Disease |
ISSN: | 1759-7218 |
Popis: | Background: Over 90% of patients with systemic sclerosis suffer from gastroesophageal reflux. Esophageal motility disturbances are associated with a reduced life quality and may force interstitial lung disease progression. We wanted to determine whether we can improve gastroesophageal reflux in these patients by esophageal stem-cell injection. Methods: We performed a pilot study including eights patients with systemic sclerosis and symptomatic gastroesophageal reflux. Sampling of adipose tissue was performed by an experienced plastic surgeon under local anesthesia. The collected fat was injected into the submucosa of the distal esophagus, each time 1 ml in all four quadrants starting 2, 4 and 6 cm proximal to the Z line (ending up to a total volume of 12 ml). Before the intervention, 3, 6 and finally 12 months after the procedure, patients answered the Gastroesophageal Reflux Disease Health-Related Quality of Life Questionnaire (GERD HRQL) and a high-resolution manometry was performed to quantify changes in motility function. Results: All patients showed an improvement in the GERD HRQL score after the stem-cell injection and a lower dosage of proton-pump inhibitors. The manometric findings showed no change throughout the time. A serious adverse event occurred, as one patient developed multiple cerebellar embolic infarcts. Conclusion: Because of the favorable effect in all patients, a safe route for esophageal fat injection needs to be developed. |
Databáze: | OpenAIRE |
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