Successful Treatment of Passive Fecal Incontinence in an Animal Model Using Engineered Biosphincters: A 3‐Month Follow‐Up Study

Autor: Khalil N. Bitar, Elie Zakhem, Jaime L. Bohl
Jazyk: angličtina
Rok vydání: 2017
Předmět:
medicine.medical_specialty
Aging
Neurodegeneration / Neurological Disorders
Myocytes
Smooth Muscle
Anal Canal
Bioengineering
Internal anal sphincter
03 medical and health sciences
Basal (phylogenetics)
0302 clinical medicine
Animal model
Translational Research Articles and Reviews
Neural Stem Cells
Tissue Engineering and Regenerative Medicine
Fecal incontinence
Reflex
Medicine
Animals
Rectoanal inhibitory reflex (RAIR)
Basal tone
Cells
Cultured
2. Zero hunger
Tissue Engineering
business.industry
Anorectal manometry
Cell Biology
General Medicine
Large animal model
Surgery
Neural/Progenitor Stem Cells
Digestive Tract Regeneration
Disease Models (Animal/Cell)
030220 oncology & carcinogenesis
Biosphincter
030211 gastroenterology & hepatology
Female
Rabbits
medicine.symptom
business
Developmental Biology
Large animal
Month follow up
Zdroj: Stem Cells Translational Medicine
ISSN: 2157-6580
2157-6564
Popis: Fecal incontinence (FI) is the involuntary passage of fecal material. Current treatments have limited successful outcomes. The objective of this study was to develop a large animal model of passive FI and to demonstrate sustained restoration of fecal continence using anorectal manometry in this model after implantation of engineered autologous internal anal sphincter (IAS) biosphincters. Twenty female rabbits were used in this study. The animals were divided into three groups: (a) Non-treated group: Rabbits underwent IAS injury by hemi-sphincterectomy without treatment. (b) Treated group: Rabbits underwent IAS injury by hemi-sphincterectomy followed by implantation of autologous biosphincters. (c) Sham group: Rabbits underwent IAS injury by hemi-sphincterectomy followed by re-accessing the surgical site followed by immediate closure without implantation of biosphincters. Anorectal manometry was used to measure resting anal pressure and recto-anal inhibitory reflex (RAIR) at baseline, 1 month post-sphincterectomy, up to 3 months after implantation and post-sham. Following sphincterectomy, all rabbits had decreased basal tone and loss of RAIR, indicative of FI. Anal hygiene was also lost in the rabbits. Decreases in basal tone and RAIR were sustained more than 3 months in the non-treated group. Autologous biosphincters were successfully implanted into eight donor rabbits in the treated group. Basal tone and RAIR were restored at 3 months following biosphincter implantation and were significantly higher compared with rabbits in the non-treated and sham groups. Histologically, smooth muscle reconstruction and continuity was restored in the treated group compared with the non-treated group. Results in this study provided promising outcomes for treatment of FI. Results demonstrated the feasibility of developing and validating a large animal model of passive FI. This study also showed the efficacy of the engineered biosphincters to restore fecal continence as demonstrated by manometry.
Databáze: OpenAIRE
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