aFGF-modified autologous fibroblasts therapy improves the outcome of esophageal anastomotic leakage

doi:10.3877/cma.j.issn.2095-8773.2024.03.06

Abstract

Abstract:

Objective

To verify the role of autologous fibroblasts modified with acidic fibroblast growth factor (aFGF) gene, combined with fibrin glue, in promoting the treatment of esophageal anastomotic leakage through a new animal model, and to explore the feasibility of this approach as a new method for treating anastomotic leakage after esophageal cancer surgery.

Methods

The esophageal anastomotic model was established by cutting and suturing the cervical esophagus of rabbits, and the skin tissue was obtained. The primary culture of autologous skin fibroblasts was performed by enzymatic digestion method. The aFGF overexpression adenovirus was transfected into fibroblasts, and the expression and secretion of aFGF in the modified cells were detected by Western blot and enzyme-linked immunosorbent assay. Twenty rabbits were randomly divided into two groups: aFGF modified fibroblasts combined with fibrin glue treatment group (aFGF + FBS group) and fibrin glue treatment group (control group) . The healing of anastomotic fistula was observed by gross specimens and cervical esophageal enhanced CT. The infection rate and survival curve were used to compare the therapeutic effect of aFGF + FBs group and control group.

Results

A rabbit model of cervical esophageal anastomotic leakage was successfully established. The modified autologous skin fibroblasts can significantly express and secrete aFGF. Compared with the control group, the infection rate of aFGF + FBs group was lower (20% vs. 70%) , and the survival rate was significantly improved (P<0.05) .

Conclusions

The application of autologous fibroblasts modified with aFGF, in conjunction with fibrin glue, can significantly reduce the infection rate of esophageal anastomotic leaks, facilitate the healing of the leaks, and decrease mortality. Consequently, this method offers a promising alternative for addressing the clinical challenge of esophageal anastomotic leaks, which urgently requires resolution.

Key words: Esophageal anastomotic leakage, Autologous fibroblasts, Acidic fibroblast growth factor

Li Xu, Yan Yan. aFGF-modified autologous fibroblasts therapy improves the outcome of esophageal anastomotic leakage[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2024, 11(03): 180-187.

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Figures/Tables 5

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