A novel method for treatment of chronic anal fissure: adipose‐derived regenerative cells – a pilot study

Andjelkov, Katarina; Sforza, Marcos; Barišić, G; Soldatović, Ivan; Hiranyakas, Art; Krivokapić, Zoran

doi:10.1111/codi.13555

Cited by 24 publications

(8 citation statements)

References 38 publications

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“…To date, there are 11 active or recruiting registered studies involving ADSCs as an intervention in conditions such as knee OA and chronic kidney disease ( 256 ). Data disclosed hitherto, mostly by pilot studies, show that—despite not living up fully to their regenerative rationale—ADSCs have shown a promising potential in multiple settings, including ischemic heart disease ( 73 , 74 ), acute myocardial infarction ( 257 ), knee OA ( 258 , 259 ), peripheral vascular disease ( 260 ), SS-associated ulcers ( 261 , 262 ), ischemic diabetic feet ( 252 ), urogenital conditions ( 263 , 264 ), and breast cancer-associated lymphedema ( 265 ). For example, an early-phase placebo-controlled trial has shown that the intracoronary infusion of ADSCs is well tolerated, improves left ventricular ejection fraction (LVEF), and reduces infarct size after 6 months of follow-up in patients with acute myocardial infarction ( 257 ).…”

Section: Clinical Benefits Of Cell Therapy By Select Fieldsmentioning

confidence: 99%

Cell Therapy: Types, Regulation, and Clinical Benefits

2021

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Cell therapy practices date back to the 19th century and continue to expand on investigational and investment grounds. Cell therapy includes stem cell- and non–stem cell-based, unicellular and multicellular therapies, with different immunophenotypic profiles, isolation techniques, mechanisms of action, and regulatory levels. Following the steps of their predecessor cell therapies that have become established or commercialized, investigational and premarket approval-exempt cell therapies continue to provide patients with promising therapeutic benefits in different disease areas. In this review article, we delineate the vast types of cell therapy, including stem cell-based and non–stem cell-based cell therapies, and create the first-in-literature compilation of the different “multicellular” therapies used in clinical settings. Besides providing the nuts and bolts of FDA policies regulating their use, we discuss the benefits of cell therapies reported in 3 therapeutic areas—regenerative medicine, immune diseases, and cancer. Finally, we contemplate the recent attention shift toward combined therapy approaches, highlighting the factors that render multicellular therapies a more attractive option than their unicellular counterparts.

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Section: Clinical Benefits Of Cell Therapy By Select Fieldsmentioning

confidence: 99%

Cell Therapy: Types, Regulation, and Clinical Benefits

2021

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“…Clinically, autologous cSVF has been used for many different clinical indications such as to regenerate and repair bone and cartilage in concert with bone grafting , in the treatment of osteoarthritis , and in the management of peripheral vascular disease sequela such as chronic wounds . Cellular SVF has been very effective in the treatment of perianal and recto vaginal fistulas as well as for Crohn's disease , in the treatment for the sequela of radiation injury such as fibrosis, atrophy, retraction, and soft tissue ulceration and to reduce aberrant scar formation . The homing mechanism of cSVF to tumor sites makes them a promising vector for therapeutic delivery to tumors and metastatic niches .…”

Section: Liposuction Aspirate Fluid (Infranatant) Processingmentioning

confidence: 99%

Intraoperative Strategies for Minimal Manipulation of Autologous Adipose Tissue for Cell- and Tissue-Based Therapies: Concise Review

Trivisonno

Alexander

Baldari

et al. 2019

Stem Cells Translational Medicine

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The stromal vascular fraction (SVF) is a heterogeneous population of stem/stromal cells isolated from perivascular and extracellular matrix (ECM) of adipose tissue complex (ATC). Administration of SVF holds a strong therapeutic potential for regenerative and wound healing medicine applications aimed at functional restoration of tissues damaged by injuries or chronic diseases. SVF is commonly divided into cellular stromal vascular fraction (cSVF) and tissue stromal vascular fraction (tSVF). Cellular SVF is obtained from ATC by collagenase digestion, incubation/isolation, and pelletized by centrifugation. Enzymatic disaggregation may alter the relevant biological characteristics of adipose tissue, while providing release of complex, multiattachment of cell-to-cell and cell-tomatrix, effectively eliminating the bioactive ECM and periadventitial attachments. In many countries, the isolation of cellular elements is considered as a "more than minimal" manipulation, and is most often limited to controlled clinical trials and subject to regulatory review. Several alternative, nonenzymatic methods of adipose tissue processing have been developed to obtain via minimal mechanical manipulation an autologous tSVF product intended for delivery, reducing the procedure duration, lowering production costs, decreasing regulatory burden, and shortening the translation into the clinical setting. Ideally, these procedures might allow for the integration of harvesting and processing of adipose tissue for ease of injection, in a single procedure utilizing a nonexpanded cellular product at the point of care, while permitting intraoperative autologous cellular and tissue-based therapies. Here, we review and discuss the options, advantages, and limitations of the major strategies alternative to enzymatic processing currently developed for minimal manipulation of adipose tissue. STEM CELLS

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“…Pain particularly may reduce the quality of life of patients ( 7 , 8 ). Chronic anal fissure is accompanied by hypertrophic papilla along whose edge internal sphincter muscle fibres become visible ( 9 ). Physical and chemical agents are used basically to reduce sphincter pressure for treating acute anal fissure.…”

Section: Introductionmentioning

confidence: 99%

Comparison of botulinum toxin (BoNT) injection and lateral internal sphincterotomy (redo-LIS) for recurrent anal fissure treatment

2022

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ObjectiveToday's gold standard for treating chronic anal fissure is the Lateral Internal Sphincterotomy (LIS). Botulinum Toxin (BoNT) injection is, on the other hand, an alternative treatment for patients who do not want to have surgical treatment, patients undergoing chemotherapy, patients of high risk for surgery, and those who have the risk of anal incontinence (e.g., elderly, past anorectal surgery, vaginal multiple births, etc.). The aim of this study is to compare the effectiveness of BoNT and redo-LIS for treatment of post-LIS recurrent chronic anal fissure, and reveal differences if any.This study aims to compare redo-LIS and BoNT injection for treating post-LIS recurrent anal fissure.Material and methodNineteen patients who received LIS treatment and then redo-LIS or BoNT injection due to recurrence in the follow-up were included in this study. Group I (redo-LIS group) include 11 patients and group 2 (BoNT group) includes 8 patients. Their data on age, sex, anal incontinence scores and pain (VAS score) score as well.ResultsDuring the 3-month post-surgery follow-up period, there was statistically significant difference (p < 0.01) between groups by pain. No deterioration in the incontinence scores of patients in the group during the 6-month post-surgery period.ConclusionThis study demonstrates that redo lateral internal sphincterotomy (LIS) is a reliable method for patients who received LIS but developed recurrent chronic anal fissure, and achieves successful results in terms of recurrence and relief of pain.

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A novel method for treatment of chronic anal fissure: adipose‐derived regenerative cells – a pilot study

Abstract: The application of ADRC may be an alternative to lateral sphincterotomy and a reliable procedure which avoids faecal incontinence.

Cited by 24 publications

References 38 publications

Cell Therapy: Types, Regulation, and Clinical Benefits

Cell Therapy: Types, Regulation, and Clinical Benefits

Intraoperative Strategies for Minimal Manipulation of Autologous Adipose Tissue for Cell- and Tissue-Based Therapies: Concise Review

Comparison of botulinum toxin (BoNT) injection and lateral internal sphincterotomy (redo-LIS) for recurrent anal fissure treatment

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