Biodegradable Stent with mTOR Inhibitor-Eluting Reduces Progression of Ureteral Stricture

Ho, Dong-Ru; Su, Solomon; Chang, Pey‐Jium; Lin, Wei‐Yu; Huang, Yun‐Ching; Lin, Jie; Huang, Kuan-Gen; Chan, Wai-Nga; Cheng, Chen-Li

doi:10.3390/ijms22115664

Cited by 14 publications

(5 citation statements)

References 71 publications

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“…Ureteral strictures are generally reported to have several etiologies such as stones, surgical injuries, malignancy, and trauma ( 26 ). And we have found that stones, injuries and even sutures left over from surgery can lead to ureteral strictures.…”

Section: Discussionmentioning

confidence: 99%

Main Pathological Changes of Benign Ureteral Strictures

Tan

Ling

et al. 2022

Front. Med.

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ObjectiveTo identify the pathological classification of benign ureteral strictures according to the histological features and explore the relationship between various pathological types and inflammatory cells, fibroblasts, and collagen.Patients and MethodsThirty one specimens from patients diagnosed with ureteral strictures between 2013 and 2021 were included and classified according to the histopathological characteristics. The number of fibroblasts and inflammatory cells was counted, and the proportion of type I and type III collagen in ureteral stricture tissues was detected by picrosirius red staining.ResultsWe identified three types of benign ureteral strictures in 31 specimens: inflammatory cell infiltration (n = 10, 32%), fibroplasia (n = 14, 45%), and hyalinization (n = 7, 23%), with significant differences in obstruction history and hydronephrosis grades among the three types. The number of inflammatory cells (lymphocytes, neutrophils and eosinophils) was significantly lower in hyalinization ureteral strictures than in the other two types (p < 0.05). The number of foreign-body giant cells associated with foreign-body reactions increased significantly in suture-induced ureteral strictures (p < 0.05). Fibroplasia type had the largest number of fibroblasts, whereas the other two types had smaller numbers. The results of type I and III collagen analysis showed that type I and III collagen were the most abundant in hyalinization among all ureteral stricture types (p < 0.05). Compared to ureteral strictures, the content of type I and III collagen in atresia increased significantly (p < 0.05).ConclusionCommon pathological types of benign ureteral strictures include inflammatory cell infiltration, fibroplasia, and hyalinization. Changes in type I and III collagen, inflammatory cells, and fibroblasts in different pathological types may be related to the progression of ureteral strictures.

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Section: Discussionmentioning

confidence: 99%

Main Pathological Changes of Benign Ureteral Strictures

Tan

Ling

et al. 2022

Front. Med.

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“…Several researchers have reported investigations on ureteral stents with rapamycin inhibitor elution, paclitaxel-coated stents, bone 6588 marrow mesenchymal stem cells, and biodegradable stents in the prevention and treatment of ureteral stricture. [23][24][25][26] However, these treatments are only in the research stage and have not yet been applied in the clinic, and the efficacy of these drugs in the ureter deserves further study. Therefore, based on these previous studies, we tried to find a new one that could better combine the drug with the ureteral stent and simultaneously deliver the drug to the ureter accurately.…”

Section: Discussionmentioning

confidence: 99%

Inhibition of Ureteral Stricture by Pirfenidone-Loaded Nanoparticle-Coated Ureteral Stents with Slow-Release Pirfenidone

Jiang¹,

Wang²,

Wang³

et al. 2022

IJN

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Ureteral stricture caused by iatrogenic ureteral injury induced ureteral injury is more common and challenging to recover quickly. The effective prevention of ureteral stricture due to iatrogenic ureteral injury-induced ureteral damage is a current challenge for urologists. The purpose of this study was to evaluate the effectiveness of nanoparticle/pirfenidone complex-coated ureteral stents with slow-release pirfenidone for the prevention of ureteral stricture in rabbits. In this study, we developed a nanoparticle/pirfenidone complex-coated ureteral stent to deliver pirfenidone into the injured ureter to inhibit ureteral stricture. Methods: Twelve New Zealand rabbits were divided into four groups: Sham, US, US+ Unmodified ureteral stent, and US+NP/PFD ureteral stent; we constructed an irreversible electroporation model of ureteral injury in rabbits and placed unmodified ureteral stents and nanoparticle/pirfenidone complex-coated ureteral stents into the ureter. Two weeks later, we euthanized the rabbits and removed their bilateral kidneys and ureters. We evaluated the effect of ureteral stent prophylaxis by gross specimen observation, section staining, and Western Blot. Results: We found that the nanoparticle/pirfenidone complexes could adhere uniformly to the surface of the ureteral stent. After placement into the ureter, the nanoparticle/pirfenidone complexes were able to remain on the surface of the ureteral stent. We found nanoparticle/pirfenidone complexes could diffuse in the ureteral epithelial tissue two weeks after the order. The study showed that nanoparticle/pirfenidone complex-coated ureteral stents placed into the ureter showed significantly less stenosis due to fibrosis than in US control rabbits and rabbits treated with unmodified ureteral stents. Conclusion:We used a novel platform based on nanoparticle/pirfenidone complex-coated ureteral stents for local and sustained delivery of pirfenidone, which can effectively deliver pirfenidone to the tissue and can slowly control the release of pirfenidone. Therefore, combining ureteral stents with nanoparticle/pirfenidone complexes was an effective measure to prevent ureteral stricture.

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“…Afterwards, Ho et al investigated the impact of a drug-eluting biodegradable stent (DE stent) loaded with an mTOR inhibitor (mTORi) on ureteral stricture associated with thermal injury in rabbits ( Ho et al, 2021 ). The DE stent is a recognized device for inhibiting coronary artery restenosis.…”

Section: Future Clinical Applications Of Busmentioning

confidence: 99%

Recent development and future application of biodegradable ureteral stents

Hu,

Hou,

Huang

et al. 2024

Front. Bioeng. Biotechnol.

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Ureteral stenting is a common clinical procedure for the treatment of upper urinary tract disorders, including conditions such as urinary tract infections, tumors, stones, and inflammation. Maintaining normal renal function by preventing and treating ureteral obstruction is the primary goal of this procedure. However, the use of ureteral stents is associated with adverse effects, including surface crusting, bacterial adhesion, and lower urinary tract symptoms (LUTS) after implantation. Recognizing the need to reduce the complications associated with permanent ureteral stent placement, there is a growing interest among both physicians and patients in the use of biodegradable ureteral stents (BUS). The evolution of stent materials and the exploration of different stent coatings have given these devices different roles tailored to different clinical needs, including anticolithic, antibacterial, antitumor, antinociceptive, and others. This review examines recent advances in BUS within the last 5 years, providing an in-depth analysis of their characteristics and performance. In addition, we present prospective insights into the future applications of BUS in clinical settings.

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Biodegradable Stent with mTOR Inhibitor-Eluting Reduces Progression of Ureteral Stricture

Cited by 14 publications

References 71 publications

Main Pathological Changes of Benign Ureteral Strictures

Main Pathological Changes of Benign Ureteral Strictures

Inhibition of Ureteral Stricture by Pirfenidone-Loaded Nanoparticle-Coated Ureteral Stents with Slow-Release Pirfenidone

Recent development and future application of biodegradable ureteral stents

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