Effects of Electroacupuncture Combined with Stem Cell Transplantation on Anal Sphincter Injury-Induced Faecal Incontinence in a Rat Model

Li, Xiaojia; Guo, Xiaoquan; Jin, Weiqi; Lu, Jin-Gen

doi:10.1136/acupmed-2016-011262

Cited by 7 publications

(13 citation statements)

References 30 publications

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“…Further well‐designed studies with larger cohorts will be required to explore the use of stem cell therapies in the treatment of FI. This work should also explore new preclinical alternatives such as the use of cells in association with hydrogels [37], trophic factors [38] or electrostimulation [39]. In conclusion, this current study proved the technical feasibility and safety of the injection of 4 × 10 7 AdMSCs but failed to improve patient incontinence.…”

Section: Discussionmentioning

confidence: 77%

Treatment of faecal incontinence with autologous expanded mesenchymal stem cells: results of a pilot study

et al. 2020

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Aim Management of faecal incontinence (FI) remains challenging because no definitive optimal treatment for this condition has yet been determined. Regenerative medicine could be an attractive therapeutic alternative for treating FI. Here, we aimed to determine the safety and feasibility of autologous expanded mesenchymal stem cells derived from adipose tissue (AdMSCs) in the treatment of patients diagnosed with structural FI. Method This was a randomized, multicentre, triple‐blinded, placebo‐controlled pilot study conducted at four sites in Spain with 16 adults with FI and a sphincter defect. Autologous AdMSCs were obtained from patients from surgically excised adipose tissue. These patients were intralesionally infused with a single dose of 4 × 107 AdMSCs or a placebo while under anaesthesia. We assessed the safety and feasibility of the treatment as the cumulative incidence of adverse events and the treatment efficacy using the Cleveland Clinic Faecal Incontinence Score, Faecal Incontinence Quality of Life score and Starck criteria to classify sphincter defects and anorectal physiology outcomes. Results Adipose tissue extraction, cell isolation and intralesional infusion procedures were successful in all the patients. There was only one adverse event connected to adipose tissue extraction (a haematoma), and none was associated with the injection procedure. There were no significant differences in any of the assessed clinical, manometric or ultrasonographic parameters. Conclusion This study indicates that this infusion procedure in the anal sphincter is feasible and safe. However, it failed to demonstrate efficacy to treat patients with structural FI.

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Section: Discussionmentioning

confidence: 77%

Treatment of faecal incontinence with autologous expanded mesenchymal stem cells: results of a pilot study

et al. 2020

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“…[36] Besides, electroacupuncture stimulation combined with bone marrow mesenchymal stem cell transplantation can effectively repair the impaired anal sphincters. [37] Therefore, acupuncture is gradually being applied to the treatment of fecal incontinence. [13] To the best of our knowledge, even though acupuncture is often used for fecal incontinence, there is no planned or published systematic review of the effectiveness and safety of acupuncture for fecal incontinence.…”

Section: Discussionmentioning

confidence: 99%

Acupuncture for fecal incontinence

Lin¹,

Zhang

et al. 2019

Medicine

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Background: Fecal incontinence is a socially and emotionally destructive condition that has a negative impact on personal image, self-confidence, and quality of life. Acupuncture is commonly used to treat chronic conditions, including fecal incontinence. However, no relevant systematic review or meta-analysis has been designed to evaluate the effects of acupuncture on fecal incontinence. Methods: We will identify relevant randomized controlled trials (RCTs) from the Cochrane Library, Medline, Embase, PubMed, Springer, Web of Science, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journals Database, Wanfang database, and clinical trial registration center from their inception to February 28, 2019. The primary outcome measures will be clinical effective rate, functional outcomes, and quality of life. Data that meets the inclusion criteria will be extracted and analyzed using RevMan V.5.3 software. Two reviewers will evaluate the studies using the Cochrane Collaboration risk of bias tool. Publication bias will be assessed by funnel plots, Egger test, and Begg test using the Stata software. Acupoints characteristics will be analyzed by Traditional Chinese Medicine inheritance support system. Results: This study will analyze the clinical effective rate, functional outcomes, quality of life, daily average number of fecal incontinence, and effective prescriptions of acupuncture for patients with fecal incontinence. Conclusion: Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupuncture for patients with fecal incontinence. PROSPERO registration number: PROSPERO CRD42019119680.

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“…Going further, Lane et al[ 49 ] performed a more aggressive injury defined as a “proctoepisiotomy”, but did not describe the technical details or extension. Similar or minor modified procedures have been employed by Mazzanti[ 60 ], Salcedo[ 75 ], Elmi[ 50 ], Pathi[ 42 ], Fitzwater[ 54 ], Montoya[ 57 ], Kuismanen[ 65 ] and Li[ 67 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most recent publication is from Li et al[ 67 ], the pioneer evaluating electroacupuncture (with a galvanic stimulation) combined with SC therapy. The authors employed Zutshi’s surgical injury[ 44 ] without repair.…”

Section: Animal Studies Publishedmentioning

confidence: 99%

Stem cell therapy for faecal incontinence: Current state and future perspectives

Trébol¹,

Carabias-Orgaz²,

García-Arranz³

et al. 2018

WJSC

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Faecal continence is a complex function involving different organs and systems. Faecal incontinence is a common disorder with different pathogeneses, disabling consequences and high repercussions for quality of life. Current management modalities are not ideal, and the development of new treatments is needed. Since 2008, stem cell therapies have been validated, 36 publications have appeared (29 in preclinical models and seven in clinical settings), and six registered clinical trials are currently ongoing. Some publications have combined stem cells with bioengineering technologies. The aim of this review is to identify and summarise the existing published knowledge of stem cell utilization as a treatment for faecal incontinence. A narrative or descriptive review is presented. Preclinical studies have demonstrated that cellular therapy, mainly in the form of local injections of muscle-derived (muscle derived stem cells or myoblasts derived from them) or mesenchymal (bone-marrow- or adipose-derived) stem cells, is safe. Cellular therapy has also been shown to stimulate the repair of both acute and subacute anal sphincter injuries, and some encouraging functional results have been obtained. Stem cells combined with normal cells on bioengineered scaffolds have achieved the successful creation and implantation of intrinsically-innervated anal sphincter constructs. The clinical evidence, based on adipose-derived stem cells and myoblasts, is extremely limited yet has yielded some promising results, and appears to be safe. Further investigation in both animal models and clinical settings is necessary to drawing conclusions. Nevertheless, if the preliminary results are confirmed, stem cell therapy for faecal incontinence may well become a clinical reality in the near future.

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Effects of Electroacupuncture Combined with Stem Cell Transplantation on Anal Sphincter Injury-Induced Faecal Incontinence in a Rat Model

Cited by 7 publications

References 30 publications

Treatment of faecal incontinence with autologous expanded mesenchymal stem cells: results of a pilot study

Treatment of faecal incontinence with autologous expanded mesenchymal stem cells: results of a pilot study

Acupuncture for fecal incontinence

Stem cell therapy for faecal incontinence: Current state and future perspectives

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