Impact of endoscopic submucosal dissection and epithelial cell sheet engraftment on systemic cytokine dynamics in patients with oesophageal cancer

Abstract

The tumour microenvironment (TME) plays an important role in cancer development, progression, and metastasis. Various cytokines are present in the TME in oesophageal cancer. Oesophageal stricture is a major complication of endoscopic submucosal dissection (ESD) for oesophageal cancer, and inflammatory cytokines are closely related to its pathogenesis. However, the cytokine crosstalk involved in the oesophageal cancer TME and post-ESD stricture has not been fully elucidated. This study investigated the comprehensive cytokine dynamics following ESD in patients with oesophageal cancer. In addition, the effect of a novel preventive technique for post-ESD stricture, autologous cell sheet engraftment, on cytokine levels was evaluated. Various pro-inflammatory and anti-tumorigenic cytokines were elevated in patients with oesophageal cancer, and ESD transiently influenced cytokine concentrations. IL-1β and TNF-α, two major pro-inflammatory cytokines that induce oesophageal stricture, were significantly suppressed by cell sheet engraftment. In conclusion, this study revealed the distinct cytokine dynamics after ESD in patients with oesophageal cancer, together with the effect of autologous cell sheet engraftment on cytokine fluctuation. These results can accelerate research on the TME and therapeutic strategies for oesophageal cancer.

Allogeneic transplantation of epidermal cell sheets followed by endoscopic submucosal dissection to prevent severe esophageal stricture in a porcine model

“…Autologous OMCS transplantation after esophageal ESD suppresses major proinflammatory cytokines that induce esophageal stricture in serum [ 17 ]. Likewise, allogeneic ECS transplantation after ESD suppressed excessive inflammation to improve the wound environment.…”

“…Oral mucosal epithelial cell sheets (OMCSs) fabricated on temperature-responsive cell culture surfaces have been shown to represent a feasible therapy using cytokines and exosomes [ 16 , 17 ]. Hence, we hypothesized that post-ESD stricture could be prevented by seeding epithelial cells on artificial ulcer sites after ESD.…”

Prospective cross‐organ analysis for the causes of fever and increased inflammatory response after endoscopic resection

“…E NDOSCOPIC RESECTION (ER) is a treatment for intramucosal tumors of the gastrointestinal tract and is commonly performed in many countries. 1,2 One of the most critical advantages of ER is its low invasiveness; however, patients often develop fever or exhibit increased inflammatory responses even after a successful ER, 3 which makes the diagnosis of adverse events such as aspiration pneumonia and post-ER coagulation syndrome (PECS) more difficult and leads to confusion about the decision of the need for additional imaging studies or antibiotic administration. Fever after esophageal and gastric endoscopic submucosal dissection (ESD) has been reported previously 4,5 ; aspiration pneumonia was the most common cause.…”