The effect of halofuginone, a specific inhibitor of collagen type 1 synthesis, in the prevention of esophageal strictures related to caustic injury

Özçelık, Mehmet Faik; Pekmezci, Salih; Sarıbeyoğlu, Kaya; Unal, Ethem; Gümüştaş, Koray; Dogusoy, Gulen

doi:10.1016/j.amjsurg.2003.11.008

Cited by 41 publications

(26 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Anti-inflammatory medications, such as pentoxifylline and interferon alpha [31], penicillamine [32], anti-oxidants (vitamin C and E, N acetylcysteine) [33], [34], anti-fibrotic treatments, such as halofugidone [35] or corticosteroids [36], anti-mitotic drugs such as 5-fluorouracile [37] or mitomycin C [38], have been tested with insufficient results to consider their use in clinical practice. Steroid administration by local injection or by the systemic route showed promising results [10], [36].…”

Section: Discussionmentioning

confidence: 99%

Amniotic Membrane Grafts for the Prevention of Esophageal Stricture after Circumferential Endoscopic Submucosal Dissection

et al. 2014

View full text Add to dashboard Cite

Background and AimsThe prevention of esophageal strictures following circumferential mucosal resection remains a major clinical challenge. Human amniotic membrane (AM) is an easily available material, which is widely used in ophthalmology due to its wound healing, anti-inflammatory and anti-fibrotic properties. We studied the effect of AM grafts in the prevention of esophageal stricture after endoscopic submucosal dissection (ESD) in a swine model.Animals and MethodsIn this prospective, randomized controlled trial, 20 swine underwent a 5 cm-long circumferential ESD of the lower esophagus. In the AM Group (n = 10), amniotic membrane grafts were placed on esophageal stents; a subgroup of 5 swine (AM 1 group) was sacrificed on day 14, whereas the other 5 animals (AM 2 group) were kept alive. The esophageal stent (ES) group (n = 5) had ES placement alone after ESD. Another 5 animals served as a control group with only ESD.ResultsThe prevalence of symptomatic strictures at day 14 was significantly reduced in the AM group and ES groups vs. the control group (33%, 40% and 100%, respectively, p = 0.03); mean esophageal diameter was 5.8±3.6 mm, 6.8±3.3 mm, and 2.6±1.7 mm for AM, ES, and control groups, respectively. Median (range) esophageal fibrosis thickness was 0.87 mm (0.78–1.72), 1.19 mm (0.28–1.95), and 1.65 mm (0.7–1.79) for AM 1, ES, and control groups, respectively. All animals had developed esophageal strictures by day 35.ConclusionsThe anti-fibrotic effect of AM on esophageal wound healing after ESD delayed the development of esophageal stricture in our model. However, this benefit was of limited duration in the conditions of our study.

show abstract

Section: Discussionmentioning

confidence: 99%

Amniotic Membrane Grafts for the Prevention of Esophageal Stricture after Circumferential Endoscopic Submucosal Dissection

et al. 2014

View full text Add to dashboard Cite

show abstract

“…However, the drugs were unable to satisfactorily prevent stricture formation (13). Previous experimental studies have indicated that the administration of miscellaneous agents, including heparin, penicillamine, β-aminopropionitrile, indomethacin, pentoxifylline, estradiol, antioxidants, epidermal growth factor and vitamin E, may exert protective effects during the early phase of burn injury (13–17). In addition to these agents, esophageal stenting during the early stages has been used without steroids in clinical and experimental studies (18,19).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of keratinocyte growth factor (palifermin) for the treatment of caustic esophageal burns

Numanoğlu

Tatlî

Bektaş

et al. 2014

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Current treatment strategies against the development of corrosive esophageal strictures remain unsatisfactory. Thus, the aim of the present study was to investigate the efficacy of keratinocyte growth factor, in the form of palifermin, for the prevention of stricture development following esophageal caustic injuries in a rat model. A total of 32 female Wistar albino rats were divided into four groups, which included the control (C), burn (B), steroid (S) and steroid plus palifermin (S/P) groups. An experimental corrosive esophageal burn model was established in the B, S and S/P groups. Weight gain was recorded and histopathological evaluation was performed for each group. Weight gain in the S and B groups was compared with the control group and statistically significant differences were observed. In addition, statistically significant differences in weight gain were observed between the S/P group and the B group. Histopathologically, statistically significant differences were identified with regard to submucosal collagen deposition, muscularis mucosa and tunica muscularis damage when comparing the B group with the C group. In addition, statistically significant differences were observed when comparing the S and S/P groups with the B group. Furthermore, significant submucosal collagen deposition and tunica muscularis damage were observed in the S group when compared with the S/P group. The stenosis indexes in the C and S groups were significantly lower compared with the B group. In addition, the stenosis index in the S/P group was significantly lower compared with the S group. To the best of our knowledge, the present study is the first to investigate the effect of palifermin on corrosive esophageal burns. The addition of palifermin to the corrosive esophageal burn standard treatment regimen was found to reduce the degree of fibrosis and ameliorate histopathological damage in an experimental model of corrosive esophagitis in rats.

show abstract

“…However, it may cause deep tissue necrosis progressing to catastrophic perforation leading to mortality. Burns due to alkali agents, especially, may cause deep penetration and liquefaction necrosis of esophageal tissue [8][9][10]. In our study, to evaluate the effectiveness of our model on histopathological examination, characteristics such as inflammatory cell infiltration, muscularis mucosa damage and collagen deposition were researched.…”

Section: Discussionmentioning

confidence: 99%

Experimental Esophagitis Model Preventing Tracheal Aspiration

Kiraz¹,

Erbaş²,

Küçük³

et al. 2015

Adv Clin Exp Med

View full text Add to dashboard Cite

Background. Corrosive esophagitis injuries are a serious clinical problem with many agents used for diagnosis and treatment. Experimental esophagus burn models use a method described mainly in studies by Gehanno and Guedon, and modified by Liu and Richardson. Objectives. The aim of this study was to describe a new esophagitis model that prevents tracheal aspiration. Material and Methods. In this study we used 16 Wistar albino rats weighing between 220-240 g. The experimental animals were randomly divided into two groups: the model group (group M, n: 8) and control group (group C, n: 8). The necessary anesthesia was administered. Passing through a median laparotomy incision, the abdomen was entered and in group M and C the esophagus was freed and held by a suture at the gastroesophageal junction. After this procedure, about 1 cm proximal to the gastroesophageal junction, the esophagus was suspended by a suture. The esophagus segment between the two sutures was exposed to 0.1 mL 10% NaOH in group M and 0.1 mL saline in group C for 20 s. Ten days later all experimental animals were sacrificed and their esophagus removed. After dying with hematoxylin and eosine trichrome, the histopathological evaluation results for the rats in all groups were investigated with a light microscope. Results. Histopathological examination indicated submucosal collagen increase, damage to muscularis mucosa and tunica muscularis and collagen deposition. In the model group, the rats had high neutrophils and tissue damage accompanied by necrosis. In the control group, the rats had minimal or no tissue damage and fibrosis was not observed. Conclusions. Our procedure is relatively less invasive and easy to apply with corrosive esophagitis only in the required region, and at the same time treatment medications can be easily administered (Adv Clin Exp Med 2015, 24, 4, 637-641).

show abstract

The effect of halofuginone, a specific inhibitor of collagen type 1 synthesis, in the prevention of esophageal strictures related to caustic injury

Cited by 41 publications

References 18 publications

Amniotic Membrane Grafts for the Prevention of Esophageal Stricture after Circumferential Endoscopic Submucosal Dissection

Amniotic Membrane Grafts for the Prevention of Esophageal Stricture after Circumferential Endoscopic Submucosal Dissection

Efficacy of keratinocyte growth factor (palifermin) for the treatment of caustic esophageal burns

Experimental Esophagitis Model Preventing Tracheal Aspiration

Contact Info

Product

Resources

About