ABSTRACT
BACKGROUND: Ulcerative colitis (UC) represents a clinically challenging condition characterized by persistent damage to the colonic epithelial mucosa as the principal pathological feature. Polyvinyl alcohol (PVA) solution, primarily composed of glue, is a biodegradable polymer material that has found utility in the medical field. This research endeavors to investigate the therapeutic potential of PVA water solution in ameliorating UC in mice. METHODS: UC was induced in 48 C57BL/6 mice by administering 2.5% DSS in their diet for 6 days. Mice were treated with different concentrations of PVA (0.1 mg/ml PVA, 0.3 mg/ml PVA, 1 mg/ml PVA, 3 mg/ml PVA, 10 mg/ml PVA) enemas (n = 6). Disease Activity Index (DAI) and histologic score were evaluated for inflammation degree. Furthermore, mouse colon organoids were cultured, which were used to assess the effects of PVA on expansion in vitro. RESULTS: PVA aqueous solutions (1 mg/ml and 3 mg/ml) were able to alleviate the DAI in mice. By DAY 6, there was a significant 3/5-fold decrease in DAI within the 1 mg/ml PVA group (p = 0.02). Histopathology scores demonstrated improvements, while the levels of inflammatory factors in the intestinal mucosal tissue were reduced. Additionally, it was confirmed that PVA could promote the expansion of colonic organoids in vitro. CONCLUSIONS: In summary, our investigation has yielded findings indicating that PVA holds the potential to ameliorate symptoms associated with colitis in murine subjects afflicted by DSS-induced colitis, primarily through its facilitation of intestinal stem cell expansion. This study might provide a new candidate for the clinical treatment of ulcerative colitis.
Subject(s)
Colitis, Ulcerative , Colitis , Humans , Mice , Animals , Colitis, Ulcerative/drug therapy , Polyvinyl Alcohol/adverse effects , Mice, Inbred C57BL , Colitis/therapy , Colitis/drug therapy , Colon/pathology , Enema , Dextran Sulfate/adverse effects , Disease Models, AnimalABSTRACT
BACKGROUND: Intra-arterial therapy with embolics is established for the treatment of malignancies of the liver. However, there are no studies comparing the different effects of various embolics used in clinical practice. Herein, we analyzed the effect of 3 different embolics on tumor growth in a rat model of colorectal liver metastases. METHODS: Eight days after subcapsular implantation of 5 × 105 colorectal cancer cells (CC531) in the left liver lobe of WAG/Rij rats were randomized into 4 groups (n = 8) and underwent intra-arterial hepatic therapy. Animals received either EmboCept S®, DC Bead® or Lipiodol® Ultra-Fluid. Animals of the control group received a comparable amount of saline. Tumor growth was measured on day 8 and 11 using a three-dimensional 40 MHz ultrasound device. On day 11 tumor and liver tissue were removed for histological and immunohistochemical analyses. RESULTS: On day 11 animals of the control group showed a tumor growth of ~ 60% compared to day 8. Application of Lipiodol Ultra-Fluid® did not significantly influence tumor growth (~ 40%). In contrast, treatment with EmboCept S® or DC Bead® completely inhibited tumor growth. Of interest, application of EmboCept S® did not only completely inhibit tumor growth but even decreased tumor size. Immunohistochemical analysis showed a significant increase of necrotic areas within the tumors after application of EmboCept S® and DC Bead® compared to Lipiodol® Ultra-Fluid. CONCLUSION: The present study demonstrates that an intra-arterial therapy with EmboCept S® and DC Bead®, but not Lipiodol® Ultra-Fluid, results in a complete inhibition of rat colorectal liver metastatic growth.
Subject(s)
Antineoplastic Agents/therapeutic use , Colonic Neoplasms/pathology , Infusions, Intra-Arterial/methods , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Microspheres , Polyvinyl Alcohol/therapeutic use , Starch/therapeutic use , Animals , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Apoptosis/drug effects , Cell Line, Tumor , Cell Proliferation/drug effects , Ethiodized Oil/administration & dosage , Ethiodized Oil/adverse effects , Ethiodized Oil/therapeutic use , Female , Hepatic Artery , Heterografts , Liver/blood supply , Liver/pathology , Male , Models, Animal , Necrosis/pathology , Neovascularization, Pathologic/drug therapy , Polyvinyl Alcohol/administration & dosage , Polyvinyl Alcohol/adverse effects , Rats , Starch/administration & dosage , Starch/adverse effects , Treatment Outcome , Tumor Burden/drug effectsABSTRACT
Objective: To investigate the clinical effect of polyvinyl alcohol (PVA) particles combined with chemoembolization using chemotherapeutic agents or chemotherapeutic agents lipiodol emulsion (CALE) in the treatment of hepatocellular carcinoma (HCC) complicated by hepatic arteriovenous shunt (HAVS) and related prognostic factors. Methods: A retrospective analysis was performed for the clinical data of 133 patients with HCC complicated by HAVS. HAVS was classified into slow-flow HAVS, intermediate-flow HAVS, and high-flow HAVS, which were treated with 300-500µm, 500-710µm, and 710-1000µm PVA particles, respectively. The patients with slow-flow and intermediate-flow HAVS underwent embolization with PVA combined with chemotherapeutic agents followed by CALE, while those with high-flow HAVS underwent the treatment with PVA combined with chemotherapeutic agents alone. The survival time, progression-free survival time, and postoperative complications were followed up and analyzed. The Kaplan-Meier method was used to calculate cumulative survival rate and the Cox proportional hazards model was used to determine prognostic factors. Results: The median overall survival (OS) of 133 patients was 9.1 months, and the 6-, 12-, and 24-month survival rates were 73.7%, 36.2%, and 10.2%, respectively. The median OS of slow-flow group (36 patients), intermediate-flow group (58 patients), and high-flow group (39 patients) were 7.3, 9.1, and 10.8 months, respectively. And the 6- and 12-month survival rates were 69.2%/19.0%, 72.4%/39.2%, and 77.8%/42.7%, respectively. There was no significant difference in survival time between the patients with different types of HAVS (χ2= 2.865,P= 0.239). The incidence rates of postoperative gastroesophageal variceal bleeding and acute liver failure were 1.1% and 0.4%, respectively. The results of Cox regression analysis showed that preoperative alpha-fetoprotein level≥400 ng/ml (HR= 2.105,P= 0.006) was an independent risk factor, while multiple embolizations (HR= 0.482,P= 0.011), tumor remission (HR= 0.431,P= 0.041), and multimodality therapy (HR= 0.416,P= 0.004) were independent protective factors. Conclusion: PVA particles combined with chemotherapeutic agents or CALE is safe and effective in the treatment of HCC complicated by HAVS. Patients with multiple embolizations, tumor remission, and multimodality therapy tend to have good prognosis, while those with a high level of alpha-fetoprotein before embolization often have poor prognosis.
Subject(s)
Arteriovenous Shunt, Surgical , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic , Liver Neoplasms/therapy , Polyvinyl Alcohol/adverse effects , Arteriovenous Fistula , Carcinoma, Hepatocellular/pathology , Combined Modality Therapy , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/epidemiology , Ethiodized Oil , Female , Gastrointestinal Hemorrhage/complications , Gastrointestinal Hemorrhage/epidemiology , Humans , Incidence , Liver Neoplasms/pathology , Male , Middle Aged , Prognosis , Proportional Hazards Models , Retrospective Studies , Survival Rate , Treatment Outcome , alpha-FetoproteinsABSTRACT
Objetivo: Evaluar la eficacia de dos lágrimas artificiales: el hialuronato sódico 0,15% y el alcohol polivinílico como tratamiento en pacientes con ojo seco.Material y métodos: Se ha seleccionado una muestra de 30 pacientes con ojo seco, en los que hemos considerado cada ojo por separado (60 ojos). A quince de ellos se les ha administrado como tratamiento alcohol polivinílico y a los otros quince hialuronato sódico 0,15%, en ambos casos 5 gotas al día durante un mes. Los parámetros que se han evaluado antes y después del tratamiento han sido: la agudeza visual, el test de Schirmer, el aclaramiento lagrimal, un cuestionario de sintomatología de ojo seco, la tinción corneal con fluoresceína, la tinción con rosa de bengala, la sensibilidad corneal así como la presencia de hiperemia bulbar, detritus en la lágrima, tapones en las glándulas de meibomio, eritema y edema en el borde libre palpebral.Resultados: Sólo hemos encontrado mejoría estadísticamente significativa tras el tratamiento en el valor del cuestionario, tinción con fluoresceína y tinción con rosa de bengala en el grupo de pacientes tratados con hialuronato sódico 0,15%. En el grupo de pacientes tratados con alcohol polivinílico no encontramos diferencia estadísticamente significativa en ninguno de los parámetros estudiados antes y después del tratamiento.Conclusiones: El hialuronato sódico 0,15% ha resultado ser más eficaz en el tratamiento de los pacientes con ojo seco que el alcohol polivinílico