Takagi Ryo
   Department   Research Institutes and Facilities, Research Institutes and Facilities
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title First-in-human autologous oral mucosal epithelial sheet transplantation to prevent anastomotic re-stenosis in congenital esophageal atresia.
Journal Formal name:Stem cell research & therapy
Abbreviation:Stem Cell Res Ther
ISSN code:17576512/17576512
Domestic / ForeginForegin
Volume, Issue, Page 13(1),pp.35
Author and coauthor FUJINO Akihiro†, FUCHIMOTO Yasushi*, BABA Yoshiyuki, ISOGAWA Nobutaka, IWATA Takanori, ARAI Katsuhiro, ABE Makoto, KANAI Nobuo, TAKAGI Ryo, MAEDA Masanori, UMEZAWA Akihiro
Publication date 2022/01
Summary BACKGROUND:Congenital esophageal atresia postoperative anastomotic stricture occurs in 30-50% of cases. Patients with severe dysphagia are treated with endoscopic balloon dilatation (EBD) and/or local injection of steroids, but many patients continue to experience frequent stricture. In this study, we investigated the transplantation of autologous oral mucosa-derived cell sheets (epithelial cell sheets) as a prophylactic treatment for congenital esophageal atresia postoperative anastomotic stricture.METHODS:Epithelial cell sheets were fabricated from a patient's oral epithelial tissue, and their safety was confirmed by quality control tests. The epithelial cell sheets were transported under controlled conditions from the fabrication facility to the transplantation facility and successfully transplanted onto the lacerations caused by EBD using a newly developed transplantation device for pediatric patients. The safety of the transplantation was confirmed by follow-up examinations over 48 weeks.RESULTS:The dates that EBD was performed were recorded for one year before and after epithelial cell sheet transplantation, and the intervals (in days) were evaluated. For about 6 months after transplantation, the intervals between EBDs were longer than in the year before transplantation. The patients were also aware of a reduction in dysphagia after transplantation.CONCLUSIONS:These results suggest that cell sheet transplantation may be effective in preventing anastomotic stricture after surgery for congenital esophageal atresia, but the effect was temporary and limited in this case. Although we chose a very severe case for the first human clinical study, it may be possible to obtain a more definitive effect if the transplantation is performed before the disease becomes so severe. Future studies are needed to identify cases in which cell sheet transplantation is most effective and to determine the appropriate timeframes for transplantation.TRIAL REGISTRATION:UMIN, UMIN00003456
DOI 10.1186/s13287-022-02710-9
PMID 35090534