Regenerative medicine approaches for the management of respiratory tract fistulas

Stem Cell Research & Therapy

Dania Nachira¹  Venanzio Porziella¹  Gabriele Toietta²  Giuliana Di Rocco²  Silvia Baldari²  Angelo Trivisonno³  Ivo Boškoski⁴ 

[1] Department of General Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy;Department of Research, Advanced Diagnostic, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, via E. Chianesi 53, 00144, Rome, Italy;Department of Surgical Science, University of Rome “La Sapienza”, Viale Regina Elena 324, 00161, Rome, Italy;Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy;

关键词: Adipose tissue;    Fistula;    Regenerative medicine;    Respiratory tract;    Lipotransfer;    Mesenchymal stromal cells;    Head and neck;    Tracheoesophageal fistula;    Minimally invasive treatments;    Airway defects restoration;   

DOI  :  10.1186/s13287-020-01968-1

来源: Springer

【 摘 要 】

Respiratory tract fistulas (or fistulae) are abnormal communications between the respiratory system and the digestive tract or the adjacent organs. The origin can be congenital or, more frequently, iatrogenic and the clinical presentation is heterogeneous. Respiratory tract fistulas can lead to severely reduced health-related quality of life and short survival. Therapy mainly relies on endoscopic surgical interventions but patients often require prolonged hospitalization and may develop complications. Therefore, more conservative regenerative medicine approaches, mainly based on lipotransfer, have also been investigated. Adipose tissue can be delivered either as unprocessed tissue, or after enzymatic treatment to derive the cellular stromal vascular fraction. In the current narrative review, we provide an overview of the main tissue/cell-based clinical studies for the management of various types of respiratory tract fistulas or injuries. Clinical experience is limited, as most of the studies were performed on a small number of patients. Albeit a conclusive proof of efficacy cannot be drawn, the reviewed studies suggest that grafting of adipose tissue-derived material may represent a minimally invasive and conservative treatment option, alternative to more aggressive surgical procedures. Knowledge on safety and tolerability acquired in prior studies can lead to the design of future, larger trials that may exploit innovative procedures for tissue processing to further improve the clinical outcome.

【 授权许可】

CC BY