Viscosity and degradation controlled injectable hydrogel for esophageal endoscopic submucosal dissection

Bioactive Materials

Shiming Yang¹  Tongchuan Wang²  Lu Liu²  Yu Huang²  Chaoqiang Fan²  Shuang Liu²  Wei Wang²  Weichao Hu²  Kaige Xu³  Malcolm Xing³ 

[1] Corresponding author.;Department of Gastroenterology, Xinqiao Hospital, Army Medical University, NO.183, Xinqiao Street, Shapingba District, Chongqing City, 400037, People's Republic of China;Department of Mechanical Engineering, Biochemistry and Medical Genetics, University of Manitoba, Winnipeg MB, R3T 2N2, Manitoba, Canada;

关键词: Injectable hydrogel;    Controllable gelation and viscosity;    Esophageal submucosal liquid cushion;    Early esophageal cancer;    Pig model;   

DOI  :  

来源: DOAJ

【 摘 要 】

Endoscopic submucosal dissection (ESD) is a common procedure to treat early and precancerous gastrointestinal lesions. Via submucosal injection, a liquid cushion is created to lift and separate the lesion and malignant part from the muscular layer where the formed indispensable space is convenient for endoscopic incision. Saline is a most common submucosal injection liquid, but the formed liquid pad lasts only a short time, and thus repeated injections increase the potential risk of adverse events. Hydrogels with high osmotic pressure and high viscosity are used as an alternate; however, with some drawbacks such as tissue damage, excessive injection resistance, and high cost. Here, we reported a nature derived hydrogel of gelatin-oxidized alginate (G-OALG). Based on the rheological analysis and compare to commercial endoscopic mucosal resection (EMR) solution (0.25% hyaluronic acid, HA), a designed G-OALG hydrogel of desired concentration and composition showed higher performances in controllable gelation and injectability, higher viscosity and more stable structures. The G-OALG gel also showed lower propulsion resistance than 0.25% HA in the injection force assessment under standard endoscopic instruments, which eased the surgical operation. In addition, the G-OALG hydrogel showed good in vivo degradability biocompatibility. By comparing the results acquired via ESD to normal saline, the G-OALG shows great histocompatibility and excellent endoscopic injectability, and enables create a longer-lasting submucosal cushion. All the features have been confirmed in the living both pig and rat models. The G-OALG could be a promising submucosal injection agent for esophageal ESD.

【 授权许可】

Unknown