Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi St, Suzhou, Jiangsu 215006, People's Republic of China.
Acta Biomater. 2013 Sep;9(9):8328-36. doi: 10.1016/j.actbio.2013.06.004. Epub 2013 Jun 14.
In benign esophageal strictures, inflammation reaction and tissue hyperplasia after stent placement greatly limit the stent retention time and affect subsequent scar formation, which is one of the main influences on long-term recurrence rate. A newly developed biodegradable electrospun drug-fiber-coated stent (DFCS) was fabricated to inhibit inflammation and scar formation. The electrospun paclitaxel/poly(ε-caprolactone) (PCL) fibers integrally covered the bare stent using the rotating collection method. The paclitaxel entrapment did not significantly affect the physical properties of electrospun PCL fibrous membranes. The mechanical results demonstrated that electrospun fibers containing paclitaxel covering the stent maintained the original mechanical characteristics of the stent, and no membrane tearing or ablation was observed after hundreds of repeated compressions. Paclitaxel release profiles were controlled mainly via diffusion of drug through the drug content, and stable release of paclitaxel continued up to 32 days at pH 4.0. Higher inhibition of smooth muscle cell proliferation rates was observed on fibrous membranes with higher paclitaxel content. DFCS showed a significant decrease in tissue inflammation and collagen fiber proliferation, and was easily removed from the esophageal part, which had almost no damage to the tissues in the dog model. Therefore, DFCSs may have great potential to markedly attenuate stent-induced inflammation and scar formation in esophageal stenosis therapy.
在良性食管狭窄中,支架放置后的炎症反应和组织增生极大地限制了支架的保留时间,并影响了随后的瘢痕形成,这是长期复发率的主要影响因素之一。本研究开发了一种新型可生物降解的电纺药物纤维涂层支架(DFCS),以抑制炎症和瘢痕形成。采用旋转收集法,将紫杉醇/聚(ε-己内酯)(PCL)电纺纤维整体覆盖在裸支架上。紫杉醇包埋对电纺 PCL 纤维膜的物理性能没有显著影响。力学结果表明,覆盖支架的含紫杉醇电纺纤维保持了支架的原始机械特性,经过数百次重复压缩后,没有观察到膜撕裂或烧蚀。紫杉醇的释放曲线主要通过药物含量的扩散来控制,在 pH4.0 下,紫杉醇能够稳定释放长达 32 天。具有较高紫杉醇含量的纤维膜对平滑肌细胞增殖率的抑制作用更高。DFCS 显示出组织炎症和胶原纤维增殖的显著减少,并且易于从食管部位取出,在犬模型中几乎对组织没有损伤。因此,DFCS 可能具有显著减轻食管狭窄治疗中支架引起的炎症和瘢痕形成的巨大潜力。