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载药橡胶圈在组织结扎中的应用

Drug-Eluting Rubber Bands for Tissue Ligation.

机构信息

Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, United States.

Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, United States.

出版信息

ACS Appl Mater Interfaces. 2022 Jun 22;14(24):27675-27685. doi: 10.1021/acsami.2c06175. Epub 2022 Jun 7.

Abstract

Rubber band ligation is a commonly used method for the removal of tissue abnormalities. Most often, rubber band ligation is performed to remove internal hemorrhoids unresponsive to first line treatments to avoid surgery. While the procedure is considered safe, patients experience mild to significant pain and discomfort until the tissue sloughs off. As patients often require multiple bandings and sessions, reducing these side effects can have a considerable effect on patient adherence and quality of life. To reduce pain and discomfort, we developed drug-eluting rubber bands for ligation procedures. We investigated the potential for a band to elute anesthetics and drug combinations to durably manage pain for a period of up to 5 days while exhibiting similar mechanical properties to conventional rubber bands. We show that the rubber bands retain their mechanical properties despite significant drug loading. Lidocaine, released from the bands, successfully altered the calcium dynamics of cardiomyocytes and modulated heart rate in zebrafish embryos, while the bands exhibited lower cytotoxicity than conventional bands. studies demonstrated substantial local drug release in enteric tissues. These latex-free bands exhibited sufficient mechanical and drug-eluting properties to serve both ligation and local analgesic functions, potentially enabling pain reduction for multiple indications.

摘要

橡皮圈结扎是一种常用于去除组织异常的方法。大多数情况下,橡皮圈结扎是为了去除对一线治疗无反应的内痔,以避免手术。虽然该手术被认为是安全的,但患者在组织脱落之前会经历轻度到重度的疼痛和不适。由于患者通常需要多次结扎和治疗,因此减轻这些副作用会对患者的依从性和生活质量产生重大影响。为了减轻疼痛和不适,我们开发了用于结扎手术的药物洗脱橡皮圈。我们研究了一种能够在长达 5 天的时间内持续释放麻醉剂和药物组合以持久缓解疼痛的可能性,同时保持与传统橡皮圈相似的机械性能。我们表明,尽管药物负载量很大,但橡皮圈仍保持其机械性能。从橡皮圈中释放的利多卡因成功改变了心肌细胞的钙动力学,并调节了斑马鱼胚胎的心率,而这些橡皮圈的细胞毒性低于传统橡皮圈。体内研究表明,在肠组织中有大量的局部药物释放。这些无乳胶橡皮圈具有足够的机械和药物洗脱性能,可同时发挥结扎和局部镇痛作用,可能为多种适应症减轻疼痛。

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