Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy.
Clinical Gastroenterology Unit, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy.
Photochem Photobiol Sci. 2023 Mar;22(3):535-547. doi: 10.1007/s43630-022-00333-w. Epub 2022 Nov 15.
Helicobacter pylori gastric infections are among the most diffused worldwide, suffering from a rising rate of antibiotic resistance. In this context, some of the authors have previously designed an ingestible device in the form of a luminous capsule to perform antibacterial photodynamic inactivation in the stomach. In this study, the light-emitting capsules were tested to verify the safety of use prior to perform clinical efficacy studies. First, laboratory tests measured the capsule temperature while in function and verified its chemical resistance in conditions mimicking the gastric and gut environments. Second, safety tests in a healthy minipig model were designed and completed, to verify both the capsule integrity and the absence of side effects, associated with its illumination and transit throughout the gastrointestinal tract. To this aim, a capsule administration protocol was defined considering a total of 6 animals with n = 2 treated with 8 capsules, n = 2 treated with 16 capsules and n = 2 controls with no capsule administration. Endoscopies were performed in sedated conditions before-after every capsule administration. Biopsies were taken from the corpus and antrum regions, while the gastric cavity temperature was monitored during illumination. The bench tests confirmed a very good chemical resistance and a moderate (about 3 °C) heating of the capsules. The animal trials showed no significant effects on the gastric wall tissues, both visually and histologically, accompanied with overall good animal tolerance to the treatment. The integrity of the administered capsules was verified as well. These encouraging results pose the basis for the definition of successive trials at the clinical level.
幽门螺杆菌胃部感染是全球最普遍的感染之一,且抗生素耐药率呈上升趋势。在此背景下,部分作者之前设计了一种可摄入的发光胶囊装置,用于在胃部进行抗菌光动力失活。在本研究中,发光胶囊在进行临床疗效研究之前,先进行了使用安全性测试。首先,实验室测试测量了胶囊在工作时的温度,并验证了其在模拟胃部和肠道环境下的化学抗性。其次,在健康小型猪模型中设计并完成了安全性测试,以验证胶囊的完整性和不存在与其照明和整个胃肠道转运相关的副作用。为此,定义了一个胶囊给药方案,共纳入 6 只动物,n=2 只动物接受 8 个胶囊治疗,n=2 只动物接受 16 个胶囊治疗,n=2 只动物作为对照,不给予胶囊。在每次胶囊给药前后,对动物进行镇静状态下的内镜检查。从胃体和胃窦区域采集活检,同时在照明过程中监测胃腔温度。台架测试证实了胶囊具有非常好的化学抗性和适度(约 3°C)的加热效果。动物试验显示,胶囊给药对胃壁组织没有明显的影响,无论是肉眼观察还是组织学观察,并且动物对治疗的总体耐受性良好。还验证了给药胶囊的完整性。这些令人鼓舞的结果为定义临床水平的后续试验奠定了基础。