Department of Biotechnology, Department of Biomedical-Chemical Engineering, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea.
Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Biomaterials. 2023 Nov;302:122336. doi: 10.1016/j.biomaterials.2023.122336. Epub 2023 Sep 23.
Duodenal ablation improves glycaemic control and weight loss, so it has been applied using hydrothermal catheters in obese and type 2 diabetes patients, indicating similar mechanisms and therapeutic effects as bariatric surgeries. Endoscopic photodynamic therapy is an innovative procedure that easily accessible to endocrine or gastrointestinal organs, so it is critical for the sprayed photosensitizer (PS) to long-term interact with target tissues for enhancing its effects. Surfactant-like PS was more stable in a wide range of pH and 2.8-fold more retained in the duodenum at 1 h than hydrophilic PS due to its amphiphilic property. Endoscopic duodenal ablation using surfactant-like PS was performed in high fat diet induced rat models, demonstrating body weight loss, enhanced insulin sensitivity, and modulation of incretin hormones. Locoregional ablation of duodenum could affect the profiles of overall intestinal cells secreting meal-stimulated hormones and further the systemic glucose and lipid metabolism, regarding gut-brain axis. Our strategy suggests a potential for a treatment of minimally invasive bariatric and metabolic therapy if accompanied by detailed clinical trials.
十二指肠消融术可改善血糖控制和体重减轻，因此已在肥胖和 2 型糖尿病患者中应用水热导管进行治疗，这表明其与减重手术具有相似的机制和治疗效果。内镜光动力疗法是一种创新性的治疗方法，可轻松应用于内分泌或胃肠道器官，因此对于喷涂的光敏剂 (PS) 与靶组织长期相互作用以增强其效果至关重要。由于具有两亲性，表面活性剂样 PS 在更宽的 pH 范围内更稳定，并且在 1 小时内在十二指肠中的保留率比亲水性 PS 高 2.8 倍。在高脂肪饮食诱导的大鼠模型中进行了使用表面活性剂样 PS 的内镜十二指肠消融术，结果显示体重减轻、胰岛素敏感性增强以及肠促胰岛素激素的调节。十二指肠的局部消融可能会影响整体肠道细胞分泌餐刺激激素的特征，并进一步影响肠道-大脑轴的全身葡萄糖和脂质代谢。如果伴有详细的临床试验，我们的策略表明有可能进行微创减重和代谢治疗。
