Universidade de São Paulo - Faculdade de Medicina - Disciplina de Cirurgia Plástica - São Paulo (SP) - Brazil.
Universidade de São Paulo - Faculdade de Medicina - Hospital das Clínicas - Serviço de Cirurgia Plástica - São Paulo (SP) - Brazil.
Acta Cir Bras. 2023 Oct 13;38:e384523. doi: 10.1590/acb384523. eCollection 2023.
Enterocutaneous fistula (ECF) is a condition in which there is an abnormal connection between the intestinal tract and the skin. It can lead to high morbidity and mortality rates despite the availability of therapeutic options. Stem cells have emerged as a potential strategy to treat ECF. This study aimed to evaluate the effect of adipose tissue-derived stem cells (ASC) on ECF in an experimental model.
ECF was induced in 21 Wistar rats, and after one month, they were divided into three groups: control group (C), culture medium without ASC group (CM), and allogeneic ASC group (ASC). After 30 days, the animals underwent macroscopic analysis of ECF diameter and histopathological analysis of inflammatory cells, tissue fibrosis, and vascular density.
The study found a 55% decrease in the ECF diameter in the ASC group (4.5 ± 1.4 mm) compared to the control group (10.0 ± 2.1 mm, p = 0.001) and a 59.1% decrease in the CM group (11.0 ± 4.3 mm, p = 0.003). The fibrosis score in the ASC group was 20.9% lower than the control group (p = 0.03). There were no significant differences in inflammation scores among the three groups.
This study suggests that ASC treatment can reduce ECF diameter, and reduction in tissue fibrosis may be a related mechanism. Further studies are needed to understand the underlying mechanisms fully.
肠皮肤瘘（ECF）是一种肠与皮肤之间存在异常连接的情况。尽管有治疗选择，但它仍可导致高发病率和死亡率。干细胞已成为治疗 ECF 的一种潜在策略。本研究旨在评估脂肪组织来源的干细胞（ASC）对实验模型中 ECF 的影响。
在 21 只 Wistar 大鼠中诱导 ECF，一个月后，将它们分为三组：对照组（C）、无 ASC 培养基组（CM）和同种异体 ASC 组（ASC）。30 天后，对动物进行 ECF 直径的宏观分析和炎症细胞、组织纤维化和血管密度的组织病理学分析。
研究发现 ASC 组的 ECF 直径降低了 55%（4.5 ± 1.4 mm），与对照组（10.0 ± 2.1 mm，p = 0.001）相比，CM 组降低了 59.1%（11.0 ± 4.3 mm，p = 0.003）。ASC 组的纤维化评分比对照组低 20.9%（p = 0.03）。三组炎症评分无显著差异。
本研究表明 ASC 治疗可减小 ECF 直径，组织纤维化减少可能是相关机制。需要进一步研究以充分了解潜在机制。
