Zhou Tianyu, Liu Zhaoxue, Xu Lei, Mao Xinli, Jin Haifeng, Xiong Yangyang, Chen Guangwu, Lv Yong, Cen Li, Wang Chunren, Zhang Yu, Ye Kexin, Shen Qien, Zhou Jiaming, Lv Bin, Dai Jianying, Yu Chaohui, Shen Zhe
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China.
Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China.
Int J Biol Macromol. 2025 May;306(Pt 1):141146. doi: 10.1016/j.ijbiomac.2025.141146. Epub 2025 Feb 20.
Endoscopic submucosal dissection (ESD) is widely used to treat gastrointestinal mucosal and submucosal lesions. However, it may cause bleeding, perforation, and stricture. Although these complications can be avoided by introducing materials such as polyglycolic acid and carboxymethyl cellulose sheets, such approaches are expensive and time-consuming. Herein, we report a hydrogel prepared by combining a colloidal solution composed of konjac glucomannan (KGM) and sodium alginate (SA) and a fixative solution containing ε-poly-l-lysine (ε-PLL) and calcium chloride. The two solutions were mixed on the wound surface to form the KGM/SA/ε-PLL hydrogel through hydrogen bonds, coordination bonds, and electrostatic attraction. The effectiveness and convenience of applying the KGM/SA/ε-PLL hydrogel to promote wound healing in the esophagus and colon were assessed in vitro and in vivo. We found that the hydrogel stimulated epithelial proliferation, reduced inflammation, promoted recapillarization, and inhibited fibrosis in the esophagus and colon. Therefore, the KGM/SA/ε-PLL hydrogel is an effective and convenient agent that can promote post-ESD wound healing and is recommended for ulcer bed protection in daily clinical practice.
内镜黏膜下剥离术(ESD)被广泛用于治疗胃肠道黏膜及黏膜下病变。然而,它可能会导致出血、穿孔和狭窄。尽管通过引入聚乙醇酸和羧甲基纤维素片等材料可以避免这些并发症,但此类方法昂贵且耗时。在此,我们报告一种水凝胶,它由魔芋葡甘聚糖(KGM)和海藻酸钠(SA)组成的胶体溶液与含有ε-聚-L-赖氨酸(ε-PLL)和氯化钙的固定液混合而成。这两种溶液在创面混合,通过氢键、配位键和静电引力形成KGM/SA/ε-PLL水凝胶。对KGM/SA/ε-PLL水凝胶促进食管和结肠创面愈合的有效性和便利性进行了体外和体内评估。我们发现该水凝胶能刺激上皮细胞增殖、减轻炎症、促进血管再生并抑制食管和结肠的纤维化。因此,KGM/SA/ε-PLL水凝胶是一种有效且便捷的促进ESD术后创面愈合的制剂,在日常临床实践中推荐用于溃疡床保护。