A novel approach for preventing esophageal stricture formation: sphingosylphosphorylcholine-enhanced tissue remodeling

Abstract

Using a new class of intracellular 2nd messengers to prevent stricture formation after caustic ingestion, sphingosylphosphorylcholine (SPC) has a wide spectrum of activity in cell growth regulation and signal transduction. Caustic esophageal burns were created with 15% NaOH in an experimental rat model. Control group animals (n = 10) had esophageal burns with no treatment, whereas the SPC group (n = 10) had esophageal burns gavaged with SPC for 7 days. Efficacy of treatment was assessed in 28 days by contrast esophagograms, histopathologic evaluation, and biochemically by tissue hydroxyproline (OHP) content. Contrast esophagograms demonstrated that SPC significantly prevented stricture formation. Obvious collagen deposition was present in submucosa, muscularis mucosa, and muscular layers in the control group compared with the SPC group. The damage to the esophageal wall on histopathologic examination was significantly lower in the SPC group (p < 0.05). Tissue OHP contents were significantly lower in the SPC-treated group (3.0 +/- 0.1 microg/mg) compared with the control group (4.3 +/- 0.2 microg/mg) (p < 0.05). We conclude that SPC improves healing following caustic esophageal burns. Furthermore, SPC is effective in preventing caustic esophageal strictures. These effects of SPC occur through its proliferative and specifically its remodeling effects on wound healing.

The effects of local and sustained release of fibroblast growth factor on wound healing in esophageal anastomoses

“…Collagen deposition was evaluated semiquantitatively and scored [30]. Table 1 shows the histopathologic scoring system that was used.…”

Effect of 3-amino benzamide, a poly(adenosine diphosphate-ribose) polymerase inhibitor, in experimental caustic esophageal burn

“…Because none of these clinical approaches gained popularity, several researches regarding vitamins C and E, heparin, caffeic acid phenethyl ester, epidermal growth factor, interferon γ, penicillamine, sphingosylphosphorylcholine, estradiol, and progesterone were conducted to reduce the risk of stricture formation [9][10][11][12][13][14][15]. The main purpose of medical treatment is to inhibit inflammatory reaction at the early phase so as to prevent stricture formation.…”

A new imaging modality in detection of caustic oesophageal injury: Technetium-99m pyrophosphate scintigraphy

“…The degree and the extent of a corrosive lesion depend on several factors which include; the nature of the caustic substance, its concentration, and the quantity swallowed, and the length of time the substance has been in contact with the tissues. In this study, a standardized experimental model was used [8,9,14]. Nevertheless, oesophageal burns were not homogeneous due to the supine position of the rats in the course of the process.…”