Comparison of statins with steroids and botulinum toxin A in the prevention of benign strictures after esophageal endoscopic submucosal dissection: a retrospective cohort study

Wang, Yanjuan; Xia, Weiyu; Liang, Tian; Zhu, Bingqian; Chen, Meihong; Si, Xiaoyan; Lin, Shengli; Gong, Yuhan

doi:10.1007/s00464-023-09906-x

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…The high expressions of K14, CDH1, β-catenin, and ZO-1 in the IE/TA group confirmed the therapeutic effect of TA on cells in an inflammatory state, which is similar to some patients with esophageal strictures using the local injection of TA in the surgical area before ESD/EMR (Nagami et al , 2018; Kato et al , 2018; Wang et al , 2023; Sakaguchi et al , 2020). In the effect of TA, CSTA-unmutated epithelial cells can resist the effects of the inflammatory environment on cells.…”

Section: Resultssupporting

confidence: 70%

“…The expressions of keratin 14 (K14), cadherin 1 (CDH1), Zona occludens 1 (ZO-1), and β-Catenin were tested. K14 is expressed explicitly in epidermal keratinocytes and is often used as a biomarker in keratinocyte-driven re-epithelialization (Candi et al, 2005;Meyer et al, 2014;Wang et al, 2021;Korbut et al, 2020). CDH1, encoded by gene CDH1, is a calcium-dependent cell adhesion protein (Candi et al, 2005;van Roy & Berx, 2008;Zhang et al, 2019).…”

Section: Effect Of Triamcinolone Acetonide (Ta) On Kcsta Cellsmentioning

confidence: 99%

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CSTA: A Biomarker Regulating Esophageal Stricture Epithelial Barrier, Potential Medication Target

Yang,

Hu,

Shi

et al. 2023

Preprint

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Esophageal strictures resulting from ESD/EMR in the esophagus are distressing, with uncertain causes and treatments due to epithelial barrier dysfunction. We explored cystatin A (CSTA) as a novel biomarker for the esophageal epithelial barrier. CSTA regulates the barrier and is influenced by tacrolimus (FK506). Analyzing biopsy samples by proteomics, we identified CSTA as an esophageal epithelial biomarker. Knocking down CSTA reduced responsiveness to triamcinolone acetonide (TA) and lowered expression of proteins related to cell-cell junctions and barrier function during inflammation. These findings suggest that down-regulate CSTA weakens tight junctions and the esophageal barrier, leading to strictures. Notably, FK506 showed promise in rescuing CSTA-knockdown cells by increasing the expression of proteins related to cell-cell junctions and barrier function. This highlights FK506 as a potential therapy for esophageal strictures in patients with CSTA mutations.

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Section: Resultssupporting

confidence: 70%

Section: Effect Of Triamcinolone Acetonide (Ta) On Kcsta Cellsmentioning

confidence: 99%

CSTA: A Biomarker Regulating Esophageal Stricture Epithelial Barrier, Potential Medication Target

Yang,

Hu,

Shi

et al. 2023

Preprint

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“…In a recent retrospective study of 204 patients [ 49 ], the authors compared the effect of oral statins, BoNT injection, oral and topical steroids, and non-intervention with each other in reducing the risk of stricture development after esophagectomy. The authors found that the effect of statins and BoNT injections in preventing the development of strictures were comparable with each other, and the stricture occurrence rates in the statins and BoNT group were significantly lower than both the steroid treatment and the non-intervention approach ( Table 3 ).…”

Section: Esophageal Stricture (Es)mentioning

confidence: 99%

Botulinum Toxin Treatment for Cancer-Related Disorders: A Systematic Review

Safarpour,

Jabbari

2023

Toxins

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This systematic review investigates the effect of botulinum neurotoxin (BoNT) therapy on cancer-related disorders. A major bulk of the literature is focused on BoNT’s effect on pain at the site of surgery or radiation. All 13 published studies on this issue indicated reduction or cessation of pain at these sites after local injection of BoNTs. Twelve studies addressed the effect of BoNT injection into the pylorus (sphincter between the stomach and the first part of the gut) for the prevention of gastroparesis after local resection of esophageal cancer. In eight studies, BoNT injection was superior to no intervention; three studies found no difference between the two approaches. One study compared the result of intra-pyloric BoNT injection with preventive pyloromyotomy (resection of pyloric muscle fibers). Both approaches reduced gastroparesis, but the surgical approach had more serious side effects. BoNT injection was superior to saline injection in the prevention of esophageal stricture after surgery (34% versus 6%, respectively, p = 0.02) and produced better results (30% versus 40% stricture) compared to steroid (triamcinolone) injection close to the surgical region. All 12 reported studies on the effect of BoNT injection into the parotid region for the reduction in facial sweating during eating (gustatory hyperhidrosis) found that BoNT injections stopped or significantly reduced facial sweating that developed after parotid gland surgery. Six studies showed that BoNT injection into the parotid region prevented the development of or healed the fistulas that developed after parotid gland resection—parotidectomy gustatory hyperhidrosis (Frey syndrome), post-surgical parotid fistula, and sialocele. Eight studies suggested that BoNT injection into masseter muscle reduced or stopped severe jaw pain after the first bite (first bite syndrome) that may develop as a complication of parotidectomy.

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“…The progression of postoperative esophageal strictures is torture for both patients and clinicians. The literature reports that resection of more than 3/4 circumference of the esophageal mucosa with ESD is a high-risk factor for esophageal stricture [9], with an incidence of 100% and 56-76% for esophagotomy and non-esophagotomy, respectively [10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

The occurrence and development mechanisms of esophageal stricture: state of the art review

Yang,

Hu,

Shi

et al. 2024

J Transl Med

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Background Esophageal strictures significantly impair patient quality of life and present a therapeutic challenge, particularly due to the high recurrence post-ESD/EMR. Current treatments manage symptoms rather than addressing the disease's etiology. This review concentrates on the mechanisms of esophageal stricture formation and recurrence, seeking to highlight areas for potential therapeutic intervention. Methods A literature search was conducted through PUBMED using search terms: esophageal stricture, mucosal resection, submucosal dissection. Relevant articles were identified through manual review with reference lists reviewed for additional articles. Results Preclinical studies and data from animal studies suggest that the mechanisms that may lead to esophageal stricture include overdifferentiation of fibroblasts, inflammatory response that is not healed in time, impaired epithelial barrier function, and multimethod factors leading to it. Dysfunction of the epithelial barrier may be the initiating mechanism for esophageal stricture. Achieving perfect in-epithelialization by tissue-engineered fabrication of cell patches has been shown to be effective in the treatment and prevention of esophageal strictures. Conclusion The development of esophageal stricture involves three stages: structural damage to the esophageal epithelial barrier (EEB), chronic inflammation, and severe fibrosis, in which dysfunction or damage to the EEB is the initiating mechanism leading to esophageal stricture. Re-epithelialization is essential for the treatment and prevention of esophageal stricture. This information will help clinicians or scientists to develop effective techniques to treat esophageal stricture in the future.

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Comparison of statins with steroids and botulinum toxin A in the prevention of benign strictures after esophageal endoscopic submucosal dissection: a retrospective cohort study

Cited by 5 publications

References 24 publications

CSTA: A Biomarker Regulating Esophageal Stricture Epithelial Barrier, Potential Medication Target

CSTA: A Biomarker Regulating Esophageal Stricture Epithelial Barrier, Potential Medication Target

Botulinum Toxin Treatment for Cancer-Related Disorders: A Systematic Review

The occurrence and development mechanisms of esophageal stricture: state of the art review

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