Haemostasis and prevention of bleeding related to ER: The role of a novel self‐assembling peptide

Subramaniam, Sharmila; Kandiah, Kesavan; Thayalasekaran, Sreedhari; Longcroft‐Wheaton, Gaius; Bhandari, Pradeep

doi:10.1177/2050640618811504

Cited by 60 publications

(90 citation statements)

References 24 publications

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“…The number of bleeds that stopped spontaneously without treatment was recorded. We used the definitions described in an earlier study to classify the bleeds into three grades (grade 1, mild oozing; grade 2, moderate non-spurting bleeding with visible vessel; grade 3, arterial spurting) [22].…”

Section: Hemostasismentioning

confidence: 99%

“…Our previous experience with Purastat demonstrated that it worked best in grade 1 and 2 bleeds, but not in grade 3 bleeds [22]. Therefore, the study protocol permitted the use of diathermy with the endoscopic knife tip (in grade 1 & 2 bleeds) if the bleeding point was clearly visible in the immediate vicinity of the knife and the Coagrasper in grade 3 spurting bleeds where Purastat was not recommended.…”

Section: Interventional Armmentioning

confidence: 99%

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A novel self-assembling peptide for hemostasis during endoscopic submucosal dissection: a randomized controlled trial

et al. 2020

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Background Endoscopic submucosal dissection (ESD) is associated with a risk of bleeding. Bleeding is usually treated with diathermy, although this does carry a risk of mucosal thermal injury. Purastat is a topical hemostat that may be effective in controlling bleeding during ESD, thereby reducing the use of heat therapy. The aim of this study was to assess the reduction in heat therapy used in the interventional group (Purastat) compared with the control group. The secondary aims were to compare the procedure length, time for hemostasis, delayed bleeding rate, adverse events, and wound healing between the groups. Methods This was a single-center randomized controlled trial of 101 patients undergoing ESD. Participants were randomized to a control group where diathermy was used to control bleeding or an interventional group where Purastat could be used. Follow-up endoscopy was performed at 4 weeks to assess wound healing. Results There was a significant reduction in the use of heat therapy for intraprocedural hemostasis in the interventional group compared with controls (49.3 % vs. 99.6 %, P < 0.001). There were no significant differences in the procedure length, time for hemostasis, and delayed bleeding rate between the groups. Complete wound healing at 4 weeks was noted in 48.8 % of patients in the interventional group compared with 25.0 % of controls (P = 0.02). Conclusions This study has demonstrated that Purastat is an effective hemostat that can reduce the need for heat therapy for bleeding during ESD. It may also have a role in improving post-resection wound healing.

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Section: Hemostasismentioning

confidence: 99%

Section: Interventional Armmentioning

confidence: 99%

A novel self-assembling peptide for hemostasis during endoscopic submucosal dissection: a randomized controlled trial

et al. 2020

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“…Accompanied with the advance of nanomedicine and nanotechnology, a myriad of hydrogel strategies are now being developed to produce the functional nanostructural biomaterials with defined biological, biochemical, and biophysical features, [ 4b,58 ] which is directing to form a great number of new economic products for clinical use. For examples, Purastat hydrogel is recently licensed for clinical hemostatic nanomaterials in endoscopic resection (ER) surgery [ 59 ] and suture‐line hemostasis in cardiac surgery. [ 60 ] The surgeons consistently rate Purastat hydrogel highly, due to the transparent nature and convenient manipulation of the suture site.…”

Section: Common Hydrogel Products and Biomedical Featuresmentioning

confidence: 99%

“…In recent three decades, a lot of designer self‐assembling peptide hydrogels perform clinical trials in human beings. [ 59,60,62 ] As the biomimetic cell constructs are approved in medicinal products, the advantages and benefits of designer self‐assembling peptide hydrogels are clear for the translation to a clinical platform setting, which open the ways to high‐quality clinical trials to explore the usefulness of cell construct‐based therapy by biomedical nanotechnology. [ 49,66b ] So, the main efforts can be put into the researches involved in complex human diseases, such as prostate cancer, [ 114b ] breast cancer.…”

Section: Instructive Cell Constructs In Tissue Engineering and Precismentioning

confidence: 99%

Designer Self‐Assembling Peptide Hydrogels to Engineer 3D Cell Microenvironments for Cell Constructs Formation and Precise Oncology Remodeling in Ovarian Cancer

Yang

Zhao

2020

Advanced Science

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mouse intestinal stem cells and primary colorectal cancer cells can be propagated in vitro long term, [1] there is an urgent need to develop more physiologically relevant, efficient, and robust precise oncology models that closely recapitulate the genetic and morphological heterogeneous composition and mimic the arrangement pattern of cancer cells in the original tumor. [2] To our knowledge in biomedical research, hydrogel is the best tool to reconstruct precise oncology models in vitro, especially tumor organoid, which not only recapitulates in vivo biology and microenvironmental factors, but also at large extent allows side-by-side comparison to evaluate the translational potential of 3D model systems to the patients. [2a,3] Generally, hydrogels are mainly composed of hydrophilic polymeric scaffolds that absorb large amounts of water, so the hydrogel matrix better mimics elastic and viscoelastic properties in ECM and microscale topographies of cell matrices, which controls proper cell morphology, directs viable cell behaviors, and drives in vivo fundamental cell-cell or cell-ECM interactions. [4] To recapitulate pathophysiological features of human tumors and imitate various aspects of human tumorigenesis in vivo, hydrogels can provide a realistic platform to establish a useful bridge between in vitro assays and in vivo cell microenvironments. In current biomedical applications, there are many kinds of hydrogels to be developed to mimic the biological properties of ECM, such Designer self-assembling peptides form the entangled nanofiber networks in hydrogels by ionic-complementary self-assembly. This type of hydrogel has realistic biological and physiochemical properties to serve as biomimetic extracellular matrix (ECM) for biomedical applications. The advantages and benefits are distinct from natural hydrogels and other synthetic or semisynthetic hydrogels. Designer peptides provide diverse alternatives of main building blocks to form various functional nanostructures. The entangled nanofiber networks permit essential compositional complexity and heterogeneity of engineering cell microenvironments in comparison with other hydrogels, which may reconstruct the tumor microenvironments (TMEs) in 3D cell cultures and tissue-specific modeling in vitro. Either ovarian cancer progression or recurrence and relapse are involved in the multifaceted TMEs in addition to mesothelial cells, fibroblasts, endothelial cells, pericytes, immune cells, adipocytes, and the ECM. Based on the progress in common hydrogel products, this work focuses on the diverse designer self-assembling peptide hydrogels for instructive cell constructs in tissue-specific modeling and the precise oncology remodeling for ovarian cancer, which are issued by several research aspects in a 3D context. The advantages and significance of designer peptide hydrogels are discussed, and some common approaches and coming challenges are also addressed in current complex tumor diseases.

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“…25,26 SAPs are completely synthetic chemicals, unlike other hydrogels, which are made of animal-derived biomaterial 27 ; therefore, SAP hydrogels are considered to be highly suitable for clinical applications and have already been clinically used as hemostats. 28 One of the extensively utilized SAPs is RADA16-I, which consists of 16 alternative amino acids (hydrophilic arginine, hydrophobic alanine, hydrophilic aspartic acid). This amphiphilic peptide can form a hydrogel when in an environment with a neutral pH.…”

Section: Introductionmentioning

confidence: 99%

Recurrent laryngeal nerve regeneration using a self‐assembling peptide hydrogel

et al. 2019

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Objectives/Hypothesis To regenerate defected recurrent laryngeal nerves (RLNs), various methods have been developed. However, no consistently effective treatments are currently available because of their insufficient functional recovery. RADA16‐I, a self‐assembling peptide used clinically as a hemostat, reportedly supports neurite outgrowth and functional synapse formation in vitro. The purpose of this study was to investigate the effect of RADA16‐I hydrogels on transected RLNs in rats. Study Design Animal experiments with controls. Methods Fifteen adult rats were divided into the following three groups: RADA16‐I (+), RADA16‐I (−), and neurectomy. A 6‐mm gap of the left RLN was bridged using an 8‐mm silicone tube in the RADA16‐I (−) and RADA16‐I (+) groups. Subsequently, RADA16‐I hydrogel was injected into the tube in the RADA16‐I (+) group. The surgical incisions were closed without any further treatment in the neurectomy group. After 8 weeks, laryngoscopy and electrophysiological and histological examinations were performed to evaluate the effect of RADA16‐I on nerve regeneration and thyroarytenoid muscle atrophy. Results Although most rats in the three groups exhibited no improvements of their vocal fold movement, partial recovery was observed in one rat in the RADA16‐I (+) group. The neurofilament‐positive areas and the number of myelinated nerves in the RADA16‐I (+) group were significantly higher than in the RADA16‐I (−) group. The area of the left thyroarytenoid muscle in the RADA16‐I (+) group was significantly larger than that of the neurectomy group. Conclusions Our results suggested that RADA16‐I hydrogel was effective for RLN regeneration. Level of Evidence NA Laryngoscope, 130:2420–2427, 2020

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Haemostasis and prevention of bleeding related to ER: The role of a novel self‐assembling peptide

Cited by 60 publications

References 24 publications

A novel self-assembling peptide for hemostasis during endoscopic submucosal dissection: a randomized controlled trial

A novel self-assembling peptide for hemostasis during endoscopic submucosal dissection: a randomized controlled trial

Designer Self‐Assembling Peptide Hydrogels to Engineer 3D Cell Microenvironments for Cell Constructs Formation and Precise Oncology Remodeling in Ovarian Cancer

Recurrent laryngeal nerve regeneration using a self‐assembling peptide hydrogel

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