Human Oral Mucosal Stem Cells Reduce Anastomotic Leak in an Animal Model of Colonic Surgery

Abstract

<b><i>Background:</i></b> Anastomotic leak is regarded as one of the most feared complications of bowel surgery; avoiding leaks is a major priority. Attempts to reduce or eliminate leaks have included alternate anastomotic techniques. Human oral mucosa stem cells (hOMSC) are self-renewing and expandable cells derived from buccal mucosa. Studies have shown that hOMSC can accelerate tissue regeneration and wound healing. The objective of this study was to evaluate whether hOMSC can decrease anastomotic leak rates in a murine model of colon surgery. <b><i>Methods:</i></b> Two experiments were performed. In the first study, mice underwent colonic anastomosis using five interrupted sutures. hOMSC (<i>n</i> = 7) or normal saline (NS; <i>n</i> = 17) was injected into the colon wall at the site of the anastomosis. To evaluate whether hOMSC can impact anastomotic healing, the model was stressed by repeating the first experiment, reducing the number of sutures used for the construction of the anastomosis from five to four. Either hOMSC (<i>n</i> = 8) or NS (<i>n</i> = 20) was injected at the anastomosis. All mice that survived were sacrificed on postoperative day 7. Anastomotic leak rate, mortality, daily weight, and daily wellness scores were compared. <b><i>Results:</i></b> In the five-suture anastomosis, there were no differences in anastomotic leak rate, mortality, or daily weight. Mice that received hOMSC had significantly higher wellness scores on postoperative day 2 (<i>p</i> < 0.05). In the four-suture anastomosis, there was a significant decrease in leak rate (70% [NS] vs. 25% [hOMSC], <i>p</i> = 0.029) and higher wellness scores in mice that received hOMSC (<i>p</i> < 0.05). <b><i>Conclusion:</i></b> Our study suggests that injecting hOMSC at the colonic anastomosis can potentially reduce anastomotic leak and improve postoperative wellness in a murine model of colon surgery.

Possible role of features of the intestinal microbiome in patients with colorectal cancer as a cause of anastomotic leak

“…Несостоятельность анастомоза, являющуюся весьма серьезной проблемой [44], в настоящее время связывают с Enterococcus faecalis, поскольку этот патоген обладает высокой активностью коллагеназы и активирует MMП-9, которые вносят основной вклад в разрушение тканей и воспаление кишечника. Металлопротеиназы представляют собой группу протеолитических ферментов, которые опосредуют деградацию внеклеточного матрикса и регулируют высвобождение факторов роста, хемокинов и белков адгезии.…”

The Lamina Propria of the Oral Mucosa Harbors a Neural Crest-Like Stem Cell Population Resistant to Hyperglycemia Induced by Diabetes Type II

“…We published that human oral mucosa stem cells (hOMSC) are a neural crest-like stem cell population contained within niches in the lamina propria of the adult oral mucosa 17 . hOMSC differentiate in vivo and in vitro into ectodermal, endodermal and mesenchymal derived linages and have been found to have therapeutic capacities in a variety of preclinical models 17,18,19,20,21,22 . We have also recently published that allogeneic murine oral mucosa stem cells (mOMSC) enhance skin wound healing in diabetic db + /db + mice 23 .…”

Human Oral Mucosa as a Potentially Effective Source of Neural Crest Stem Cells for Clinical Practice

“…OM lamina propria contains mesenchymal stem cell populations that can be differentiated to form bone cells [ 6 , 7 , 8 , 9 ] or neuronal–dopaminergic cells with therapeutic potential in the hemi-Parkinsonian rat model [ 10 ] or differentiated into astrocyte-like cells that provide peripheral neuroprotection, significantly increasing motor performance after sciatic nerve injury in rats [ 11 ]. Using OMSCs, wound healing was enhanced in a diabetic mouse model [ 12 ], anastomotic leak rates were reduced, and improved postoperative wellness in a murine model of colon surgery was noticed [ 13 ]. A 3D construct of OMSCs was engineered and implanted and achieved substantial recovery in spinal cord injury [ 14 ].…”