Different solutions used for submucosal injection influenced early healing of gastric endoscopic mucosal resection in a preclinical study in experimental pigs.
BACKGROUND
We hypothesised that different solutions for submucosal injection may influence early healing of endoscopic mucosal resection (EMR). The aim of this study was to evaluate histological and immunological changes after EMR in experimental pigs.


METHODS
Two parallel EMRs on the anterior and posterior wall of the gastric body were performed by means of the cap technique in 21 female pigs. A glycerol-based solution (anterior EMR) and hydroxypropyl methylcellulose solution (posterior EMR) were applied for submucosal injection. The animals were sacrificed 7 days later, and tissue sections of all EMRs were stained using combined trichrome. Computer image analysis was used for objective evaluation of elastic and collagen fibres content. Two-colour indirect immunophenotyping of blood and gastric samples were performed using mouse anti-pig monoclonal antibodies.


RESULTS
The values of collagen fibre content 7 days after EMR were significantly higher in lesions after the use of solution A in comparison with solution B (2.10 +/- 0.25% versus 1.57 +/- 0.25%, p = 0.009). Concordant results were found in elastic fibres (3.23 +/- 0.49% versus 2.93 +/- 0.61%, p = 0.018). No systemic changes in major leukocyte subpopulations were found. In gastric tissue, lymphocyte subsets exhibited only minor changes. CD4(+) T-lymphocytes were increased in the healing tissue after EMR using solution A (17.08 +/- 9.24% versus 9.76 +/- 7.97%, p = 0.011). Significant increase of SWC3(+) leukocytes was observed after EMR using solution B (47.70 +/- 25.41% versus 18.70 +/- 12.16%, p = 0.001).


CONCLUSIONS
The use of glycerol-based solution for submucosal injection was associated with more pronounced histological signs of early healing of EMRs compared with hydroxypropyl methylcellulose.
Bures
Jan
J
Second Department of Internal Medicine, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Sokolská 581, 500 05, Hradec Králové, Czech Republic. bures@lfhk.cuni.cz
Kopácová
Marcela
M
Kvetina
Jaroslav
J
Osterreicher
Jan
J
Sinkorová
Zuzana
Z
Svoboda
Zbynek
Z
Tachecí
Ilja
I
Filip
Stanislav
S
Spelda
Stanislav
S
Kunes
Martin
M
Rejchrt
Stanislav
S
D000818:Animals; D003094:Collagen / Q000032:analysis; D004353:Drug Evaluation, Preclinical; D004547:Elastic Tissue / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D005773:Gastroscopy; D005990:Glycerol / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D065347:Hypromellose Derivatives; D007267:Injections; D007962:Leukocytes / Q000187:drug effects; D016131:Lymphocyte Subsets / Q000187:drug effects; D008747:Methylcellulose / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D019999:Pharmaceutical Solutions / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D034421:Sus scrofa; D013997:Time Factors; D014783:Viscosity; D014945:Wound Healing / Q000187:drug effects*
D019999:Pharmaceutical Solutions; D065347:Hypromellose Derivatives; D008747:Methylcellulose; D003094:Collagen; D005990:Glycerol