title: Stem cell transplantation effectively occludes bronchopleural fistula in an animal model.
abstract: BACKGROUND
  Bronchopleural fistula after lung resection still represents a challenging life-threatening complication for thoracic surgeons. Considering its extremely high mortality rate, an effective treatment is urgently required. Our project investigated the hypothesis of experimental bronchopleural fistula closure by bronchoscopic injection of autologous bone marrow-derived mesenchymal stem cells into the cavity of the fistula, evaluating its feasibility and safety in a large animal model.
  
  
  METHODS
  An experimental bronchopleural fistula was created in 9 goats after right upper tracheal lobectomy. The animals were randomly assigned to two groups: one received autologous bone marrow-derived mesenchymal stem cell bronchoscopic transplantation; the other received standard bronchoscopic fibrin glue injection.
  
  
  RESULTS
  All animals receiving bronchoscopic stem cell transplantation presented fistula closure by extraluminal fibroblast proliferation and collagenous matrix development; none (0%) died during the study period. All animals receiving standard treatment still presented bronchopleural fistula; 2 of them (40%) died. Findings were confirmed by pathology examination, computed tomography, and magnetic resonance imaging.
  
  
  CONCLUSIONS
  Bronchoscopic transplantation of bone marrow-derived mesenchymal stem cells effectively closes experimental bronchopleural fistula by extraluminal fibroblast proliferation and collagenous matrix development. Stem cells may play a crucial role in the treatment of postresectional bronchopleural fistula after standard lung resection. Although these results provide a basis for the development of clinical therapeutic strategies, the exact mechanism by which they are obtained is not yet completely clear; further studies are required to understand exactly how stem cells work in this field.
authors.affiliation: Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy. Electronic address: francesco.petrella@ieo.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Petrella
authors.affiliation: Division of Medical Oncology of the Respiratory Tract, European Institute of Oncology, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Toffalorio
authors.affiliation: Department of Health, Animal Science and Public Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Brizzola
authors.affiliation: Division of Medical Oncology of the Respiratory Tract, European Institute of Oncology, Milan, Italy.
authors.forename: Tommaso Martino
authors.initials: TM
authors.lastname: De Pas
authors.affiliation: Department of Radiology, European Institute of Oncology, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Rizzo
authors.affiliation: Department of Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Barberis
authors.affiliation: Department of Experimental Oncology, European Institute of Oncology, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Pelicci
authors.affiliation: Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Spaggiari
authors.affiliation: Department of Health, Animal Science and Public Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Acocella
mesh_terms: D000818:Animals; D001983:Bronchial Fistula / Q000601:surgery*; D004195:Disease Models, Animal; D005260:Female; D006041:Goats; D010995:Pleural Diseases / Q000601:surgery*; D012074:Remission Induction; D016156:Respiratory Tract Fistula / Q000601:surgery*; D033581:Stem Cell Transplantation
keywords: 15