title: Mesenchymal stromal cells from adipose tissue attached to suture material enhance the closure of enterocutaneous fistulas in a rat model.
abstract: OBJECTIVE
  Surgical treatment for enterocutaneous fistulas (EF) frequently fails. Cell therapy may represent a new approach to treatment. Mesenchymal stromal cells (MSCs) have high proliferative and differentiation capacity. This study aimed to investigate whether MSCs could adhere to suture filament (SF), promoting better EF healing.
  
  
  METHODS
  MSCs, 1 × 10(6), from adipose tissue (ATMSCs) were adhered to a Polyvicryl SF by adding a specific fibrin glue formulation. Adhesion was confirmed by confocal and scanning electron microscopy (SEM). A cecal fistula was created in 22 Wistar rats by incising the cecum and suturing the opening to the surgical wound subcutaneously with four separate stitches. The animals were randomly allocated to three groups: control (CG)-five animals, EF performed; injection (IG)-eight animals 1 × 10(6) ATMSCs injected around EF borders; and suture filament (SG): nine animals, sutured with 1 × 10(6) ATMSCs attached to the filaments with fibrin glue. Fistulas were photographed on the operation day and every 3 days until the 21st day and analyzed by two observers using ImageJ Software.
  
  
  RESULTS
  Confocal and SEM results demonstrated ATMSCs adhered to SF (ATMSCs-SF). The average reduction size of the fistula area at 21st day was greater for the SG group (90.34%, P < 0.05) than the IG (71.80%) and CG (46.54%) groups.
  
  
  CONCLUSIONS
  ATMSCs adhered to SF maintain viability and proliferative capacity. EF submitted to ATMSCs-SF procedure showed greater recovery and healing. This approach might be a new and effective tool for EF treatment.
authors.affiliation: Public Umbilical Cord Blood Bank, Haematology Hemotherapy Center/INCT do Sangue, University of Campinas, Campinas, Brazil.
authors.forename: Bruno Bosch
authors.initials: BB
authors.lastname: Volpe
authors.affiliation: Public Umbilical Cord Blood Bank, Haematology Hemotherapy Center/INCT do Sangue, University of Campinas, Campinas, Brazil.
authors.forename: Adriana da Silva
authors.initials: Ada S
authors.lastname: Santos Duarte
authors.affiliation: Public Umbilical Cord Blood Bank, Haematology Hemotherapy Center/INCT do Sangue, University of Campinas, Campinas, Brazil.
authors.forename: Thiago Borsoi
authors.initials: TB
authors.lastname: Ribeiro
authors.affiliation: Plastic Surgery Department, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.
authors.forename: Ithamar
authors.initials: I
authors.lastname: Stocchero
authors.affiliation: Plastic Surgery Department, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Kharmandayan
authors.affiliation: Internal Medicine Department, Faculty of Medical Sciences, Haematology Hemotherapy Center/INCT do Sangue, University of Campinas, Campinas, Brazil.
authors.forename: Sara Teresinha
authors.initials: ST
authors.lastname: Olalla Saad
authors.affiliation: Paediatric Surgery Department, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.
authors.forename: Joaquim Murray
authors.initials: JM
authors.lastname: Bustorff-Silva
authors.affiliation: Public Umbilical Cord Blood Bank, Haematology Hemotherapy Center/INCT do Sangue, University of Campinas, Campinas, Brazil. Electronic address: luzo@unicamp.br.
authors.forename: Angela Cristina
authors.initials: AC
authors.lastname: Malheiros Luzo
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000818:Animals; D049109:Cell Proliferation; D002470:Cell Survival; D007412:Intestinal Fistula / Q000601:surgery*; D059630:Mesenchymal Stem Cells / Q000378:metabolism*; D051381:Rats; D017208:Rats, Wistar; D013537:Sutures; D014945:Wound Healing
keywords: Crohn disease; cell therapy; enterocutaneous fistula; mesenchymal stem cells; suture filaments