Accelerating Post-Resection Healing in the Upper GI Tract: Insights from a Pig Model

Aims Background: With advancements in endoscopic resection techniques, such as EMR and ESD, there is an increased demand to promote wound healing and bleeding control. The synthetic self-assembling RADA16-I peptide hydrogel has repeatedly demonstrated an effect on hemostasis and promise to improve wound healing after complex endoscopic resections.

Aims: The study aimed to evaluate the efficacy of self-assembling peptide hydrogel in promoting healing after endoscopic resections in the esophagus and stomach of a pig model.

Methods The study included 21 pigs randomly assigned to self-assembling peptide hydrogel (n=11) or control groups (n=10). Each animal underwent endoscopic mucosal resections (EMR) and submucosal dissections (ESD) in both the oesophagus and stomach, followed by either peptide hydrogel application or saline rinse of all lesions. Histological analysis of post-resection lesions was conducted after 8 days, focusing on histologically determined re-epithelialization index (the re-epithelialized ratio of the section through the largest diameter of lesion). The data were statistically analysed using the Mann – Whitney rank-sum test [1] [2] [3].

Results Histopathological examination revealed a significantly higher re-epithelialization index in the intervention group compared to the control group (0.36 and 0.25 resp., p=0.03). Subgroup analysis showed the greatest effect in EMR (0.45 versus 0.28, P=0.04), mainly esophageal (0.65 versus 0.39, p=0.04). Other parameters showed a non-significant trend towards better healing in the intervention compared to the control group.

Conclusions The self-assembling RADA16-I peptide hydrogel has shown potential in enhancing post-resection wound healing by supporting re-epithelialization in a porcine model. These findings suggest that the agent could enhance regeneration after endoscopic procedures, warranting further clinical trials to confirm its efficacy in human patients and advanced resection technique.

Disclosure: The study was funded by 3-D Matrix Inc., Newton, MA, US, the manufacturer of the agent used. The sponsor had no role in study design, data collection, analysis or interpretation of results.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

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