Kolit oluşturulan siçanlarda adipoz doku kaynakli kök hücre tedavisinde verilme yollarinin karşilaştirilmasi : Deneysel çalişma

Inflammatory bowel diseases (IBD) is a disease whose incidence has increased in recent years and is caused by immunity, genetic and environmental factors affecting the young population. Treatment methods have been increasing over the years and studies on IBD continue. Due to the curative effect of Stem Cells on colitis, stem cell studies have been increasing in recent years. In these studies, an IBD-like colitis model is created chemically and stem cells are applied in different ways. Stem cells are mostly given locally or systemically. Locally administered stem cells cause damage to the cell wall and its application to all areas of a long colon segment is technically challenging in humans. Systemically administered stem cells, on the other hand, reach the diseased area in low concentration and are retained in other organs such as the spleen and lung. For these reasons, the effect of systemically administered stem cells decreases. In this study, in the colitis model induced by acetic acid (AA), we selectively perfused the inferior mesenteric artery (IMA) and injected the stem cell directly into the disease-induced sigmoid colon in high concentration. We also compared intra-arterial stem cell application with the local technique injected into the intestinal wall. 5 groups were formed with 6 male Wistar-Albino rats in each group. Group 1; colitis control group Group 2; local phosphate buffered saline (PBS) group Group 3; local stem cell group Group 4; intraarterial PBS group Group 5; It was planned as an intra-arterial stem cell group. Colitis was induced in all rats with acetic acid via rectal enema. All rats were weighed on the day of colitis, the day of surgery (day 7), and the day of sacrification (day 14), which received stem cells. All groups were evaluated for weight loss, macroscopic laparotomy finding, blood TNF-induced gene-6 (TSG-6) level and histopathologically. TSG-6 is a molecule that mediates the immunomodulation of the stem cell and shows the activity of the stem cell. At the same time, stem cells were labeled with green fluorescent protein (GFP) and examined under a fluorescent microscope. As a result of the study, significant weight loss occurred in all animals with colitis (p<0.05). In the histopathological examination, mucosal damage and healing were found to be significantly better in the intra-arterial group (p<0.05). Although not statistically significant, histopathological improvement was found to be better in the intra-arterial group (p>0.05). The blood TSG-6 level was also found to be significantly higher in the intra-arterial group compared to the other groups (p<0.05). There was no significant difference in laparotomy findings (p>0.05). There were no complications related to the technique in the intra-arterial stem cell group. In the immunofluorescent microscope, it was shown that the intra-arterially administered stem cells spread to the entire colon more homogeneously and diffusely. Stem cells given intra-arterially spread to the colon more effectively than stem cells given locally. Intra-arterial stem cell administration may be a safe treatment option for inflammatory bowel diseases with interventional angiographic techniques. More experimental and clinical studies are needed for this treatment. Keywords: colitis model, intraarterial stem cell, green fluorescent protein