Regenerative medicine approaches for the management of respiratory tract fistulas
Abstract Respiratory tract fistulas (or fistulae) are abnormal communications between the respiratory system and the digestive tract or the adjacent organs. The origin can be congenital or, more frequently, iatrogenic and the clinical presentation is heterogeneous. Respiratory tract fistulas can lea...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Stem Cell Research & Therapy |
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| Online Access: | http://link.springer.com/article/10.1186/s13287-020-01968-1 |
| _version_ | 1811325135935766528 |
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| author | Angelo Trivisonno Dania Nachira Ivo Boškoski Venanzio Porziella Giuliana Di Rocco Silvia Baldari Gabriele Toietta |
| author_facet | Angelo Trivisonno Dania Nachira Ivo Boškoski Venanzio Porziella Giuliana Di Rocco Silvia Baldari Gabriele Toietta |
| author_sort | Angelo Trivisonno |
| collection | DOAJ |
| description | Abstract Respiratory tract fistulas (or fistulae) are abnormal communications between the respiratory system and the digestive tract or the adjacent organs. The origin can be congenital or, more frequently, iatrogenic and the clinical presentation is heterogeneous. Respiratory tract fistulas can lead to severely reduced health-related quality of life and short survival. Therapy mainly relies on endoscopic surgical interventions but patients often require prolonged hospitalization and may develop complications. Therefore, more conservative regenerative medicine approaches, mainly based on lipotransfer, have also been investigated. Adipose tissue can be delivered either as unprocessed tissue, or after enzymatic treatment to derive the cellular stromal vascular fraction. In the current narrative review, we provide an overview of the main tissue/cell-based clinical studies for the management of various types of respiratory tract fistulas or injuries. Clinical experience is limited, as most of the studies were performed on a small number of patients. Albeit a conclusive proof of efficacy cannot be drawn, the reviewed studies suggest that grafting of adipose tissue-derived material may represent a minimally invasive and conservative treatment option, alternative to more aggressive surgical procedures. Knowledge on safety and tolerability acquired in prior studies can lead to the design of future, larger trials that may exploit innovative procedures for tissue processing to further improve the clinical outcome. |
| first_indexed | 2024-04-13T14:27:47Z |
| format | Article |
| id | doaj.art-cad2e5b8b49f4126ba360e59246ace11 |
| institution | Directory Open Access Journal |
| issn | 1757-6512 |
| language | English |
| last_indexed | 2024-04-13T14:27:47Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Stem Cell Research & Therapy |
| spelling | doaj.art-cad2e5b8b49f4126ba360e59246ace112022-12-22T02:43:16ZengBMCStem Cell Research & Therapy1757-65122020-10-0111111310.1186/s13287-020-01968-1Regenerative medicine approaches for the management of respiratory tract fistulasAngelo Trivisonno0Dania Nachira1Ivo Boškoski2Venanzio Porziella3Giuliana Di Rocco4Silvia Baldari5Gabriele Toietta6Department of Surgical Science, University of Rome “La Sapienza”Department of General Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCSDigestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCSDepartment of General Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCSDepartment of Research, Advanced Diagnostic, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer InstituteDepartment of Research, Advanced Diagnostic, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer InstituteDepartment of Research, Advanced Diagnostic, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer InstituteAbstract Respiratory tract fistulas (or fistulae) are abnormal communications between the respiratory system and the digestive tract or the adjacent organs. The origin can be congenital or, more frequently, iatrogenic and the clinical presentation is heterogeneous. Respiratory tract fistulas can lead to severely reduced health-related quality of life and short survival. Therapy mainly relies on endoscopic surgical interventions but patients often require prolonged hospitalization and may develop complications. Therefore, more conservative regenerative medicine approaches, mainly based on lipotransfer, have also been investigated. Adipose tissue can be delivered either as unprocessed tissue, or after enzymatic treatment to derive the cellular stromal vascular fraction. In the current narrative review, we provide an overview of the main tissue/cell-based clinical studies for the management of various types of respiratory tract fistulas or injuries. Clinical experience is limited, as most of the studies were performed on a small number of patients. Albeit a conclusive proof of efficacy cannot be drawn, the reviewed studies suggest that grafting of adipose tissue-derived material may represent a minimally invasive and conservative treatment option, alternative to more aggressive surgical procedures. Knowledge on safety and tolerability acquired in prior studies can lead to the design of future, larger trials that may exploit innovative procedures for tissue processing to further improve the clinical outcome.http://link.springer.com/article/10.1186/s13287-020-01968-1Adipose tissueFistulaRegenerative medicineRespiratory tractLipotransferMesenchymal stromal cells |
| spellingShingle | Angelo Trivisonno Dania Nachira Ivo Boškoski Venanzio Porziella Giuliana Di Rocco Silvia Baldari Gabriele Toietta Regenerative medicine approaches for the management of respiratory tract fistulas Stem Cell Research & Therapy Adipose tissue Fistula Regenerative medicine Respiratory tract Lipotransfer Mesenchymal stromal cells |
| title | Regenerative medicine approaches for the management of respiratory tract fistulas |
| title_full | Regenerative medicine approaches for the management of respiratory tract fistulas |
| title_fullStr | Regenerative medicine approaches for the management of respiratory tract fistulas |
| title_full_unstemmed | Regenerative medicine approaches for the management of respiratory tract fistulas |
| title_short | Regenerative medicine approaches for the management of respiratory tract fistulas |
| title_sort | regenerative medicine approaches for the management of respiratory tract fistulas |
| topic | Adipose tissue Fistula Regenerative medicine Respiratory tract Lipotransfer Mesenchymal stromal cells |
| url | http://link.springer.com/article/10.1186/s13287-020-01968-1 |
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