Abstract
It is generally accepted that stent implantation is the mainstream therapy in clinics for esophageal cancer in the later period. However, the restenosis caused by tumor cells, epithelial cells, and fibroblasts seriously interferes with the stent medical application and limits its long-term services. To address this conundrum, a series of drug-eluting stents were invented and verified to be feasible in the early stage after implantation, but the limited drug loading and good cell compatibility of the stent materials may lead to more serious restenosis and further endanger the patient’s life. In previous work, we modified the esophageal stent material 317L stainless steel (317L SS) surface with a poly-dopamine/poly-ethylenimine layer (PDA/PEI), which had strong anti-tumor functions. In this contribution, we employed a usual drug in clinic, 5-fluorouracil (5-Fu), with series of density onto the PDA/PEI modified 317L SS to investigate the influence of 5-Fu immobilization on the anti-restenosis function. The surface characterization including 5-Fu quantity, atomic force microscopy (AFM). Water contact angle measurement indicated successful preparation of the PDA/PEI/5-Fu layers. The spectrophotometric characterization revealed that the immobilized 5-Fu rapidly released over 24 h. However, the Eca109, Het-1A, and L929 cells culture results suggested that the released 5-Fu made a significant contribution to improving the apoptosis and necrosis of these pathological cells, and the PDA/PEI/5-Fu layers maintain the consistent anti-restenosis function on their surfaces with the PDA/PEI layer after 24 h. All the results demonstrated the PDA/PEI/5-Fu layers’ excellent ability to suppress esophageal tumor cells, epithelial cells, and fibroblasts, suggesting a potential application on the surface modification of esophageal stents for better anti-restenosis function.
Highlights
All the results demonstrated the poly-dopamine/poly-ethylenimine layer (PDA/PEI)/5-Fu layers’ excellent ability to suppress esophageal tumor cells, epithelial cells, and fibroblasts, suggesting a potential application on the surface modification of esophageal stents for better anti-restenosis function
Esophageal cancer is a malignant tumor of the digestive tract in esophageal epithelial tissue
Esophageal drug-eluting stents have the advantage of a certain anti-restenosis function through the release of the loaded drug for in situ therapy [6,7,8], the drug loading on the stent surface is limited, and the stent’s anti-restenosis function will gradually lose potency with the drug release [9]
Summary
Esophageal cancer is a malignant tumor of the digestive tract in esophageal epithelial tissue. Metal stent implantation is generally accepted as the crucial method for relieving late esophageal obstruction in nonsurgical palliative care [4] and the stent types include fully covered stents, bare metal stents, and drug-eluting stents [5]. Covered stents have a high migration rate and are removed with 8 weeks of placement of the stents, while chemotherapy and radiation therapy has to be given in the meantime to shrink the tumor so that they may not need the stents. Drug-eluting stents are predominantly used for uncovered stents and this is for a minority of patients who do not tolerate chemotherapy and radiation therapy. It is desirable to develop functional modified layers on continuous anti-restenosis
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