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Abstract Background Endoscopic submucosal dissection (ESD) is the current standard treatment for early-stage esophageal neoplasms. However, the postoperative esophageal stricture after extensive mucosal dissection remains a severe challenge with limited effective treatments available. In this study, we introduced a chitosan/gelatin (ChGel) sponge encapsulating the adipose mesenchymal stem cells (ADMSCs)-derived exosomes (ChGelMSC−Exo) for the prevention of esophageal stenosis after ESD in a porcine model. Results Pigs were randomly assigned into (1) ChGelMSC−Exo treatment group, (2) ChGelPBS group, and (3) the controls. Exosome treatments were applied immediately on the day after ESD as well as on day 7. Exosome components crucial for wound healing were investigated by liquid chromatography-tandem mass spectrometry (LC–MS/MS) and small RNA sequencing. ChGelMSC−Exo treatment significantly reduced mucosal contraction on day 21, with less fiber accumulation and inflammatory infiltration, and enhanced angiogenesis when compared with the control and ChGelPBS groups. The anti-fibrotic effects following MSC-Exo treatment were further found to be associated with the anti-inflammatory M2 polarization of the resident macrophages, especially within the M2b subset characterized by the reduced TGFβ1 secretion, which sufficiently inhibited inflammation and prevented the activation of myofibroblast with less collagen production at the early stage after ESD. Moreover, the abundant expression of exosomal MFGE8 was identified to be involved in the transition of the M2b-macrophage subset through the activation of MFGE8/STAT3/Arg1 axis. Conclusions Our study demonstrates that exosomal MFGE8 significantly promotes the polarization of the M2b-macrophage subset, consequently reducing collagen deposition. These findings suggest a promising potential for MSC-Exo therapy in preventing the development of esophageal stricture after near-circumferential ESD. Graphical Abstract

Therapeutic drug monitoring (TDM) is pivotal for optimizing drug dosage regimens in individual patients, particularly for drugs with a narrow therapeutic index. Surface-enhanced Raman spectroscopy (SERS) has shown great potential in TDM due to high sensitivity, non-destructive analysis, specific fingerprint spectrum, low sample consumption, simple operation, and low ongoing costs. Due to the rapid development of SERS for TDM, a review focusing on the analytical method is presented to better understand the trends. This review examines the latest advancements in SERS substrates and their applications in TDM, highlighting the innovations in substrate design that enhance detection sensitivity and selectivity. We discuss the challenges faced by SERS for TDM, such as substrate signal reproducibility and matrix interference from complex biological samples, and explore solutions like digital colloid-enhanced Raman spectroscopy, enrichment detection strategies, microfluidic SERS, tandem instrument technologies, and machine learning-enabled SERS. These advancements address the limitations of traditional SERS applications and improve analytical efficiency in TDM. Finally, conclusions and perspectives on future research directions are presented. The integration of SERS with emerging technologies presents a transformative approach to TDM, with the potential to significantly enhance personalized medicine and improve patient outcomes.

The development of a drug delivery system capable of prolonged retention in the gastrointestinal tract remains a clinical challenge. Here the authors present a bio-adhesive liquid coacervate coating on the intestinal tract that acts as a flowable drug carrier, mediates the sustained release of diverse drugs, and potentially enhances therapeutic efficacy against gastrointestinal diseases.

Abstract Background Chemotherapy resistance is one of the main causes of recurrence in colorectal cancer (CRC) patients and leads to poor prognosis. Long noncoding RNAs (lncRNAs) have been reported to regulate chemoresistance. We aimed to determine the role of the lncRNA small nucleolar RNA host gene 6 (SNHG6) in CRC cell chemoresistance. Methods Cell drug sensitivity tests and flow cytometry were performed to analyze CRC cell chemoresistance. Animal models were used to determine chemoresistance in vivo, and micro RNA (miRNA) binding sites were detected by dual-luciferase reporter assays. Bioinformatics analysis was performed to predict miRNAs binding to SNHG6 and target genes of miR-26a-5p. SNHG6/miR-26a-5p/ULK1 axis and autophagy-related proteins were detected by qRT-PCR and western blotting. Furthermore, immunofluorescence was employed to confirm the presence of autophagosomes. Results SNHG6 enhanced CRC cell resistance to 5-fluorouracil (5-FU), promoted autophagy, inhibited 5-FU-induced apoptosis, and increased 5-FU resistance in vivo. Bioinformatics analysis showed that miR-26a-5p might bind to SNHG6 and target ULK1, and dual-luciferase reporter assays confirmed this activity. qRT-PCR and western blotting showed that SNHG6 was able to negatively regulate miR-26a-5p but correlated positively with ULK1. Conclusion SNHG6 may promote chemoresistance through ULK1-induced autophagy by sponging miR-26a-5p in CRC cells.

Background/Aim: Magnetically-controlled capsule endoscopy (MCE) is a potential option for the evaluation of gastric diseases in cases that are unsuited for conventional endoscopy, avoiding discomfort, sedation, and related complications. This retrospective study investigated associations between MCE findings and patient gender, age, and inpatient/outpatient status. Patients and Methods: The data of 580 consecutive patients who underwent MCE from 2015 to 2016 were analyzed. Data included age, gender, indication for MCE, inpatient/outpatient status, overall coverage of gastric anatomical landmarks, and comorbid conditions. Results: Compared with outpatients, inpatients had a higher rate of overall significant MCE findings (P = 0.014), polyp (P = 0.03), and ulceration (P = 0.003). MCE findings of the inpatient men and women were similar. Considering all patients, the percentage with ulceration was significantly higher in men than in women (P = 0.004), and men were younger (P < 0.001). Compared with younger patients, those aged ≥60 years had significantly higher rates of overall significant findings, mainly polyp and angiodysplasia. Conclusions: Compared with outpatients, the inpatients showed higher overall significant findings. Men undergoing MCE were younger than the women, and more likely to have ulcerations. Older patients, whether outpatient or inpatient, had higher rates of significant findings, mainly polyp and angiodysplasia.