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. 2024 Sep 25;25(19):10330.
doi: 10.3390/ijms251910330.

Biologic Brachytherapy: Genetically Modified Surgical Flap as a Therapeutic Tool-A Systematic Review of Animal Studies

Wiktor Pascal  1 , Mateusz Gotowiec  1 , Antoni Smoliński  1 , Michał Suchecki  1 , Michał Kopka  1   2 , Adriana M Pascal  1 , Paweł K Włodarski  1
Affiliations

Biologic Brachytherapy: Genetically Modified Surgical Flap as a Therapeutic Tool-A Systematic Review of Animal Studies

Wiktor Pascal et al. Int J Mol Sci. .

Abstract

Surgical flaps are rudimentary tools in reconstructive surgery, especially following extensive solid tumour resections. They cover skin and soft tissue defects but are prone to ischaemia and necrosis. Since their primary aim is reconstruction, they rarely exhibit a therapeutic activity against the treated disease. Attempts have been made to develop a new therapeutic strategy-biologic brachytherapy, which uses genetically engineered surgical flaps as a drug delivery vehicle, allowing the flap tissue to act as a "biologic pump". This systematic review summarizes the preclinical evidence on using genetically modified surgical flaps. A literature search was conducted in PubMed, EMBASE, Scopus and Web of Science. The initial literature search yielded 714 papers, and, eventually, seventy-seven studies were included in qualitative analysis. The results show that genetic enhancement of flaps has been used as a local or systemic therapy for numerous disease models. Frequently, it has been used to increase flap survival and limit ischaemia or promote flap survival in a non-ischemic context, with some studies focusing on optimizing the technique of such gene therapy. The results show that genetically modified flaps can be successfully used in a variety of contexts, but we need more studies to implement this research into specific clinical scenarios.

Keywords: animal study; biologic brachytherapy; gene therapy; surgical flap; translational research.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Figure presenting the basic idea of biologic brachytherapy. Created with BioRender.com.
Figure 2
Figure 2
PRISMA flowchart of included studies.
Figure 3
Figure 3
Figure showing pathological processes in ischemic surgical flap and currently developed management approaches using genetically enhanced surgical flaps. Green arrows show the main treatment strategies using target upregulation and black arrows show the effects of such treatment. Created with BioRender.com.
Figure 4
Figure 4
Figure presenting the summary of potential conditions treated with biologic brachytherapy tools. Created with BioRender.com.
See this image and copyright information in PMC

References

    1. Matsen C.B., Mehrara B., Eaton A., Capko D., Berg A., Stempel M., Van Zee K.J., Pusic A., King T.A., Cody H.S., 3rd, et al. Skin Flap Necrosis After Mastectomy With Reconstruction: A Prospective Study. Ann. Surg. Oncol. 2016;23:257–264. doi: 10.1245/s10434-015-4709-7. - DOI - PMC - PubMed
    1. Afrooghe A., Damavandi A.R., Ahmadi E., Jafari R.M., Dehpour A.R. The current state of knowledge on how to improve skin flap survival: A review. J. Plast. Reconstr. Aesthet. Surg. 2023;82:48–57. - PubMed
    1. Berry C.E., Le T., An N., Griffin M., Januszyk M., Kendig C.B., Fazilat A.Z., Churukian A.A., Pan P.M., Wan D.C. Pharmacological and cell-based treatments to increase local skin flap viability in animal models. J. Transl. Med. 2024;22:68. doi: 10.1186/s12967-024-04882-9. - DOI - PMC - PubMed
    1. Li Y., Jiang Q.L., Van der Merwe L., Lou D.H., Lin C. Preclinical efficacy of stem cell therapy for skin flap: A systematic review and meta-analysis. Stem Cell Res. Ther. 2021;12:28. doi: 10.1186/s13287-020-02103-w. - DOI - PMC - PubMed
    1. Takeshita S., Weir L., Chen D., Zheng L.P., Riessen R., Bauters C., Symes J.F., Ferrara N., Isner J.M. Therapeutic angiogenesis following arterial gene transfer of vascular endothelial growth factor in a rabbit model of hindlimb ischemia. Biochem. Biophys. Res. Commun. 1996;227:628–635. doi: 10.1006/bbrc.1996.1556. - DOI - PubMed

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