| Project/Area Number |
20K09017
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 55020:Digestive surgery-related
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| Research Institution | Nara Medical University |
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Principal Investigator |
Koyama Fumikazu 奈良県立医科大学, 医学部, 病院教授 (40316063)
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| Co-Investigator(Kenkyū-buntansha) |
福岡 晃平 奈良県立医科大学, 医学部附属病院, 研究員 (20812316)
久下 博之 奈良県立医科大学, 医学部, 講師 (30801774)
森田 剛平 奈良県立医科大学, 医学部, 助教 (60533718)
松本 弥生 奈良県立医科大学, 医学部附属病院, 研究員 (90833707)
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| Project Period (FY) |
2020-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2022: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2021: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2020: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 潰瘍性大腸 / 大腸全摘・回腸嚢肛門吻合術 / ileocecal valve cuff / neorectum / 潰瘍性大腸炎 / 神経筋ネットワーク / 神経幹細胞 / 再生医療 / 回盲弁 / Neorectum |
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| Outline of Research at the Start |
潰瘍性大腸炎に対する再生医療工学を応用した新しい手術術式の開発を行う．ラット大腸全摘モデルを用いて，回盲弁温存終末回腸を神経幹細胞シートと Brain Derived Neurotrophic Factor徐放ビーズを介して肛門と吻合する．回盲弁筋層と内肛門括約筋の筋間に新たな神経ネットワークを形成させることで，貯留能と排便反射を有する Neorectum を創出する．
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| Outline of Final Research Achievements |
Focusing on the anatomical similarity between the ileal valve and the anorectal region, and the physiological similarity between ileal valve movement and defecation movement, we aimed to develop a new ulcerative colitis surgery by creating a Neorectum in a rat model by anastomosing the terminal ileum with ileal valve and the internal anal sphincter.
Based on the detailed dissection of the rat anorectal and ileal regions, we devised a method for dissection of the rectum and the terminal ileum with ileal valve. Ileal-anal anastomosis, ileal sac-anal anastomosis, and ileal valve-anal anastomosis were compared in rats. Unfortunately, the epidemic of COVID-19 infection prevented continued experimentation, and results could not be evaluated in many cases. Although we demonstrated the possibility of Neorectum creation in ileal valve-preserving terminal ileal-anal anastomosis, we could not clarify the function of Neorectum creation.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究は，現在の潰瘍性大腸炎根治手術の限界を、最新の解剖生理知見と再生医療工学を駆使して克服することを目指したものである．本研究の結果からその可能性の一端は示せたが，実現性についてはさらなる研究が必要である．
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