Preparation of nanofibrous membrane-covered saccule gastric tubes and their treatment of radiation esophagitis.

Abstract

Radiation esophagitis (RE) is a frequent acute complication in patients receiving radiotherapy, yet effective local treatment remain unavailable due to the anatomical constraints of the esophagus. Severe cases often require gastric tube placement for symptomatic relief only. In this study, we engineered a therapeutic gastric tube by integrating a compliant medical saccule into the esophageal segment of the tube. The saccule exhibits excellent softness and predictable radial expansion upon gas inflation, returning to its original shape after deflation. A drug-loaded core-shell nanofibrous membrane-comprising a Poly(L-lactide-co-caprolactone) (PLCL) core and a PLCL/collagen (3:1, w/w) shell and encapsulating dexamethasone and lidocaine-was deposited onto the saccule surface via coaxial electrospinning under a 16 kV positive voltage. This design enables intimate contact with the injured esophageal mucosa and sustained local drug release for both prevention and treatment of RE. This membrane demonstrated controlled drug-release behavior, good biocompatibility, and significant anti-inflammatory effects in vitro. In vivo, implantation of the membrane-covered gastric tube markedly alleviated symptoms and improved mucosal healing in a rat RE model. These findings indicate that this therapeutic gastric tube not only mitigates RE-related discomfort but also delivers targeted, localized treatment to the affected site. This work presents a promising interventional strategy for managing radiation esophagitis using a nanofibrous membrane-covered saccule gastric tube. STATEMENT OF SIGNIFICANCE: Radiation esophagitis is a common clinical acute adverse reaction that usually occurs in cancer patients undergoing radiotherapy. There is currently no direct treatment for radiation esophagitis, Severe patients can only relieve their symptoms by gastric tubes. In this study, a compliant saccule was added to the esophageal section of the gastric tube. The drug-loaded core-shell nanofibrous membrane was covered on the surface of the saccule through coaxial electrospinning, so that the nanofibrous membrane could be combined to the affected esophageal area to release the drug, thereby treating and preventing radiation esophagitis. The results of this study indicate that drug-loaded membrane-covered gastric tubes can not only improve the symptoms of radiation esophagits but also provide direct treatment.