2. Academic Validation
  3. Triamcinolone acetonide-loaded chitosan-polyethylene glycol hydrogel for preventing esophageal stricture post-endoscopic submucosal dissection

Triamcinolone acetonide-loaded chitosan-polyethylene glycol hydrogel for preventing esophageal stricture post-endoscopic submucosal dissection

  • Regen Biomater. 2026 Jan 14:13:rbag002. doi: 10.1093/rb/rbag002.
Yaqiang Li 1 2,  Rui Gao 3,  Zhen He 1,  Kuiliang Liu 1,  Zujian Feng 4,  Pingsheng Huang 3,  Chuangnian Zhang 3,  Haijun Hou 5,  Baohong Xu 2,  Jianduo An 2,  Yan Zhao 1,  Weiwei Wang 4,  Shutian Zhang 1,  Peng Li 1
Affiliations

Affiliations

  • 1 Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Beijing 100050, P. R. China.
  • 2 Department of Gastroenterology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, P. R. China.
  • 3 State Key Laboratory of Advanced Medical Materials and Devices, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, P. R. China.
  • 4 College of Life Sciences, Key Laboratory of Bioactive Materials (Ministry of Education), State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, P. R. China.
  • 5 Department of Pain Medicine, Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China.
PMID: 41716490 DOI: 10.1093/rb/rbag002
Abstract

Postoperative esophageal stricture remains a significant challenge following endoscopic submucosal dissection (ESD), with limited effective prophylactic options in clinic. Here, we report the development of an injectable and tissue-adhesive hydrogel drug delivery system composed of quaternary ammonium chitosan and polyethylene glycol (QCS-PEG), which was loaded with triamcinolone acetonide (QCS-PEG@TA), designed to mitigate post-ESD strictures. In vitro assays demonstrated that the hydrogel formulation modulated macrophage polarization and inhibited fibroblast migration. In an ESD-induced porcine esophageal stricture model, treatment with drug-encapsulated hydrogel efficiently suppressed esophageal stricture and promoted tissue repair, which were superior over drug or hydrogel alone. Histological and immunohistochemical analyses revealed that the administration of hydrogel formulation reduced fibrosis and inflammatory cell infiltration in esophageal tissues. These findings suggest that QCS-PEG@TA hydrogel provides mechanical support, inflammation-modulatory and pro-healing effects that collectively prevent stricture formation, offering a clinically translatable approach to improve therapeutic outcomes after ESD.

Keywords

chitosan hydrogel; endoscopic submucosal dissection; esophageal stricture; tissue repair; triamcinolone acetonide.

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