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Alginate Hydrogel as a Potential Alternative to Hyaluronic Acid as Submucosal Injection Material

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Abstract

Background

Sodium alginate is currently used in medical products, including drugs and cosmetic materials. It can also be used as a submucosal injection material due to its excellent water retention ability. Alginate with a high water retention ability is called alginate hydrogel (AH). The aim of this study was to investigate the usefulness of AH as a submucosal injection material.

Methods

To investigate the optimal viscosity of AH as a submucosal injection material, we observed the changes in submucosal height from the initial submucosal height in the stomachs of six miniature pigs for each injection material tested (0.3 % AH, 0.5 % hyaluronic acid, glycerol). All submucosal heights were compared serially over time (3, 5, 10, 20, and 30 min). Both immediate and 1-week delayed tissue reactions were investigated endoscopically in the same living pigs. Histological analyses were performed after the animals had been sacrificed.

Results

In a preliminary study, we determined that 0.3 % sodium alginate mixed with BaCl2 (400 μl) was the optimal viscosity of AH as an injection material. Our comparison of submucosal height changes over time showed that there was a significant decrease in submucosal height just 3 min following the injection of hyaluronic acid and glycerol, but that following the injection of AH a significant decrease in submucosal height was observed only after 10 min (p < 0.05). The histological analyses revealed that there were mild capillary dilations with congestion and mild fibrotic changes with some lymphocytic infiltration at the AH injection site.

Conclusion

Alginate hydrogel demonstrated long-lasting maintenance of submucosal elevation, safety, and cost-effectiveness in a pig model, which makes it a potential alternative to hyaluronic acid.

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Acknowledgments

This study was supported by a grant (Hp-2011-04) from the Korean College of Helicobacter and Upper Gastrointestinal Research.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Medicine, Hallym University College of Medical School, Hallym University Sacred Heart Hospital, Anyang, Korea

    Ki Joo Kang

  2. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Byung-Hoon Min, Jun Haeng Lee, Eun Ran Kim & Jae J. Kim

  3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Chang Ohk Sung

  4. Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Korea

    Soo Won Seo

  5. Gastrointestinal Cancer Center, Soon Chun Hyang University Hospital, Seoul, Korea

    Joo Young Cho

Authors
  1. Ki Joo Kang
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  2. Byung-Hoon Min
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  3. Jun Haeng Lee
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  4. Eun Ran Kim
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  5. Chang Ohk Sung
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  6. Joo Young Cho
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  7. Soo Won Seo
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Corresponding authors

Correspondence to Soo Won Seo or Jae J. Kim.

Additional information

Soo Won Seo and Jae J. Kim contributed equally to this work.

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Kang, K.J., Min, BH., Lee, J.H. et al. Alginate Hydrogel as a Potential Alternative to Hyaluronic Acid as Submucosal Injection Material. Dig Dis Sci 58, 1491–1496 (2013). https://doi.org/10.1007/s10620-012-2555-z

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  • DOI: https://doi.org/10.1007/s10620-012-2555-z

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