ABSTRACT
En la actualidad, la investigación biomédica se ha centrado en el estudio de enfermedades como el cáncer, que causan un elevado índice de mortalidad. Existen diferentes modelos animales, empleados para generar diversos tipos de carcinogénesis; el daño directo al ADN es uno de los mecanismos más utilizados. Sin embargo, en la normatividad nacional e internacional vigente, no se señalan los aspectos bioéticos que se deben seguir para desarrollar un modelo experimental de daño al ADN. Además, no se realiza una correcta semejanza de la enfermedad. Debido a lo anterior, esta revisión analiza los avances en cuanto a normatividad que se han generado en diferentes países, comparando los estudios encontrados en Estados Unidos, México y España. La perspectiva a futuro es poder contar con guías de experimentación actualizadas, que permitan pautar las normas necesarias para el adecuado desarrollo de los modelos de investigación animal de daño al ADN y que cumplan con la regla de las 3R en la experimentación animal. Esta iniciativa se debe de realizar en conjunto entre la Organización Mundial de la Salud y los organismos especializados en manejo y cuidado de animales de laboratorio en los ámbitos nacional e internacional.
Currently, biomedical research has focused on the study of diseases such as cancer that causes a high mortality rate. Different animal models are used to generate different types of carcinogenesis; direct DNA damage is one of the most used mechanisms. However, current national and international regulations do not indicate the bioethical aspects that must be followed to develop an experimental model of DNA damage. In addition, they do not perform a correct resemblance of the disease. Due to the above, this review analyzes the advances in regulations generated in different countries, comparing the studies found in the United States, Mexico, and Spain. The future perspective is to be able to count on updated experimentation guidelines, which allow the establishment of the necessary norms for the adequate development of animal research models of DNA damage that comply with the 3R rule in animal experimentation. This initiative should be carried out jointly by the World Health Organization and organizations specialized in managing and caring laboratory animals at the national and international levels.
Na atualidade, a pesquisa biomédica vem se focando no estudo de doenças que causam um elevado índice de mortalidade, como o câncer. Existem diferentes modelos animais utilizados para gerar diversos tipos de carcinogêneses; o dano direto ao DNA é um dos mecanismos mais utilizados. Contudo, na legislação nacional e internacional vigente, não são sinalizados os aspectos bioéticos que devem ser seguidos para desenvolver um modelo experimental de dano ao DNA, além de não ser realizada uma correta semelhança da doença. Devido a isso, esta revisão analisa o avanço quanto à legislação que vem sendo gerada em diferentes países, comparando os estudos encontrados nos Estados Unidos, no México e na Espanha. A perspectiva para o futuro é poder contar com atualizadas, que permitam estabelecer as normas necessárias para desenvolver os modelos de pesquisa animal de dano ao DNA e que cumpram com a regra das 3R na experimentação animal. Essa iniciativa se deve realizar em conjunto entre a Organização Mundial da Saúde e as organizações especializadas na gestão e cuidado de animais de laboratório nos contextos nacional e internacional.
ABSTRACT
INTRODUCTION AND OBJECTIVES: Achalasia is the most widely studied esophageal motility disorder. No treatment has achieved completely satisfactory results. The laparoscopic Heller esophagomyotomy is currently the most accepted technique. With the advent of minimally invasive surgery, the appearance of peroral endoscopic myotomy (POEM) has promising results. The primary aim of our study was to perform peroral endoscopic esophagomyotomy in animal experimentation models to perfect the technique and later apply it to humans. The secondary aims were to evaluate the intraoperative and postoperative complications and to describe the anatomopathologic findings. MATERIALS AND METHODS: An experimental study was conducted on 8 live porcine models that were followed for 30 days to identify postoperative complications. Necropsy was then performed to evaluate the histopathologic findings. The international requirements and regulations for animal experimentation were met. RESULTS: The technique was carried out in all the models. There was one intraoperative death. Pneumothorax was observed in 50% of the units in experimentation and subcutaneous cervical emphysema in 75%, with no significant clinical repercussions. Histologic muscle layer (myotomy) involvement was above the gastroesophageal junction in 87% of the cases and below it in 25%. CONCLUSION: Peroral endoscopic esophagomyotomy is a feasible, albeit complex, procedure that requires advanced training, and thus should be performed in highly specialized centers. Specific skills in advanced therapeutic endoscopic procedures of this type must continue to be developed through continuing education (ideally in in vivo models), to then be performed on humans.
