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Yahyazadeh R, Baradaran Rahimi V, Ahmad Mohajeri S, Iranshahy M, Hasanpour M, Askari VR. Intra-peritoneal lavage of Zingiber officinale rhizome and its active constituent gingerol impede inflammation, angiogenesis, and fibrosis following post-operative peritoneal adhesion in male rats. Saudi Pharm J 2024; 32:102092. [PMID: 38737808 PMCID: PMC11087237 DOI: 10.1016/j.jsps.2024.102092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024] Open
Abstract
Post-operative peritoneal adhesions (PA) are a common and important clinical problem. In this study, we focused on the ameliorative efficacy of ginger and gingerol compounds on surgical-induced peritoneal adhesion, and their strategies that disrupted the PA formation pathways to suppress their incidence. First, liquid chromatography-mass spectrometry (LC-MS) was established to separate and identify several chemical groups of ginger rhizome extract. In the next steps, male Wistar albino rats were randomly selected and divided into various groups, namely sham, control, ginger extract (0.6, 1.8, 5 %w/v), and gingerol (0.05, 0.1, 0.3, and 1 %w/v). Finally, we investigated the macroscopic parameters such as wound healing, body weight as well as spleen height and weight. In addition, visual peritoneal adhesion assessment was performed via Nair et al and Adhesion Scoring Scheme. Moreover, the microscopic parameters and biological assessment was performed via and immunoassays. The present findings revealed significant improvement in wound healing and reduction of the adhesion range, as Nair et al. and Adhesion Scoring Scheme scoring, in both the ginger and gingerol groups compared to the PA group (P < 0.05). Whereas, gingerol (0.3 % w/v) was able to increase the body weight in rats (P < 0.0001) at end stage of experiment. Also, inflammation, angiogenesis, and fibrosis were significantly decreased due to the downregulation of interleukin (IL)-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), respectively, in the ginger and gingerol groups compared to the PA group (P < 0.05). In contrast, the levels of IL-10 were increased in the ginger and gingerol groups compared to the control group (P < 0.01). Our results proved that ginger rhizome and gingerol, as novel therapeutic compounds, could be used to prevent PA for their beneficial anti-inflammatory as well as anti-fibrosis properties in clinical trials. However, further clinical studies are required to approve the effectiveness of ginger and gingerol.
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Affiliation(s)
- Roghayeh Yahyazadeh
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vafa Baradaran Rahimi
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Ahmad Mohajeri
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Milad Iranshahy
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maede Hasanpour
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Reza Askari
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Kazemi K, Jamshidi K, Naseri R, Shahriarirad R, Shamsaeefar A, Hosseinzadeh A. Comparison of the effect of Everolimus, Prednisolone, and a combination of both on experimentally induced peritoneal adhesions in rats. Sci Rep 2024; 14:11077. [PMID: 38745015 PMCID: PMC11093995 DOI: 10.1038/s41598-024-61620-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
Postoperative intra-abdominal adhesions represent a significant post-surgical problem. Its complications can cause a considerable clinical and cost burden. Herein, our study aimed to investigate the effect of Everolimus on peritoneal adhesion formation after inducing adhesions in rats. In this experimental study, adhesion bands were induced by intraperitoneal injection of 3 ml of 10% sterile talc solution in 64 male albino rats. The first group served as the control group. The second one received oral Prednisolone (1 mg/kg/day), the third received Everolimus (0.1 mg/kg/day), and group four received both drugs with similar dosages for four consecutive weeks. The formation of adhesion bands was qualitatively graded according to the Nair classification. The rats in the control group had extensive adhesions between the abdominal wall and the organs. Regarding substantial adhesion formation, 50% (8/16) of animals in the control group had substantial adhesions, while this rate in the groups receiving Prednisolone, Everolimus, and combination treatment was 31%, 31%, and 31%, respectively. Also, 68.75% (5/11) of the Prednisolone recipients had insubstantial adhesions, the same as Everolimus recipients, while in the combination group, 66.66% (10/15) rats had insubstantial adhesions. Everolimus demonstrated satisfactory results in reducing the rates of induced peritoneal adhesion in an experimental model, similar to Prednisolone and superior to a combination regime.
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Affiliation(s)
- Kourosh Kazemi
- Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Jamshidi
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reyhaneh Naseri
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Shamsaeefar
- Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Hosseinzadeh
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran.
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Lu W, Wang X, Kong C, Chen S, Hu C, Zhang J. Hemoadhican-Based Bioabsorbable Hydrogel for Preventing Postoperative Adhesions. ACS APPLIED MATERIALS & INTERFACES 2024; 16:17267-17284. [PMID: 38556996 DOI: 10.1021/acsami.4c01088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Postoperative peritoneal adhesions are a prevalent clinical issue following abdominal and pelvic surgery, frequently resulting in heightened personal and societal health burdens. Traditional biomedical barriers offer limited benefits because of practical challenges for doctors and their incompatibility with laparoscopic surgery. Hydrogel materials, represented by hyaluronic acid gels, are receiving increasing attention. However, existing antiadhesive gels still have limited effectiveness or carry the risk of complications in clinical applications. Herein, we developed a novel hydrogel using polysaccharide hemoadhican (HD) as the base material and polyethylene glycol diglycidyl ether (PEGDE) as the cross-linking agent. The HD hydrogels exhibit appropriate mechanical properties, injectability, and excellent cytocompatibility. We demonstrate resistance to protein adsorption and L929 fibroblast cell adhesion to the HD hydrogel. The biodegradability and efficacy against peritoneal adhesion are further evaluated in C57BL/6 mice. Our results suggest a potential strategy for anti-postoperative tissue adhesion barrier biomaterials.
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Affiliation(s)
- Weiling Lu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Xianjin Wang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Changchang Kong
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Shijunyin Chen
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Chengtao Hu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Jianfa Zhang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
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Lv K, Lou P, Liu S, Wang Y, Yang J, Zhou P, Zhou X, Lu Y, Wang H, Cheng J, Liu J. Injectable Multifunctional Composite Hydrogel as a Combination Therapy for Preventing Postsurgical Adhesion. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2303425. [PMID: 37649233 DOI: 10.1002/smll.202303425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/24/2023] [Indexed: 09/01/2023]
Abstract
Postsurgical adhesion (PA) is a common and serious postoperative complication that affects millions of patients worldwide. However, current commercial barrier materials are insufficient to inhibit diverse pathological factors during PA formation, and thus, highly bioactive materials are needed. Here, this work designs an injectable multifunctional composite hydrogel that can serve as a combination therapy for preventing PA. In brief, this work reveals that multiple pathological events, such as chronic inflammatory and fibrotic processes, contribute to adhesion formation in vivo, and such processes can not be attenuated by barrier material (e.g., hydrogel) alone treatments. To solve this limitation, this work designs a composite hydrogel made of the cationic self-assembling peptide KLD2R and TGF-β receptor inhibitor (TGF-βRi)-loaded mesenchymal stem cell-derived nanovesicles (MSC-NVs). The resulting composite hydrogel displays multiple functions, including physical separation of the injured tissue areas, antibacterial effects, and local delivery and sustained release of anti-inflammatory MSC-NVs and antifibrotic TGF-βRi. As a result, this composite hydrogel effectively inhibited local inflammation, fibrosis and adhesion formation in vivo. Moreover, the hydrogel also exhibits good biocompatibility and biodegradability in vivo. Together, the results highlight that this "all-in-one" composite hydrogel strategy may provide insights into designing advanced therapies for many types of tissue injury.
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Affiliation(s)
- Ke Lv
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Peng Lou
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Shuyun Liu
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yizhuo Wang
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jinlin Yang
- Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Pingya Zhou
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiyue Zhou
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yanrong Lu
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hongren Wang
- Department of Pathogenic Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Jingqiu Cheng
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jingping Liu
- Department of General Surgery and NHC Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Zou L, Hou Y, Zhang J, Chen M, Wu P, Feng C, Li Q, Xu X, Sun Z, Ma G. Degradable carrier-free spray hydrogel based on self-assembly of natural small molecule for prevention of postoperative adhesion. Mater Today Bio 2023; 22:100755. [PMID: 37593217 PMCID: PMC10430199 DOI: 10.1016/j.mtbio.2023.100755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/27/2023] [Accepted: 07/29/2023] [Indexed: 08/19/2023] Open
Abstract
Postoperative peritoneal adhesion (PPA) is frequent and extremely dangerous complication after surgery. Different tactics have been developed to reduce it. However, creating a postoperative adhesion method that is multifunctional, biodegradable, biocompatible, low-toxic but highly effective, and therapeutically applicable is still a challenge. Herein, we have prepared a degradable spray glycyrrhetinic acid hydrogel (GAG) based on natural glycyrrhetinic acid (GA) by straightforward heating and cooling without the use of any additional chemical cross-linking agents to prevent postoperative adhesion. The resultant hydrogel was demonstrated to possess various superior anti-inflammatory activity, and multiple functions, such as excellent degradability and biocompatibility. Specifically, spraying characteristic and excellent antibacterial activities essentially eliminated secondary infections during the administration of drugs in surgical wounds. In the rat models, the carrier-free spray GAG could not only slow-release GA to inhibit inflammatory response, but also serve as physical anti-adhesion barrier to reduce collagen deposition and fibrosis. The sprayed GAG would shed a new light on the prevention of postoperative adhesion and broaden the application of the hydrogels based on natural products in biomedical fields.
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Affiliation(s)
- Linjun Zou
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
| | - Yong Hou
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
| | - Jiawen Zhang
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
| | - Meiying Chen
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
| | - Peiying Wu
- School of Pharmacy; Guangxi Medical University, Nanning, 530021, China
| | - Changcun Feng
- School of Pharmacy; Guangxi Medical University, Nanning, 530021, China
| | - Qinglong Li
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
| | - Xudong Xu
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
| | - Zhaocui Sun
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
| | - Guoxu Ma
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education; Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China
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İpek E, Aşıcı GSE, Kurt BK, Epikmen ET, Özsoy ŞY, Tunca R. Carbon monoxide (CO) derived from the CO-releasing molecule CORM-2 reduces peritoneal adhesion formation in a rat model. Mol Biol Rep 2023; 50:8483-8495. [PMID: 37639152 DOI: 10.1007/s11033-023-08753-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Although low-dose carbon monoxide (CO) administration has been shown to have an anti-fibrotic effect in various fibrotic diseases, its effects on peritoneal adhesion (PA), one of the postoperative complications, are not elucidated. In this study, the effect of CO-releasing tricarbonyldichlororuthenium (II) dimer (CORM-2) administration on the formation of PA and the underlying factors of its potential effect were investigated. METHODS AND RESULTS After the induction of PA, rats were divided into four groups with 8 rats in each group. The rats received either (i) dimethyl sulfoxide:saline solution (1:10) as a vehicle, (ii) 2.5 mg/kg CORM-2, (iii) 5 mg/kg CORM-2, or (iv) inactive (i) CORM (iCORM) intragastrically every day for a duration of 7 days. PA was not induced in rats (n = 8) designated as sham controls. Gross, histological, immunohistochemical and quantitative real-time polymerase chain reaction analyses were performed to evaluate the effectiveness of CORM-2 administration. Gross analysis showed that CORM-2 administration reduced PA formation compared to rats treated with vehicle. Histological and immunohistochemical examinations showed that increased collagen deposition, myofibroblast accumulation, microvessel density, and M1 macrophage count in the peritoneal fibrosis area of vehicle-treated rats decreased following CORM-2 treatments. PCR analyses showed that CORM-2 treatments decreased hypoxia-induced Hif1a, profibrotic Tgfb1, ECM components Col1a1 and Col3a1, collagen degradation suppressor Timp1, fibrinolysis inhibitor Serpine1, and pro-inflammatory Tnf mRNA expressions, while increasing the M2 macrophage marker Arg1 mRNA expression. CONCLUSIONS These results suggested that CORM-2 administration reduces PA formation by affecting adhesiogenic processes such as pro-inflammatory response, fibrinolytic system, angiogenesis and fibrogenesis.
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Affiliation(s)
- Emrah İpek
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey.
| | - Gamze Sevri Ekren Aşıcı
- Department of Biochemistry, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Büşra Kibar Kurt
- Department of Surgery, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Erkmen Tuğrul Epikmen
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Şule Yurdagül Özsoy
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Recai Tunca
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
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Bananzade A, Dehghankhalili M, Bahrami F, Tadayon SMK, Ghaffarpasand F. Outcome of early versus late ileostomy closure in patients with rectal cancers undergoing low anterior resection: A prospective cohort study. Asian J Surg 2023; 46:4277-4282. [PMID: 36797086 DOI: 10.1016/j.asjsur.2023.01.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Protective loop ileostomy is performed following low anterior resection (LAR) in patients with rectal cancer to reduce the complications of primary anastomosis. The optimal timing for ileostomy closure remains controversial. The aim of the current study was to compare the effects of early (<2 weeks) versus late (≥2 months) closure of the stoma in patients with rectal cancer undergoing LAR on surgical outcome and complications rates. METHODS This prospective cohort study was conducted in two referral centers in Shiraz, Iran, during a 2-year period. We have consecutively and prospectively included adult patients with rectal adenocarcinoma who underwent LAR followed by protective loop ileostomy in our center during the study period. The baseline, tumor characteristics and complication as well as outcome was recorded in a 1-year follow-up and was compared between early and late ileostomy closure. RESULTS Overall, 69 patients (32 in early and 37 in late group) were included. The mean age of the patients was 59.40 ± 9.30 years and there were 46 (66.7%) men and 23 (33.3%) women. Patients undergoing early closure of the ileostomy had significantly shorter operation duration (p<0.001) and lower intraoperative bleeding (p<0.001) compared to late ileostomy closure. There was no significant difference between two study groups regarding the complications. Early closure was also not found to be a predictive factor of post-ileostomy closure complications. CONCLUSION Early closure (<2 weeks) of ileostomy after LAR in patients with rectal adenocarcinoma is a safe and feasible technique which is associated with favorable outcome.
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Affiliation(s)
- Alimohammad Bananzade
- Colorectal Research Center, Department of Colorectal Surgery, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Faranak Bahrami
- Colorectal Research Center, Department of Colorectal Surgery, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Mohammad Kazem Tadayon
- Colorectal Research Center, Department of Colorectal Surgery, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fariborz Ghaffarpasand
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran.
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Li G, Zeng Y, Zeng J, Lu S, Huang Y, Huang Y, Li W, Cao J. Analysis of abdominal adhesion using the ileostomy model. Medicine (Baltimore) 2023; 102:e35350. [PMID: 37773815 PMCID: PMC10545243 DOI: 10.1097/md.0000000000035350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/01/2023] [Indexed: 10/01/2023] Open
Abstract
Abdominal adhesion occurs commonly in clinical practice, causing unfavorable symptoms and readmission. The ileostomy operation is a common surgical procedure and we utilized this model to evaluate abdominal adhesion. Adhesion grade score was calculated in 35 patients (Cohort 1) and subjected to correlation and receiver operating characteristic analysis. Then 98 consecutive patients (Cohort 2) who underwent ileostomy and ileostomy closure were included into a retrospective study. Logistic regression analysis was performed, and the risk of small bowel obstruction was also assessed. The time of ileostomy closure correlated with adhesion grade score in Cohort 1, justifying its use as an indicator of abdominal adhesion. All patients in Cohort 2 were then divided into the high- and low-adhesion group. A multi-variable logistic regression analysis indicated that type of surgery and peritoneum suture during ileostomy were significant factors affecting the risk of abdominal adhesion. Abdominal adhesion had the trend to prolong the length of stay postoperatively without increasing the risk of bowel obstruction. Nine patients suffered bowel obstruction, and age older than 65 significantly increased the risk. We proposed the ileostomy procedure to be a model of abdominal adhesion, and the operative time of ileostomy closure could be used as an alternative of adhesion score. Type of surgery and peritoneum suture may be risk factors of abdominal adhesion. Older age increased the risk of small bowel obstruction after ileostomy surgery.
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Affiliation(s)
- Guanwei Li
- Department of Gastrointestinal Surgery, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Yunfei Zeng
- Department of Gastrointestinal Surgery, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Jie Zeng
- Department of Thoracic Surgery, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Shuo Lu
- Department of Gastrointestinal Surgery, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Yu Huang
- Department of Hepatobiliary Surgery, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Yutong Huang
- Department of Otolaryngology, Guangzhou Women and Children’s Medical Center, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Wanglin Li
- Department of Gastrointestinal Surgery, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Jie Cao
- Department of Gastrointestinal Surgery, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
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Oral Administration Evaluation of the Hydro-Ethanolic Extract of Ginger (Rhizome of Zingiber officinale) against Postoperative-Induced Peritoneal Adhesion: Investigating the Role of Anti-Inflammatory and Antioxidative Effects. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2023; 2023:4086631. [PMID: 36865747 PMCID: PMC9974257 DOI: 10.1155/2023/4086631] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/10/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023]
Abstract
Peritoneal adhesions (PAs) occur and develop after abdominal surgery. Abdominal adhesions are common and often develop after abdominal surgery. Currently, there are no effective targeted pharmacotherapies for treating adhesive disease. In this regard, ginger is wildly used in traditional medicine because of its anti-inflammatory and antioxidant effects and has been investigated for peritoneal adhesion treatment. This study analyzed ginger ethanolic extraction via HPLC to have a 6-gingerol concentration. Four groups induced peritoneal adhesion to evaluate ginger's effects on peritoneal adhesion. Then, ginger extract (50, 150, and 450 mg/kg) was administered by gavage in various groups of male Wistar rats (220 ± 20 g, 6-8 weeks). After scarifying the animals for biological assessment, macroscopic and microscopic parameters were determined via scoring systems and immunoassays in the peritoneal lavage fluid. Next, the adhesion scores and interleukin IL-6, IL-10, tumor necrosis factor-(TNF-) α, transforming growth factor-(TGF-) β1, vascular endothelial growth factor (VEGF), and malondialdehyde (MDA) were elevated in the control group. The results showed that ginger extract (450 mg/kg) notably decreased inflammatory (IL-6 and TNF-α), fibrosis (TGF-β1), anti-inflammatory cytokine (IL-10), angiogenesis (VEGF), and oxidative (MDA) factors, while increased antioxidant factor glutathione (GSH), compared to the control group. These findings suggest that a hydro-alcoholic extract of ginger is a potentially novel therapeutic strategy for inhibiting adhesion formation. Also, it might be considered a beneficial anti-inflammatory or antifibrosis herbal medicine in clinical trials. However, further clinical studies are required to approve the effectiveness of ginger.
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Karaman K, Çakıroğlu H, Tuncer FB, Şekeroğlu MR, Yılmaz F. The preventive effect of omega-3 fish oil on the formation of peritoneal adhesions. POLISH JOURNAL OF SURGERY 2023; 96:8-14. [PMID: 38353094 DOI: 10.5604/01.3001.0016.2730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
<br><b>Introduction:</b> Postoperative peritoneal adhesions that form after abdominal surgery still continue to exist as an unresolved health problem.</br> <br><b>Aim:</b> The aim of the study is to examine whether omega-3 fish oil has a preventive effect on postoperative peritoneal adhesions.</br> <br><b>Material and methods:</b> Twenty-one female Wistar albino rats were separated into 3 groups (sham, control and experimental), each consisting of 7 rats. In the sham group, only laparotomy was performed. In both the control and experimental group rats, the right parietal peritoneum and cecum were traumatised to form petechiae. Following this procedure, the abdomen was irrigated with omega-3 fish oil in the experimental group. The rats were re-explored on the 14<sup>th</sup> postoperative day and any adhesions were scored. Tissue samples and blood samples were taken for histopathological and biochemical analysis.</br> <br><b>Results:</b> None of the rats that were administered omega-3 fish oil developed macroscopic postoperative peritoneal adhesions (P = 0.005). The omega-3 fish oil formed an anti-adhesive lipid barrier on the injured tissue surfaces. Microscopic evaluation revealed diffuse inflammation with excessive connective tissue and fibroblastic activity in the control group rats, while foreign body reactions were common in the omega-3 rats. The mean amount of hydroxyproline in samples from injured tissues was significantly lower in the omega-3 rats than in the control rats (P = 0.004).</br> <br><b>Conclusion:</b> Intraperitoneal application of omega-3 fish oil prevents postoperative peritoneal adhesions by forming an anti-adhesive lipid barrier on injured tissue surfaces. However, further studies are needed to determine whether this adipose layer is permanent or will be resorbed over time.</br>.
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Affiliation(s)
- Kerem Karaman
- Department of Gastroenterology Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Hüseyin Çakıroğlu
- Department of Experimental Medicine Research and Application Centre, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Fatıma Betül Tuncer
- Department of Biochemistry, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | | | - Fahri Yılmaz
- Department of Pathology, Sakarya University Faculty of Medicine, Sakarya, Turkey
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Askarnia-Faal MM, Sayyed-Hosseinian SH, Nazari SE, Asgharzadeh F, Vahedi E, Eskandari M, Ghasemi H, Avan A, Alaei M, Naimi H, Daghiani M, Soleimani A, Alalikhan A, Mohammadzadeh R, Ferns G, Ryzhikov M, Khazaei M, Hassanian SM. Exploring new therapeutic potentials of curcumin against post-surgical adhesion bands. BMC Complement Med Ther 2023; 23:27. [PMID: 36721147 PMCID: PMC9887929 DOI: 10.1186/s12906-022-03808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/23/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Adhesion band formation is a common cause of morbidity for patients undergoing surgeries. Anti-inflammatory and anti-fibrotic properties of curcumin, a pharmacologically active component of Curcuma longa, have been investigated in several studies. The aim of this study is to explore the therapeutic potential of curcumin in attenuating post-operative adhesion band (PSAB) formation in both peritoneal and peritendinous surgeries in animal models. METHODS Bio-mechanical, histological and quantitative evaluation of inflammation, and total fibrosis scores were graded and measured in the presence and absence of phytosomal curcumin. RESULTS Results showed that phytosomal curcumin significantly decreased severity, length, density and tolerance of mobility of peritendinous adhesions as well as incidence and severity of abdominal fibrotic bands post-surgery. Curcumin may decrease inflammation by attenuating recruitment of inflammatory cells and regulating oxidant/anti-oxidant balance in post-operative tissue samples. Moreover, markedly lower fibrosis scores were obtained in the adhesive tissues of phytosomal curcumin-treated groups which correlated with a significant decrease in quantity, quality and grading of fibers, and collagen deposition in animal models. CONCLUSION These results suggest that protective effects of phytosomal curcumin against PSAB formation is partially mediated by decreasing inflammation and fibrosis at site of surgery. Further studies are needed to investigate the therapeutic potential of this molecule in preventing PSAB.
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Affiliation(s)
- Mohammad-Mostafa Askarnia-Faal
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayyed-Hadi Sayyed-Hosseinian
- grid.411583.a0000 0001 2198 6209Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Elnaz Nazari
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshteh Asgharzadeh
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Vahedi
- grid.411583.a0000 0001 2198 6209Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Moein Eskandari
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Haniyeh Ghasemi
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- grid.411583.a0000 0001 2198 6209Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Human Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Alaei
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Naimi
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Daghiani
- grid.411583.a0000 0001 2198 6209Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atena Soleimani
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Alalikhan
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Mohammadzadeh
- grid.449862.50000 0004 0518 4224Department of Biology, Faculty of Basic Sciences, University of Maragheh, Maragheh, Iran
| | - Gordon Ferns
- grid.414601.60000 0000 8853 076XDivision of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex BN1 9PH UK
| | - Mikhail Ryzhikov
- grid.262962.b0000 0004 1936 9342Saint Louis University, School of Medicine, Saint Louis, MO USA
| | - Majid Khazaei
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Rakhshandeh H, Baradaran Rahimi V, Habibi Z, Sirousi Z, Askari VR. Punica granatum seed oil detracts peritoneal adhesion: Perusing antioxidant, anti-inflammatory, antifibrotic, and antiangiogenic impacts. Physiol Rep 2022; 10:e15545. [PMID: 36541264 PMCID: PMC9768730 DOI: 10.14814/phy2.15545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/11/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023] Open
Abstract
Peritoneal adhesion is a significant problem following gastrointestinal surgeries, accompanied by a significant economic burden and morbidity for patients. Punica granatum seed oil (PSO) possesses antioxidative, anti-inflammatory, and anticancer effects. Thus, we aimed to evaluate the antiperitoneal adhesive properties of PSO in rats. Forty-eight Wistar rats (200-250 g) were randomly and equally divided into six groups: sham group, control group; peritoneal adhesion without any treatment, vehicle group; peritoneal adhesion with saline + Tween-80.5% treatment, and experimental groups; peritoneal adhesion with 0.5%, 1.5%, and 4.5% v/v PSO treatment. In addition, peritoneal adhesion was examined macroscopically along with evaluating the oxidative stress (malondialdehyde [MDA], nitric oxide [NO], and glutathione [GSH]) inflammatory (interleukin [IL]-6, IL-1β, and tumor necrosis factor-α [TNF-α]), fibrotic (transforming growth factor-β [TGF-β]), and angiogenic (vascular endothelial growth factor [VEGF]) factors. Our results revealed that the levels of adhesion scores, MDA, NO, IL-6, TNF-α, IL-1β, TGF-β, and VEGF, were propagated in the vehicle group while the GSH level was alleviated (p < 0.001). In contrast, premedication with PSO, especially at the lowest concentration, notably lessened the levels of adhesion scores, MDA, NO, IL-6, TNF-α, IL-1β, TGF-β, and VEGF as well as GSH in comparison to the vehicle group following the peritoneal adhesion induction (p < 0.001-0.05). As a result, PSO may prevent peritoneal adhesion through its antioxidant, anti-inflammatory, antifibrotic, and antiangiogenic properties. Therefore, PSO could be considered a beneficial candidate for the treatment of postoperative peritoneal adhesion.
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Affiliation(s)
- Hassan Rakhshandeh
- Pharmacological Research Center of Medicinal PlantsMashhad University of Medical SciencesMashhadIran
| | - Vafa Baradaran Rahimi
- Department of Cardiovascular Diseases, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Zahra Habibi
- Pharmacological Research Center of Medicinal PlantsMashhad University of Medical SciencesMashhadIran
| | - Zahra Sirousi
- Pharmacological Research Center of Medicinal PlantsMashhad University of Medical SciencesMashhadIran
| | - Vahid Reza Askari
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
- Applied Biomedical Research CenterMashhad University of Medical SciencesMashhadIran
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13
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Gao J, Wen J, Hu D, Liu K, Zhang Y, Zhao X, Wang K. Bottlebrush inspired injectable hydrogel for rapid prevention of postoperative and recurrent adhesion. Bioact Mater 2022; 16:27-46. [PMID: 35386330 PMCID: PMC8958549 DOI: 10.1016/j.bioactmat.2022.02.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 12/28/2022] Open
Abstract
Postsurgical adhesion is a common clinic disease induced by surgical trauma, accompanying serious subsequent complications. Current non-surgical approaches of drugs treatment and biomaterial barrier administration only show limited prevention effects and couldn't effectively promote peritoneum repair. Herein, inspired by bottlebrush, a novel self-fused, antifouling, and injectable hydrogel is fabricated by the free-radical polymerization in aqueous solution between the methacrylate hyaluronic acid (HA-GMA) and N-(2-hydroxypropyl) methacrylamide (HPMA) monomer without any chemical crosslinkers, termed as H-HPMA hydrogel. The H-HPMA hydrogel can be tuned to perform excellent self-fused properties and suitable abdominal metabolism time. Intriguingly, the introduction of the ultra-hydrophilic HPMA chains to the H-HPMA hydrogel affords an unprecedented antifouling capability. The HPMA chains establish a dense hydrated layer that rapidly prevents the postsurgical adhesions and recurrent adhesions after adhesiolysis in vivo. The H-HPMA hydrogel can repair the peritoneal wound of the rat model within 5 days. Furthermore, an underlying mechanism study reveals that the H-HPMA hydrogel significantly regulated the mesothelial-to-mesenchymal transition (MMT) process dominated by the TGF-β-Smad2/3 signal pathway. Thus, we developed a simple, effective, and available approach to rapidly promote peritoneum regeneration and prevent peritoneal adhesion and adhesion recurrence after adhesiolysis, offering novel design ideas for developing biomaterials to prevent peritoneal adhesion.
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Affiliation(s)
- Jushan Gao
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Jinpeng Wen
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Datao Hu
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Kailai Liu
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yuchen Zhang
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xinxin Zhao
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Ke Wang
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
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Activating SIRT3 in peritoneal mesothelial cells alleviates postsurgical peritoneal adhesion formation by decreasing oxidative stress and inhibiting the NLRP3 inflammasome. EXPERIMENTAL & MOLECULAR MEDICINE 2022; 54:1486-1501. [PMID: 36100663 PMCID: PMC9535009 DOI: 10.1038/s12276-022-00848-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 07/02/2022] [Accepted: 07/19/2022] [Indexed: 11/08/2022]
Abstract
Peritoneal adhesions (PAs) are a serious complication of abdominal surgery and negatively affect the quality of life of millions of people worldwide. However, a clear molecular mechanism and a standard therapeutic strategy for PAs have not been established. Here, we developed a standardized method to mimic the pathological changes in PAs and found that sirtuin 3 (SIRT3) expression was severely decreased in adhesion tissues, which was consistent with our bioinformatics analysis and patient adhesion tissue analysis. Thus, we hypothesized that activating SIRT3 could alleviate postsurgical PAs. Sirt3-deficient (Sirt3−/−) mice exhibited many more PAs after standardized abdominal surgery. Furthermore, compared with wild-type (Sirt3+/+) mice, Sirt3-deficient (Sirt3−/−) mice showed more prominent reactive oxygen species (ROS) accumulation, increased levels of inflammatory factors, and exacerbated mitochondrial damage and fragmentation. In addition, we observed NLRP3 inflammasome activation in the adhesion tissues of Sirt3−/− but, not Sirt3+/+ mice. Furthermore, mesothelial cells sorted from Sirt3−/− mice exhibited impaired mitochondrial bioenergetics and redox homeostasis. Honokiol (HKL), a natural compound found in several species of the genus Magnolia, could activate SIRT3 in vitro. Then, we demonstrated that treatment with HKL could reduce oxidative stress and the levels of inflammatory factors and suppress NLRP3 activation in vivo, reducing the occurrence of postsurgical PAs. In vitro treatment with HKL also restored mitochondrial bioenergetics and promoted mesothelial cell viability under oxidative stress conditions. Taken together, our findings show that the rescue of SIRT3 by HKL may be a new therapeutic strategy to alleviate and block postsurgical PA formation. Treatment with honokiol, a compound found in magnolia tree bark, significantly reduces formation of internal scar tissue after abdominal surgery in mice. Healing of incisions in the peritoneum, the connective tissue lining the abdomen, can result in scar tissue bonds known as peritoneal adhesions (PA), causing complications such as infertility or bowel obstructions. The mechanism of PA formation is unknown, and no therapies are available. Xuqi Li at The First Affiliated Hospital of Xi’an Jiaotong University, China, and co-workers found that PA tissues in both mice and human patients had decreased levels of SIRT3, a stress-response protein. Mice lacking SIRT3 showed increased inflammation and PA formation. When mice were treated with honokiol the day after surgery in order to boost SIRT3 levels, PA formation was significantly decreased. These results suggest a possible preventative treatment for post-surgical PAs.
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15
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Combined treatment of xyloglucan derivative hydrogel and anti-C5a receptor antibody in preventing peritoneal adhesion. Acta Biomater 2022; 151:163-173. [DOI: 10.1016/j.actbio.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/15/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2022]
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16
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Regenerative Medicine Therapies for Prevention of Abdominal Adhesions: A Scoping Review. J Surg Res 2022; 275:252-264. [DOI: 10.1016/j.jss.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/26/2021] [Accepted: 02/08/2022] [Indexed: 01/02/2023]
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17
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Prevention of postoperative adhesion with a colloidal gel based on decyl group-modified Alaska pollock gelatin microparticles. Acta Biomater 2022; 149:139-149. [PMID: 35697199 DOI: 10.1016/j.actbio.2022.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022]
Abstract
Postoperative adhesion, bonding of the abdominal wall to damaged organs, causes severe complications after abdominal surgery. Despite the availability of physical barriers (i.e., solutions, films, and hydrogels), adhesion prevention materials that are a single-substance system with stability in wet tissue and ease of use have not been reported. Here, we report a microparticle based, sprayable adhesion prevention material comprising decyl group modified Alaska pollock gelatin (C10-ApGltn). C10-ApGltn microparticles (C10-MPs) were prepared by a coacervation method, freeze drying, and thermal crosslinking. The C10-MPs adhered to and formed a colloidal gel layer on intestinal serosal tissue by hydration without any crosslinking agents. After hydration of the C10-MPs, the resulting colloidal gel layer did not adhere to other tissues. Additionally, the C10-MP colloidal gel layer formed on the stomach serosal tissue showed stability when submersed in saline for 2 days. The colloidal gel layer also showed tissue followability. An in vivo rat adhesion model revealed that C10-MP colloidal gel layer on the cecum and abdominal wall defects effectively reduced postoperative adhesion and induced tissue remodeling, including re-mesothelialization. Therefore, C10-MPs are a potential anti-adhesion material for preventing postoperative adhesion. STATEMENT OF SIGNIFICANCE: We evaluated the postoperative adhesion prevention ability of a colloidal gel based on decyl group modified Alaska pollock gelatin (ApGltn) microparticles (C10-MPs). These microparticles are sprayable and form a colloidal gel with only hydration on the gastrointestinal tissue. We revealed that the modification of the decyl group into ApGltn improved the stability of C10-MP colloidal gel on the tissue by hydrophobic interaction in the in-vitro experiments. The gel prevented postoperative adhesion by being a physical barrier in the in-vivo rat adhesion model.
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Kazemi K, Hosseinzadeh A, Shahriarirad R, Nikeghbalian S, Kamran H, Hosseinpour P, Tanideh N, Jamshidi K. Comparison of Oral Sirolimus, Prednisolone, and Combination of Both in Experimentally Induced Peritoneal Adhesion. J Surg Res 2022; 276:168-173. [PMID: 35344743 DOI: 10.1016/j.jss.2022.02.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Peritoneal adhesion formation is a challenging postoperative complication. We aim to evaluate the effect of orally administered sirolimus, prednisolone, and their combination to prevent this entity. METHODS Eighty female albino underwent intraperitoneal injection of 3 mL of 10% sterile talc solution to induce peritoneal adhesion, and were subsequently and randomly divided into four groups (each n = 20); including a control group; 1 mg/kg oral prednisolone daily in the morning; 0.1 mg/kg oral sirolimus daily; and a combination group which received both drugs, with the same dosage. On the 29th day, abdominal cavities were explored, and classification was done based on Nair classification. RESULTS All rats were healthy on the 29th day, in which exploration was performed. The rats in the control group had extensive intra-abdominal adhesions, while 17 (85%) rats in the control group had substantial adhesion; however, the prednisolone, sirolimus, and combination group had lesser adhesion formation. Also, 14 (70%) rats of prednisolone group, 13 (65%) of sirolimus group, and 16 (80%) of combination group had insubstantial adhesion. The decrease in the grade of peritoneal adhesion bands was highly significant in the combination group (P > 0.001). CONCLUSIONS The combination of sirolimus and prednisolone was effective for preventing peritoneal adhesions in rats.
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Affiliation(s)
- Kourosh Kazemi
- Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Hosseinzadeh
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran.
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Saman Nikeghbalian
- Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hooman Kamran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Hosseinpour
- School of Medicine, Islamic Azad University, Kazeroun branch, Kazeroun, Iran
| | - Nader Tanideh
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Pharmacology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Jamshidi
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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Ruiz-Esparza GU, Wang X, Zhang X, Jimenez-Vazquez S, Diaz-Gomez L, Lavoie AM, Afewerki S, Fuentes-Baldemar AA, Parra-Saldivar R, Jiang N, Annabi N, Saleh B, Yetisen AK, Sheikhi A, Jozefiak TH, Shin SR, Dong N, Khademhosseini A. Nanoengineered Shear-Thinning Hydrogel Barrier for Preventing Postoperative Abdominal Adhesions. NANO-MICRO LETTERS 2021; 13:212. [PMID: 34664123 PMCID: PMC8523737 DOI: 10.1007/s40820-021-00712-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
More than 90% of surgical patients develop postoperative adhesions, and the incidence of hospital re-admissions can be as high as 20%. Current adhesion barriers present limited efficacy due to difficulties in application and incompatibility with minimally invasive interventions. To solve this clinical limitation, we developed an injectable and sprayable shear-thinning hydrogel barrier (STHB) composed of silicate nanoplatelets and poly(ethylene oxide). We optimized this technology to recover mechanical integrity after stress, enabling its delivery though injectable and sprayable methods. We also demonstrated limited cell adhesion and cytotoxicity to STHB compositions in vitro. The STHB was then tested in a rodent model of peritoneal injury to determine its efficacy preventing the formation of postoperative adhesions. After two weeks, the peritoneal adhesion index was used as a scoring method to determine the formation of postoperative adhesions, and STHB formulations presented superior efficacy compared to a commercially available adhesion barrier. Histological and immunohistochemical examination showed reduced adhesion formation and minimal immune infiltration in STHB formulations. Our technology demonstrated increased efficacy, ease of use in complex anatomies, and compatibility with different delivery methods, providing a robust universal platform to prevent postoperative adhesions in a wide range of surgical interventions.
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Affiliation(s)
- Guillermo U Ruiz-Esparza
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Xichi Wang
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Xingcai Zhang
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
| | - Sofia Jimenez-Vazquez
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- School of Engineering and Science, Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, 64849, Mexico
- School of Medicine and Health Science, Campus Guadalajara, Zapopan, Jalisco, 45201, Mexico
| | - Liliana Diaz-Gomez
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- School of Engineering and Science, Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, 64849, Mexico
- School of Medicine and Health Science, Campus Guadalajara, Zapopan, Jalisco, 45201, Mexico
| | - Anne-Marie Lavoie
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Samson Afewerki
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Andres A Fuentes-Baldemar
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- School of Engineering and Science, Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, 64849, Mexico
- School of Medicine and Health Science, Campus Guadalajara, Zapopan, Jalisco, 45201, Mexico
| | - Roberto Parra-Saldivar
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- School of Engineering and Science, Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, 64849, Mexico
- School of Medicine and Health Science, Campus Guadalajara, Zapopan, Jalisco, 45201, Mexico
| | - Nan Jiang
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Nasim Annabi
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Bahram Saleh
- Department of Chemical Engineering, Northeastern University, Boston, MA, 02115, USA
| | - Ali K Yetisen
- Department of Chemical Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Amir Sheikhi
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Chemical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Thomas H Jozefiak
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Su Ryon Shin
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Nianguo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Ali Khademhosseini
- Biomaterials Innovation Research Center, Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA.
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
- Terasaki Institute for Biomedical Innovation, 11570 W Olympic Blvd, Los Angeles, CA, 90024, USA.
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Bakibaev AA, Tuguldurova VP, Lyapunova MV, Ivanov VV, Kaidash OA, Udut EV, Bukterov MV, Buyko EE, Kasyanova AS, Malkov VS. Anti-Adhesion Effect of Composite Film Materials Based on Glycoluril-Modified Sodium Carboxymethyl Cellulose. Sovrem Tekhnologii Med 2021; 13:35-40. [PMID: 34513064 PMCID: PMC8353686 DOI: 10.17691/stm2021.13.1.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to develop composite film materials derived from modified sodium carboxymethyl cellulose and to evaluate their anti-adhesive effects.
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Affiliation(s)
- A A Bakibaev
- Engineer, Laboratory of Synthesis of High-Energy Compounds, Institute for Problems of Chemical and Energetic Technologies of the Siberian Branch of the Russian Academy of Sciences, 1 Sotsialisticheskaya St., Biysk, 659322, Russia
| | - V P Tuguldurova
- Engineer, Laboratory of Synthesis of High-Energy Compounds, Institute for Problems of Chemical and Energetic Technologies of the Siberian Branch of the Russian Academy of Sciences, 1 Sotsialisticheskaya St., Biysk, 659322, Russia
| | - M V Lyapunova
- Engineer, Laboratory of Synthesis of High-Energy Compounds, Institute for Problems of Chemical and Energetic Technologies of the Siberian Branch of the Russian Academy of Sciences, 1 Sotsialisticheskaya St., Biysk, 659322, Russia
| | - V V Ivanov
- Associate Professor, Head of the Center for Preclinical Research, Central Research Laboratory, Siberian State Medical University, 2 Moskovsky trakt, Tomsk, 634050, Russia
| | - O A Kaidash
- Senior Researcher, Center for Preclinical Research, Central Research Laboratory, Siberian State Medical University, 2 Moskovsky trakt, Tomsk, 634050, Russia
| | - E V Udut
- Professor of the Russian Academy of Sciences, Head of Central Research Laboratory, Siberian State Medical University, 2 Moskovsky trakt, Tomsk, 634050, Russia
| | - M V Bukterov
- Researcher, Center for Preclinical Research, Central Research Laboratory, Siberian State Medical University, 2 Moskovsky trakt, Tomsk, 634050, Russia
| | - E E Buyko
- PhD Student, Research School of Chemical and Biomedical Technologies, National Research Tomsk Polytechnic University, 30 Lenin Avenue, Tomsk, 634050, Russia, Researcher, Center for Preclinical Research, Central Research Laboratory, Siberian State Medical University, 2 Moskovsky trakt, Tomsk, 634050, Russia
| | - A S Kasyanova
- Laboratory Assistant, Laboratory of Organic Synthesis, Research Office, National Research Tomsk State University, 36 Lenin Avenue, Tomsk, 634050, Russia
| | - V S Malkov
- Head of the Laboratory of Organic Synthesis, Research Office, National Research Tomsk State University, 36 Lenin Avenue, Tomsk, 634050, Russia
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