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Lipid emulsions prevent postoperative abdominal adhesions. Asian J Surg 2023; 46:465-471. [PMID: 35688763 DOI: 10.1016/j.asjsur.2022.05.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/27/2022] [Accepted: 05/20/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Adhesions are the most common cause of long-term morbidity after abdominal surgery and most often cause various forms of intestinal passage disorders ranging from partial obstruction to complete, life-threatening intestinal obstruction. The aim of the present study was to evaluate the protective effect of intraperitoneally administered lipid emulsions on the formation of adhesions in larger animal model, as the lubricating effect of phospholipids and the mechanical barrier of the lipid component are combined with the anti-inflammatory effect of fish oil. METHODS Thirty-one female domestic pigs were randomly divided into three groups. At the end of the surgical procedure, a lipid emulsion or saline solution was applied intraperitoneally. After 14 days, an independent macroscopic, histological and immunohistochemical evaluation of the adhesions were performed. RESULTS Intraperitoneal administration of lipid emulsions significantly reduced the incidence of intra-abdominal adhesions. Microscopic examination demonstrated a significant reduction in the number of inflammatory elements and the amount of collagen in the adhesions, especially after administration of the fish oil-based emulsion. A simultaneous decrease in neovascularization was observed in the adhesions. Evaluation of the intestinal anastomosis did not reveal significant differences in healing between the groups. CONCLUSION Intraperitoneal administration of lipid emulsions can reduce the development of postoperative intra-abdominal adhesions by the combined action of phospholipids as important lubricants and lipids as a mechanical barrier. Their effect is caused by a reduction in proinflammatory and profibrotic mediators. At the same time, intraperitoneal administration of lipid emulsions does not impair healing of the anastomosis in larger animal model.
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Akhlaghi S, Rabbani S, Karimi H, Haeri A. Hyaluronic acid gel incorporating curcumin-phospholipid complex nanoparticles prevents postoperative peritoneal adhesion. J Pharm Sci 2022. [DOI: 10.1016/j.xphs.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Efatpanah A, Rabbani S, Talimi R, Mortazavi SA, Haeri A. Indomethacin Sustained-Release Anti-adhesion Membrane Composed of a Phospholipid and Polycaprolactone Blend. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2022; 21:e127353. [PMID: 36710990 PMCID: PMC9872549 DOI: 10.5812/ijpr-127353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/20/2022] [Accepted: 03/09/2022] [Indexed: 02/01/2023]
Abstract
Background Postoperative peritoneal adhesions are among common challenging problems in surgery. The availability of limited efficient strategies to prevent intra-abdominal adhesion reinforces the need to explore new methods. Given the favorable prolonged drug release characteristics of polycaprolactone (PCL) films and their ability to act as a biodegradable physical barrier implant, along with the anti-inflammatory and anti-adhesion properties of indomethacin and phospholipids, this study hypothesized that indomethacin sustained-release membrane composed of phosphatidylcholine (PC) and PCL blend could efficiently prevent abdominal adhesion formation. Methods Different polymeric and polymeric/lipidic hybrid formulations with three feeding materials to drug weight ratios were prepared, and their physicochemical characteristics and drug release kinetics were evaluated and compared. Abdominal adhesions were induced in 48 rats by the abrasion of the cecum and excision of a section of the opposite abdominal wall. Adhesion formation was evaluated by macroscopic scoring, histological, scanning electron microscopy, and polymerase chain reaction analyses. Results Both PCL and PCL-PC films exhibited sustained indomethacin release profiles. The X-ray diffraction and Fourier-transform infrared spectroscopy studies confirmed indomethacin incorporation in formulations in molecular dispersion form without any interaction. The films showed smooth surfaces and good mechanical properties. The treatment with indomethacin PCL-PC membrane significantly reduced the expression levels of tumor necrosis factor-alpha, transforming growth factor-beta, interleukin-1, interleukin-6, and fibrinogen in the adhesion tissues. The separation of the injured peritoneum, very low adhesion scores, and complete mesothelial cell regeneration were also achieved. Conclusions This study suggests that indomethacin-eluting PCL-PC membrane acting through the combination of physical barrier, anti-inflammatory agents, and controlled drug delivery warrants an effective approach to prevent intra-abdominal adhesion.
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Affiliation(s)
- Adrina Efatpanah
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Rabbani
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rozhin Talimi
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Mortazavi
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Azadeh Haeri
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Protein Technology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, P. O. Box: 14155-6153, Tehran, Iran. Tel: +98-2188200212,
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Babadi D, Rabbani S, Akhlaghi S, Haeri A. Curcumin polymeric membranes for postoperative peritoneal adhesion: Comparison of nanofiber vs. film and phospholipid-enriched vs. non-enriched formulations. Int J Pharm 2022; 614:121434. [PMID: 34995747 DOI: 10.1016/j.ijpharm.2021.121434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 12/08/2022]
Abstract
Intra-abdominal adhesion remains a major postoperative problem and is able to place individuals at lifelong risk of serious complications. Among available approaches, insertion of a barrier membrane at the site of injury partially inhibited adhesion formation. Moreover, the local administration of an anti-adhesive agent showed some favorable effects. In this study, we aimed to prepare and fully characterize polycaprolactone (PCL)-based film casts and electrospun nanofibers (NFs) containing a natural anti-inflammatory agent, curcumin (CUR), with extended-release properties. We also compared their efficiencies in preventing tissue adhesions. Additionally, the impact of soy phosphatidylcholine (SPC) enrichment on adhesion prevention was investigated. Prepared membranes were evaluated in terms of surface morphology (SEM, AFM), surface wettability, CUR release profiles, structural properties (FTIR, XRD, DSC), and mechanical behaviors. To further analyze the anti-adhesion effectiveness, a cecal abrasion model was performed on rats. SEM and AFM images showed a smoother surface in SPC-containing films. Concerning NFs, uniform bead-free fibers were observed and SPC containing NFs showed higher conductivity and lower viscosity and therefore, smaller fibers. All formulations exhibited sustained drug release over 4 weeks. In vivo findings revealed the superior performance of films compared to NFs and phospholipid-enriched formulations over non-enriched ones. Among all film formulations and in comparison to the positive control (Seprafilm®), CUR-SPC-PCL films significantly reduced peritoneal adhesions, as evidenced by gross examination, histological evaluation and immunohistochemical (IHC) analysis. The remarkable in vivo anti-adhesion activity together with suitable in vitro properties have made CUR-SPC-PCL films a promising system for postoperative anti-adhesion purposes in the clinic.
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Affiliation(s)
- Delaram Babadi
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Rabbani
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sarah Akhlaghi
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Haeri
- Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Protein Technology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Facile fabrication of phospholipid-functionalized nanofiber-based barriers with enhanced anti-adhesion efficiency. Colloids Surf B Biointerfaces 2021; 203:111728. [PMID: 33819819 DOI: 10.1016/j.colsurfb.2021.111728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/04/2021] [Accepted: 03/24/2021] [Indexed: 11/21/2022]
Abstract
Electrospun nanofibrous membranes (NFMs) have attracted considerable attention as a potential physical barrier for reducing postoperative adhesion. However, no anti-adhesion barrier can completely prevent adhesion formation. In this study, phospholipid-functionalized NFMs were readily fabricated by one-step electrospinning to obtain nanofiber-based barriers with enhanced wettability and anti-adhesion efficiency. The optimized phospholipid NFMs were shown to have a fiber diameter of 831 nm ± 135 nm that is drastically decreasing, high porosity of 87.6 % ± 1.1 %, and superior hydrophilicity. Moreover, the phospholipid NFMs with excellent cytocompatibility exhibited fibroblasts being significantly reduced (≈ 51 %) after incubation of 3 days compared to that of the NFMs (≈ 96 %), confirming long-lasting anti-adhesion capability against fibroblasts. Meanwhile, less cell adhesion and proliferation of Raw 264.7 macrophages on NFM-10Lec indicated its superior anti-inflammatory effects. Thus, the facile phospholipid-functionalized nanofibers provided a promising strategy for anti-adhesion applications.
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Cell membrane-biomimetic coating via click-mediated liposome fusion for mitigating the foreign-body reaction. Biomaterials 2021; 271:120768. [PMID: 33812321 DOI: 10.1016/j.biomaterials.2021.120768] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022]
Abstract
The foreign-body reaction (FBR) caused by the implantation of synthetic polymer scaffolds seriously affects tissue-biomaterial integration and tissue repair. To address this issue, we developed a cell membrane-biomimetic coating formed by "click"-mediated liposome immobilization and fusion on the surface of electrospun fibers to mitigate the FBR. Utilization of electrospun polystyrene microfibrous scaffold as a model matrix, we deposited azide-incorporated silk fibroin on the surface of the fibers by the layer-by-layer assembly, finally, covalently modified with clickable liposomes via copper-free SPAAC click reaction. Compared with physical adsorption, liposomes click covalently binding can quickly fuse to form lipid film and maintain fluidity, which also improved liposome stability in vitro and in vivo. Molecular dynamics simulation proved that "click" improves the binding rate and strength of liposome to silk substrate. Importantly, histological observation and in vivo fluorescent probes imaging showed that liposome-functionalized electrospun fibers had negligible characteristics of the FBR and were accompanied by many infiltrated host cells and new blood vessels. We believe that the promotion of macrophage polarization toward a pro-regenerative phenotype plays an important role in vascularization. This bioinspired strategy paves the way for utilizing cell membrane biomimetic coating to resist the FBR and promote tissue-scaffold integration.
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张 明, 任 高. [Application of medical biomaterials in prevention and treatment of tendon adhesion]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:1065-1070. [PMID: 32794680 PMCID: PMC8171898 DOI: 10.7507/1002-1892.201910024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 05/31/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To review the research progress of medicine biomaterials in prevention and treatment of adhesion after tendon injury, and to provide reference for clinical treatment. METHODS The literature on the application of medical biomaterials in the prevention and treatment of tendon adhesions in recent years was reviewed, and the biological process, treatment methods, and current status of tendon adhesions were summarized. RESULTS Tendon adhesion as part of the healing process of the tendon is the biological response of the tendon to the injury and is also a common complication of joint dysfunction. Application of medical biomaterials can achieve better biological function of postoperative tendon by reducing the adhesion of peritendon tissues as far as possible without adversely affecting the tendon healing process. CONCLUSION The use of medical biomaterials is conducive to reduce the adhesion of tendon after operation, and the appropriate anti-adhesion material should be selected according to the patients' condition and surgical needs.
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Affiliation(s)
- 明敏 张
- 南方医科大学附属南方医院创伤骨科(广州 510515)Department of Trauma Orthopedics, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou Guangdong, 510515, P.R.China
| | - 高宏 任
- 南方医科大学附属南方医院创伤骨科(广州 510515)Department of Trauma Orthopedics, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou Guangdong, 510515, P.R.China
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Saha T, Houshyar S, Ranjan Sarker S, Ghosh S, Dekiwadia C, Padhye R, Wang X. Surface-Functionalized Polypropylene Surgical Mesh for Enhanced Performance and Biocompatibility. ACS APPLIED BIO MATERIALS 2019; 2:5905-5915. [DOI: 10.1021/acsabm.9b00849] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Tanushree Saha
- Centre for Materials Innovation and Future Fashion (CMIFF), School of Fashion and Textiles, RMIT University, Brunswick, 3056 Victoria, Australia
- School of Engineering, RMIT University, Melbourne, 3000 Victoria, Australia
| | - Shadi Houshyar
- Centre for Materials Innovation and Future Fashion (CMIFF), School of Fashion and Textiles, RMIT University, Brunswick, 3056 Victoria, Australia
- School of Engineering, RMIT University, Melbourne, 3000 Victoria, Australia
| | - Satya Ranjan Sarker
- Centre for Advanced Materials and Industrial Chemistry (CAMIC), School of Science, RMIT University, Melbourne, 3001 Victoria, Australia
- Department of Biotechnology and Genetic Engineering, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Subir Ghosh
- School of Engineering, RMIT University, Melbourne, 3000 Victoria, Australia
| | - Chaitali Dekiwadia
- RMIT Microscopy and Microanalysis Facility, RMIT University, Melbourne, 3000 Victoria, Australia
| | - Rajiv Padhye
- Centre for Materials Innovation and Future Fashion (CMIFF), School of Fashion and Textiles, RMIT University, Brunswick, 3056 Victoria, Australia
| | - Xin Wang
- Centre for Materials Innovation and Future Fashion (CMIFF), School of Fashion and Textiles, RMIT University, Brunswick, 3056 Victoria, Australia
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Tsaousi G, Stavrou G, Fotiadis K, Kotzampassi K, Kolios G. Implementation of phospholipids as pharmacological modalities for postoperative adhesions prevention. Eur J Pharmacol 2018; 842:189-196. [PMID: 30391744 DOI: 10.1016/j.ejphar.2018.10.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/25/2018] [Accepted: 10/31/2018] [Indexed: 01/23/2023]
Abstract
Adhesions formation is considered a significant clinical entity implicating the healing process following major abdominal surgery, with serious clinical consequences and need for substantial health care expenditures. Several agents and substances applied either locally or systematically could potentially function as inhibitors of the formation of peritoneal adhesions endowed by limiting tissue apposition during the critical stages of mesothelial repair. Phospholipids are identified as surfactant-like substances, acting as a temporary membrane-like coverage of serosal defects. The experimental use of phospholipids for adhesions formation totals 24 publications. All retrieved studies, out of two, demonstrated the efficacy of phospholipids use in adhesions prevention. A single intraperitoneal dose of approximately 75 mg/kg of phosphatidylcholine, for a 30-min exposure time, emerges as the standard practice in terms of efficacy in both surgical alone or combined to peritonitis settings. The findings revealing an unimpeded healing of anastomoses and laparotomy wounds support the safety of this agent. The two additional properties of intraperitoneal use of phospholipids involve the inhibition of bacterial adherence/growth following impregnation of intra-abdominal drainages with phospholipids, without influencing bacterial translocation and the elimination of peritoneal carcinosis, through inhibition of intraperitoneal adhesion of tumor cells. The latter effect is achieved by a dose of phospholipids equal to 150 mg/kg. These experimental data, support that the intraperitoneal phospholipids administration can forestall adhesions formation following intra-abdominal surgical trauma, with no considerable overdosing-related adverse effects. Furthermore, these substances could possibly attenuate posttraumatic inflammation, and inhibit intraperitoneal tumor cell adhesion.
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Affiliation(s)
- Georgia Tsaousi
- Department of Anesthesiology and ICU, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, P.O. 54006, Thessaloniki, Greece.
| | - George Stavrou
- Department of Surgery, Faculty of Medicine, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, P.O. 54006, Thessaloniki, Greece; Department of General Surgery, York Teaching Hospital, NHS Foundation Trust, Wigginton Road, York, North Yorkshire YO31 8HE, UK.
| | - Kyriakos Fotiadis
- Department of Surgery, Faculty of Medicine, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, P.O. 54006, Thessaloniki, Greece.
| | - Katerina Kotzampassi
- Department of Surgery, Faculty of Medicine, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, P.O. 54006, Thessaloniki, Greece.
| | - George Kolios
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis 68100, Greece.
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Filidou E, Valatas V, Drygiannakis I, Arvanitidis K, Vradelis S, Kouklakis G, Kolios G, Bamias G. Cytokine Receptor Profiling in Human Colonic Subepithelial Myofibroblasts: A Differential Effect of Th Polarization-Associated Cytokines in Intestinal Fibrosis. Inflamm Bowel Dis 2018; 24:2224-2241. [PMID: 29860326 DOI: 10.1093/ibd/izy204] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Colonic subepithelial myofibroblasts (cSEMFs) are mesenchymal cells with a pivotal role in the pathophysiology of Crohn's disease (CD) fibrosis. Here, we demonstrate for the first time a complete expression mapping of cytokine receptors, implicated in inflammatory bowel diseases, in primary human cSEMFs and how pro-inflammatory cytokines regulate this expression. Furthermore, we show the effect of Th1-, Th2-, Th17- and Treg-related cytokines on a fibrosis-related phenotype of cSEMFs. METHODS Colonic subepithelial myofibroblasts were isolated from healthy individuals' colonic biopsies. Interleukin (IL)-1α- and/or tumor necrosis factor (TNF)-α-induced mRNA and protein expression of cytokine receptors was assayed by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunofluorescence, respectively. Th-related cytokine effects on mRNA and protein profibrotic factor expression were analyzed by qRT-PCR and/or colorimetric assays and on the wound-healing capacity of cSEMFs by scratch test. RESULTS In cSEMFs, we observed basal cytokine receptor expression, which was modified by IL-1α and TNF-α. Th1-related cytokines upregulated tissue factor (TF), collagen, fibronectin and matrix metalloproteinase (MMP)-1 and downregulated α-smooth muscle actin (α-SMA), MMP-9, and wound healing rate. Th2-related cytokines upregulated collagen, TF, α-SMA, MMP-1, and wound healing rate and downregulated fibronectin and MMP-9. IL-17 and IL-23 upregulated fibronectin, and IL-22 downregulated TF. IL-17 and IL-22 decreased wound healing rate. Similar to TGF-β, IL-23 upregulated MMP-1, tissue inhibitor of metalloproteinases-1, collagen expression, and wound healing rates. CONCLUSIONS Our results suggest that cSEMFs have a central role in inflammation and fibrosis, as they express a great variety of Th-related cytokine receptors, making them responsive to pro-inflammatory cytokines, abundant in the inflamed mucosa of CD patients.
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Affiliation(s)
- Eirini Filidou
- Laboratory of Pharmacology, Faculty of Medicine, Alexandroupolis, Greece
| | - Vasilis Valatas
- Laboratory of Gastroenterology, University of Crete, Heraklion, Greece
| | | | | | - Stergios Vradelis
- 2nd Department of Internal Medicine of University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Georgios Kouklakis
- 1st Department of Internal Medicine of University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - George Kolios
- Laboratory of Pharmacology, Faculty of Medicine, Alexandroupolis, Greece
| | - Giorgos Bamias
- GI Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
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Lemke A, Ferguson J, Gross K, Penzenstadler C, Bradl M, Mayer RL, Gerner C, Redl H, Wolbank S. Transplantation of human amnion prevents recurring adhesions and ameliorates fibrosis in a rat model of sciatic nerve scarring. Acta Biomater 2018; 66:335-349. [PMID: 29191510 DOI: 10.1016/j.actbio.2017.11.042] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/19/2017] [Accepted: 11/22/2017] [Indexed: 12/12/2022]
Abstract
Peripheral nerve fibrosis and painful adhesions are common, recurring pathological sequelae following injury. In this study, vital human amnion (hAM), an increasingly interesting biomaterial for regenerative medicine, was investigated as a novel therapy. hAM was first analyzed in vitro regarding its anti-adhesive characteristics. Then, the reflected region of hAM which was identified as more suitable, was transplanted into female Sprague Dawley rats with recurring sciatic nerve scarring (n = 24) and compared with untreated controls (n = 30) at one, four and twelve weeks. Immune response and fibrosis were investigated by (immuno)histochemical analysis. Nerve structure was examined and function determined using electrophysiology and gait analysis. Here we identified strongly reduced adhesions in the hAM-treated rats, displaying a significant difference at four weeks post transplantation compared to untreated controls (p = .0052). This correlated with the in vitro cell attachment test on hAM explants, which demonstrated a distinctly limited ability of fibroblasts to adhere to amniotic epithelial cells. Upon hAM transplantation, significantly less intraneural fibrosis was identified at the later time points. Moreover, hAM-treated rats exhibited a significantly higher sciatic functional index (SFI) after four weeks compared to controls (p < .05), which indicated a potentially pro-regenerative effect of hAM. As a possible explanation, an impact of hAM on the endogenous immune response, including T cell and macrophage subsets, was indicated. We conclude that hAM is strongly effective against recurring nerve scarring and induces an anti-fibrotic and pro-regenerative effect, making it highly promising for treating adhesion-related disorders. STATEMENT OF SIGNIFICANCE Abnormal fibrotic bonding of tissues, frequently involving peripheral nerves, affects millions of people worldwide. These so-called adhesions usually cause severe pain and drastically reduce quality of life. To date, no adequate treatment exists and none is routinely used in the clinical practice. In this study, vital human amnion, the innermost of the fetal membranes, was transplanted in a rat model of peripheral nerve scarring and recurring adhesions as novel therapeutic approach. Amniotic cells have already demonstrated to feature stem-cell like properties and produce pro-regenerative factors, which makes the amnion an increasingly promising biomaterial for regenerative medicine. We identified that its transplantation was very effective against peripheral nerve scarring and distinctly reduced recurring adhesions. Moreover, we identified a pro-regenerative effect. This study showed that the amnion is a highly promising novel therapeutic approach for adhesion-related disorders.
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Affiliation(s)
- Angela Lemke
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, 1200 Vienna, Austria; Austrian Cluster for Tissue Regeneration, Austria.
| | - James Ferguson
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, 1200 Vienna, Austria; Austrian Cluster for Tissue Regeneration, Austria
| | - Kelly Gross
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, 1200 Vienna, Austria
| | - Carina Penzenstadler
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, 1200 Vienna, Austria
| | - Monika Bradl
- Department of Neuroimmunology, Center for Brain Research, Medical University Vienna, Spitalgasse 4, 1090 Vienna, Austria
| | - Rupert Laurenz Mayer
- Department of Analytical Chemistry, Faculty of Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria
| | - Christopher Gerner
- Department of Analytical Chemistry, Faculty of Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, 1200 Vienna, Austria; Austrian Cluster for Tissue Regeneration, Austria
| | - Susanne Wolbank
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, 1200 Vienna, Austria; Austrian Cluster for Tissue Regeneration, Austria
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Tian L, Li H, Li Y, Liu K, Sun Y, Cong Z, Luan X, Li Y, Chen J, Wang L, Ren Z, Cong D, Wang H, Pei J. A Combination of Chitosan, Cellulose, and Seaweed Polysaccharide Inhibits Postoperative Intra-abdominal Adhesion in Rats. J Pharmacol Exp Ther 2017; 364:399-408. [DOI: 10.1124/jpet.117.244400] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/07/2017] [Indexed: 01/23/2023] Open
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Wu W, Cheng R, das Neves J, Tang J, Xiao J, Ni Q, Liu X, Pan G, Li D, Cui W, Sarmento B. Advances in biomaterials for preventing tissue adhesion. J Control Release 2017; 261:318-336. [DOI: 10.1016/j.jconrel.2017.06.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
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Antiadhesive and anti-inflammatory effects of pirfenidone in postoperative intra-abdominal adhesion in an experimental rat model. J Surg Res 2016; 201:348-55. [DOI: 10.1016/j.jss.2015.11.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 11/15/2015] [Accepted: 11/20/2015] [Indexed: 11/23/2022]
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Kallinowski F, Baumann E, Harder F, Siassi M, Mahn A, Vollmer M, Morlock MM. Dynamic intermittent strain can rapidly impair ventral hernia repair. J Biomech 2015; 48:4026-4036. [DOI: 10.1016/j.jbiomech.2015.09.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/25/2015] [Accepted: 09/26/2015] [Indexed: 12/29/2022]
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