The preventive effect of Met-RANTES on postoperative intraperitoneal adhesion formation in the rat model

Suppressive Effects of Aspirin for Postthoracotomy Pleural Adhesion in Rats

BACKGROUND

Postoperative adhesion is one of major concerns at re-thoracotomy. Aspirin has both the anti-platelet and anti-inflammatory effects, and decreases several cytokines production.

OBJECTIVE

We investigated that aspirin could reduce postoperative adhesion formation in a rat model.

METHODS

We cauterised the lung visceral pleural to make postoperative adhesion in rats. The animals were allocated to a control group and an aspirin administration group (100 mg/kg/day for 14 days). We performed re-thoracotomy and evaluated the adhesion lengths on day 14. We also investigated the cytokine expression in the adhesion region and the peripheral tissue with platelet-derived growth factor (PDGF), platelet-derived growth factor receptor (PDGFR), alpha smooth muscle actin (α-SMA), transforming growth factor beta 1 (TGF-β1), and vascular endothelial growth factor-A (VEGF-A), sequentially.

RESULTS

The adhesion lengths were significantly shorter in the aspirin group than that in the control group (8.7±2.0 mm vs 11.2±1.1 mm, p=0.024). The expressions of PDGF and PDGFR were lower in the aspirin group than that in the control group on day 3. The expression of α-SMA on fibroblasts decreased in the aspirin group on day 3. There was no significant difference in the expressions of TGF-β1 and VEGF-A with administration of aspirin.

CONCLUSIONS

Aspirin could reduce postoperative pleural adhesion by inhibiting the expression of PDGF.

Electroacupuncture ST36 prevents postoperative intra-abdominal adhesions formation

BACKGROUND

We have recently proved electroacupuncture (EA) ST36 exerted an anti-inflammatory effect in the early phase of intra-abdominal adhesion formation. Evidences indicate that the anti-inflammatory effect of EA ST36 involves a cholinergic anti-inflammatory pathway-dependent mechanism via the vagus nerve. However, the exact effects and accurate vagal modulation of acupuncture in prevention of postoperative intra-abdominal adhesion formation has not been thoroughly evaluated.

MATERIALS AND METHODS

Sprague-Dawley rats subjected to abdominal adhesion lesions operation at the cecum and abdominal wall were randomly divided into six groups as follows: (a) EAN: EA non-channel acupoints; (b) EA: EA ST36 after abdominal lesions; (c) VGX/EA: vagotomy (VGX) after abdominal lesions, then EA ST36; (d) VGX/EAN: VGX after abdominal lesions, then EAN; (e) α-BGT/EA: intraperitoneal injection of α-bungarotoxin (α-BGT, an antagonist of α7 subunit of cholinergic nicotinic receptor) before EA ST36, and (f) α-BGT/EAN group: α-BGT injection before EAN. Seven days after abdominal surgical lesions, the levels of tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) in the adhesive tissue were evaluated, macroscopic observation and histopathologic evaluation of adhesion formation and assessment of angiogenesis by immunohistochemical staining of platelet endothelial cell adhesion molecule-1 (CD31) were performed.

RESULTS

EA ST36 reduced TNF-α and VEGF levels in adhesive tissue homogenates 7 d after surgery, whereas vagotomy or intraperitoneal injection of α-BGT before EA ST36 reversed its suppressive effects. EA at non-channel acupoints with or without vagotomy or intraperitoneal injection of α-BGT before EA had no suppressive effects on TNF-α and VEGF levels. EA ST36 alleviated the adhesion formation, with both of macroscopic and histopathologic adhesion scores significantly lower than those of the EAN group (1.56 ± 0.29 versus 3.00 ± 0.82, 1.35 ± 0.4 versus 3.91 ± 0.8, respectively, both P < 0.05). Compared with the EAN group, EA ST36 significantly decreased angiogenesis evidenced by reduced CD31 positive microvessel density in adhesive tissue.

CONCLUSIONS

EA ST36 might reduce the postoperative local inflammatory response, attenuate the angiogenesis, and alleviate the adhesion formation partly via activating the cholinergic anti-inflammatory mechanism.

Gynecologic use of Sepraspray Adhesion Barrier for reduction of adhesion development after laparoscopic myomectomy: a pilot study

OBJECTIVE

To assess the safety and efficacy of Sepraspray Adhesion Barrier (a modified hyaluronic acid and carboxymethylcellulose powder) after laparoscopic surgery, in view of both the high efficacy of Seprafilm Adhesion Barrier in reducing postoperative adhesions after open surgical procedures and the difficulty with laparoscopic delivery.

DESIGN

Multicenter, randomized, reviewer-blinded trial.

SETTING

Reproductive endocrinology and infertility clinics.

PATIENT(S)

Women undergoing laparoscopic myomectomy for indications including infertility.

INTERVENTION(S)

Randomization to treatment with (n = 21) or without (n = 20) Sepraspray Adhesion Barrier.

MAIN OUTCOME MEASURE(S)

Postoperative adhesions development was assessed at early second-look laparoscopy. Adhesions were scored using the modified American Fertility Society scoring system.

RESULT(S)

Surgical procedure duration length was 99 versus 102 minutes in the control versus Sepraspray Adhesion Barrier groups, respectively, with the median number of fibroids removed being two in each group and corresponding fibroid weights of 134 ± 103 versus 113 ± 161 g, respectively. Adhesions scores increased in both the control and Sepraspray Adhesion Barrier groups, with larger although nonstatistically significant increases noted in control subjects when evaluating for the anterior uterus, the posterior uterus, and the entire uterus.

CONCLUSION(S)

Laparoscopic application of Sepraspray Adhesion Barrier after myomectomy in this pilot study was associated with a trend toward a reduction in postoperative adhesion development, as well as an encouraging safety profile. Further evaluation is warranted.

CLINICAL TRIAL NUMBER

Sepraspray Adhesion Barrier #NCT00624930.

The effect of antivascular endothelial growth factor on the development of adhesion formation in laparotomized rats: experimental study

Aims. This study determined the effects of a single dose of bevacizumab, an antiangiogenic recombinant monoclonal antibody that specifically targets vascular endothelial growth factor (VEGF), on adhesion formation in the rat cecal abrasion model. Methodology. Thirty female Wistar albino rats (200-224 g) were divided into three groups. All rats underwent laparotomy at which time cecal wall abrasion and abdominal wall injuries were induced. Group I (control) underwent only the abrasion procedure; Groups II and III received saline or bevacizumab intraperitoneally, respectively, following the abrasion. The rats were killed on postoperative day 7, and the severity of adhesions was evaluated, together with histopathological fibrosis parameters and immunohistochemical staining to identify the VEGF receptor. Results. The mean adhesion severity score in Groups I-III was 2.5 ± 0.52, 2.4 ± 0.69, and 0.7 ± 0.82, respectively; the score in Group III was significantly lower than that in Groups I (P < 0.001) and II (P < 0.001). In the histopathological evaluation, the mean fibrosis score in Group III was significantly lower that the scores in Groups I (P < 0.001) and II (P < 0.001). VEGF staining of the adhesion areas in Group III was significantly lower than that in Groups I (P < 0.001) and II (P < 0.001). Conclusion. Bevacizumab decreases adhesion formation following laparotomy in rats by blocking VEGF receptor occupancy.

Met-RANTES down-regulates the expression of MIP-3α and CCR6 in the colon of mice with experimental ulcerative colitis

AIM: To investigate the role of macrophage inflammatory protein-3α (MIP-3α) and chemokine receptor 6 (CCR6) in the pathogenesis of ulcerative colitis (UC) and to explore the mechanism of therapeutic effect of Met-RANTES against UC.

METHODS: Forty mice were randomly and equally divided into four groups: blank control group, model control group, normal saline group, and Met-RANTES treatment group. Ulcerative colitis was induced in mice by giving dextran sodium sulfate (DSS). The impact of Met-RANTES on disease activity index (DAI), gross morphological score (GMS) and histopathological score (HPS) in UC was then evaluated. The expression of MIP-3α and CCR6 mRNAs was measured by reverse transcription-polymerase chain reaction (RT-PCR). The expression of MIP-3α and CCR6 proteins was examined by Western blot and immunohistochemistry.

RESULTS: The DAI, GMS and HPS were higher in the model control group and the normal saline group than in the blank control group. The expression levels of MIP-3α and CCR6 mRNAs and proteins in UC were significantly higher in the model control group and the normal saline group than in the blank control group (all P < 0.01). The DAI, GMS and HPS as well as the expression levels of MIP-3α and CCR6 mRNAs and proteins in the Met-RANTES treatment group were significantly lower than those in the model control group and the normal saline group (mRNA: 0.21 ± 0.08 vs 1.09 ± 0.08 and 1.08 ± 0.07, and 0.25 ± 0.08 vs 1.11 ± 0.07 and 1.05 ± 0.08; protein: 0.28 ± 0.08 vs 0.98 ± 0.07 and 1.05 ± 0.06, and 0.25 ± 0.07 vs 1.19 ± 0.07 and 1.15 ± 0.06; all P < 0.01). In contrast, no statistical differences were noted in DAI, GMS and HPS as well as the expression levels of MIP-3α and CCR6 mRNAs and proteins between the model control group and the normal saline group (all P > 0.05).

CONCLUSION: The expression of MIP-3α and its receptor CCR6 is up-regulated in UC, which is closely related with the development and progression of UC. Met-RANTES can down-regulate the expression of MIP-3α and CCR6 and ameliorate inflammatory damage in mice with UC. MIP-3α and CCR6 may represent novel pharmacological targets for treatment of UC.