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Nishino H, Nishimura T, Miyashita S, Tada M, Fujimoto Y, Fujimoto J, Iijima H, Hatano E. Preoperative diagnosis of adhesion severity between the abdominal wall and intestinal tract with novel abdominal ultrasound methodology to enhance surgical safety. Surgery 2024; 176:469-476. [PMID: 38811324 DOI: 10.1016/j.surg.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/26/2024] [Accepted: 04/13/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Adhesions between the abdominal wall and intestinal tract from previous surgeries can complicate reoperations; however, predicting the extent of adhesions preoperatively is difficult. This study aimed to develop a straightforward approach for predicting adhesion severity using a novel abdominal ultrasound technique that quantifies the displacement of motion vectors of two organs to enhance surgical safety. The efficacy of this methodology was assessed experimentally and clinically. METHODS Using Aplio500T, a system we developed, we measured the displacement of the upper peritoneum and intestinal tract as a vector difference and computed the motion difference ratio. Twenty-five rats were randomized into surgery and nonsurgery groups. The motion difference ratio was assessed 7 days after laparotomy to classify adhesions. In a clinical trial, 51 patients undergoing hepatobiliary pancreatic surgery were evaluated for the motion difference ratio within 3 days preoperatively. Intraoperatively, adhesion severity was rated and compared with the motion difference ratio. A receiver operating characteristic curve was used to appraise the diagnostic value of the motion difference ratio. RESULTS In the animal experiment, the adhesion group exhibited a significantly higher motion difference ratio than the no-adhesion group (0.006 ± 0.141 vs 0.435 ± 0.220, P < .001). In the clinical trial, the no-adhesion or no-laparotomy group had a motion difference ratio of 0.128 ± 0.074; mild-adhesion group, 0.143 ± 0.170; moderate-adhesion group, 0.326 ± 0.153; and high-adhesion group, 0.427 ± 0.152. The motion difference ratio receiver operating characteristic curve to diagnose the adhesion level (≥moderate) was 0.938, indicating its high diagnostic value (cut-off 0.204). CONCLUSION This methodology may preoperatively predict moderate-to-high adhesions.
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Affiliation(s)
- Hiroto Nishino
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Nishimura
- Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Japan
| | - Seikan Miyashita
- Department of Hepato-Biliary-Pancreatic Surgery, Hyogo Medical University, Nishinomiya, Japan
| | - Masaharu Tada
- Department of Hepato-Biliary-Pancreatic Surgery, Hyogo Medical University, Nishinomiya, Japan
| | - Yasuhiro Fujimoto
- Department of Hepato-Biliary-Pancreatic Surgery, Hyogo Medical University, Nishinomiya, Japan
| | - Jiro Fujimoto
- Department of Hepato-Biliary-Pancreatic Surgery, Hyogo Medical University, Nishinomiya, Japan; Osaka Heavy Ion Therapy Center, Osaka International Cancer Treatment Foundation, Osaka, Japan
| | - Hiroko Iijima
- Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Japan
| | - Etsuro Hatano
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Hepato-Biliary-Pancreatic Surgery, Hyogo Medical University, Nishinomiya, Japan.
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Dai Y, Inagaki NF, Ueki R, Sando S, Hasegawa K, Ito T. Hepatocyte Growth Factor DNA Aptamer for Prevention of Postoperative Peritoneal Adhesion via Enhancement of Fibrinolysis and Inhibition of Mesothelial Mesenchymal Transition. ACS APPLIED BIO MATERIALS 2024; 7:4679-4689. [PMID: 38963794 DOI: 10.1021/acsabm.4c00507] [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: 07/06/2024]
Abstract
Postoperative peritoneal adhesion (PPA) is a prevalent complication of abdominal surgery, posing a significant hindrance to postsurgical recovery. Although several strategies have been developed to alleviate and prevent adhesions, their efficacy remains unsatisfactory. For the first time, we studied the therapeutic effect and mechanism of our recently developed thermally stable oligonucleotide-based mimetics of hepatocyte growth factor (HGF DNA aptamer) to prevent PPA. The HGF DNA aptamer effectively inhibited canonical TGF-β1 signaling transduction, partially suppressing mesothelial mesenchymal transition. Additionally, the aptamer, respectively, upregulated and downregulated the expression of tissue plasminogen activator and plasminogen activator inhibitor 1, thereby enhancing fibrinolytic activity. As a pleiotropic factor, the HGF DNA aptamer also enhanced the migratory and proliferative capacities of mesothelial cells. Finally, the aptamer demonstrated a higher level of effectiveness in preventing PPAs than the commercially available antiperitoneal adhesion barrier, Seprafilm. Due to its therapeutic benefits, excellent stability, biosafety, cost-effectiveness, and versatility, the HGF DNA aptamer demonstrates promise for preventing PPA in future clinical settings.
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Affiliation(s)
- Yizhou Dai
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Bioengineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Natsuko F Inagaki
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Radiology and Biomedical Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ryosuke Ueki
- Department of Chemistry & Biotechnology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Shinsuke Sando
- Department of Bioengineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Chemistry & Biotechnology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Taichi Ito
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Bioengineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Radiology and Biomedical Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Chen J, An X, Xu L, Gao Y, Zhou M, Liu Z. Adhesive Nanoparticle-in-Microgel System with ROS Scavenging Capability and Hemostatic Activity for Postoperative Adhesion Prevention. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2306598. [PMID: 38295133 DOI: 10.1002/smll.202306598] [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: 08/02/2023] [Revised: 01/07/2024] [Indexed: 02/02/2024]
Abstract
Postoperative adhesion is a noteworthy clinical complication in abdominal surgery due to the existing physical barriers are unsatisfactory and inefficient in preventing its occurrence. In this work, an elaborate nanoparticle-in-microgel system (nMGel) is presented for postoperative adhesion prevention. nMGel is facilely formed by crosslinking manganese dioxide (MnO2) nanoparticles-loaded gelatin microspheres with polydopamine using a modified emulsification-chemical crosslinking method, generating a nano-micron spherical hydrogel. After drying, powdery nMGel with sprayability can perfectly cover irregular wounds and maintains robust tissue adhesiveness even in a wet environment. Additionally, nMGel possesses prominent antioxidant and free radical scavenging activity, which protects cell viability and preserves cell biological functions in an oxidative microenvironment. Furthermore, nMGel displays superior hemostatic property as demonstrated in mouse tail amputation models and liver trauma models. Importantly, nMGel can be conveniently administrated in a mouse cecal defect model to prevent adhesion between the injured cecum and the peritoneum by reducing inflammation, oxidative stress, collagen synthesis, and angiogenesis. Thus, the bioactive nMGel offers a practical and efficient approach for ameliorating postsurgical adhesion.
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Affiliation(s)
- Jianmei Chen
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China
- Jiangsu Key Laboratory of Experimental & Translational Noncoding RNA Research, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China
| | - Xueying An
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, P. R. China
| | - Li Xu
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China
- Jiangsu Key Laboratory of Experimental & Translational Noncoding RNA Research, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China
| | - Ya Gao
- Institute of Translational Medicine, Zhejiang Shuren University, Hangzhou, 310015, P. R. China
| | - Mengqin Zhou
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China
- Jiangsu Key Laboratory of Experimental & Translational Noncoding RNA Research, Medical College, Yangzhou University, Yangzhou, 225009, P. R. China
| | - Zongguang Liu
- College of Physics Science and Technology, Yangzhou University, Yangzhou, 225009, P. R. China
- Microelectronics Industry Research Institute, Yangzhou University, Yangzhou, 225009, P. R. China
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Lu X, Xu L, Song Y, Yu X, Li Q, Liu F, Li X, Xi J, Wang S, Wang L, Wang Z. A Graphene Composite Film Based Wearable Far-Infrared Therapy Apparatus (GRAFT) for Effective Prevention of Postoperative Peritoneal Adhesion. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2309330. [PMID: 38526158 PMCID: PMC11165485 DOI: 10.1002/advs.202309330] [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: 12/01/2023] [Revised: 03/10/2024] [Indexed: 03/26/2024]
Abstract
Postoperative peritoneal adhesion (PPA) is the most frequent complication after abdominal surgery. Current anti-adhesion strategies largely rely on the use of physical separating barriers creating an interface blocking peritoneal adhesion, which cannot reduce inflammation and suffers from limited anti-adhesion efficacy with unwanted side effects. Here, by exploiting the alternative activated macrophages to alleviate inflammation in adhesion development, a flexible graphene-composite-film (F-GCF) generating far-infrared (FIR) irradiation that effectively modulates the macrophage phenotype toward the anti-inflammatory M2 type, resulting in reduced PPA formation, is designed. The anti-adhesion effect of the FIR generated by F-GCF is determined in the rat abdominal wall abrasion-cecum defect models, which exhibit reduced incidence and area of PPA by 67.0% and 92.1% after FIR treatment without skin damage, significantly superior to the clinically used chitosan hydrogel. Notably, within peritoneal macrophages, FIR reduces inflammation reaction and promotes tissue plasminogen activator (t-PA) level via the polarization of peritoneal macrophages through upregulating Nr4a2 expression. To facilitate clinical use, a wirelessly controlled, wearable, F-GCF-based FIR therapy apparatus (GRAFT) is further developed and its remarkable anti-adhesion ability in the porcine PPA model is revealed. Collectively, the physical, biochemical, and in vivo preclinical data provide compelling evidence demonstrating the clinical-translational value of FIR in PPA prevention.
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Affiliation(s)
- Xiaohuan Lu
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Department of Gastrointestinal SurgeryUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Luming Xu
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Department of Clinical LaboratoryUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Yu Song
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Xiangnan Yu
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Nanchang UniversityNanchang330006China
| | - Qilin Li
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Department of Clinical LaboratoryUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Feng Liu
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Xiaoqiong Li
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Department of Gastrointestinal SurgeryUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Jiangbo Xi
- School of Chemistry and Environmental EngineeringWuhan Institute of TechnologyWuhan430205China
| | - Shuai Wang
- Key Laboratory of Material Chemistry for Energy Conversion and Storage of Ministry of EducationDepartment of Chemistry and Chemical EngineeringHuazhong University of Science and TechnologyWuhan430074China
| | - Lin Wang
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Department of Clinical LaboratoryUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Zheng Wang
- Hubei Key Laboratory of Regenerative Medicine and Multi‐disciplinary Translational ResearchUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart EquipmentUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Research Center for Tissue Engineering and Regenerative MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Department of Gastrointestinal SurgeryUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
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5
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Chen S, Duan Y, Zhang Y, Cheng L, Cai L, Hou X, Li W. Associations Between Single Nucleotide Polymorphisms of Hypoxia-Related Genes and Capsule Formation in Hepatocellular Carcinoma. J Hepatocell Carcinoma 2023; 10:1785-1797. [PMID: 37841371 PMCID: PMC10576505 DOI: 10.2147/jhc.s417830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/12/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose Tumor capsule is an independent prognostic factor for patients with hepatocellular carcinoma (HCC) and used increasingly to guide clinical decision-making. Considering the genetic complexity for capsule formation and its potential association with hypoxia, the significance of the polymorphisms of hypoxia-related genes in capsule formation and HCC prognosis remains to be elucidated. Patients and Methods Peripheral blood samples from HCC patients were collected in this study. Single nucleotide polymorphism (SNP) genotyping was conducted by the iPLEX chemistry on a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (Sequenom, Inc.). The demographic and clinical data for the patients were obtained through medical chart review and/or consultation with the treating physicians. SPSS 25.0, R 4.1.1, and PLINK toolset were used to perform statistical analysis. Results A total of 183 patients were enrolled, including 88 patients assigned to the capsule group and 95 to the non-capsule group. SLC2A1 rs841858 T allele, SLC2A1 rs2297977 T allele, STAT1 rs1547550 C allele, and STAT1 rs34997637 G allele were associated with significantly increased risk of capsule formation. The genotypes of SLC2A1 rs841858, SLC2A1 rs2297977, STAT1 rs34997637, and STAT1 rs1914408 were significantly associated with the formation of HCC capsule. The polymorphisms of STAT1 rs2066802, STAT1 rs12693591, and HIF1A rs2057482 showed close relationship with the prognosis of HCC patients in the capsule group, while the genotype distributions of CTNNB1 rs4135385, IFNG rs1861494, and SERPINE1 rs2227631 were closely related to the survival of patients in the non-capsule group. Further haplotype analysis suggested that SLC2A1 block 1 and STAT1 block 2 were related to the susceptibility of HCC capsule. Conclusion The polymorphisms of the hypoxia-related genes (HIF1A, SERPINE1, IFNG, STAT1, CTNNB1, and SLC2A1) were correlated with the formation of HCC capsule. Several SNPs in these genes also showed association with HCC prognosis except SLC2A1. Further functional studies are warranted to explore the underlying mechanisms.
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Affiliation(s)
- Shanshan Chen
- Cancer Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Youjia Duan
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yongchao Zhang
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Long Cheng
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Liang Cai
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaopu Hou
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Wei Li
- Cancer Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
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Gao R, Li F, Zhang Y, Kong P, Gao Y, Wang J, Liu X, Li S, Jiang L, Zhang J, Zhang C, Feng Z, Huang P, Wang W. An anti-inflammatory chondroitin sulfate-poly(lactic- co-glycolic acid) composite electrospinning membrane for postoperative abdominal adhesion prevention. Biomater Sci 2023; 11:6573-6586. [PMID: 37602380 DOI: 10.1039/d3bm00786c] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Postoperative abdominal adhesion is a very common and serious complication, resulting in pain, intestinal obstruction and heavy economic burden. Post-injury inflammation that could activate the coagulation cascade and deposition of fibrin is a major cause of adhesion. Many physical barrier membranes are used to prevent abdominal adhesion, but their efficiency is limited due to the lack of anti-inflammatory activity. Here, an electrospinning membrane composed of poly(lactic-co-glycolic acid) (PLGA) providing support and mechanical strength and chondroitin sulfate (CS) conferring anti-inflammation activity is fabricated for preventing abdominal adhesion after injury. The PLGA/CS membrane shows a highly dense fiber network structure with improved hydrophilicity and good cytocompatibility. Importantly, the PLGA/CS membrane with a mass ratio of CS at 20% provides superior anti-adhesion efficiency over a native PLGA membrane and commercial poly(D, L-lactide) (PDLLA) film in abdominal adhesion trauma rat models. The mechanism is that the PLGA/CS membrane could alleviate the local inflammatory response as indicated by the promoted percentage of anti-inflammatory M2-type macrophages and decreased expression of pro-inflammatory factors, such as IL-1β, TNF-α and IL-6, resulting in the suppression of the coagulation system and the activation of the fibrinolytic system. Furthermore, the deposition of fibrin at the abdominal wall was inhibited, and the damaged abdominal tissue was repaired with the treatment of the PLGA/CS membrane. Collectively, the PLGA/CS electrospinning membrane is a promising drug-/cytokine-free anti-inflammatory barrier for post-surgery abdominal adhesion prevention and a bioactive composite for tissue regeneration.
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Affiliation(s)
- Rui Gao
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Fenghui Li
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extra-corporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
| | - Yushan Zhang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Pengxu Kong
- Structural Heart Disease Center, National Center for Cardiovascular Disease, China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Yu Gao
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Jingrong Wang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Xiang Liu
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Shuangyang Li
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Liqin Jiang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Ju Zhang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Chuangnian Zhang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Zujian Feng
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
| | - Pingsheng Huang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Weiwei Wang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China.
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing 100037, China
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Mori S, Tanabe K, Wada M, Hamada Y, Yasudome R, Sonoda T, Matsushita D, Shimonosono M, Arigami T, Sasaki K, Kurahara H, Nakajo A, Ohtsuka T. Modified pull-through coloanal anastomosis to avoid permanent stomas and reduce postoperative complications for lower rectal tumors. Surg Endosc 2023:10.1007/s00464-023-10184-w. [PMID: 37311894 DOI: 10.1007/s00464-023-10184-w] [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: 04/03/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND We performed pull-through hand-sewn coloanal anastomosis immediately after sphincter-preserving ultralow anterior resection (ULAR) [pull-through ultra (PTU)] to avoid permanent stoma and reduce postoperative complications of lower rectal tumors. This study aimed to compare the clinical outcomes of PTU versus non-PTU (stapled or hand-sewn coloanal anastomosis with diverting stoma) after sphincter-preserving ULAR for lower rectal tumors. METHODS This retrospective cohort study analyzed prospectively maintained data from 100 consecutive patients who underwent PTU (n = 29) or non-PTU (n = 71) after sphincter-preserving ULAR for rectal tumors between January 2011 and March 2023. In PTU, hand-sewn coloanal anastomosis was immediately performed using 16 stitches of 4-0 monofilament suture during primary surgery. The clinical outcomes were assessed. The primary outcomes were rates of permanent stomas and overall postoperative complications. RESULTS The PTU group was significantly less likely to require a permanent stoma than the non-PTU group (P < 0.01). None of the patients in the PTU group required permanent stoma and the rate of overall complications was significantly lower in the PTU group (P = 0.01). The median operative time was comparable between the two groups (P = 0.33) but the median operative time during the second stage was significantly shorter in the PTU group (P < 0.01). The rates of anastomotic leakage and complications of Clavien-Dindo grade III were comparable between the two groups. Diverting ileostomy was performed in two patients with an anastomotic leak in the PTU group. The PTU group was significantly less likely to require a diverting ileostomy than those in the non-PTU group (P < 0.01). The composite length of hospital stay was significantly shorter in the PTU group (P < 0.01). CONCLUSIONS PTU via immediate coloanal anastomosis for lower rectal tumors is a safe alternative to the current sphincter-preserving ULAR with diverting ileostomy for patients who wish to avoid a stoma.
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Affiliation(s)
- Shinichiro Mori
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan.
| | - Kan Tanabe
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Masumi Wada
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Yuki Hamada
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Ryutaro Yasudome
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Tomohiro Sonoda
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Daisuke Matsushita
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Masataka Shimonosono
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Takaaki Arigami
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Ken Sasaki
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Hiroshi Kurahara
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Akihiro Nakajo
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Takao Ohtsuka
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
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8
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Liu B, Kong Y, Alimi OA, Kuss MA, Tu H, Hu W, Rafay A, Vikas K, Shi W, Lerner M, Berry WL, Li Y, Carlson MA, Duan B. Multifunctional Microgel-Based Cream Hydrogels for Postoperative Abdominal Adhesion Prevention. ACS NANO 2023; 17:3847-3864. [PMID: 36779870 PMCID: PMC10820954 DOI: 10.1021/acsnano.2c12104] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Postoperative abdominal adhesions are a common problem after surgery and can produce serious complications. Current antiadhesive strategies focus mostly on physical barriers and are unsatisfactory and inefficient. In this study, we designed and synthesized advanced injectable cream-like hydrogels with multiple functionalities, including rapid gelation, self-healing, antioxidation, anti-inflammation, and anti-cell adhesion. The multifunctional hydrogels were facilely formed by the conjugation reaction of epigallocatechin-3-gallate (EGCG) and hyaluronic acid (HA)-based microgels and poly(vinyl alcohol) (PVA) based on the dynamic boronic ester bond. The physicochemical properties of the hydrogels including antioxidative and anti-inflammatory activities were systematically characterized. A mouse cecum-abdominal wall adhesion model was implemented to investigate the efficacy of our microgel-based hydrogels in preventing postoperative abdominal adhesions. The hydrogels, with a high molecular weight HA, significantly decreased the inflammation, oxidative stress, and fibrosis and reduced the abdominal adhesion formation, compared to the commercial Seprafilm group or Injury-only group. Label-free quantitative proteomics analysis demonstrated that S100A8 and S100A9 expressions were associated with adhesion formation; the microgel-containing hydrogels inhibited these expressions. The microgel-containing hydrogels with multifunctionality decreased the formation of postoperative intra-abdominal adhesions in a murine model, demonstrating promise for clinical applications.
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Affiliation(s)
- Bo Liu
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Yunfan Kong
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Olawale A. Alimi
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Mitchell A. Kuss
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Huiyin Tu
- Department of Emergency Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Wenfeng Hu
- Department of Emergency Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Abu Rafay
- Mass Spectrometry & Proteomics Core, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Kumar Vikas
- Mass Spectrometry & Proteomics Core, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Wen Shi
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Megan Lerner
- Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - William L. Berry
- Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Yulong Li
- Department of Emergency Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Mark A. Carlson
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Surgery-General Surgery, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Bin Duan
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Surgery-General Surgery, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA
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9
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Zhou J, Zhang H, Fareed MS, He Y, Lu Y, Yang C, Wang Z, Su J, Wang P, Yan W, Wang K. An Injectable Peptide Hydrogel Constructed of Natural Antimicrobial Peptide J-1 and ADP Shows Anti-Infection, Hemostasis, and Antiadhesion Efficacy. ACS NANO 2022; 16:7636-7650. [PMID: 35533290 DOI: 10.1021/acsnano.1c11206] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Postoperative adhesion is a common complication of abdominal surgery, which always has many adverse effects in patients. At present, there is still a lack of effective treatment measures and materials to prevent adhesion in the clinics. Herein, we report the potential use of J-1-ADP hydrogel formed by natural antimicrobial peptide jelleine-1 (J-1) self-assembling in adenosine diphosphate (ADP) sodium solution to prevent postsurgery adhesion formation. J-1-ADP hydrogel was found to have good antimicrobial activity against the bacteria and fungi tested and can be used to prevent tissue infection, which was thought to be one of the incitements of adhesion. Due to ADP being a platelet-activating factor, J-1-ADP hydrogel showed significant hemostatic activity in vitro verified by whole blood coagulation, plasma coagulation, platelet activation, and platelet adhesion assays. Further, it showed potent hemostatic activity in a mouse liver hemorrhage model. Bleeding was believed to be a cause of the formation of postsurgery adhesion. J-1-ADP hydrogel had a significant antiadhesion effect in a rat side wall defect-cecum abrasion model. In addition, it had good biocompatibility and degradation properties. So the present study may provide an alternative strategy for designing antimicrobial peptide hydrogel material to prevent postoperative adhesion formation in the clinic.
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Affiliation(s)
| | - Hanru Zhang
- Department of Obstetrics & Gynecology, Gansu Provincial Maternity and Child Care Hospital, Lanzhou 730000, P. R. China
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10
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Nakamura Y, Matsuda K, Yokoyama S, Iwamoto H, Mizumoto Y, Mitani Y, Oku Y, Yamaue H. High visceral to subcutaneous fat area ratio predicts early postoperative small bowel obstruction after surgery for colorectal cancer. Langenbecks Arch Surg 2022; 407:2021-2026. [PMID: 35488912 DOI: 10.1007/s00423-022-02518-4] [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: 09/10/2021] [Accepted: 04/13/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Risks for postoperative small bowel obstruction have been demonstrated in several reports, most of which indicated male sex was a risk factor, but with the reason remaining unknown. We tested the hypothesis that it could be because males have more visceral fat than females. This prospective observational study aims to examine risks of early postoperative small bowel obstruction (EPSBO) after colorectal cancer surgery and the association between visceral to subcutaneous fat area ratio (V/S ratio) and EPSBO. METHODS Four hundred and seventy-four patients who underwent colectomy for colorectal cancer in our hospital were enrolled in this study. The influence of several factors including V/S ratio on the development of EPSBO was analyzed. RESULTS Thirty-one of the 474 patients (6.5%) developed EPSBO. EPSBO occurred more frequently in males (p = 0.03) and cases who developed postoperative anastomotic leakage (p < 0.001) or wound infection (p = 0.02). Higher V/S ratio was strongly related to male sex (p < 0.001). Multivariate analysis revealed higher V/S ratio (OR 2.25; p = 0.049) and anastomotic leakage (OR 5.86; p < 0.001) were independent risk factors for EPSBO. CONCLUSION Higher V/S ratio was significantly related to EPSBO, suggesting that one of the reasons EPSBO was more likely to occur in males because they have more visceral fat than females. Preoperative identification of this risk factor could help us watch out for this potential complication.
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Affiliation(s)
- Yuki Nakamura
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Kenji Matsuda
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
| | - Shozo Yokoyama
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Hiromitsu Iwamoto
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Yuki Mizumoto
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Yasuyuki Mitani
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Yoshimasa Oku
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
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11
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Ma T, Cong L, Ma Q, Huang Z, Hua Q, Li X, Wang X, Chen Y. Study on the correlation between preoperative inflammatory indexes and adhesional perinephric fat before laparoscopic partial nephrectomy. BMC Urol 2021; 21:174. [PMID: 34893056 PMCID: PMC8665523 DOI: 10.1186/s12894-021-00940-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/06/2021] [Indexed: 01/20/2023] Open
Abstract
Objective This study was aimed to evaluate the effect of preoperative composite inflammatory index on adhesional perinephric fat (APF), providing a help for preoperative risk assessment of laparoscopic partial nephrectomy (LPN) in patients with renal cell carcinoma. Materials and methods A retrospective study was conducted on 231 patients with renal cell carcinoma, who underwent laparoscopic partial nephrectomy. They were divided into two groups according to whether there was APF during operation. Relevant clinical data, laboratory parameters and imaging examination were obtained before operation to calculate the composite inflammatory index and MAP score. The composite inflammatory index was divided into high value group and low value group by ROC curve method. The related predictive factors of APF were analyzed by logistic regression method. Results The APF was found in 105 patients (45.5%). In multivariate analysis, systemic immune inflammation index (SII) (high/low), MAP score, tumor size and perirenal fat thickness were independent predictors of APF. The operation time of patients with APF was longer, and the difference of blood loss was not statistically significant. Conclusion SII is an independent predictor of APF before laparoscopic partial nephrectomy. Trial registration ChiCTR, ChiCTR2100045944. Registered 30 April 2021—Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=125703.
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Affiliation(s)
- Teng Ma
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Lin Cong
- Department of Medical Imaging Interventional Therapy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Qianli Ma
- Department of Radiology, Taian City Central Hospital, Taian, 271000, Shandong, China
| | - Zhaoqin Huang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Qianqian Hua
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Xiaojiao Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Yunchao Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China.
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12
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Hu Q, Lu X, Li G, Kang X, Chen K, Wang M, Liu S, Guan W. Mitoquinone treatment for the prevention of surgical adhesions via regulation of the NRF2/HO-1 signaling pathway in mice. Surgery 2021; 171:428-436. [PMID: 34742568 DOI: 10.1016/j.surg.2021.08.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Postoperative adhesion is a common cause of long-term morbidity after abdominal or pelvic surgery. The development of postoperative adhesion involves oxidative stress, inflammatory response, and collagen deposition mechanisms. Here, we demonstrate that mitoquinone could be useful for the treatment of postoperative adhesion. METHODS A murine adhesion model was established by induction of peritoneal ischemic buttons. Mice received different doses of mitoquinone via the tail vein. All the ischemic buttons were dissected at 1 day and 7 days after surgery to investigate the effect of mitoquinone in the early and late stage of the adhesion process, respectively. Human peritoneal mesothelial cells were treated with H2O2 to examine the potential mechanisms of mitoquinone in oxidative insult. RESULTS Postoperative adhesion scores were markedly decreased in mitoquinone-treated mice compared with the control mice. The degree of oxidative stress, inflammatory injury, and collagen deposition were also significantly reduced in the mitoquinone-treated mice. The expression of plasminogen-activating inhibitor, interleukin-1, interleukin-6, tumor necrosis factor-α, vascular endothelial growth factor, malondialdehyde, and nitric oxide was decreased, while the expression of tissue-type plasminogen activator, glutathione, superoxide dismutase, and Nrf2 was increased in the peritoneal ischemic buttons after mitoquinone treatment. Cellular reactive oxygen species and the canonical inflammatory pathway were inhibited in mitoquinone-treated human peritoneal mesothelial cells after H2O2 challenge. Mechanistically, mitoquinone was found to enhance the activity of Nrf2 and heme oxygenase-1 and to induce nuclear translocation of Nrf2 in human peritoneal mesothelial cells. CONCLUSION The mitochondria-targeting antioxidant molecule mitoquinone attenuates postoperative adhesion formation by inhibiting oxidative stress, inflammation, and collagen accumulation, and therefore provides a therapeutic agent for the management of surgical adhesion.
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Affiliation(s)
- Qiongyuan Hu
- Department of General Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China; Department of Gastrointestinal Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing; Medical School of Nanjing University, Nanjing, China
| | - Xiaofeng Lu
- Department of General Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Guanwei Li
- Department of Colorectal and Anal Surgery, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Xing Kang
- Department of General Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Kai Chen
- Department of General Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Meng Wang
- Department of General Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China; Department of Gastrointestinal Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing.
| | - Song Liu
- Department of General Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China; Department of Gastrointestinal Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing.
| | - Wenxian Guan
- Department of General Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, China; Department of Gastrointestinal Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing.
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13
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Kosaka H, Kaibori M, Chu DI, Stucchi AF, Sekimoto M. Role of Substance P-Dependent Chemotactic Signaling in Postoperative Adhesion Formation. J Surg Res 2021; 270:49-57. [PMID: 34638093 DOI: 10.1016/j.jss.2021.08.038] [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: 09/16/2020] [Revised: 07/30/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Postoperative adhesions are a potentially life-threatening complication of abdominal surgery. We previously showed that substance P (SP), acting through the neurokinin-1 receptor (NK-1R), is an important early mediator of adhesiogenesis through its regulation of the tissue plasminogen activator/plasminogen activator inhibitor-1 (PAI-1) fibrinolytic system. SP also mediates neurogenic inflammation by recruiting inflammatory leukocytes, such as neutrophils and macrophages. Our objective was to determine the role of SP-dependent chemotactic recruitment of these inflammatory cells through the CXCR2 in postsurgical adhesion formation. MATERIALS AND METHODS A mouse cecal cauterization model was used to generate intra-abdominal adhesions. Protein and mRNA levels of the chemokines CXCL1 and CXCL2 and their receptor CXCR2 were measured at 3 h and 6 h after surgery in peritoneal tissue and in peritoneal lavages in response to antagonists for the SP receptor and CXCR2, and in IFN-γ knockout mice. RESULTS Postsurgical adhesion formation was inhibited by both an antagonist to NK-1R and an antagonist to CXCR2. Expression levels of neutrophil chemokines and CXCR2 in peritoneal tissue peaked 3-6 h after surgery and partially depended on SP and IFN-γ, one of its downstream mediators. An NK-1R antagonist inhibited SP-mediated increases in the expression of the PAI-1 inhibitory component of the fibrinolytic system, but the CXCR2 antagonist had no effect. CONCLUSIONS Postsurgical adhesiogenesis involves upregulation of chemokine signaling that is partially SP- and IFN-γ-dependent. However, the adhesiogenic properties of chemokine signaling are not mediated through the inhibition of fibrinolysis with PAI-1, as was previously shown for SP.
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Affiliation(s)
- Hisashi Kosaka
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, JAPAN.
| | - Masaki Kaibori
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, JAPAN
| | - Daniel I Chu
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Arthur F Stucchi
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | - Mitsugu Sekimoto
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, JAPAN
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da Fonseca CAR, Dos Reis AS, Pinz MP, Peglow TJ, Schumacher RF, Perin G, Martins AWDS, Domingues WB, Campos VF, Soares MP, Roehrs JA, Luchese C, Wilhelm EA. Bis-(3-amino-2-pyridine) diselenide improves psychiatric disorders -atopic dermatitis comorbidity by regulating inflammatory and oxidative status in mice. Chem Biol Interact 2021; 345:109564. [PMID: 34161785 DOI: 10.1016/j.cbi.2021.109564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/26/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
Suppressive effect of bis (3-amino-2-pyridine) diselenide (BAPD) on psychiatric disorders - atopic dermatitis (AD) comorbidity in mice was investigated. To sensitize the animals, 2,4-dinitrochlorobenzene (DNCB) was applied to their dorsal skin on days 1-3. Mice were challenged with DNCB on their ears and dorsal skin on days 14, 17, 20, 23, 26, and 29. BAPD and Dexamethasone were administered to the animals, from days 14-29, and skin severity scores and behavioral tests were determined. Oxidative stress and inflammatory parameters were evaluated on the dorsal skin of mice. Na+, K+-ATPase activity and corticosterone levels were determined in hippocampus/cerebral cortex and plasma of mice, respectively. BAPD improved cutaneous damage, scratching behavior, inflammatory and oxidative stress markers. BAPD showed anxiolytic- and antidepressant-like effects and restored Na+, K+-ATPase activity and corticosterone levels. The present study was performed using female mice due the susceptibility for this disease. But, the evaluation of AD model in male mice would help to verify whether the male gender has the same predisposition to present this pathology. Our data demonstrated the suppressive effect of BAPD on psychiatric disorders - AD comorbidity by regulating inflammatory and oxidative status in mice.
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Affiliation(s)
- Caren Aline Ramson da Fonseca
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil
| | - Angélica Schiavom Dos Reis
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil
| | - Mikaela Peglow Pinz
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil
| | - Thiago Jacobsen Peglow
- Programa de Pós-graduação em Química, Laboratório de Síntese Orgânica Limpa - LASOL - CCQFA - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Ricardo Frederico Schumacher
- Programa de Pós-graduação em Química, Laboratório de Síntese Orgânica Limpa - LASOL - CCQFA - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Gelson Perin
- Programa de Pós-graduação em Química, Laboratório de Síntese Orgânica Limpa - LASOL - CCQFA - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Amanda Weege da Silveira Martins
- Programa de Pós-Graduação em Biotecnologia, Laboratório de Genômica Estrutural do Centro de Desenvolvimento Tecnológico - CDTec - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - William Borges Domingues
- Programa de Pós-Graduação em Biotecnologia, Laboratório de Genômica Estrutural do Centro de Desenvolvimento Tecnológico - CDTec - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Vinicius Farias Campos
- Programa de Pós-Graduação em Biotecnologia, Laboratório de Genômica Estrutural do Centro de Desenvolvimento Tecnológico - CDTec - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Mauro Pereira Soares
- Laboratório Regional de Diagnóstico, Faculdade de Veterinária - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Juliano Alex Roehrs
- Instituto Federal de Educação, Ciência e Tecnologia Sul-rio-grandense, IFSul, CEP - 96015-360, Pelotas, RS, Brazil
| | - Cristiane Luchese
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil.
| | - Ethel Antunes Wilhelm
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil.
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15
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Ito T, Shintani Y, Fields L, Shiraishi M, Podaru MN, Kainuma S, Yamashita K, Kobayashi K, Perretti M, Lewis-McDougall F, Suzuki K. Cell barrier function of resident peritoneal macrophages in post-operative adhesions. Nat Commun 2021; 12:2232. [PMID: 33854051 PMCID: PMC8046819 DOI: 10.1038/s41467-021-22536-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 03/15/2021] [Indexed: 12/20/2022] Open
Abstract
Post-operative adhesions are a leading cause of abdominal surgery-associated morbidity. Exposed fibrin clots on the damaged peritoneum, in which the mesothelial barrier is disrupted, readily adhere to surrounding tissues, resulting in adhesion formation. Here we show that resident F4/80HighCD206− peritoneal macrophages promptly accumulate on the lesion and form a ‘macrophage barrier’ to shield fibrin clots in place of the lost mesothelium in mice. Depletion of this macrophage subset or blockage of CD11b impairs the macrophage barrier and exacerbates adhesions. The macrophage barrier is usually insufficient to fully preclude the adhesion formation; however, it could be augmented by IL-4-based treatment or adoptive transfer of this macrophage subset, resulting in robust prevention of adhesions. By contrast, monocyte-derived recruited peritoneal macrophages are not involved in the macrophage barrier. These results highlight a previously unidentified cell barrier function of a specific macrophage subset, also proposing an innovative approach to prevent post-operative adhesions. Peritoneal adhesions are a major cause of complications after abdominal surgery. Here the authors use a post-operative abdominal adhesion model in mice to show that resident F4/80HighCD206− macrophages form a protective barrier that can be enhanced by IL-4 administration or adoptive transfer of these cells.
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Affiliation(s)
- Tomoya Ito
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Yusuke Shintani
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Laura Fields
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Manabu Shiraishi
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mihai-Nicolae Podaru
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Satoshi Kainuma
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kizuku Yamashita
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kazuya Kobayashi
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mauro Perretti
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Fiona Lewis-McDougall
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ken Suzuki
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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16
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Hu Q, Xia X, Kang X, Song P, Liu Z, Wang M, Lu X, Guan W, Liu S. A review of physiological and cellular mechanisms underlying fibrotic postoperative adhesion. Int J Biol Sci 2021; 17:298-306. [PMID: 33390851 PMCID: PMC7757036 DOI: 10.7150/ijbs.54403] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/13/2020] [Indexed: 12/27/2022] Open
Abstract
Postoperative adhesions (PA) are fibrotic tissues that are the most common driver of long-term morbidity after abdominal and pelvic surgery. The optimal drug or material to prevent adhesion formation has not yet been discovered. Comprehensive understanding of cellular and molecular mechanisms of adhesion process stimulates the design of future anti-adhesive strategies. Recently, disruption of peritoneal mesothelial cells were suggested as the 'motor' of PA formation, followed by a cascade of events (coagulation, inflammation, fibrinolysis) and influx of various immune cells, ultimately leading to a fibrous exudate. We showed that a variety of immune cells were recruited into adhesive peritoneal tissues in patients with small bowel obstruction caused by PA. The interactions among various types of immune cells contribute to PA development following peritoneal trauma. Our review focuses on the specific role of different immune cells in cellular and humoral mechanisms underpinning adhesion development.
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Affiliation(s)
- Qiongyuan Hu
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Xuefeng Xia
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Xing Kang
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Peng Song
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Zhijian Liu
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Meng Wang
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Xiaofeng Lu
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Wenxian Guan
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
| | - Song Liu
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
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17
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Is There a Genetic Predisposition to Postoperative Adhesion Development? Reprod Sci 2020; 28:2076-2086. [PMID: 33090376 PMCID: PMC7579853 DOI: 10.1007/s43032-020-00356-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
Adhesions are permanent fibrovascular bands between peritoneal surfaces, which develop following virtually all body cavity surgeries. The susceptibility to develop, and the severity, of adhesions following intra-abdominal surgery varies within and between individuals, suggesting that heritable factors influence adhesion development. In this manuscript, we discuss the pathophysiology of adhesion development from the perspective of genetic susceptibility. We restrict our discussion to genes and single-nucleotide polymorphisms (SNPs) that are specifically involved in, or that cause modification of, the adhesion development process. We performed a literature search using the PubMed database for all relevant English language articles up to March 2020 (n = 186). We identified and carefully reviewed all relevant articles addressing genetic mutations or single-nucleotide polymorphisms (SNPs) that impact the risk for adhesion development. We also reviewed references from these articles for additional information. We found several reported SNPs, genetic mutations, and upregulation of messenger RNAs that directly or indirectly increase the propensity for postoperative adhesion development, namely in genes for transforming growth factor beta, vascular endothelial growth factor, interferon-gamma, matrix metalloproteinase, plasminogen activator inhibitor-1, and the interleukins. An understanding of genetic variants could provide insight into the pathophysiology of adhesion development. The information presented in this review contributes to a greater understanding of adhesion development at the genetic level and may allow modification of these genetic risks, which may subsequently guide management in preventing and treating this challenging complication of abdominal surgery. In particular, the information could help identify patients at greater risk for adhesion development, which would make them candidates for anti-adhesion prophylaxis. Currently, agents to reduce postoperative adhesion development exist, and in the future, development of agents, which specifically target individual genetic profile, would be more specific in preventing intraperitoneal adhesion development.
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18
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Neutrophil and monocyte kinetics play critical roles in mouse peritoneal adhesion formation. Blood Adv 2020; 3:2713-2721. [PMID: 31519647 DOI: 10.1182/bloodadvances.2018024026] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/28/2019] [Indexed: 01/22/2023] Open
Abstract
Peritoneal adhesions are pathological fibroses that ensnare organs after abdominal surgery. This dense connective tissue can cause small bowel obstruction, female infertility, and chronic abdominal pain. The pathogenesis of adhesions is a fibrotic response to tissue damage coordinated between mesothelial cells, fibroblasts, and immune cells. We have previously demonstrated that peritoneal adhesions are a consequence of mechanical injury to the mesothelial layer sustained during surgery. Neutrophils are among the first leukocytes involved in the early response to tissue damage. Here, we show that when subjected to mechanical stress, activated mesothelial cells directly recruit neutrophils and monocytes through upregulation of chemokines such as CXCL1 and monocyte chemoattractant protein 1 (MCP-1). We find that neutrophils within the adhesion sites undergo cell death and form neutrophil extracellular traps (NETosis) that contribute to pathogenesis. Conversely, tissue-resident macrophages were profoundly depleted throughout the disease time course. We show that this is distinct from traditional inflammatory kinetics such as after sham surgery or chemically induced peritonitis, and suggest that adhesions result from a primary difference in inflammatory kinetics. We find that transient depletion of circulating neutrophils significantly decreases adhesion burden, and further recruitment of monocytes with thioglycolate or MCP-1 also improves outcomes. Our findings suggest that the combination of neutrophil depletion and monocyte recruitment is sufficient to prevent adhesion formation, thus providing insight for potential clinical interventions.
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19
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Yang Y, Zhao X, Yu J, Chen X, Chen X, Cui C, Zhang J, Zhang Q, Zhang Y, Wang S, Cheng Y. H-Bonding Supramolecular Hydrogels with Promising Mechanical Strength and Shape Memory Properties for Postoperative Antiadhesion Application. ACS APPLIED MATERIALS & INTERFACES 2020; 12:34161-34169. [PMID: 32631044 DOI: 10.1021/acsami.0c07753] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Development of a physical barrier with mechanical properties similar to human smooth muscle and an on-demand degradation profile is crucial for the clinical prevention of postoperative adhesion. Herein, a series of supramolecular hydrogels (PMI hydrogels) composed of poly(ethylene glycol) (PEG), methylenediphenyl 4, 4-diisocyanate (MDI), and imidazolidinyl urea (IU, hydrogen bonding reinforced factor) with biodegradability and high toughness are reported to serve as physical barriers for abdominal adhesion prevention. The tensile fracture strength and strain of the PMI hydrogels could be adjusted in the ranges of 0.6-2.3 MPa and 100-440%, respectively, and their Young's moduli (0.2-1.6 MPa) are close to that of human soft tissues like smooth muscle and skin tissue as well as they have outstanding shape memory properties. The PMI hydrogels show good cell and tissue biocompatibility, and the in vivo retention time is in accord with the needs for the postoperative antiadhesion physical barriers. Through an abdominal defect model on mice, this study shows that the PMI hydrogel can completely prevent tissue adhesion compared to the commercialized Seprafilm with high safety. Owing to the promising mechanical properties and good biocompatibility, the PMI hydrogels may be extended for various biomedical applications and the development of advanced flexible electronic devices.
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Affiliation(s)
- Yuxuan Yang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049 China
| | - Xiaodan Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049 China
| | - Jing Yu
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
| | - Xiaojing Chen
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
| | - Xingxing Chen
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
| | - Chenhui Cui
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
| | - Junjie Zhang
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
| | - Qiang Zhang
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
| | - Yanfeng Zhang
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
| | - Shuang Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049 China
| | - Yilong Cheng
- Department of Applied Chemistry, School of Science, MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, State Key Lab for Strength and Vibration of Mechanical Structures, Xi'an Jiaotong University, Xi'an 710049 China
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20
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Zhang M, Zhang S. T Cells in Fibrosis and Fibrotic Diseases. Front Immunol 2020; 11:1142. [PMID: 32676074 PMCID: PMC7333347 DOI: 10.3389/fimmu.2020.01142] [Citation(s) in RCA: 165] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 05/11/2020] [Indexed: 01/08/2023] Open
Abstract
Fibrosis is the extensive deposition of fibrous connective tissue, and it is characterized by the accumulation of collagen and other extracellular matrix (ECM) components. Fibrosis is essential for wound healing and tissue repair in response to a variety of triggers, which include infection, inflammation, autoimmune disorder, degenerative disease, tumor, and injury. Fibrotic remodeling in various diseases, such as liver cirrhosis, pulmonary fibrosis, renal interstitial fibrosis, myocardial infarction, systemic sclerosis (SSc), and graft-versus-host disease (GVHD), can impair organ function, causing high morbidity and mortality. Both innate and adaptive immunity are involved in fibrogenesis. Although the roles of macrophages in fibrogenesis have been studied for many years, the underlying mechanisms concerning the manner in which T cells regulate fibrosis are not completely understood. The T cell receptor (TCR) engages the antigen and shapes the repertoire of antigen-specific T cells. Based on the divergent expression of surface molecules and cell functions, T cells are subdivided into natural killer T (NKT) cells, γδ T cells, CD8+ cytotoxic T lymphocytes (CTL), regulatory T (Treg) cells, T follicular regulatory (Tfr) cells, and T helper cells, including Th1, Th2, Th9, Th17, Th22, and T follicular helper (Tfh) cells. In this review, we summarize the pro-fibrotic or anti-fibrotic roles and distinct mechanisms of different T cell subsets. On reviewing the literature, we conclude that the T cell regulations are commonly disease-specific and tissue-specific. Finally, we provide perspectives on microbiota, viral infection, and metabolism, and discuss the current advancements of technologies for identifying novel targets and developing immunotherapies for intervention in fibrosis and fibrotic diseases.
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Affiliation(s)
- Mengjuan Zhang
- College of Life Sciences, Nankai University, Tianjin, China
| | - Song Zhang
- College of Life Sciences, Nankai University, Tianjin, China
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21
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Kikuchi K, Setoyama K, Takada S, Otsuka S, Nakanishi K, Norimatsu K, Tani A, Sakakima H, Kawahara KI, Hosokawa K, Kiyama R, Sumizono M, Tancharoen S, Maruyama I, Hattori G, Morioka M, Tanaka E, Uchikado H. E8002 Inhibits Peripheral Nerve Adhesion by Enhancing Fibrinolysis of l-Ascorbic Acid in a Rat Sciatic Nerve Model. Int J Mol Sci 2020; 21:ijms21113972. [PMID: 32492845 PMCID: PMC7313081 DOI: 10.3390/ijms21113972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/12/2020] [Accepted: 05/31/2020] [Indexed: 12/23/2022] Open
Abstract
Perineural adhesions leading to neuropathy are one of the most undesirable consequences of peripheral nerve surgery. However, there are currently no widely used compounds with anti-adhesive effects in the field of peripheral nerve surgery. E8002 is a novel, anti-adhesive, multi-layer membrane that contains L-ascorbic acid (AA). Here, we investigated the effect and mechanism of E8002 in a rat sciatic nerve adhesion model. A total of 21 rats were used. Six weeks after surgery, macroscopic adhesion scores were significantly lower in the E8002 group (adhesion procedure followed by nerve wrapping with E8002) compared to the E8002 AA(−) group (adhesion procedure followed by nerve wrapping with the E8002 membrane excluding AA) and adhesion group (adhesion procedure but no treatment). Correspondingly, a microscopic examination revealed prominent scar tissue in the E8002 AA(−) and adhesion groups. Furthermore, an in vitro study using human blood samples showed that AA enhanced tissue-type, plasminogen activator-mediated fibrinolysis. Altogether, these results suggest that E8002 may exert an anti-adhesive action via AA and the regulation of fibrinolysis.
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Affiliation(s)
- Kiyoshi Kikuchi
- Division of Brain Science, Department of Physiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan;
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (G.H.); (M.M.)
- Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima 890-8520, Japan; (S.T.); (S.O.); (K.-i.K.); (I.M.)
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand;
| | - Kentaro Setoyama
- Natural Science Center for Research and Education, Division of Laboratory Animal Science, Kagoshima University, Kagoshima 890-8520, Japan;
| | - Seiya Takada
- Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima 890-8520, Japan; (S.T.); (S.O.); (K.-i.K.); (I.M.)
| | - Shotaro Otsuka
- Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima 890-8520, Japan; (S.T.); (S.O.); (K.-i.K.); (I.M.)
| | - Kazuki Nakanishi
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan; (K.N.); (K.N.); (A.T.); (H.S.); (R.K.)
| | - Kosuke Norimatsu
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan; (K.N.); (K.N.); (A.T.); (H.S.); (R.K.)
| | - Akira Tani
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan; (K.N.); (K.N.); (A.T.); (H.S.); (R.K.)
| | - Harutoshi Sakakima
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan; (K.N.); (K.N.); (A.T.); (H.S.); (R.K.)
| | - Ko-ichi Kawahara
- Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima 890-8520, Japan; (S.T.); (S.O.); (K.-i.K.); (I.M.)
- Laboratory of Functional Foods, Department of Biomedical Engineering, Osaka Institute of Technology, Osaka 535-8585, Japan
| | - Kazuya Hosokawa
- Research Institute, Fujimori Kogyo Co., Ltd., 1-10-1 Sachiura, Kanazawa-ku, Yokohama, Kanagawa 236-0003, Japan;
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan; (K.N.); (K.N.); (A.T.); (H.S.); (R.K.)
| | - Megumi Sumizono
- Department of Rehabilitation, Faculty of Nursing and Welfare, Kyushu University of Nursing and Social Welfare, Tamana, Kumamoto 865-0062, Japan;
| | - Salunya Tancharoen
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand;
| | - Ikuro Maruyama
- Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima 890-8520, Japan; (S.T.); (S.O.); (K.-i.K.); (I.M.)
| | - Gohsuke Hattori
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (G.H.); (M.M.)
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (G.H.); (M.M.)
| | - Eiichiro Tanaka
- Division of Brain Science, Department of Physiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan;
- Correspondence: (E.T.); (H.U.); Tel.: +81-942-31-7542 (E.T.); +81-92-477-2355 (H.U.); Fax: +81-942-31-7695 (E.T.); +81-92-477-2325 (H.U.)
| | - Hisaaki Uchikado
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (G.H.); (M.M.)
- Uchikado Neuro-Spine Clinic, Fukuoka 812-0893, Japan
- Correspondence: (E.T.); (H.U.); Tel.: +81-942-31-7542 (E.T.); +81-92-477-2355 (H.U.); Fax: +81-942-31-7695 (E.T.); +81-92-477-2325 (H.U.)
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22
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Hu W, Zhang Z, Zhu L, Wen Y, Zhang T, Ren P, Wang F, Ji Z. Combination of Polypropylene Mesh and in Situ Injectable Mussel-Inspired Hydrogel in Laparoscopic Hernia Repair for Preventing Post-Surgical Adhesions in the Piglet Model. ACS Biomater Sci Eng 2020; 6:1735-1743. [PMID: 33455390 DOI: 10.1021/acsbiomaterials.9b01333] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Polypropylene (PP) mesh has been used successfully for a long time in clinical practice as an impressive prosthesis for ventral hernia repair. To utilize a physical barrier for separating mesh from viscera is a general approach for preventing adhesions in clinical practice. However, a serious abdominal adhesion between the mesh and viscera can possibly occur post-hernia, especially with the small intestine; this can lead to a series of complications, such as chronic pain, intestinal obstruction, and fistula. Thus, determining how to prevent abdominal adhesions between the mesh and viscera is still an urgent clinical problem. In this study, a dopamine-functionalized polysaccharide derivative (oxidized-carboxymethylcellulose-g-dopamine, OCMC-DA) was synthesized; this was blended with carboxymethylchitosan (CMCS) to form a hydrogel (OCMC-DA/CMCS) in situ at the appropriate time. The physical and chemical properties of the hydrogel were characterized successfully, and its excellent biocompatibility was presented by the in vitro cell test. The combination of this hydrogel and PP mesh was used in laparoscopic surgery for repairing the abdominal wall defect, where the hydrogel could become fixed in situ on the PP mesh to form an anti-adhesion gel-mesh. The results showed that the gel-mesh could prevent abdominal adhesions effectively in the piglet model. Moreover, the histology and immunohistochemical staining proved that the gel-mesh could effectively alleviate the inflammation reaction and deposition of collagen around the mesh, and it did not disturb the integration between mesh and abdominal wall. Thus, the gel-mesh has superior tissue compatibility.
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Affiliation(s)
- Wanjun Hu
- State Key Lab of Bioelectronics, National Demonstration Center for Experimental Biomedical Engineering Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China.,Collaborative Innovation Center of Tissue Repair Material of Sichuan Province, College of Life Science, China West Normal University, Nanchong 637009, China
| | - Zhigang Zhang
- State Key Lab of Bioelectronics, National Demonstration Center for Experimental Biomedical Engineering Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China.,Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Long Zhu
- Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yazhou Wen
- Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Tianzhu Zhang
- State Key Lab of Bioelectronics, National Demonstration Center for Experimental Biomedical Engineering Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China
| | - Pengfei Ren
- State Key Lab of Bioelectronics, National Demonstration Center for Experimental Biomedical Engineering Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China
| | - Faming Wang
- State Key Lab of Bioelectronics, National Demonstration Center for Experimental Biomedical Engineering Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China
| | - Zhenling Ji
- Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
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23
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Bian YY, Yang LL, Yan Y, Zhao M, Chen YQ, Zhou YQ, Wang ZX, Li WL, Zeng L. Identification of candidate biomarkers correlated with pathogenesis of postoperative peritoneal adhesion by using microarray analysis. World J Gastrointest Oncol 2020; 12:54-65. [PMID: 31966913 PMCID: PMC6960070 DOI: 10.4251/wjgo.v12.i1.54] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/05/2019] [Accepted: 09/13/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Postoperative peritoneal adhesion (PPA), characterized by abdominal pain, female infertility, and even bowel obstruction after surgery, has always been a major concern. The occurrence and formation of adhesion are from complex biological processes. However, the molecular mechanisms underlying the basis of microarray data profile, followed by peritoneal adhesion formation, are largely unknown.
AIM To reveal the underlying pathogenesis of PPA at the molecular level.
METHODS The gene expression profile was retrieved from the Gene Expression Omnibus database for our analysis. We identified a panel of key genes and related pathways involved in adhesion formation using bioinformatics analysis methods. We performed quantitative PCR and western blotting in vivo to validate the results preliminarily.
RESULTS In total, 446 expressed genes were altered in peritoneal adhesion. We found that several hub genes (e.g., tumor necrosis factor, interleukin 1 beta, interleukin 6, C-X-C motif chemokine ligand 1, C-X-C motif chemokine ligand 2) were marked as significant biomarkers. Functional analysis suggested that these genes were enriched in the Toll-like receptor signaling pathway. According to the Kyoto Encyclopedia of Genes and Genomes pathway and published studies, TLR4, myeloid differentiation primary response protein 88 (MyD88), and nuclear factor kappa B (NF-κB) played essential roles in Toll-like signaling transduction. Here, we obtained a regulatory evidence chain of TLR4/MyD88/NF-κB/inflammatory cytokines/peritoneal adhesion involved in the pathogenesis of postoperative adhesion. The results of the microarray analysis were verified by the animal experiments. These findings may extend our understanding of the molecular mechanisms of PPA.
CONCLUSION The regulatory evidence chain of TLR4/MyD88/NF-κB/inflammatory cytokines/peritoneal adhesion may play key roles in the pathogenesis of PPA. Future studies are required to validate our findings.
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Affiliation(s)
- Yao-Yao Bian
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Li-Li Yang
- School of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
- Jingwen Library, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Yan Yan
- Guang′anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Min Zhao
- School of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Yan-Qi Chen
- School of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Ya-Qi Zhou
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Zi-Xin Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Wen-Lin Li
- Jingwen Library, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Li Zeng
- School of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
- Jingwen Library, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
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24
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Wang Q, Huang Y, Zhou R, Wu K, Li W, Shi L, Xia Z, Tao K, Wang G, Wang G. Regulation and function of IL-22 in peritoneal adhesion formation after abdominal surgery. Wound Repair Regen 2020; 28:105-117. [PMID: 31148320 DOI: 10.1111/wrr.12740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/10/2019] [Accepted: 05/20/2019] [Indexed: 12/20/2022]
Abstract
Peritoneal adhesion occurs frequently after gastrointestinal/gynecological surgery. Tissue repair and regeneration are very important during this process. IL-22 is an important cytokine that is secreted from immune cells but functions on mesenchymal cells, such as mesothelial cells. The objective of this study was to investigate the roles of IL-22 and its regulators during adhesion formation. Postsurgical peritoneal drainage fluid from patients and rodent models was examined by enzyme-linked immunosorbent assay and fluorescence-activated cell sorting. It was observed that IL-22 expression in the abdominal cavity was rapidly induced 12 hours after surgery and then slowly decreased to a lower, steady level for up to 7 days after surgery. However, neutralizing IL-22 at the time point at which the highest level of expression was observed failed to reduce adhesion, but neutralizing IL-22 at a later time point, i.e., 3 days after surgery, prevented adhesion significantly. The IL-22 receptor was induced on the mesothelial membrane, and IL-22BP, an inhibitor of IL-22, was reduced 3 days after surgery. Furthermore, IFN-γ was identified to have the ability to induce IL-22R, and IL-18, which was induced by the infiltrating macrophages, was found to inhibit IL-22BP expression both in vivo and in vitro. Together, these data suggest that IL-22 may promote adhesion formation and that the regulation of IL-22, IL-22R, and IL-22BP may have therapeutic potential to prevent adhesion formation after surgery without disturbing the normal immune process.
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Affiliation(s)
- Qingbo Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yongming Huang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Rui Zhou
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Ke Wu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wei Li
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Liang Shi
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zefeng Xia
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Kaixiong Tao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Guobin Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Geng Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Anti-interleukin-6 receptor antibody treatment ameliorates postoperative adhesion formation. Sci Rep 2019; 9:17558. [PMID: 31772282 PMCID: PMC6879753 DOI: 10.1038/s41598-019-54175-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 11/05/2019] [Indexed: 12/14/2022] Open
Abstract
Postoperative adhesion formation often ruins the quality of life or is an obstacle to illnesses with curative operation such as cancer. Previously we demonstrated that interferon-γ-promoted fibrin deposition drove postoperative adhesion formation. However, its underlying cellular and molecular mechanisms remain poorly understood. We found that myofibroblasts of the adhesion predominantly expressed signature molecules of mesothelial cells that line the serosa. Microarray analysis revealed IL-6 as a key underlying player, supported by elevated IL-6 levels in the peritoneal fluid of post-laparotomy human subjects. Injured serosa of cecum-cauterized mice also exhibited induction of Il6, which was followed by Tnf, concomitant with rapid accumulation of neutrophils, substantial population of which expressed TGF-β1, a master regulator of fibrosis. Besides, neutrophil-ablated mice showed reduction in induction of the adhesion, suggesting that TGF-β1+neutrophils triggered the adhesion. Human neutrophils expressed TGFB1 in response to TNF-α and TNF in response to IL-6. Moreover, anti-IL-6 receptor monoclonal antibody abrogated neutrophil recruitment and adhesion formation. Thus, IL-6 signaling represents a potential target for the prevention of postoperative adhesions.
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Li G, Dong J, Huang W, Zhang Z, Wang D, Zou M, Xu Q, Lu G, Cao Z. Establishment of a novel system for the preoperative prediction of adherent perinephric fat (APF) occurrence based on a multi-mode and multi-parameter analysis of dual-energy CT. Transl Androl Urol 2019; 8:421-431. [PMID: 31807419 DOI: 10.21037/tau.2019.09.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Adherent perinephric fat (APF) is evaluated preoperatively with the Mayo adhesive probability (MAP) scoring system using conventional single-form computed tomography (CT) images. An objective or quantitative indicator for predicting APF is urgently needed for clinical application. Methods A total of 150 patients with renal tumours who underwent laparoscopic partial nephrectomy (LPN) were retrospectively enrolled and divided into the APF group (n=100) and the non-APF group (n=50) according to surgical results. All patients underwent a renal contrast-enhanced dual-energy CT (DECT) scan. The obtained CT DICOM data were transmitted to the DECT post-processing workstation and adopted virtual non-contrast (VNC), Rho/Z Maps, and Monoenergetic Plus (mono+) modes separately to undergo a multi-parameter analysis. A logistic stepwise investigation was utilized to analyse the related risk factors. The cutoff value was determined by the Youden index. Fifty patients were prospectively enrolled to validate the constructed model. The area under the curve (AUC), sensitivity, specificity and accuracy of the model were calculated. Results The study demonstrated that age, sex, body mass index (BMI), smoking status, tumour diameter, exophytic status, degree of malignancy and posterior perinephric fat thickness were related to the occurrence of APF (P<0.05). Model 1 was selected with the contrast material (CM) parameter (cutoff point 0.5), model 2 was selected with the effective atomic number (Zeff) parameter (cutoff point 6.5), and model 3 was selected with the slope K (K) parameter (cutoff point -0.95). The AUC, sensitivity, specificity and accuracy of model 1 were 0.94, 0.94, 0.93 and 0.94, respectively; for model 2, they were 0.94, 0.93, 0.93 and 0.96, respectively; and for model 3, they were 0.92, 0.92, 0.93 and 0.92, respectively. Conclusions Multi-mode and multi-parameter models of DECT can effectively be used to predict the occurrence of APF.
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Affiliation(s)
- Guan Li
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Jie Dong
- Department of Urology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Wei Huang
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Zhengyu Zhang
- Department of Urology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Di Wang
- Department of Pathology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Mingyu Zou
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Qinmei Xu
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Guangming Lu
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Zhiqiang Cao
- Department of Urology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Engineering antimicrobial and biocompatible electrospun PLGA fibrous membranes by irradiation grafting polyvinylpyrrolidone and periodate. Colloids Surf B Biointerfaces 2019; 181:918-926. [DOI: 10.1016/j.colsurfb.2019.06.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/16/2019] [Accepted: 06/25/2019] [Indexed: 12/24/2022]
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Li G, Huang W, Xu Q, Dong J, Cao Z, Wang D, Zou M, Lu G. Application value of dual-energy computed tomography spectrum curve combined with clinical risk factors in predicting adherent perinephric fat. Quant Imaging Med Surg 2019; 9:1421-1428. [PMID: 31559171 DOI: 10.21037/qims.2019.06.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background Adherent perinephric fat (APF) is evaluated preoperatively with the Mayo adhesive probability (MAP) scoring system using conventional single form computed tomography (CT) images. An objective or quantitative indicator for predicting APF is urgently needed for clinical application. Methods Data obtained from 150 renal tumor patients with partial nephrectomy (PN) were used in the present study. Patients were divided into two groups based on the surgical results: an APF group (n=100) and a non-APF group (n=50). All patients had renal contrast-enhanced dual-energy CT (DECT) scan, and the data were brought into a post-processing workstation. Monoenergetic plus mode was adopted to analyze the spectrum curve of the region of interest (ROI). Logistic stepwise relapse investigation was utilized to analyze the related risk factors. The maximum Youden index was taken as the cut-off value. The sensitivity, specificity, accuracy, and 95% CI of the model were calculated. Results APF is related to patients' clinical characteristics of age, gender, BMI, smoking, tumor diameter, exophytic, and benign or malignant nature of the renal masses (P<0.05). The shape of the curve of ROI1 in the APF group was different from that of the ROI4 in the non-APF group, and the curve slope of K1 (-0.21±0.47) was different from that of K4 (-1.30±0.14) (P<0.001). Statistical analysis showed that the slope K was solely retained in the model index. The best cut-off point for the K value was -0.95. The AUC of the cut-off point was 0.97 (95% CI: 0.96-0.99). Conclusions The DECT spectrum curve performed well in predicting APF, and the curve slope K can be used as an objective quantitative indicator.
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Affiliation(s)
- Guan Li
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Wei Huang
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Qinmei Xu
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Jie Dong
- Department of Urology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
| | - Zhiqiang Cao
- Department of Urology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Di Wang
- Department of Pathology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Mingyu Zou
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Guangming Lu
- Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China
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A novel chrysin derivative produced by gamma irradiation attenuates 2,4-dinitrochlorobenzene-induced atopic dermatitis-like skin lesions in Balb/c mice. Food Chem Toxicol 2019; 128:223-232. [DOI: 10.1016/j.fct.2019.03.048] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/24/2019] [Accepted: 03/26/2019] [Indexed: 02/06/2023]
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Wu S, Uyama N, Itou RA, Hatano E, Tsutsui H, Fujimoto J. The Effect of Daikenchuto, Japanese Herbal Medicine, on Adhesion Formation Induced by Cecum Cauterization and Cecum Abrasion in Mice. Biol Pharm Bull 2019; 42:179-186. [PMID: 30713250 DOI: 10.1248/bpb.b18-00543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Daikenchuto (DKT) has been widely used for the treatment of postsurgical ileus in Japan. However, its effect on postsurgical adhesion formation has been obscure. In this study, the effect of DKT on postsurgical adhesion formation induced by cecum cauterization or cecum abrasion in mice was investigated. First, the expression of adhesion-related molecules in damaged ceca was investigated by quantitative (q)RT-PCR. During 24 h after surgery, mRNA expressions of interferon-γ (IFN-γ), plasminogen activator inhibitor-1 (PAI-1), interleukin-17 (IL-17), and Substance P (SP) in cauterized ceca and those of PAI-1 and IL-17 in abraded ceca were significantly up-regulated. Next, the effect of DKT on adhesion formation macroscopically evaluated with adhesion scoring standards. DKT (22.5-67.5 mg/d) was administered orally for 7 d during the perioperative period, and DKT did not reduce adhesion scores in either the cauterization model (control : DKT 67.5 mg/d, 4.8 ± 0.2 : 4.8 ± 0.2) or in the abrasion model (control : DKT 67.5 mg/d, 4.9 ± 0.1 : 4.5 ± 0.3). Histologically, collagen deposition and leukocyte accumulation were found at the adhesion areas of control mice in both models, and DKT supplementation did not alleviate them. Last, effect of DKT on expression of proadhesion moleculs was evaluated. DKT also failed to down-regulate mRNA expression levels of them in damaged ceca of both models. In conclusion, PAI-1 and IL-17 may be key molecules of postsurgical adhesion formation. Collagen deposition and leukocytes accumulation are histological characteristic feature of post-surgical adhesion formation. DKT may not have any preventive effect on postsurgical adhesion formation in mice.
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Affiliation(s)
- Songtao Wu
- Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
| | - Naoki Uyama
- Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
| | - Rei Atono Itou
- Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
| | - Etsuro Hatano
- Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
| | - Hiroko Tsutsui
- Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
| | - Jiro Fujimoto
- Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
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The Distribution of Vascular Endothelial Growth Factor (VEGF), Human Beta-Defensin-2 (HBD-2), and Hepatocyte Growth Factor (HGF) in Intra-Abdominal Adhesions in Children under One Year of Age. ScientificWorldJournal 2018; 2018:5953095. [PMID: 30692872 PMCID: PMC6332881 DOI: 10.1155/2018/5953095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/04/2018] [Accepted: 12/02/2018] [Indexed: 12/17/2022] Open
Abstract
The regulatory role between ischemia related factors and antimicrobial peptides in congenital intra-abdominal adhesions has not yet been defined. The aim of this research was to investigate the appearance and relative distribution of VEGF, HBD-2, and HGF in congenital intra-abdominal adhesions compared with relatively healthy tissue controls. The study group material was obtained from 48 patients who underwent abdominal surgery due to partial or complete bowel obstruction. VEGF, HBD-2, and HGF were detected using immunohistochemistry methods and their relative distribution was evaluated by means of the semiquantitative counting method. The results were analyzed using nonparametric statistic methods. A moderate number of VEGF positive endotheliocytes were detected, but there was no statistically significant difference between the groups. In the experimental group, a moderate to high number of VEGF positive macrophages was observed. In control group tissues, such macrophages were seen in significantly lower number (U = 61.0, p = 0.001). The increase of VEGF positive cells indicates support of angiogenesis due to the hypoxic conditions in case of adhesion disease. The number of HBD-2 marked fibroblasts and macrophages was moderate to high, but only few positive endotheliocytes were observed. Persisting appearance of HBD-2 positive structures might be a result of the inflammatory process. Most specimens showed occasional HGF positive macrophages and fibroblasts and there was no statistically significant difference between the groups. The relatively weak appearance of HGF suggests that the lack of this factor promotes the formation of fibrotic changes in case of intra-abdominal adhesions.
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Tsai JM, Sinha R, Seita J, Fernhoff N, Christ S, Koopmans T, Krampitz GW, McKenna KM, Xing L, Sandholzer M, Sales JH, Shoham M, McCracken M, Joubert LM, Gordon SR, Poux N, Wernig G, Norton JA, Weissman IL, Rinkevich Y. Surgical adhesions in mice are derived from mesothelial cells and can be targeted by antibodies against mesothelial markers. Sci Transl Med 2018; 10:eaan6735. [PMID: 30487249 DOI: 10.1126/scitranslmed.aan6735] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/26/2017] [Accepted: 04/30/2018] [Indexed: 11/20/2023]
Abstract
Peritoneal adhesions are fibrous tissues that tether organs to one another or to the peritoneal wall and are a major cause of postsurgical and infectious morbidity. The primary molecular chain of events leading to the initiation of adhesions has been elusive, chiefly due to the lack of an identifiable cell of origin. Using clonal analysis and lineage tracing, we have identified injured surface mesothelium expressing podoplanin (PDPN) and mesothelin (MSLN) as a primary instigator of peritoneal adhesions after surgery in mice. We demonstrate that an anti-MSLN antibody diminished adhesion formation in a mouse model where adhesions were induced by surgical ligation to form ischemic buttons and subsequent surgical abrasion of the peritoneum. RNA sequencing and bioinformatics analyses of mouse mesothelial cells from injured mesothelium revealed aspects of the pathological mechanism of adhesion development and yielded several potential regulators of this process. Specifically, we show that PDPN+MSLN+ mesothelium responded to hypoxia by early up-regulation of hypoxia-inducible factor 1 alpha (HIF1α) that preceded adhesion development. Inhibition of HIF1α with small molecules ameliorated the injury program in damaged mesothelium and was sufficient to diminish adhesion severity in a mouse model. Analyses of human adhesion tissue suggested that similar surface markers and signaling pathways may contribute to surgical adhesions in human patients.
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Affiliation(s)
- Jonathan M Tsai
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Rahul Sinha
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jun Seita
- AI based Healthcare and Medical Data Analysis Standardization Unit, Medical Sciences Innovation Hub Program, RIKEN, Tokyo 103-0027, Japan
| | - Nathaniel Fernhoff
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Simon Christ
- Comprehensive Pneumology Center, Institute of Lung Biology and Disease,Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Tim Koopmans
- Comprehensive Pneumology Center, Institute of Lung Biology and Disease,Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Geoffrey W Krampitz
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of General Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kelly M McKenna
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Liujing Xing
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michael Sandholzer
- Comprehensive Pneumology Center, Institute of Lung Biology and Disease,Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Jennifer Horatia Sales
- Comprehensive Pneumology Center, Institute of Lung Biology and Disease,Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Maia Shoham
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Melissa McCracken
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lydia-Marie Joubert
- Cell Sciences Imaging Facility, Beckman Center, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sydney R Gordon
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Nicolas Poux
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Gerlinde Wernig
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jeffrey A Norton
- Department of General Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Irving L Weissman
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Ludwig Center for Cancer Stem Cell Biology and Medicine at Stanford University, Stanford, CA 94305, USA
| | - Yuval Rinkevich
- Comprehensive Pneumology Center, Institute of Lung Biology and Disease,Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany.
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Thermoresponsive polysaccharide-based composite hydrogel with antibacterial and healing-promoting activities for preventing recurrent adhesion after adhesiolysis. Acta Biomater 2018; 74:439-453. [PMID: 29803006 DOI: 10.1016/j.actbio.2018.05.037] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 01/11/2023]
Abstract
Postoperative adhesions are very common complications after general abdominal surgery. Although adhesiolysis has been proven effective in eliminating the preexisting adhesions, the new trauma caused by surgical lysis can induce recurrent adhesion. The prevention of recurrent adhesion after adhesiolysis is more difficult because the injury is more severe and adhesion mechanism is more complicated compared with the primary adhesion. In this study, a thermoresponsive hydrogel contained galactose modified xyloglucan (mXG) and hydroxybutyl chitosan (HBC) was developed as a barrier device for recurrent adhesion prevention after adhesiolysis due to its injectability and spontaneous gelling behaviors at the body temperature without any chemical reactions or extra driving factors. First, mXG and HBC were synthesized via enzymatic modification and etherification reaction, respectively. Rheological measurements indicated that the mXG/HBC composite system showed excellent thermosensitivity properties, and their gelation temperature and time can be modulated via adjusting the mXG/HBC ratio. Moreover, the mXG/HBC hydrogel exhibited excellent cytocompatibility and hemocompatibility in vitro. Furthermore, the mXG/HBC hydrogel could promote wound healing in the rat skin wound model. Finally, the efficacy of the mXG/HBC composite hydrogel in the prevention of recurrent adhesion was evaluated in a more rigorous rat repeated-injury adhesion model. The results demonstrated that the composite hydrogel could not only effectively prevent recurrent adhesion after adhesiolysis, but also promote wound healing and reduce scare formation. These results suggested that the mXG/HBC composite hydrogel may be a promising candidate as an injectable anti-adhesion system for clinical applications. STATEMENT OF SIGNIFICANCE Although adhesiolysis has been proven effective in eliminating the preexisting adhesions, the new trauma caused by surgical lysis can induce recurrent adhesion. So far, most of the existing barrier systems and pharmacological approaches were developed for primary adhesion prevention while few attention has paid on prevention of recurrent adhesion after adhesiolysis. In the present study, we developed a thermoresponsive polysaccharide-based composite hydrogel by simple mixing galactose modified xyloglucan (mXG) and hydroxybutyl chitosan (HBC). The resulting mXG/HBC composite hydrogel not only was easy to handle and highly effective in preventing the recurrent adhesion after adhesiolysis, but also could promote wound healing and reduce scare formation. Our study provide an effective anti-adhesion system for preventing recurrent adhesion after adhesiolysis.
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Fu Y, Tsauo J, Sun Y, Wang Z, Kim KY, Lee SH, Kim DY, Jing F, Lim D, Song HY, Hyun H, Choi EY. Developmental endothelial locus-1 prevents development of peritoneal adhesions in mice. Biochem Biophys Res Commun 2018; 500:783-789. [PMID: 29684347 DOI: 10.1016/j.bbrc.2018.04.158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/19/2018] [Indexed: 01/01/2023]
Abstract
Postoperative peritoneal adhesions, fibrous bands formed in the peritoneal cavity following surgery, represent a common, challenging and costly problem faced by surgeons and patients, for which effective therapeutic options are lacking. Since aberrant inflammation is one of the key mechanisms underlying peritoneal adhesion formation, here we set out to study the role of developmental endothelial locus-1 (Del-1), which has been recently identified as an endogenous inhibitor of inflammation, in the formation of postoperative peritoneal adhesions using a mouse model of peritoneal adhesions induced by ischemic buttons. Del-1-deficient mice had a higher incidence of adhesions, and their adhesions had higher quality and tenacity scores. Del-1 deficiency also led to enhanced inflammation mediators and collagen production. Finally, Del-1 supplementation decreased the incidence and severity of postoperative peritoneal adhesions. Taken together, these results indicate a protective role for Del-1 in postoperative peritoneal adhesion formation.
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Affiliation(s)
- Yan Fu
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiaywei Tsauo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Yucheng Sun
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Zhe Wang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Kun Yung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong-Young Kim
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Feifeng Jing
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dahae Lim
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho-Young Song
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hoon Hyun
- Department of Biomedical Sciences, Chonnam National University Medical School, Gwangju, Republic of Korea.
| | - Eun Young Choi
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Schönfelder T, Brandt M, Kossmann S, Knopp T, Münzel T, Walter U, Karbach SH, Wenzel P. Lack of T-bet reduces monocytic interleukin-12 formation and accelerates thrombus resolution in deep vein thrombosis. Sci Rep 2018; 8:3013. [PMID: 29445199 PMCID: PMC5813037 DOI: 10.1038/s41598-018-21273-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/01/2018] [Indexed: 12/11/2022] Open
Abstract
The role of leukocytes in deep vein thrombosis (DVT) resolution is incompletely understood. We determined how depletion of lysozyme positive (LysM+) cells and a switched-off type 1 immune response influences thrombus resolution. DVT was induced in 12-week-old male mice by inferior vena cava (IVC) stenosis. Toxin mediated depletion of myeloid cells improved thrombus resolution in mice with Cre-inducible expression of the diphtheria toxin receptor in LysM+ cells. This correlated with decreased CD45+ cells, a population shift of Gr-1+ to Gr-1- CD11b+ myelomonocytic cells (flow cytometry) and an increase in CC-chemokine ligand 2, interleukin-4 and interleukin-10 mRNA expressions. Tbx21-/- mice (lacking transcription factor T-bet and marked by an attenuated type 1 immune response) with DVT had faster thrombus resolution, a reduction of pro-inflammatory Ly6Chi monocytes in thrombi and decreased interleukin-12p40 mRNA expression than control mice resulting in increased vascular endothelial growth factor mRNA expression and improved neovascularization of thrombotic veins. Transfer of Tbx21-/- bone marrow into irradiated Tbx21+/+ recipients lead to accelerated thrombus resolution with lower T-bet-dependent interleukin-12p40 mRNA levels following IVC-stenosis. We conclude that inhibition of Tbet+ interleukin-12 forming myelomonocytic cells accelerated thrombus resolution. Modulating the inflammatory immune response might be an approach to improve therapy of DVT.
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Affiliation(s)
| | - Moritz Brandt
- Center for Thrombosis and Hemostasis Mainz, Mainz, Germany.,Center for Cardiology-Cardiology I, Mainz, Germany.,Deutsches Zentrum für Herzkreislaufforschung (DZHK)-Partner site Rhine-Main, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Sabine Kossmann
- Center for Thrombosis and Hemostasis Mainz, Mainz, Germany.,Center for Cardiology-Cardiology I, Mainz, Germany
| | - Tanja Knopp
- Center for Thrombosis and Hemostasis Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Thrombosis and Hemostasis Mainz, Mainz, Germany.,Center for Cardiology-Cardiology I, Mainz, Germany.,Deutsches Zentrum für Herzkreislaufforschung (DZHK)-Partner site Rhine-Main, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Ulrich Walter
- Center for Thrombosis and Hemostasis Mainz, Mainz, Germany.,Deutsches Zentrum für Herzkreislaufforschung (DZHK)-Partner site Rhine-Main, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Susanne H Karbach
- Center for Thrombosis and Hemostasis Mainz, Mainz, Germany.,Center for Cardiology-Cardiology I, Mainz, Germany
| | - Philip Wenzel
- Center for Thrombosis and Hemostasis Mainz, Mainz, Germany. .,Center for Cardiology-Cardiology I, Mainz, Germany. .,Deutsches Zentrum für Herzkreislaufforschung (DZHK)-Partner site Rhine-Main, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
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Yang Y, Liu X, Li Y, Wang Y, Bao C, Chen Y, Lin Q, Zhu L. A postoperative anti-adhesion barrier based on photoinduced imine-crosslinking hydrogel with tissue-adhesive ability. Acta Biomater 2017; 62:199-209. [PMID: 28867650 DOI: 10.1016/j.actbio.2017.08.047] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/07/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022]
Abstract
Postoperative adhesion is a serious complication that can further lead to morbidity and/or mortality. Polymer anti-adhesion barrier material provides an effective precaution to reduce the probability of postoperative adhesion. Clinical application requires these materials to be easily handled, biocompatible, biodegradable, and most importantly tissue adherent to provide target sites with reliable isolation. However, currently there is nearly no polymer barrier material that can fully satisfy these requirements. In this study, based on the photoinduced imine-crosslinking (PIC) reaction, we had developed a photo-crosslinking hydrogel (CNG hydrogel) that composed of o-nitrobenzyl alcohol (NB) modified carboxymethyl cellulose (CMC-NB) and glycol chitosan (GC) as an anti-adhesion barrier material. Under light irradiation, CMC-NB generated aldehyde groups which subsequently reacted with amino groups distributed on GC or tissue surface to form a hydrogel barrier that covalently attached to tissue surface. Rheological analysis demonstrated that CNG hydrogel (30mg/mL polymer content) could be formed in 30s upon light irradiation. Tissue adhesive tests showed that the tissue adhesive strength of CNG hydrogel (30mg/mL) was about 8.32kPa-24.65kPa which increased with increasing CMC-NB content in CNG hydrogel. Toxicity evaluation by L929 cells demonstrated that CNG hydrogel was cytocompatible. Furthermore, sidewall defect-cecum abrasion model of rat was employed to evaluate the postoperative anti-adhesion efficacy of CNG hydrogel. And a significantly reduction of tissue adhesion (20% samples with low score adhesion) was found in CNG hydrogel treated group, compared with control group (100% samples with high score adhesion). In addition, CNG hydrogel could be degraded in nearly 14days and showed no side effect on wound healing. These findings indicated that CNG hydrogel can effectively expanded the clinical treatments of postoperative tissue adhesion. STATEMENT OF SIGNIFICANCE In this study, a tissue adhesive photo-crosslinking hydrogel (CNG) was developed based on photo-induced imine crosslinking reaction (PIC) for postoperative anti-adhesion. CNG hydrogel showed the features of easy and convenient operation, fast and controllable gelation, suitable gel strength, good biocompatibility, and most importantly strong tissue adhesiveness. Therefore, it shows very high performance to prevent postoperative tissue adhesion. Overall, our study provides a more suitable hydrogel barrier material that can overcome the shortcomings of current barriers for clinical postoperative anti-adhesion.
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Affiliation(s)
- Yunlong Yang
- Key Laboratory for Advanced Materials, Institute of Fine Chemicals, East China University of Science and Technology, 130# Meilong Road, Shanghai 200237, China; Institute of Microsurgery on Extremities, Institute of Orthopaedic Surgery, Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People' Hospital, 600# Yishan Road, Shanghai 200233, China
| | - Xiaolin Liu
- Institute of Microsurgery on Extremities, Institute of Orthopaedic Surgery, Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People' Hospital, 600# Yishan Road, Shanghai 200233, China
| | - Yan Li
- Key Laboratory for Advanced Materials, Institute of Fine Chemicals, East China University of Science and Technology, 130# Meilong Road, Shanghai 200237, China
| | - Yang Wang
- Institute of Microsurgery on Extremities, Institute of Orthopaedic Surgery, Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People' Hospital, 600# Yishan Road, Shanghai 200233, China.
| | - Chunyan Bao
- Key Laboratory for Advanced Materials, Institute of Fine Chemicals, East China University of Science and Technology, 130# Meilong Road, Shanghai 200237, China
| | - Yunfeng Chen
- Institute of Microsurgery on Extremities, Institute of Orthopaedic Surgery, Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People' Hospital, 600# Yishan Road, Shanghai 200233, China
| | - Qiuning Lin
- Key Laboratory for Advanced Materials, Institute of Fine Chemicals, East China University of Science and Technology, 130# Meilong Road, Shanghai 200237, China.
| | - Linyong Zhu
- Key Laboratory for Advanced Materials, Institute of Fine Chemicals, East China University of Science and Technology, 130# Meilong Road, Shanghai 200237, China
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Strowitzki MJ, Ritter AS, Radhakrishnan P, Harnoss JM, Opitz VM, Biller M, Wehrmann J, Keppler U, Scheer J, Wallwiener M, Schmidt T, Ulrich A, Schneider M. Pharmacological HIF-inhibition attenuates postoperative adhesion formation. Sci Rep 2017; 7:13151. [PMID: 29030625 PMCID: PMC5640636 DOI: 10.1038/s41598-017-13638-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 09/29/2017] [Indexed: 02/06/2023] Open
Abstract
Peritoneal adhesions represent a common complication of abdominal surgery, and tissue hypoxia is a main determinant in adhesion formation. Reliable therapeutic options to reduce peritoneal adhesions are scarce. We investigated whether the formation of postsurgical adhesions can be affected by pharmacological interference with hypoxia-inducible factors (HIFs). Mice were treated with a small molecule HIF-inhibitor, YC-1 (3-[5′-Hydroxymethyl-2′-furyl]-1-benzyl-indazole), or vehicle three days before and seven days after induction of peritoneal adhesions or, alternatively, once during induction of peritoneal adhesions. Pretreatment or single intraperitoneal lavage with YC-1 significantly reduced postoperative adhesion formation without prompting systemic adverse effects. Expression analyses of cytokines in peritoneal tissue and fluid and in vitro assays applying macrophages and peritoneal fibroblasts indicated that this effect was cooperatively mediated by various putatively HIF-1α-dependent mechanisms, comprising attenuated pro-inflammatory activation of macrophages, impaired recruitment and activation of peritoneal fibroblasts, mitigated epithelial-mesenchymal-transition (EMT), as well as enhanced fibrinolysis and impaired angiogenesis. Thus, this study identifies prevention of postsurgical peritoneal adhesions as a novel and promising field for the application of HIF inhibitors in clinical practice.
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Affiliation(s)
- Moritz J Strowitzki
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Alina S Ritter
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Praveen Radhakrishnan
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Jonathan M Harnoss
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.,Cancer Immunology, Genentech, Inc., South San Francisco, USA
| | - Vanessa M Opitz
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Marvin Biller
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Julian Wehrmann
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ulrich Keppler
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Jana Scheer
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Markus Wallwiener
- Department of General Gynaecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - Thomas Schmidt
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Alexis Ulrich
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Martin Schneider
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
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Lee SM, Robertson I, Stonier T, Simson N, Amer T, Aboumarzouk OM. Contemporary outcomes and prediction of adherent perinephric fat at partial nephrectomy: a systematic review. Scand J Urol 2017; 51:429-434. [PMID: 28784033 DOI: 10.1080/21681805.2017.1357656] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Current guidelines recommend partial nephrectomy for the management of T1a tumours. Adherent perinephric fat (APF) has been recognized as a complicating feature of such surgery. The objective of this article was to present a systematic review of the published literature investigating APF aetiology, risk factors and outcomes. MATERIALS AND METHODS To identify relevant studies, the PubMed, MEDLINE, Web of Science and Google Scholar databases were searched from 1990 to 2017. RESULTS Eight studies studying APF were identified. The aetiology of APF appears to be multifactorial, but is thought to be associated with a systemic, chronic inflammatory state secondary to metabolic syndrome. Several risk factors have been identified. Clinically, APF is more prevalent in ageing and male populations, particularly those with high body mass index and waist measurements. Radiological risk factors for APF include increased perinephric fat thickness and stranding, which can be combined to produce the Mayo Adhesive Probability (MAP) score, a predictive index that has been validated in small, external cohorts. The presence of APF at partial nephrectomy is associated with increased operative time and estimated blood loss. However, there is no documented increase in warm ischaemia time or perioperative complications in patients with APF. CONCLUSIONS More studies are required to identify outcomes and risk factors for APF. Early identification of patients with APF can allow surgeons to guide preoperative planning and patient assessment.
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Affiliation(s)
- Su-Min Lee
- a Department of Urology , Weston Area Health NHS Trust , Weston-super-Mare , UK
| | - Ian Robertson
- b Department of Urology , St George's University Hospitals NHS Foundation Trust , London , UK
| | - Thomas Stonier
- c Department of Urology , Princess Alexandra Hospital NHS Trust , Harlow , UK
| | - Nicholas Simson
- c Department of Urology , Princess Alexandra Hospital NHS Trust , Harlow , UK
| | - Tarik Amer
- d Department of Urology , Queen Elizabeth University Hospital , Glasgow , UK
| | - Omar M Aboumarzouk
- d Department of Urology , Queen Elizabeth University Hospital , Glasgow , UK
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Orciani M, Campanati A, Caffarini M, Ganzetti G, Consales V, Lucarini G, Offidani A, Di Primio R. T helper (Th)1, Th17 and Th2 imbalance in mesenchymal stem cells of adult patients with atopic dermatitis: at the origin of the problem. Br J Dermatol 2017; 176:1569-1576. [DOI: 10.1111/bjd.15078] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 01/06/2023]
Affiliation(s)
- M. Orciani
- Department of Molecular and Clinical Sciences - Histology; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
| | - A. Campanati
- Dermatological Clinic; Department of Molecular and Clinical Sciences; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
| | - M. Caffarini
- Department of Molecular and Clinical Sciences - Histology; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
| | - G. Ganzetti
- Dermatological Clinic; Department of Molecular and Clinical Sciences; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
| | - V. Consales
- Dermatological Clinic; Department of Molecular and Clinical Sciences; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
| | - G. Lucarini
- Department of Molecular and Clinical Sciences - Histology; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
| | - A. Offidani
- Dermatological Clinic; Department of Molecular and Clinical Sciences; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
| | - R. Di Primio
- Department of Molecular and Clinical Sciences - Histology; Marche Polytechnic University; Via Tronto 10/A 60126 Ancona Italy
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Honjo K, Munakata S, Tashiro Y, Salama Y, Shimazu H, Eiamboonsert S, Dhahri D, Ichimura A, Dan T, Miyata T, Takeda K, Sakamoto K, Hattori K, Heissig B. Plasminogen activator inhibitor‐1 regulates macrophage‐dependent postoperative adhesion by enhancing EGF‐HER1 signaling in mice. FASEB J 2017; 31:2625-2637. [DOI: 10.1096/fj.201600871rr] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 02/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Kumpei Honjo
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
- Department of Coloproctological Surgery Tokyo Japan
| | - Shinya Munakata
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
- Department of Coloproctological Surgery Tokyo Japan
| | - Yoshihiko Tashiro
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
- Department of Coloproctological Surgery Tokyo Japan
| | - Yousef Salama
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Hiroshi Shimazu
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Salita Eiamboonsert
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Douaa Dhahri
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Atsuhiko Ichimura
- United Centers for Advanced Research and Translational MedicineGraduate School of Medicine, Tohoku University Sendai Japan
| | - Takashi Dan
- United Centers for Advanced Research and Translational MedicineGraduate School of Medicine, Tohoku University Sendai Japan
| | - Toshio Miyata
- United Centers for Advanced Research and Translational MedicineGraduate School of Medicine, Tohoku University Sendai Japan
| | - Kazuyoshi Takeda
- Department of Immunology and Atopy CenterGraduate School of Medicine, Juntendo University Tokyo Japan
| | | | - Koichi Hattori
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
- Center for Genomic and Regenerative MedicineFaculty of Medicine Tokyo Japan
| | - Beate Heissig
- Division of Stem Cell Dynamics Center for Stem Cell Biology and Regenerative MedicineThe Institute of Medical Science The University of Tokyo Tokyo Japan
- Department of Immunology and Atopy CenterGraduate School of Medicine, Juntendo University Tokyo Japan
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Peritoneal adhesion prevention with a biodegradable and injectable N,O-carboxymethyl chitosan-aldehyde hyaluronic acid hydrogel in a rat repeated-injury model. Sci Rep 2016; 6:37600. [PMID: 27869192 PMCID: PMC5116612 DOI: 10.1038/srep37600] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 11/01/2016] [Indexed: 02/05/2023] Open
Abstract
Postoperative peritoneal adhesion is one of the serious issues because it induces severe clinical disorders. In this study, we prepared biodegradable and injectable hydrogel composed of N,O-carboxymethyl chitosan (NOCC) and aldehyde hyaluronic acid (AHA), and assessed its anti-adhesion effect in a rigorous and severe recurrent adhesion model which is closer to clinical conditions. The flexible hydrogel, which gelated in 66 seconds at 37 °C, was cross-linked by the schiff base derived from the amino groups of NOCC and aldehyde groups in AHA. In vitro cytotoxicity test showed the hydrogel was non-toxic. In vitro and in vivo degradation examinations demonstrated the biodegradable and biocompatibility properties of the hydrogel. The hydrogel discs could prevent the invasion of fibroblasts, whereas fibroblasts encapsulated in the porous 3-dimensional hydrogels could grow and proliferate well. Furthermore, the hydrogel was applied to evaluate the anti-adhesion efficacy in a more rigorous recurrent adhesion model. Compared with normal saline group and commercial hyaluronic acid (HA) hydrogel, the NOCC-AHA hydrogel exhibited significant reduction of peritoneal adhesion. Compared to control group, the blood and abdominal lavage level of tPA was increased in NOCC-AHA hydrogel group. These findings suggested that NOCC-AHA hydrogel had a great potential to serve as an anti-adhesion candidate.
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42
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Hinoki A, Saito A, Kinoshita M, Yamamoto J, Saitoh D, Takeoka S. Polylactic acid nanosheets in prevention of postoperative intestinal adhesion and their effects on bacterial propagation in an experimental model. Br J Surg 2016; 103:692-700. [DOI: 10.1002/bjs.10122] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/26/2015] [Accepted: 01/05/2016] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Ultrathin films (nanosheets) adhere tightly to organ surfaces but prevent adhesion to other organs. The antiadhesive effect of nanosheets and their effect on bacterial propagation were investigated in a murine intestinal adhesion model.
Methods
Polylactic acid nanosheets (approximately 80 nm thick) were produced. Serosal defects were created by peeling off the intestinal serosa; these were left open or covered with nanosheets or Seprafilm® and the formation of intestinal adhesions was analysed. To examine bacterial propagation, a nanosheet or Seprafilm® was placed on intact murine jejunum followed by Escherichia coli inoculation at the site.
Results
Treatment both with nanosheets and with Seprafilm® reduced postoperative intestinal adhesion (mean adhesion score 0·67 for nanosheets, 0·43 for Seprafilm® and 2·87 for no antiadhesive treatment; P < 0·001 for nanosheets or Seprafilm® versus no adhesive treatment). Nanosheet treatment did not affect bacterial propagation in the peritoneal cavity, whereas Seprafilm®-treated mice showed bacterial propagation, leading to increased mortality.
Conclusion
Nanosheets may be effective novel antiadhesive agents even in the presence of bacterial contamination. Surgical relevanceIntra-abdominal adhesions following surgical contamination can trigger postoperative complications and lead to deterioration in long-term quality of life. However, currently there are no effective antiadhesion materials to prevent the formation of adhesions.Treatment with ultrathin nanosheets effectively reduced postoperative intestinal adhesion in an experimental mouse model, and did not affect bacterial propagation in the peritoneal cavity.These nanosheets are potent novel antiadhesive materials that potentially can be applied even in contaminated conditions.
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Affiliation(s)
- A Hinoki
- Department of Surgery, National Defence Medical College, Tokorozawa, Japan
- Department of Paediatric Surgery, Nagoya University Graduate School of Medicine, Showa, Nagoya, Japan
| | - A Saito
- Department of Life Science and Medical BioScience, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - M Kinoshita
- Department of Immunology and Microbiology, National Defence Medical College, Tokorozawa, Japan
| | - J Yamamoto
- Department of Surgery, National Defence Medical College, Tokorozawa, Japan
| | - D Saitoh
- Department of Traumatology, National Defence Medical College, Tokorozawa, Japan
| | - S Takeoka
- Department of Life Science and Medical BioScience, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
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Abstract
Postoperative peritoneal adhesions are common sequelae of abdominal surgery. Acute as well as chronic complications, including bowel obstruction, abdominal pain and infertility can arise from adhesion formation. So far, the only reliable treatment is surgical adhesiolysis, which in turn is accompanied by an increased risk of adhesion recurrence. Despite significant progress in modern perioperative medicine, only limited prophylactic approaches are available and atraumatic surgery is still the most important factor.Current research concepts focus on two major antiadhesion strategies: firstly, the intraoperative placement of mechanical barriers and secondly novel immunomodulation concepts. Clinical data about the use of antiadhesive barriers show a heterogeneous outcome. Promising data have arisen from the immunomodulatory approaches and now require a step-up development from experimental to clinical trial level.The present review gives a short overview about the current research on the pathophysiology and prevention of peritoneal adhesions. The promising data are encouraging and require realization of carefully designed prospective clinical trials.
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Beyene RT, Kavalukas SL, Barbul A. Intra-abdominal adhesions: Anatomy, physiology, pathophysiology, and treatment. Curr Probl Surg 2015; 52:271-319. [PMID: 26258583 DOI: 10.1067/j.cpsurg.2015.05.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/12/2015] [Indexed: 12/18/2022]
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Use of mouse liver mesothelial cells to prevent postoperative adhesion and promote liver regeneration after hepatectomy. J Hepatol 2015; 62:1141-7. [PMID: 25514558 DOI: 10.1016/j.jhep.2014.12.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 11/12/2014] [Accepted: 12/06/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Repeated hepatectomy is widely accepted as one of the most effective curative treatment for recurrent hepatocellular carcinoma or liver metastasis from colorectal cancer. It has, however, two critical issues; postoperative adhesion and decrease of liver regenerative capacity. Postoperative adhesion makes surgical operations technically more demanding, leading to increased mortality and morbidity rates. Although the liver has a remarkable regenerative ability, volume and functional restoration after multiple repeated hepatectomy is not generally complete. So a new procedure that overcomes these two issues is required. We examined if a fetal liver mesothelial cells (FL-MCs) sheet could solve these two clinical issues simultaneously. METHODS We established a novel mouse hepatectomy model that reproduces postoperative adhesion on the resected liver surface. We isolated FL-MCs from mouse fetal liver and prepared a cell sheet. The FL-MCs sheet was then transplanted to the resected liver surface. RESULTS The FL-MCs sheet effectively prevented postoperative adhesion by expressing PCLP1, one of the transmembrane sialomucin family proteins and by activating the fibrinolytic system. Furthermore, the FL-MCs sheet facilitated liver regeneration by providing growth factors for hepatocytes, allowing quick recovery of liver weight and function. Additionally, we showed that an allogeneic FL-MCs sheet was as effective as a syngeneic cell sheet. CONCLUSIONS We demonstrate that the FL-MCs sheet is able to not only prevent postoperative adhesion but also promote liver regeneration in both syngeneic and allogeneic transplantation, and hence FL-MCs may serve as a potentially useful cell source for regenerative medicine after hepatectomy.
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Inagaki NF, Inagaki FF, Kokudo N, Miyajima A. Cell-based therapy for preventing postoperative adhesion and promoting regeneration after hepatectomy. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2015; 22:524-30. [PMID: 25877017 DOI: 10.1002/jhbp.247] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 03/12/2015] [Indexed: 12/31/2022]
Abstract
Postoperative adhesion is a critical clinical issue after almost all abdominal or pelvic surgeries including liver surgery. Postoperative adhesion causes several complications, such as small bowel obstruction and chronic abdominal pain. Furthermore, it makes reoperation much more difficult, leading to increased mortality and morbidity rate. Postoperative adhesion is particularly problematic for repeated hepatectomy, since hepatic malignant neoplasm recurs frequently and repeated hepatectomy is widely used as one of the most curative treatments. Several treatments to reduce postoperative adhesion have been developed, which include laparoscopic surgery, administration of pharmacological agents and use of prophylactic barrier materials. However, none of them are optimal. We have proposed a novel treatment using a cell sheet of fetal liver mesothelial cells (FL-MCs) to prevent postoperative adhesion in a novel mouse model. Besides adhesion, repeated hepatectomy has another serious problem; although the liver has a remarkable ability to regenerate, the recovery of liver mass and function of the remnant liver after multiple repeated hepatectomy is limited. The FL-MC cell sheet enhances proliferation of hepatocytes after hepatectomy by providing growth factors for hepatocytes. Thus the FL-MC sheet could simultaneously solve the two problems associated with repeated hepatectomy.
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Affiliation(s)
- Natsuko F Inagaki
- Institute of Molecular and Cellular Biosciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo, 113-0032, Japan
| | - Fuyuki F Inagaki
- Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norihiro Kokudo
- Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsushi Miyajima
- Institute of Molecular and Cellular Biosciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo, 113-0032, Japan.
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An injured tissue affects the opposite intact peritoneum during postoperative adhesion formation. Sci Rep 2015; 5:7668. [PMID: 25566876 PMCID: PMC4286739 DOI: 10.1038/srep07668] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/03/2014] [Indexed: 01/17/2023] Open
Abstract
The pathophysiology of adhesion formation needs to be clarified to reduce the adhesion-related morbidity. The epithelial characteristics of the peritoneum suggest a protective role against adhesion formation, yet how the peritoneum is involved in adhesion formation is not well characterized. We microscopically observed an experimental model of adhesion formation to investigate the effects of an injured tissue on the opposite intact peritoneum. Adhesions were induced between injured and intact hepatic lobes, and the intact peritoneum opposite to the injured tissue was examined for 8 days. The opposite intact peritoneum was denuded of mesothelial cells for 6 hours, and the remnant mesothelial cells changed morphologically for 24 hours. The detachment of mesothelial cells allowed fibrin to attach to the basement membrane of the opposite peritoneum, connecting the two lobes. Moreover, macrophages and myofibroblasts accumulated between the two lobes, and angiogenesis occurred from the opposite intact lobe to the injured lobe. These observations indicate that an injured tissue deprives the opposite intact peritoneum of its epithelial structure and causes fibrous adhesions to the opposite intact tissue. This study implies a possible role of mesothelial cells for barrier function against adhesion formation, that is, keeping mesothelial cells intact might lead to its prophylaxis.
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Zhang W, Wu Q, Li L, Cui T, Sun L, Wang N, Liu L, Li X, Gong C. Prevention of desiccation induced postsurgical adhesion by thermosensitive micelles. Colloids Surf B Biointerfaces 2014; 122:309-315. [DOI: 10.1016/j.colsurfb.2014.06.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 06/05/2014] [Accepted: 06/09/2014] [Indexed: 12/08/2022]
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Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with specific genetic and immunological mechanisms. The rapid development of new techniques in molecular biology had ushered in new discoveries on the role of cytokines, chemokines, and immune cells in the pathogenesis of AD. New polymorphisms of AD are continually being reported in different populations. The physical and immunological barrier of normal intact skin is an important part of the innate immune system that protects the host against microbials and allergens that are associated with AD. Defects in the filaggrin gene FLG may play a role in facilitating exposure to allergens and microbial pathogens, which may induce Th2 polarization. Meanwhile, Th22 cells also play roles in skin barrier impairment through IL-22, and AD is often considered to be a Th2/Th22-dominant allergic disease. Mast cells and eosinophils are also involved in the inflammation via Th2 cytokines. Release of pruritogenic substances by mast cells induces scratching that further disrupts the skin barrier. Th1 and Th17 cells are mainly involved in chronic phase of AD. Keratinocytes also produce proinflammatory cytokines such as thymic stromal lymphopoietin (TSLP), which can further affect Th cells balance. The immunological characteristics of AD may differ for various endotypes and phenotypes. Due to the heterogeneity of the disease, and the redundancies of these mechanisms, our knowledge of the pathophysiology of the disease is still incomplete, which is reflected by the absence of a cure for the disease.
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Affiliation(s)
- Zhanglei Mu
- Department of Dermatology, Peking University People's Hospital, No11, Xizhimen South Street, Beijing, 100044, China
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50
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Wang G, Wu K, Li W, Zhao E, Shi L, Wang J, Shuai X, Cai K, Lu X, Tao K, Wang G. Role of IL-17 and TGF-β in peritoneal adhesion formation after surgical trauma. Wound Repair Regen 2014; 22:631-9. [PMID: 24898474 DOI: 10.1111/wrr.12203] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/27/2014] [Indexed: 01/03/2023]
Affiliation(s)
- Geng Wang
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Ke Wu
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Wei Li
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Ende Zhao
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Liang Shi
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Jiliang Wang
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Xiaoming Shuai
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Kailin Cai
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Xiaoming Lu
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Kaixiong Tao
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Guobin Wang
- Department of Surgery; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
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