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İpek E, Aşıcı GSE, Kurt BK, Epikmen ET, Özsoy ŞY, Tunca R. Carbon monoxide (CO) derived from the CO-releasing molecule CORM-2 reduces peritoneal adhesion formation in a rat model. Mol Biol Rep 2023; 50:8483-8495. [PMID: 37639152 DOI: 10.1007/s11033-023-08753-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Although low-dose carbon monoxide (CO) administration has been shown to have an anti-fibrotic effect in various fibrotic diseases, its effects on peritoneal adhesion (PA), one of the postoperative complications, are not elucidated. In this study, the effect of CO-releasing tricarbonyldichlororuthenium (II) dimer (CORM-2) administration on the formation of PA and the underlying factors of its potential effect were investigated. METHODS AND RESULTS After the induction of PA, rats were divided into four groups with 8 rats in each group. The rats received either (i) dimethyl sulfoxide:saline solution (1:10) as a vehicle, (ii) 2.5 mg/kg CORM-2, (iii) 5 mg/kg CORM-2, or (iv) inactive (i) CORM (iCORM) intragastrically every day for a duration of 7 days. PA was not induced in rats (n = 8) designated as sham controls. Gross, histological, immunohistochemical and quantitative real-time polymerase chain reaction analyses were performed to evaluate the effectiveness of CORM-2 administration. Gross analysis showed that CORM-2 administration reduced PA formation compared to rats treated with vehicle. Histological and immunohistochemical examinations showed that increased collagen deposition, myofibroblast accumulation, microvessel density, and M1 macrophage count in the peritoneal fibrosis area of vehicle-treated rats decreased following CORM-2 treatments. PCR analyses showed that CORM-2 treatments decreased hypoxia-induced Hif1a, profibrotic Tgfb1, ECM components Col1a1 and Col3a1, collagen degradation suppressor Timp1, fibrinolysis inhibitor Serpine1, and pro-inflammatory Tnf mRNA expressions, while increasing the M2 macrophage marker Arg1 mRNA expression. CONCLUSIONS These results suggested that CORM-2 administration reduces PA formation by affecting adhesiogenic processes such as pro-inflammatory response, fibrinolytic system, angiogenesis and fibrogenesis.
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Affiliation(s)
- Emrah İpek
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey.
| | - Gamze Sevri Ekren Aşıcı
- Department of Biochemistry, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Büşra Kibar Kurt
- Department of Surgery, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Erkmen Tuğrul Epikmen
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Şule Yurdagül Özsoy
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Recai Tunca
- Department of Pathology, Faculty of Veterinary Medicine, Aydın Adnan Menderes University, Aydın, Turkey
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Liao J, Li X, Fan Y. Prevention strategies of postoperative adhesion in soft tissues by applying biomaterials: Based on the mechanisms of occurrence and development of adhesions. Bioact Mater 2023; 26:387-412. [PMID: 36969107 PMCID: PMC10030827 DOI: 10.1016/j.bioactmat.2023.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/26/2023] [Accepted: 02/23/2023] [Indexed: 03/19/2023] Open
Abstract
Postoperative adhesion (POA) widely occurs in soft tissues and usually leads to chronic pain, dysfunction of adjacent organs and some acute complications, seriously reducing patients' quality of life and even being life-threatening. Except for adhesiolysis, there are few effective methods to release existing adhesion. However, it requires a second operation and inpatient care and usually triggers recurrent adhesion in a great incidence. Hence, preventing POA formation has been regarded as the most effective clinical strategy. Biomaterials have attracted great attention in preventing POA because they can act as both barriers and drug carriers. Nevertheless, even though much reported research has been demonstrated their efficacy on POA inhibition to a certain extent, thoroughly preventing POA formation is still challenging. Meanwhile, most biomaterials for POA prevention were designed based on limited experiences, not a solid theoretical basis, showing blindness. Hence, we aimed to provide guidance for designing anti-adhesion materials applied in different soft tissues based on the mechanisms of POA occurrence and development. We first classified the postoperative adhesions into four categories according to the different components of diverse adhesion tissues, and named them as "membranous adhesion", "vascular adhesion", "adhesive adhesion" and "scarred adhesion", respectively. Then, the process of the occurrence and development of POA were analyzed, and the main influencing factors in different stages were clarified. Further, we proposed seven strategies for POA prevention by using biomaterials according to these influencing factors. Meanwhile, the relevant practices were summarized according to the corresponding strategies and the future perspectives were analyzed.
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Ensan B, Bathaei P, Nassiri M, Khazaei M, Hassanian SM, Abdollahi A, Ghorbani HR, Aliakbarian M, Ferns GA, Avan A. The Therapeutic Potential of Targeting Key Signaling Pathways as a Novel Approach to Ameliorating Post-Surgical Adhesions. Curr Pharm Des 2022; 28:3592-3617. [PMID: 35466868 DOI: 10.2174/1381612828666220422090238] [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: 11/27/2021] [Revised: 01/24/2022] [Accepted: 02/04/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Peritoneal adhesions (PA) are a common complication of abdominal operations. A growing body of evidence shows that inhibition of inflammation and fibrosis at sites of peritoneal damaging could prevent the development of intra-abdominal adhesions. METHODS A search of PubMed, Medline, CINAHL and Embase databases was performed using the keywords 'postsurgical adhesion', 'post-operative adhesion', 'peritoneal adhesion', 'surgery-induced adhesion' and 'abdominal adhesion'. Studies detailing the use of pharmacological and non-pharmacological agents for peritoneal adhesion prevention were identified, and their bibliographies were thoroughly reviewed to identify further related articles. RESULTS Several signaling pathways, such as tumor necrosis factor-alpha, tissue plasminogen activator, and type 1 plasminogen activator inhibitor, macrophages, fibroblasts, and mesothelial cells play a key part in the development of plasminogen activator. Several therapeutic approaches based on anti-PA drug barriers and traditional herbal medicines have been developed to prevent and treat adhesion formation. In recent years, the most promising method to prevent PA is treatment using biomaterial-based barriers. CONCLUSION In this review, we provide an overview of the pathophysiology of adhesion formation and various agents targeting different pathways, including chemical agents, herbal agents, physical barriers, and clinical trials concerning this matter.
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Affiliation(s)
- Behzad Ensan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parsa Bathaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadreza Nassiri
- Recombinant Proteins Research Group, The Research Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Majid Khazaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Abdollahi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Reza Ghorbani
- Orology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Aliakbarian
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Postoperative peritoneal adhesion: an update on physiopathology and novel traditional herbal and modern medical therapeutics. Naunyn Schmiedebergs Arch Pharmacol 2020; 394:317-336. [PMID: 32979062 DOI: 10.1007/s00210-020-01961-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023]
Abstract
Postoperative peritoneal adhesion (PPA) is a serious clinical condition that affects the high percentage of patients after abdominal surgery. In this review, we have tried to focus on pathophysiology and different underlying signal pathways of adhesion formation based on recent progress in the molecular and cellular mechanisms. Also, the strategies, developed based on traditional herbal and modern medicines, to prevent and treat the PPA via regulation of the molecular mechanisms were investigated. The search engines such as Google Scholar, PubMed, Scopus, and Science Direct have been used to evaluate the current literature related to the pathogenesis of adhesion formation and novel products. Recently, different mechanisms have been defined for adhesion formation, mainly categorized in fibrin formation and adhesion fibroblast function, inflammation, and angiogenesis. Therefore, the suppression of these mechanisms via traditional and modern medicine has been suggested in several studies. While different strategies with encouraging findings have been developed, most of the studies showed contradictory results and were performed on animals. The herbal products have been introduced as safe and effective agent which can be considered in future preclinical and clinical studies. Although a wide range of therapeutics based on traditional and modern medicines have been suggested, there is no agreement in the efficacy of these methods to prevent or treat adhesion formation after surgeries. Further basic and clinical researches are still needed to propose the efficiency of recommended strategies for prevention and treatment of PPA.
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Peripheral serotonin regulates postoperative intra-abdominal adhesion formation in mice. Sci Rep 2017; 7:10001. [PMID: 28855642 PMCID: PMC5577130 DOI: 10.1038/s41598-017-10582-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/09/2017] [Indexed: 01/21/2023] Open
Abstract
The aim of the present study is to investigate the role and potential mechanisms of peripheral serotonin in postoperative intra-abdominal adhesion formation in mice. The caecum-rubbing operations were conducted for intra-abdominal adhesion formation modelling in wild-type and Tph1−/− mice. The deficiency of serotonin significantly decreased the adhesion scores, weight loss, and adhesion thickness as well as levels of collagen fibres and hydroxyproline in the adhesive tissues. The Tph1−/− mice exhibited a milder inflammatory response and oxidative stress in the adhesive tissues than did the wild-type mice. Moreover, the deficiency of serotonin reduced the levels of PAI-1 and fibrinogen, and raised the t-PA and t-PA/PAI levels in the peritoneal fluids. Moreover, the expressions of CD34, VEGF, TGF-β and 5-HT2B receptor in the adhesive tissues were significantly decreased in the Tph1−/− group mice. Furthermore, the Tph1−/− +5-HTP group showed more severe adhesions than did the Tph1−/− group mice, and the p-chlorophenylalanine (PCPA) could markedly alleviated the adhesion formation in the WT mice. In conclusion, the present study showed that peripheral serotonin regulated postoperative intra-abdominal adhesion formation by facilitating inflammation, oxidative stress, disorder of the fibrinolytic system, angiopoiesis and TGF-β1 expression via the 5-HT2B receptor in the adhesive tissues.
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Sandoval P, Jiménez-Heffernan JA, Guerra-Azcona G, Pérez-Lozano ML, Rynne-Vidal Á, Albar-Vizcaíno P, Gil-Vera F, Martín P, Coronado MJ, Barcena C, Dotor J, Majano PL, Peralta AA, López-Cabrera M. Mesothelial-to-mesenchymal transition in the pathogenesis of post-surgical peritoneal adhesions. J Pathol 2016; 239:48-59. [DOI: 10.1002/path.4695] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 12/30/2015] [Accepted: 01/26/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Pilar Sandoval
- Centro de Biología Molecular-Severo Ochoa; CSIC. Cantoblanco; Madrid Spain
| | - José A Jiménez-Heffernan
- Departamento de Anatomía Patológica; Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IP); Madrid Spain
| | | | | | - Ángela Rynne-Vidal
- Centro de Biología Molecular-Severo Ochoa; CSIC. Cantoblanco; Madrid Spain
| | - Patricia Albar-Vizcaíno
- Unidad de Biología Molecular y Servicio de Nefrología, Hospital Universitario La Princesa; Instituto de Investigación Sanitaria Princesa (IP); Madrid Spain
| | | | - Paloma Martín
- Departamento de Anatomía Patológica; Hospital Universitario Puerta de Hierro; Madrid Spain
| | - María José Coronado
- Unidad de Microscopía Confocal, Instituto de Investigación Sanitaria Hospital Puerta de Hierro; Madrid Spain
| | - Carmen Barcena
- Departamento de Anatomía Patológica, Hospital Universitario 12 de Octubre; Madrid Spain
| | | | - Pedro Lorenzo Majano
- Unidad de Biología Molecular y Servicio de Nefrología, Hospital Universitario La Princesa; Instituto de Investigación Sanitaria Princesa (IP); Madrid Spain
| | - Abelardo Aguilera Peralta
- Unidad de Biología Molecular y Servicio de Nefrología, Hospital Universitario La Princesa; Instituto de Investigación Sanitaria Princesa (IP); Madrid Spain
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Atilgan R, Kuloglu T, Ozkan ZS, Kavak SB, Kumbak B, Deveci D, Simsek M, Baspinar M, Sapmaz E. Evaluation of vitamin C and vitamin E for prevention of postoperative adhesion: A rat uterine horn model study. J Obstet Gynaecol Res 2014; 41:418-23. [DOI: 10.1111/jog.12544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/31/2014] [Indexed: 01/27/2023]
Affiliation(s)
- Remzi Atilgan
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Tuncay Kuloglu
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Zehra Sema Ozkan
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Salih Burcin Kavak
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Banu Kumbak
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Derya Deveci
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Mehmet Simsek
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Melike Baspinar
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Ekrem Sapmaz
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
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Inhibiting effect of electroacupuncture at zusanli on early inflammatory factor levels formed by postoperative abdominal adhesions. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:950326. [PMID: 25197314 PMCID: PMC4145794 DOI: 10.1155/2014/950326] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 07/27/2014] [Indexed: 11/17/2022]
Abstract
We observed the inhibitive effect of electroacupuncture (EA) at Zusanli on inflammatory mediators of postoperative intra-abdominal adhesions to find out the relationship between EA and the cholinergic anti-inflammatory pathway. Sixty-four rats were divided into 8 groups (A–H, each = 8): A = sham control; B = abdominal adhesions model; C = abdominal adhesions plus EA; D = sham acupoint control; E = abdominal adhesions plus vagotomy; F = abdominal adhesions plus EA after vagotomy; G = abdominal adhesions plus α-bungarotoxin (BGT); and H = abdominal adhesions plus EA after α-BGT. α-BGT (1 μg/kg) was injected into the abdominal cavity after surgery, and the bilateral celiac vagotomy was done during the surgery. On the third day the levels of inflammatory mediators (TNF-α, nitric oxide (NO), and nitric oxide synthase (NOS)) in tissues were evaluated. The abdominal adhesion groups developed obvious edema. Compared with sham control, the abdominal adhesion resulted in a significant elevation of inflammatory mediators. EA lowered the elevated levels of inflammatory mediators significantly; EA plus α-BGT and vagotomy showed less anti-inflammatory effects. The activation of the cholinergic anti-inflammatory pathway might be one of the mechanisms of EA at Zusanli acupoints to exert the anti-inflammatory effects.
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Kawanishi K, Yamato M, Sakiyama R, Okano T, Nitta K. Peritoneal cell sheets composed of mesothelial cells and fibroblasts prevent intra-abdominal adhesion formation in a rat model. J Tissue Eng Regen Med 2013; 10:855-866. [PMID: 24323675 DOI: 10.1002/term.1860] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 09/24/2013] [Accepted: 11/10/2013] [Indexed: 01/27/2023]
Abstract
Postoperative intra-abdominal adhesions remain an unsolved problem despite significant progress in the surgical procedures themselves. They often lead to small-bowel obstruction, chronic abdominal and pelvic pain, as well as female infertility. The loss of mesothelial cells and several components of the inflammatory system following injury to the peritoneum results in fibrin formation and angiogenesis. The remaining fibrin matrix and angiogenesis lead to replacement by fibroblasts and fibrous band formation. The aim of this study was to develop a new therapeutic method of preventing intra-abdominal adhesions. We fabricated transplantable peritoneal cell sheets from the rat peritoneum by cell sheet engineering using a temperature-responsive culture system. The peritoneal cell sheets developed were composed of an upper monolayer of mesothelial cells and underlying multilayered fibroblasts, similar to the peritoneum in vivo. Transplantation of peritoneal cell sheets prevented tissue adhesion, fibrin deposition and angiogenesis, and, moreover, lymphangiogenesis and macrophage infiltration in a rat caecum cauterization adhesion model. Copyright © 2013 John Wiley & Sons, Ltd.
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Affiliation(s)
- Kunio Kawanishi
- Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Masayuki Yamato
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryouichi Sakiyama
- Department of Clinical Engineering, Tokyo Women's Medical University, Tokyo, Japan
| | - Teruo Okano
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.
| | - Kosaku Nitta
- Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
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Moraloglu Ö, Işık H, Kılıç S, Şahin U, Çaydere M, Üstün H, Batıoglu S. Effect of bevacizumab on postoperative adhesion formation in a rat uterine horn adhesion model and the correlation with vascular endothelial growth factor and Ki-67 immunopositivity. Fertil Steril 2011; 95:2638-41. [DOI: 10.1016/j.fertnstert.2011.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 02/02/2011] [Accepted: 02/02/2011] [Indexed: 10/18/2022]
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Cilostazol and pentoxifylline decrease angiogenesis, inflammation, and fibrosis in sponge-induced intraperitoneal adhesion in mice. Life Sci 2009; 84:537-43. [DOI: 10.1016/j.lfs.2009.01.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 01/09/2009] [Accepted: 01/28/2009] [Indexed: 11/21/2022]
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Yuan J, Fang W, Ni Z, Dai H, Lin A, Cao L, Qian J. Peritoneal morphologic changes in a peritoneal dialysis rat model correlate with angiopoietin/Tie-2. Pediatr Nephrol 2009; 24:163-70. [PMID: 18751736 DOI: 10.1007/s00467-008-0944-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Revised: 06/18/2008] [Accepted: 06/20/2008] [Indexed: 10/21/2022]
Abstract
The angiopoietin/Tie-2 system plays an important role in the initiation of angiogenesis. However, the role of angiopoietin/Tie-2 in peritoneal angiogenesis and fibrosis is unclear. In our study we investigated the peritoneal morphologic changes in a uremic peritoneal dialysis (PD) rat model, focusing on the relationship between angiopoietin/Tie-2 and peritoneal angiogenesis. We subjected uremic (subtotal nephrectomy) rats to dialysis, using a standard PD solution, for 10 days, 28 days, or 56 days, and compared them with uremic rats that had not undergone dialysis and control rats. Functional [dialysate-to-plasma (D/P) creatinine; ultrafiltration (UF)] and structural (vessel density and thickness of the submesothelial extracellular matrix) changes of the peritoneum were quantified. Levels of angiopoietin (Ang)-1, Ang-2, Tie-2 and vascular endothelial growth factor (VEGF) were examined in the peritoneum by real-time quantitative polymerase chain reaction (PCR) and related to angiogenesis. The uremic group that had not undergone dialysis was characterized by increased vessel density in the peritoneum compared with that of the control, which correlated with decreased UF and increased D/P creatinine. Progressive angiogenesis and fibrosis were found in the PD groups when compared with the uremic non-dialyzed or control group, accompanied by an increased D/P creatinine that occurred in the PD group after 56 days, while UF decreased. Furthermore, Ang-2 and VEGF levels increased, while Tie-2 level decreased significantly in the uremic non-dialyzed group compare with the control. This tendency was more obvious in the PD groups than in the uremic non-dialyzed or control group, but no difference was found among the PD groups. Both VEGF and Ang-2 correlated positively with vessel density, while Tie-2 correlated negatively. We confirmed angiogenesis and fibrosis changes of the peritoneum as a result of uremic status and PD therapy in the uremic PD rat model. An increased level of Ang-2 and a reduced level of Tie-2 in conditions of uremia and PD therapy correlated with peritoneal angiogenesis and functional deterioration.
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Affiliation(s)
- Jiangzi Yuan
- Renal Division, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
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Kim S, Lee S, Greene AK, Arsenault DA, Le H, Meisel J, Novak K, Flynn E, Heymach JV, Puder M. Inhibition of Intra-Abdominal Adhesion Formation With the Angiogenesis Inhibitor Sunitinib. J Surg Res 2008; 149:115-9. [DOI: 10.1016/j.jss.2007.10.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 09/25/2007] [Accepted: 10/12/2007] [Indexed: 12/01/2022]
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Akyildiz H, Akcan A, Sozuer E, Kucuk C, Yilmaz N, Deniz K. The preventive effect of Met-RANTES on postoperative intraperitoneal adhesion formation in the rat model. Surgery 2008; 144:404-9. [PMID: 18707039 DOI: 10.1016/j.surg.2008.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Accepted: 04/16/2008] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chemokines are proinflammatory proteins that participate in immune and inflammatory responses through chemoattraction and leukocyte activation. The chemokine antagonist Met-RANTES (Regulated upon Activation Normal T cell Expressed and Secreted) has been shown to be efficacious in decreasing inflammation in several animal disease models. The purpose of this study was to investigate the effects of administration of Met-RANTES on intra-abdominal adhesion formation after abdominal operation. MATERIALS AND METHODS A 42 and 4-month-old female Wistar-Albino rats were subjected to standardized lesions by cauterization of the cecum and uterine horn. They were divided randomly into 3 groups containing 14 rats each: group 1 (control), operative procedure without further treatment; group 2 (Seprafilm), operative procedure with an antiadhesive membrane; 2 x 1 cm of Seprafilm was interposed beneath the peritoneal incision, and group 3 (Met-RANTES), operative procedure with the chemokine antagonist Met-RANTES. The extent and severity of adhesions at the operative site were evaluated. Light microscopic examination was performed to determine semiquantitative scores of VEGF expression. RESULTS Rats in the control group formed extensive adhesions. In comparison with the control group, the adhesion scores were significantly lower in the 2 other groups. The immunohistochemical grading scores of vascular endothelial growth factor correlated closely with the total adhesion scores and were less in groups 2 and 3 (P < .005). CONCLUSIONS Selective chemokine suppression with Met-RANTES seems to decrease rates, extent, and severity of postoperative intraperitoneal adhesions.
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Affiliation(s)
- Hizir Akyildiz
- Department of General Surgery, School of Medicine, Erciyes University, Kayseri, Turkey.
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15
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Seguimiento del comportamiento peritoneal de diferentes biomateriales empleando laparoscopia secuencial. Aplicabilidad en la reparación de hernias ventrales. Cir Esp 2007; 82:290-6. [DOI: 10.1016/s0009-739x(07)71727-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Numanoğlu V, Cihan A, Salman B, Uçan BH, Cakmak GK, Cesur A, Balbaloğlu H, Ilhan MN. Comparison between powdered gloves, powder-free gloves and hyaluronate/carboxymethylcellulose membrane on adhesion formation in a rat caecal serosal abrasion model. Asian J Surg 2007; 30:96-101. [PMID: 17475577 DOI: 10.1016/s1015-9584(09)60139-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Intraabdominal adhesion formation and prevention is one of the major conflicts of modern surgery. We aimed to determine the effects of powdered gloves versus powder-free gloves and hyaluronate/carboxymethylcellulose membrane (H/CMCm) in a rat caecal serosal abrasion model. METHODS Sixty wistar albino rats were subjected to a standardized lesion by caecal abrasion model. In group 1, the procedure was performed with sterile powdered gloves. In group 2, the procedure was performed with powder-free sterile gloves. The H/CMCm was applied directly to the abraded caecum in group 3. Formation of adhesions were determined on one half of the animals from each group on the 7th postoperative day, and on the other half on the 15th postoperative day. RESULTS There was a statistically significant difference between the adhesion scores on day 7 and 15 in groups 1 and 2 (p = 0.005, p = 0.007). There was no significant difference in adhesion scores on day 7 and 15 in group 3 (p = 0.145). The mean adhesion score was significantly higher in group 1 (powdered glove group) than group 2 (powder-free glove group) and group 3 (powder-free glove plus H/CMCm) on postoperative day 7 (p = 0.001). However, no significant difference was found between groups regarding adhesion scores on postoperative day 15 (p = 0.607). The comparisons of group 2 versus group 3, both on postoperative day 7 (p = 0.051) was not statistically significant, whereas a significant difference was detected between group 1 versus group 2 and group 3 on postoperative day 7 (p = 0.013, p = 0.001). CONCLUSION Our experiment shows that the use of powder-free gloves may be as beneficial as Seprafilm in preventing postoperative adhesion formation.
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Affiliation(s)
- Varim Numanoğlu
- Department of Pediatric Surgery, Medical Faculty of Zonguldak Karaelmas University, Zonguldak, Turkey
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Binda MM, Molinas CR, Bastidas A, Koninckx PR. Effect of reactive oxygen species scavengers, antiinflammatory drugs, and calcium-channel blockers on carbon dioxide pneumoperitoneum-enhanced adhesions in a laparoscopic mouse model. Surg Endosc 2007; 21:1826-34. [PMID: 17479336 DOI: 10.1007/s00464-007-9296-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Accepted: 01/17/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Postoperative adhesions are a clinical problem. They can cause female infertility, intestinal obstruction, chronic pelvic pain, and difficulties at the time of reoperation. A variety of approaches described to prevent adhesions have shown variable and inconsistent results. Therefore, this study aimed to evaluate most known substances in a laparoscopic mouse model to obtain quantitative and comprehensive information on adhesion prevention. Specifically, this first study aimed to investigate the effects of reactive oxygen species (ROS) scavengers, antiinflammatory agents, and a calcium-channel blocker on pneumoperitoneum-enhanced adhesions. METHODS Adhesions were induced during laparoscopy in BALB/c female mice by creation of a bipolar lesion. Carbon dioxide (CO2) pneumoperitoneum was maintained for 60 min using humidified CO2. Six experiments were conducted to evaluate the effects of ROS scavengers (superoxide dismutase [SOD], catalase, melatonin, and ascorbic acid), antiinflammatory agents (dexamethasone, tenoxicam, ibuprofen, parecoxib, nimesulide, anti-tumor necrosis factor [TNF]-alpha), and a calcium-channel blocker (diltiazem). Adhesions were scored after 7 days during laparotomy. RESULTS Adhesions were reduced by SOD (p < 0.01, proc general linear methods (GLM) of experiments 1 and 2), diltiazem (p = 0.05, Wilcoxon), and dexamethasone (p < 0.03), but not by nonsteroidal antiinflammatory drugs (NSAIDs) nor by anti-TNF-alpha. When all the experiments were grouped for analysis, adhesions also decreased with one and three doses of SOD (p < 0.01 and p < 0.01, respectively) and with one and three doses of ascorbic acid (p < 0.02 and p = 0.05, respectively). CONCLUSIONS These experiments confirm that SOD, diltiazem, and dexamethasone can decrease adhesion formation. The absence of effect from the other antiinflammatory drugs and anti-TNF-alpha is surprising.
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Affiliation(s)
- M M Binda
- Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Herestraat 49 Bus 611, B3000, Leuven, Belgium.
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Bellón JM, Rodríguez M, García-Honduvilla N, Pascual G, Buján J. Efficiency of 4% Icodextrin in Preventing Adhesions to Spiral Tacks Used to Fix Intraperitoneal Prostheses. Eur Surg Res 2006; 38:458-63. [PMID: 16912485 DOI: 10.1159/000095089] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2006] [Accepted: 06/23/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS This study was designed to evaluate the extent of adhesion formation to prostheses fixed with spiral tacks and to establish whether the use of Ringer's lactate or icodextrin could prevent these adhesions. METHODS 24 New Zealand white rabbits weighing around 3,000 g were implanted with a 7 x 5 cm patch of ePTFE (DualMesh) through a midline laparotomy. The prosthesis was fixed to the intact peritoneum using spiral tacks. Three study groups were established according to whether the animals were: implanted with ePTFE fixed with spiral tacks or implanted with ePTFE fixed with spiral tacks and simultaneously administered Ringer's lactate or 4% icodextrin in the peritoneal cavity. Adhesion formation and prosthetic behavior at the prosthesis/peritoneal interface were evaluated and quantified by sequential laparoscopy performed at 3, 7 and 14 days. RESULTS Adhesions generally formed on the tacks and were classified as the fully integrated type. No significant differences were observed in terms of the extent of adhesions or of neoperitoneal thickness between control animals and those receiving Ringer's lactate or icodextrin. CONCLUSIONS (a) Prosthesis-fixing tacks induced adhesions; (b) the use of substances such as icodextrin or Ringer's lactate does not seem to diminish adhesion formation, and (c) the use of icodextrin offered no benefits over that of Ringer's lactate solution.
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Affiliation(s)
- J M Bellón
- Department of Surgery, Faculty of Medicine, Alcalá University, Alcalá de Henares/Madrid, Spain.
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Zacharakis N, Tone P, Flordellis CS, Maragoudakis ME, Tsopanoglou NE. Methylene blue inhibits angiogenesis in chick chorioallontoic membrane through a nitric oxide-independent mechanism. J Cell Mol Med 2006; 10:493-8. [PMID: 16796814 PMCID: PMC3933136 DOI: 10.1111/j.1582-4934.2006.tb00414.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Angiogenesis is the process of generating new blood vessels from preexisting vessels and is considered essential in many pathological conditions. The purpose of the present study was to evaluate the effect of methylene blue in chick chorioallantoic membrane angiogenesis model in vivo. In this well characterized model, methylene blue inhibited angiogenesis in a concentration-dependent manner. In addition, when methylene blue was combined with sodium nitroprusside, a spontaneous generator of nitric oxide, an inhibition of angiogenesis was evident which was comparable with that observed by the application of methylene blue alone. Sodium nitroprusside, alone, caused a significant inhibition in basal angiogenesis. These results provide evidence that methylene blue inhibits angiogenesis independently of nitric oxide pathway and suggest that methylene blue may be useful for treating angiogenesis-dependent human diseases.
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Affiliation(s)
- N Zacharakis
- Department of Pharmacology, Medical School, University of PatrasGreece
| | - P Tone
- St. Vincent Catholic Medical Centers of New York, Staten Island DivisionNew York, USA
| | - CS Flordellis
- Department of Pharmacology, Medical School, University of PatrasGreece
| | - ME Maragoudakis
- Department of Pharmacology, Medical School, University of PatrasGreece
| | - NE Tsopanoglou
- Department of Pharmacology, Medical School, University of PatrasGreece
- * Correspondence to: Nikos E. TSOPANOGLOU Department of Pharmacology, Medical School, University of Patras, 26500 Patras, Greece. Tel: 0030-2610-996171 Fax: 0030-2610-994720 E-mail:
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Thaler K, Mack JA, Berho M, Grotendorst G, Wexner SD, Abramson SR. Coincidence of connective tissue growth factor expression with fibrosis and angiogenesis in postoperative peritoneal adhesion formation. Eur Surg Res 2006; 37:235-41. [PMID: 16260874 DOI: 10.1159/000087869] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2005] [Accepted: 05/23/2005] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate the relationship between connective tissue growth factor (CTGF) and fibrosis and angiogenesis in postoperative peritoneal adhesion formation. METHODS Adhesions were performed in 35 rats by creation of a peritoneal patch. Animals were sacrificed at 7 different time-points over 3 weeks. Adhesions and uninjured peritoneum from all animals were assessed by Northern blotting for CTGF and collagen-I mRNA and by immunohistochemistry for CTGF localization, degree of fibrosis and angiogenesis. RESULTS Persistent adhesions formed in all animals. CTGF and collagen-I mRNA were increased in adhesions compared to uninjured peritoneum (p < 0.05 for both). The temporal expression pattern depicted delayed peak levels of collagen-I mRNA with increasing tendency for both transcripts at the end of the observation period. Fibrosis within adhesions correlated positively with time after surgery (r = 0.85; p < 0.001) and showed typical signs of chronic tissue fibrosis at later time points. Angiogenesis was detected in adhesions but not in uninjured peritoneum (p = 0.001) and coincided with the spatial and temporal expression of CTGF protein in fibroblasts and vascular endothelial cells. CONCLUSIONS The co-expression of CTGF with increasing fibrosis and angiogenesis in postoperative peritoneal adhesions suggests a role for CTGF as critical molecule in fibrous adhesive disease and target for future adhesion prevention.
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Affiliation(s)
- K Thaler
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA
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Greene AK, Alwayn IPJ, Nose V, Flynn E, Sampson D, Zurakowski D, Folkman J, Puder M. Prevention of intra-abdominal adhesions using the antiangiogenic COX-2 inhibitor celecoxib. Ann Surg 2005; 242:140-6. [PMID: 15973112 PMCID: PMC1357715 DOI: 10.1097/01.sla.0000167847.53159.c1] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To determine the effects of COX-2 specific inhibitors on postoperative adhesion formation. SUMMARY AND BACKGROUND DATA Intra-abdominal adhesions are the major cause of intestinal obstruction and secondary infertility after surgical procedures. Because adhesion synthesis requires angiogenesis, and cyclooxygenase-2 enzyme (COX-2) inhibitors have antiendothelial activity, we tested COX-2 inhibitors in a murine model of intra-abdominal adhesion formation. METHODS A silicone patch was secured to the lateral abdominal wall of groups of C57BL/6 mice, followed by cecal abrasion to promote adhesion formation. Beginning on the day of surgery, mice were treated with the selective COX-2 agents, celecoxib or rofecoxib, and the nonspecific COX inhibitors, aspirin, naproxen, ibuprofen, or indomethacin. Animals were treated for 10 days and killed. A second group (celecoxib, rofecoxib, aspirin) was treated for 10 days and observed for an additional 25 days. After treatment, intra-abdominal adhesions were scored using a standard method. The patch was subjected to immunohistochemistry with the endothelial-specific marker, CD31. RESULTS Animals treated with selective and nonselective COX-2 inhibitors, except aspirin, had significantly fewer adhesions than control animals. Celecoxib produced a maximal reduction in adhesion formation compared with rofecoxib and the nonselective COX-2 inhibitors at 10 days. After 25 days, celecoxib and rofecoxib, but not aspirin, had fewer adhesions than control mice. Adhesions from mice treated with celecoxib had reduced microvessel density compared with rofecoxib, the nonselective COX inhibitors, and control animals. CONCLUSIONS Selective COX-2 inhibitors, in particular celecoxib, provide durable inhibition of intra-abdominal adhesions through an antiangiogenic mechanism.
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Affiliation(s)
- Arin K Greene
- Department of Surgery, Children's Hospital and Harvard Medical School, Boston, MA, USA
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Barreras biológicas contra las adherencias postoperatorias. Estudio experimental. Cir Esp 2004. [DOI: 10.1016/s0009-739x(04)72353-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Primary central nervous system tumors are infrequent lesions observed in both pediatric and adult patients that account for a disproportionate amount of cancer related morbidity and mortality. A significant number of advances in neurosurgical and radiation therapy techniques have occurred over the last few decades and yet only small improvements in long-term outcome have resulted. The major reason for this is the ability of these advances to minimize surgical or radiation morbidity on surrounding normal tissue rather than eradicating the microscopic infiltrating disease that remains after up-front standard therapy. As such, a great deal of effort has gone into adjuvant chemotherapy that might complement the standard surgical and radiation approaches. This paper will review the literature on anti-angiogenic therapies in central nervous system (CNS) tumor models and clinical disease, with a focus on anti-angiogenic chemotherapy (also referred to as metronomic or low-dose chemotherapy) and the utilization of this approach in conjunction with standard radiation and surgery. A number of excellent reviews covering related aspects of this topic are also available (1-13).
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Affiliation(s)
- Mark W Kieran
- Harvard Medical School, Pediatric Medical Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA
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Margetts PJ, Gyorffy S, Kolb M, Yu L, Hoff CM, Holmes CJ, Gauldie J. Antiangiogenic and antifibrotic gene therapy in a chronic infusion model of peritoneal dialysis in rats. J Am Soc Nephrol 2002; 13:721-728. [PMID: 11856777 DOI: 10.1681/asn.v133721] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
To identify the relative importance of peritoneal fibrosis and angiogenesis in peritoneal membrane dysfunction, adenoviral mediated gene transfer of angiostatin, a recognized angiogenesis inhibitor, and decorin, a transforming growth factor-beta-inhibiting proteoglycan, were used in a daily infusion model of peritoneal dialysis. A peritoneal catheter and subcutaneous port were inserted in rats. Five and fourteen d after insertion, adenovirus-expressing angiostatin, decorin, or AdDL70, a null control virus, were administered. Daily infusion of 4.25% Baxter Dianeal was initiated 7 d after catheter insertion and continued until day 35. Three initial doses of lipopolysaccharide were administered on days 8, 10, and 12 to promote an inflammatory response. Net ultrafiltration was used as a measure of membrane function, and peritoneum-associated vasculature and mesenteric collagen content was quantified. Ultrafiltration dysfunction, angiogenesis, and fibrosis were observed in daily infusion control animals. Animals treated with AdAngiostatin demonstrated an improvement in net ultrafiltration (-3.1 versus -7.8 ml for control animals; P = 0.0004) with a significant reduction in vessel density. AdDecorin-treated animals showed a reduction in mesenteric collagen content (1.8 versus 2.9 microg/mg; P = 0.04); however, AdDecorin treatment had no effect on net ultrafiltration. In a rodent model of peritoneal membrane failure, net ultrafiltration was significantly improved and peritoneal-associated blood vessels were significantly reduced by using adenovirus-mediated gene transfer of angiostatin. Decorin, a transforming growth factor-beta-inhibiting proteoglycan, reduced collagen content but did not affect net ultrafiltration. Improvement in the function of the peritoneum as a dialysis membrane after treatment with angiostatin has implications for treatment of peritoneal membrane dysfunction seen in patients on long-term dialysis.
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Affiliation(s)
- Peter J Margetts
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Steve Gyorffy
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Martin Kolb
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Lisa Yu
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Catherine M Hoff
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Clifford J Holmes
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Jack Gauldie
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
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Bond SJ, Klein SA. TNP-470 reduces collagen and macrophage accumulation in expanded polytetrafluoroethylene tube implants. J Surg Res 2001; 101:99-103. [PMID: 11676562 DOI: 10.1006/jsre.2001.6259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND TNP-470 is a potent angiogenic inhibitor that has been demonstrated to decrease the rate of cutaneous wound healing. This study investigated the effect that TNP-470 has upon collagen growth and macrophage infiltration into expanded polytetrafluoroethylene (e-PTFE) tube implants. METHODS e-PTFE tubes (1.0 cm in length) were implanted into the dorsum of male Swiss-Webster mice (8-10 weeks old). TNP-470 was administered subcutaneously in doses of 0.5, 1.0, or 5.0 mg/kg for determination of hydroxyproline accumulation on day 18 after implantation. Additionally, TNP-470 was administered at 5.0 mg/kg for determination of macrophage infiltration on days 4, 8, 13, and 18 after implantation. RESULTS Administration of TNP-470 at doses of 1.0 and 5.0 mg/kg on days 0, 2, and 4 significantly (P < 0.05) decreased hydroxyproline accumulation in e-PTFE implants on day 18 after implantation. Administration of 0.5 mg/kg of TNP-470 yielded no significant difference vs the vehicle control (P < 0.81). Additionally, administration of TNP-470 at 5.0 mg/kg on days 0, 2, and 4 significantly (P < 0.05) decreased macrophage infiltration into e-PTFE implants on day 4 after implantation. There was also a significantly (P < 0.05) increased percentage of macrophages in the e-PTFE implants on day 13 after wounding. No significant differences were observed between the experimental and control groups on days 8 and 18. CONCLUSIONS Administration of TNP-470 significantly decreases hydroxyproline accumulation in e-PTFE implants. These data suggest that while TNP-470 is administered, macrophage infiltration is impaired; however, upon discontinuing administration, macrophage infiltration increases. Possible mechanisms to account for these findings are discussed.
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Affiliation(s)
- S J Bond
- Department of Surgery, University of Louisville, Louisville, Kentucky 40292, USA.
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Kruger EA, Figg WD. TNP-470: an angiogenesis inhibitor in clinical development for cancer. Expert Opin Investig Drugs 2000; 9:1383-96. [PMID: 11060750 DOI: 10.1517/13543784.9.6.1383] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
TNP-470, an analogue of fumagillin, has been shown to inhibit angiogenesis in vitro and in vivo. In 1992, TNP-470 entered clinical development for cancer as an anti-angiogenic agent. It is currently in Phase I/II trials in Kaposi's sarcoma, renal cell carcinoma, brain cancer, breast cancer, cervical cancer and prostate cancer. In early clinical reports, TNP-470 is tolerated up to 177 mg/m(2) with neurotoxic effects (fatigue, vertigo, ataxia, and loss of concentration) being the principal dose limiting toxicity (DLT). Terminal half-life values are short and have shown intermittent and intrapatient variation (range: 0.05 - 1.07 h). Recently, mechanistic studies have identified cell cycle mediators and the protein methionine aminopeptidase-2 (MetAP-2) as molecular targets of TNP-470 and fumagillin. Animal studies confirm some toxic effects on normal angiogenic processes such as the female reproductive system and wound healing, which will require caution and close monitoring in the clinic. TNP-470 is one of the first anti-angiogenic compounds to enter clinical trials, making it a valuable prototype for future trials of angiogenesis inhibitors in oncology.
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Affiliation(s)
- E A Kruger
- National Cancer Institute/NIH, Medicine Branch, 9000 Rockville Pike, Bethesda, MD 20892, USA
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