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2000
Volume 32, Issue 6
  • ISSN: 1381-6128
  • E-ISSN: 1873-4286

Abstract

Objective

Despite recent advances in surgical procedures, postoperative peritoneal adhesions are common following major abdominopelvic surgery. Here, the therapeutic potential of (PGP) on postoperative peritoneal adhesions has been explored in a rat uterine horn adhesion model.

Methods

Eighteen Albino Wistar female rats were divided into three groups: control group, sham, and treatment group receiving 400 mg/kg/day PGP orally for ten days. An identical surgical technique was employed to induce adhesion of the uterine horn in both the control and treatment groups. At the end of the experiments, all rats were re-operated for evaluation of adhesion. The macroscopic evaluation and fibrotic bands scaling were conducted and inflammation and fibrosis were assessed and graded, microscopically. Additionally, the effect of PGP on inflammation and fibrosis was assessed PCR, ELISA, and histopathology.

Results

PGP could significantly reduce the peritoneal adhesion score (treatment group . control group; <0.001). Histopathological analysis indicated that PGP prevented adhesion formation by suppressing inflammation and fibrosis. Moreover, inflammatory and fibrosis biomarkers were decreased following PGP treatment. Furthermore, rats in the treatment group had significantly lower oxidative stress markers in adhesion tissues when compared to the control group.

Conclusion

Oral PGP was associated with reduced peritoneal adhesion formation in rats, postoperatively. This therapy might be an effective and safe strategy for preventing intraperitoneal adhesion after abdominopelvic surgeries.

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References

  1. KrämerB. NeisF. BruckerS. KommossS. AndressJ. HoffmannS. Peritoneal adhesions and their prevention - current trends.Surg. Technol. Int.2021382213310.52198/21.STI.38.HR138533503674
    [Google Scholar]
  2. OkabayashiK. AshrafianH. ZacharakisE. HasegawaH. KitagawaY. AthanasiouT. DarziA. Adhesions after abdominal surgery: A systematic review of the incidence, distribution and severity.Surg. Today201444340542010.1007/s00595‑013‑0591‑823657643
    [Google Scholar]
  3. MorisD. ChakedisJ. Rahnemai-AzarA.A. WilsonA. HennessyM.M. AthanasiouA. BealE.W. ArgyrouC. FelekourasE. PawlikT.M. Postoperative abdominal adhesions: Clinical significance and advances in prevention and management.J. Gastrointest. Surg.201721101713172210.1007/s11605‑017‑3488‑928685387
    [Google Scholar]
  4. LiuB. ZhangQ. WuX. FuY. WangH. GuanY. YangS. LiuY. CaoW. WangJ. Effect of Bletilla striata on the prevention of postoperative peritoneal adhesions in abrasion-induced rat model.Evid. Based Complement. Alternat. Med.2019201911010.1155/2019/914875431281407
    [Google Scholar]
  5. ZafariN. VelayatiM. FahimM. MaftouhM. PouraliG. KhazaeiM. NassiriM. HassanianS.M. Ghayour-MobarhanM. FernsG.A. KianiM.A. AvanA. Role of gut bacterial and non-bacterial microbiota in alcohol-associated liver disease: Molecular mechanisms, biomarkers, and therapeutic prospective.Life Sci.202230512076010.1016/j.lfs.2022.12076035787997
    [Google Scholar]
  6. HuQ. XiaX. KangX. SongP. LiuZ. WangM. GuanW. LiuS. LiuS. A review of physiological and cellular mechanisms underlying fibrotic postoperative adhesion.Int. J. Biol. Sci.202117129830610.7150/ijbs.5440333390851
    [Google Scholar]
  7. HassanabadAF ZarzyckiAN JeonK DenisetJF FedakPWM Post-operative adhesions: A comprehensive review of mechanisms.Biomedicines20219886710.3390/biomedicines908086734440071
    [Google Scholar]
  8. SaedG.M. ZhangW. DiamondM.P. Molecular characterization of fibroblasts isolated from human peritoneum and adhesions.Fertil. Steril.200175476376810.1016/S0015‑0282(00)01799‑411287032
    [Google Scholar]
  9. EghbaliS. AskariS.F. AvanR. SahebkarA. Therapeutic effects of Punica granatum (Pomegranate): An updated review of clinical trials.J. Nutr. Metab.2021202112210.1155/2021/529716234796029
    [Google Scholar]
  10. MahmoudiehM. KeleidariB. EsfahaniFN ZolfaghariB. MelaliH. Davarpanah JaziA.H. MehdinezhadN. MokhtariM. The effect of Punica granatum L. flower extract on post-surgical peritoneal adhesions in a rat model.Eur. J. Obstet. Gynecol. Reprod. Biol.202024611311610.1016/j.ejogrb.2019.12.03432004879
    [Google Scholar]
  11. Sedigh-RahimabadiM. FaniM. Rostami-chijanM. ZarshenasM.M. ShamsM. A traditional mouthwash (Punica granatum var pleniflora) for controlling gingivitis of diabetic patients.J. Evid. Based Complementary Altern. Med.2017221596710.1177/215658721663337026922436
    [Google Scholar]
  12. HamidiS.P. Koohi-HosseinabadiO. KhaksarS. GhanbariasadA. DehghanianA.R. DehghanA. HaddadiZ. GorginR. FarjamM. AlipanahH. Evaluation of the topical gel and oral administration of Punica granatum Var pleniflora on oral mucositis induced by 5-fluorouracil in golden hamsters.BMC Complementary Med Ther202323122510.1186/s12906‑023‑04053‑137420236
    [Google Scholar]
  13. LiJ. YinW. LiangY. YangZ. LiL. MaiZ. YuX. LuY. ZhangZ. AbulaS. WuY. WusimanA. GuoQ. Pomegranate flower polysaccharide improves mastitis in mice by regulating intestinal flora and restoring the blood-milk barrier.Front. Pharmacol.202415142735510.3389/fphar.2024.142735539211783
    [Google Scholar]
  14. HemadehO. ChilukuriS. BonetV. HusseinS. ChaudryI.H. Prevention of peritoneal adhesions by administration of sodium carboxymethyl cellulose and oral vitamin E.Surgery199311459079108236013
    [Google Scholar]
  15. LeachR.E. BurnsJ.W. DaweE.J. SmithBarbourM.D. DiamondM.P. Reduction of postsurgical adhesion formation in the rabbit uterine horn model with use of hyaluronate/carboxymethylcellulose gel.Fertil. Steril.199869341541810.1016/S0015‑0282(97)00573‑69531869
    [Google Scholar]
  16. SwolinK. Experimental studies on the prevention of intra-abdominal adhesions. Studies on rats with an emulsion of lipid and prednisolone.Acta Obstet. Gynecol. Scand.196645447349810.3109/000163466091584646005951
    [Google Scholar]
  17. GiustoG. VercelliC. IussichS. AudisioA. MorelloE. OdoreR. GandiniM. A pectin-honey hydrogel prevents postoperative intraperitoneal adhesions in a rat model.BMC Vet. Res.20161315510.1186/s12917‑017‑0965‑z28212637
    [Google Scholar]
  18. BavaS.V. PuliappadambaV.T. DeeptiA. NairA. KarunagaranD. AntoR.J. Sensitization of taxol-induced apoptosis by curcumin involves down-regulation of nuclear factor-kappaB and the serine/threonine kinase Akt and is independent of tubulin polymerization.J. Biol. Chem.200528086301630810.1074/jbc.M41064720015590651
    [Google Scholar]
  19. KavicS.M. KavicS.M. Adhesions and adhesiolysis: the role of laparoscopy.JSLS2002629910912113430
    [Google Scholar]
  20. ZafariN. BathaeiP. VelayatiM. Khojasteh-LeylakoohiF. KhazaeiM. FiujiH. NassiriM. HassanianS.M. FernsG.A. NazariE. AvanA. Integrated analysis of multi-omics data for the discovery of biomarkers and therapeutic targets for colorectal cancer.Comput. Biol. Med.202315510663910.1016/j.compbiomed.2023.10663936805214
    [Google Scholar]
  21. GaoQ. WeiG. WuY. YaoN. ZhouC. WangK. WangK. SunX. LiX. Paeoniflorin prevents postoperative peritoneal adhesion formation in an experimental rat model.Oncotarget2017855938999391110.18632/oncotarget.2133329212197
    [Google Scholar]
  22. WeiG. WuY. GaoQ. ZhouC. WangK. ShenC. WangG. WangK. SunX. LiX. Effect of emodin on preventing postoperative intra-abdominal adhesion formation.Oxid. Med. Cell. Longev.201720171174031710.1155/2017/174031728831292
    [Google Scholar]
  23. ChiorescuS. AndercouO.A. GradN.O. MironiucI.A. Intraperitoneal administration of rosuvastatin prevents postoperative peritoneal adhesions by decreasing the release of tumor necrosis factor.Clujul Med.2018911798429440955
    [Google Scholar]
  24. De WildeR.L. DevassyR. BroekR.P.G. MillerC.E. AdlanA. AquinoP. BeckerS. DarmawanF. GergoletM. HabanaM.A.E. KhooC.K. KoninckxP.R. KorellM. KrentelH. MusigavongO. PistofidisG. PuntambekarS. RachmanI.A. SendagF. WallwienerM. Torres-de la RocheL.A. The future of adhesion prophylaxis trials in abdominal surgery: An expert global consensus.J. Clin. Med.2022116147610.3390/jcm1106147635329802
    [Google Scholar]
  25. ZafariN. VelayatiM. MaftoohM. KhazaeiM. NassiriM. HassanianS.M. Ghayour-MobarhanM. FernsG.A. AvanA. Mechanism-based pharmacological management of chemotherapy-induced neuropathic pain from preclinical studies to clinical prospective: Platinum-based drugs, taxanes, and vinca alkaloids.Curr. Pharm. Des.202329161245126510.2174/138161282966623051512404437190803
    [Google Scholar]
  26. MahboubiA. AsgarpanahJ. SadaghiyaniP.N. FaiziM. Total phenolic and flavonoid content and antibacterial activity of Punica granatum L. var. pleniflora flowers (Golnar) against bacterial strains causing foodborne diseases.BMC Complement. Altern. Med.201515136610.1186/s12906‑015‑0887‑x26470879
    [Google Scholar]
  27. GavanjiS. LarkiB. BakhtariA. The effect of extract of Punica granatum var. pleniflora for treatment of minor recurrent aphthous stomatitis.Integr. Med. Res.201432839010.1016/j.imr.2014.03.00128664082
    [Google Scholar]
  28. RupashriS.V. SelvaganeshS. EahwaramoorthyR. NesappanT. Herbal formulation of high phenols and flavonoids with the extract of Phyllanthus emblica, punica granatum, and Illicium verum and assessment of hematotoxicity assay: An in vitro study.Ann. Afr. Med.202423343744210.4103/aam.aam_164_2339034570
    [Google Scholar]
  29. LaurindoL.F. RodriguesV.D. MinnitiG. de CarvalhoA.C.A. ZutinT.L.M. DeLibertoL.K. BishayeeA. BarbalhoS.M. Pomegranate (Punica granatum L.) phytochemicals target the components of metabolic syndrome.J. Nutr. Biochem.202413110967010.1016/j.jnutbio.2024.10967038768871
    [Google Scholar]
  30. ÖkmenG. GiannettoD. FazioF. ArslanK. Investigation of Pomegranate (Punica granatum L.) Flowers’ antioxidant properties and antibacterial activities against different Staphylococcus species associated with bovine mastitis.Vet. Sci.202310639410.3390/vetsci1006039437368780
    [Google Scholar]
  31. GholamalizadehH. ZafariN. VelayatiM. FiujiH. MaftoohM. GhorbaniE. HassanianS.M. KhazaeiM. FernsG.A. NazariE. AvanA. Prognostic value of primary tumor location in colorectal cancer: an updated meta-analysis.Clin. Exp. Med.20232384369438310.1007/s10238‑023‑01120‑237405571
    [Google Scholar]
  32. GigliobiancoM.R. CorteseM. NanniniS. Di NicolantonioL. PeregrinaD.V. LupidiG. VitaliL.A. BocchiettoE. Di MartinoP. CensiR. Chemical, antioxidant, and antimicrobial properties of the peel and male flower by-products of four varieties of Punica granatum L. cultivated in the marche region for their use in cosmetic products.Antioxidants202211476810.3390/antiox1104076835453453
    [Google Scholar]
  33. CheongY.C. SheltonJ.B. LairdS.M. RichmondM. KudesiaG. LiT.C. LedgerW.L. IL-1, IL-6 and TNF-alpha concentrations in the peritoneal fluid of women with pelvic adhesions.Hum. Reprod.2002171697510.1093/humrep/17.1.6911756364
    [Google Scholar]
  34. SoltanyS. Postoperative peritoneal adhesion: an update on physiopathology and novel traditional herbal and modern medical therapeutics.Naunyn Schmiedebergs Arch. Pharmacol.2021394231733610.1007/s00210‑020‑01961‑832979062
    [Google Scholar]
  35. Rodrigues-DíezR. AroeiraL.S. OrejudoM. BajoM.A. HeffernanJ.J. Rodrigues-DíezR.R. Rayego-MateosS. OrtizA. Gonzalez-MateoG. López-CabreraM. SelgasR. EgidoJ. Ruiz-OrtegaM. IL-17A is a novel player in dialysis-induced peritoneal damage.Kidney Int.201486230331510.1038/ki.2014.3324552849
    [Google Scholar]
  36. HolmdahlL. ErikssonE. Al-JabreenM. RisbergB. Fibrinolysis in human peritoneum during operation.Surgery1996119670170510.1016/S0039‑6060(96)80196‑68650612
    [Google Scholar]
  37. RoutU.K. SaedG.M. DiamondM.P. Transforming growth factor-β1 modulates expression of adhesion and cytoskeletal proteins in human peritoneal fibroblasts.Fertil. Steril.200278115416110.1016/S0015‑0282(02)03176‑X12095506
    [Google Scholar]
  38. CheginiN. TGF-beta system: the principal profibrotic mediator of peritoneal adhesion formation.Semin. Reprod. Med.200826429831210.1055/s‑0028‑108238818756407
    [Google Scholar]
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