A Randomized Controlled Trial on the Efficacy and Safety of a New Crosslinked Hyaluronan Gel in Reducing Adhesions after Gynecologic Laparoscopic Surgeries

Liu, Chongdong; Lü, Qing; Zhang, Zhiqiang; Xue, Min; Zhang, Youzhong; Zhang, Yi; Wang, Huilan; Li, Huajun; Zhou, Yingfang; Li, Wei; Zhai, Yixuan; Jiang, Ying; Sang, Cuiqin; Xiao, Songshu; Xiao, Fang; Ye, Mingzhu; Zhang, Airong; Jiang, Jie Ting; Wang, Guoyun; Yang, Xingsheng; Cui, B H; Lü, Qiu-bo; Meng, Qingwei; Zhang, Qinxia; Lu, Ye; Wang, Yang; Ofek, Gidon

doi:10.1016/j.jmig.2015.04.011

Cited by 35 publications

(17 citation statements)

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“…Hyaluronic acid (HA), either native or crosslinking modified, has been broadly used to prevent postoperative adhesion with varies level of successes [ 4 – 6 ]. HA is a non-sulfated glycosaminoglycan consisting of repeated disaccharide units (a-1,4-D-glucuronic acid and β-1,3- N -acetyl-D-glucosamine) and presents in all connective tissues as a major constituent of extracellular matrix.…”

Section: Introductionmentioning

confidence: 99%

Cross-linked hyaluronic acid gel inhibits metastasis and growth of gastric and hepatic cancer cells:in vitroandin vivostudies

Lan

Pang

et al. 2016

Oncotarget

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Cross-linked hyaluronic acid gel (CHAG) has been used to prevent postoperative adhesion of abdominal tumorectomy. However, its effect on tumor cells is still unknown. This paper was designed to investigate the effect of CHAG on metastasis and growth of tumor cells. Migration and invasion assays, Western blotting, pull down assay, siRNA interference, and nude mice implantation tumor model were applied in this study. The results of in vitro experiments with gastric cancer cell line AGS and hepatic cancer cell line HepG2 showed that CHAG inhibited the migration and invasion activities, the MAPK and PI3K/Akt mediated signaling, the activation of small G proteins Rac1 and RhoA, and the expression of MMPs and PCNA initiated by EGF, through blocking the activation of EGFR. CHAG also had inhibitory effect on activation of other membrane receptors, including integrin and VEGFR. When the expression of hyaluronic acid receptors (CD44 or RHAMM) was interfered, the above inhibitory effects of CHAG still existed. In vivo experimental results showed that CHAG suppressed colonization, growth and metastasis of gastric cancer cell line SGC-7901 in peritoneal cavity of nude mice. In conclusion, CHAG had inhibitory effect on tumor cells, through covering cell surface and blocking the interaction between extracellular stimulative factors and their receptors.

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Section: Introductionmentioning

confidence: 99%

Cross-linked hyaluronic acid gel inhibits metastasis and growth of gastric and hepatic cancer cells:in vitroandin vivostudies

Lan

Pang

et al. 2016

Oncotarget

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“…So, modification might be one of the effective ways to prolong the half-life of HA, such as crosslinking modification. In fact, CHAG applied in this paper had been reported to significantly reduce adhesion in abdominopelvic cavity after gynecological laparoscopic surgeries [ 12 , 34 ]. However, since there was no data elucidating the effect of CHAG on the cells of gynecologic tumor, it is still unclear whether CHAG is safe enough for preventing postoperative adhesion in pelvic surgery of this kind of tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical research showed that injection of hydrogel containing HA and chitosan could serve as an ideal barrier to prevent postoperative tissue adhesion [ 11 ]. A randomly-controlled trial reported that a new crosslinked gel (CHAG) was efficient and safe in reducing adhesions after gynecologic laparoscopic surgeries in clinical practice [ 12 ]. Additionally, absorbable auto-crosslinked hyaluronan gel could prevent intrauterine adhesion (IUA), decrease adhesion severity, and improve menopause postoperatively, indicating that this absorbable gel could be proposed as a barrier for preventing IUA after intrauterine procedures [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Cross-linked hyaluronan gel inhibits the growth and metastasis of ovarian carcinoma

et al. 2018

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BackgroundThe recurrence, metastasis and poor prognosis are important characteristics of ovarian carcinoma (OC), which are associated with exfoliation of cells from the primary tumor and colonization of the cells in pelvic cavity. On the other hand, the life quality of the patients undergoing surgical resection of OC was influenced by postoperative adhesions. Therefore, preventing postoperative implant tumor and adhesion may be effective methods to improve OC treatment. HyaRegen Gel, a cross-linked hyaluronan gel (CHAG), has been widely used as an anti-adhesive agent following pelvic operation in clinic. However, whether it can affect the implantation and growth of OC cells or not is still not clear.MethodsMigration and invasion assays were applied to detect the effect of CHAG on migration and invasion of OC cells. Western blotting was performed to detect the phosphorylation/activation of EGFR and ERK, and the expression of PCNA and MMP7. Pull down assay was used to analyze the effect of CHAG on the activation of small G protein Rac1. Nude mice implantation tumor model was applied to observe the effect of CHAG on implantation tumor of OC cells.ResultsThe results of in vitro experiments showed that CHAG suppressed both basic and EGF-induced migration and invasion of OC cells, blocked the activation of EGF-initiated EGFR activation, inhibited downstream signal transduction of EGFR, and decreased expression of proliferation and migration/invasion related proteins. Meanwhile, results of in vivo experiments showed that CHAG not only inhibited the formation of implantation tumor of OC cells but also delayed the of the growth of the tumors.ConclusionsCHAG inhibited migration, invasion and proliferation of OC cells in vitro, and suppressed development of implantation tumor of OC in vivo. This made it as both anti-tumor and anti-adhesion agents.Electronic supplementary materialThe online version of this article (10.1186/s13048-018-0394-z) contains supplementary material, which is available to authorized users.

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“…A new crosslinked hyaluronan gel was also evaluated for its ability to reduce postoperative adhesions in a randomized study comprising of 215 Chinese women who underwent surgical laparoscopy for the initial removal of existing endometrial lesions. The study found that use of the gel decreased the number and severity of post-operative adnexal and abdominopelvic adhesions in patients, thus potentially reducing the incidence of disease recurrence [ 60 ]. In this study, the authors propose that since hyaluron has a sufficiently long elimination half -life (metabolic clearance is slowed down by its ability to cross-link), it is able to persist within the body for the time window during which new adhesions are formed.…”

Section: Introductionmentioning

confidence: 99%

A review of the risk factors, genetics and treatment of endometriosis in Chinese women: a comparative update

Dai

Shi

et al. 2018

Reprod Health

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Endometriosis is one of the major causes of economic burden and compromised quality of life in a very large percentage of Asian women. While it is perceived as a benign condition, recent research has shown that it may be a significant cause of infertility and metastatic cancer. It has also been associated with other diseases linked to the functioning of the immune system. Genetic as well as environmental factors are known to affect the manifestation and progression of endometriosis. This review aims to summarize recent research pertaining to the risk factors, diagnosis and treatment of endometriosis in Chinese women. It also provides an overview of identified genetic mutations and polymorphisms and their effects on the risk of developing endometriosis in the Chinese population. A comparison has been drawn between Asian and European-American female populations and the differences in risk factors and treatment responses have been summarized. Since traditional Chinese medicine (TCM) is often used to treat endometriosis, wherever possible, a comparison between efficacies of Western medicine and TCM in the Chinese population has also been provided. Although much progress has been made in the treatment and resolution of endometriosis, several gaps remain and this review also highlights possible areas of future research and advancement that can result in an improvement in patient outcomes and quality of life.

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A Randomized Controlled Trial on the Efficacy and Safety of a New Crosslinked Hyaluronan Gel in Reducing Adhesions after Gynecologic Laparoscopic Surgeries

Cited by 35 publications

References 50 publications

Cross-linked hyaluronic acid gel inhibits metastasis and growth of gastric and hepatic cancer cells:in vitroandin vivostudies

Cross-linked hyaluronic acid gel inhibits metastasis and growth of gastric and hepatic cancer cells:in vitroandin vivostudies

Cross-linked hyaluronan gel inhibits the growth and metastasis of ovarian carcinoma

A review of the risk factors, genetics and treatment of endometriosis in Chinese women: a comparative update

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