Abstract:Alcohol supplementation substantially reduced postoperative pericardial adhesion formation, attenuated pericardial thickening, and reduced myocardial fibrosis in response to chronic ischemia. Alcohol supplementation modulates adhesion protein and MMP/tissue inhibitor of metalloproteinase expression, favoring a profile associated with reduced pericardial adhesions. These results suggest that the myocardium is the driving factor in reducing pericardial adhesions and mediating the postoperative healing process.
“…9 ), indicating that the PPMT membrane has an anti-fibroblast effect in vivo . Interestingly, the anti-adhesion effect of the PPMT membrane mainly occurred on its visceral layer, consistent with previous literature [ 59 ], indicating that fibroblasts or myofibroblasts from myocardium could be the dominant factors that drive pericardial adhesion formation [ [60] , [61] , [62] ]. Fig.…”
Pericardial barrier destruction, inflammatory cell infiltration, and fibrous tissue hyperplasia, trigger adhesions after cardiac surgery. There are few anti-adhesion materials that are both functional and sutureable for pericardial reconstruction. Besides, a few studies have reported on the mechanism of preventing pericardial adhesion. Herein, a functional barrier membrane with sutureability was developed via a modified electrospinning method. It was composed of poly(
l
-lactide-
co
-caprolactone) (PLCL) nanofibers, poly(vinyl alcohol) (PVA) aerogel, and melatonin, named PPMT. The PPMT had a special microstructure manifested as a staggered arrangement of nanofibers on the surface and a layered macroporous aerogel structure in a cross-section. Besides providing the porosity and hydrophilicity obtained from PVA, the structure also had suitable mechanical properties for stitching due to the addition of PLCL nanofibers. Furthermore, it inhibited the proliferation of fibroblasts by suppressing the activation of
Fas
and
P53
, and achieved anti-inflammatory effects by affecting the activity of inflammatory cells and reducing the release of pro-inflammatory factors, such as interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α). Finally,
in vivo
transplantation showed that it up-regulated the expression of matrix metalloproteinase-1 (MMP1) and tissue inhibitor of metalloproteinase-1 (TIMP1), and down-regulated the expression of Vinculin and transforming growth factor β (TGF-β) in the myocardium, thereby reducing the formation of adhesions. Collectively, these results demonstrate a great potential of PPMT membrane for practical application to anti-adhesion.
“…9 ), indicating that the PPMT membrane has an anti-fibroblast effect in vivo . Interestingly, the anti-adhesion effect of the PPMT membrane mainly occurred on its visceral layer, consistent with previous literature [ 59 ], indicating that fibroblasts or myofibroblasts from myocardium could be the dominant factors that drive pericardial adhesion formation [ [60] , [61] , [62] ]. Fig.…”
Pericardial barrier destruction, inflammatory cell infiltration, and fibrous tissue hyperplasia, trigger adhesions after cardiac surgery. There are few anti-adhesion materials that are both functional and sutureable for pericardial reconstruction. Besides, a few studies have reported on the mechanism of preventing pericardial adhesion. Herein, a functional barrier membrane with sutureability was developed via a modified electrospinning method. It was composed of poly(
l
-lactide-
co
-caprolactone) (PLCL) nanofibers, poly(vinyl alcohol) (PVA) aerogel, and melatonin, named PPMT. The PPMT had a special microstructure manifested as a staggered arrangement of nanofibers on the surface and a layered macroporous aerogel structure in a cross-section. Besides providing the porosity and hydrophilicity obtained from PVA, the structure also had suitable mechanical properties for stitching due to the addition of PLCL nanofibers. Furthermore, it inhibited the proliferation of fibroblasts by suppressing the activation of
Fas
and
P53
, and achieved anti-inflammatory effects by affecting the activity of inflammatory cells and reducing the release of pro-inflammatory factors, such as interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α). Finally,
in vivo
transplantation showed that it up-regulated the expression of matrix metalloproteinase-1 (MMP1) and tissue inhibitor of metalloproteinase-1 (TIMP1), and down-regulated the expression of Vinculin and transforming growth factor β (TGF-β) in the myocardium, thereby reducing the formation of adhesions. Collectively, these results demonstrate a great potential of PPMT membrane for practical application to anti-adhesion.
“…One study supplemented the diets of the subjects with alcohol and compared the effects with a sucrose-supplemented diet group. There was evidence of fewer adhesions, thinner pericardial thickness, and decreased intra-myocardial fibrosis in the alcohol group [192].…”
Section: Alcoholmentioning
confidence: 87%
“…Ethanol has been assessed in a porcine pericardial adhesion model [192,193]. One study supplemented the diets of the subjects with alcohol and compared the effects with a sucrose-supplemented diet group.…”
Post-operative adhesions affect patients undergoing all types of surgeries. They are associated with serious complications, including higher risk of morbidity and mortality. Given increased hospitalization, longer operative times, and longer length of hospital stay, post-surgical adhesions also pose a great financial burden. Although our knowledge of some of the underlying mechanisms driving adhesion formation has significantly improved over the past two decades, literature has yet to fully explain the pathogenesis and etiology of post-surgical adhesions. As a result, finding an ideal preventative strategy and leveraging appropriate tissue engineering strategies has proven to be difficult. Different products have been developed and enjoyed various levels of success along the translational tissue engineering research spectrum, but their clinical translation has been limited. Herein, we comprehensively review the agents and products that have been developed to mitigate post-operative adhesion formation. We also assess emerging strategies that aid in facilitating precision and personalized medicine to improve outcomes for patients and our healthcare system.
“…These changes in EtOH‐treated hiPSC‐CMs are consistent with observations from other in vitro and in vivo studies of chronic EtOH exposure (Table S12). In a swine model, the myocardium of EtOH‐treated animals had decreased expression of proadhesion proteins focal adhesion kinase, paxillin, integrin‐β1, and TGF‐beta compared with sucrose‐treated animals (Elmadhun et al, 2017). The impact of chronic EtOH exposure to actin cytoskeleton and ECM has also been documented in both cardiac cells (Fernandez‐Sola, 2020) and noncardiac cells such as hepatocytes (Shepard & Tuma, 2010).…”
Alcohol is the most consumed and highly addictive chemical substance, and chronic consumption of alcohol can lead to increased risk of health problems. According to the National Institute on Alcohol Abuse and Alcoholism, nearly one million people died from alcohol-related causes between 1999 and 2017, and in 2017 alcohol was involved with 2.6% of the ~2.8 million deaths in the United States (White et al., 2020). The impact of alcohol on human health is more prevalent on a global scale: in 2018, the World Health Organization reported that the harmful use of alcohol contributed to more than 5% of deaths worldwide per annum (World Health
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