Effects of dexamethasone on proliferation of autologous fibroblasts and on the immune profile in women undergoing pelvic surgery for infertility

Granat, Menachem; Schenker, Joseph G.; Mor-Yosef, Shlomo; E, Rosenkovitch; Castellanos, Raul Cano; Galili, Uri

doi:10.1016/s0015-0282(16)46816-0

Cited by 14 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, adverse events such as suppression of the pituitary-adrenal axis, immunosuppression and delayed wound healing have been reported with the use of corticosteroids (Granat et al, 1983;Harris and Daniell 1983;Risberg, 1997).…”

Section: Corticosteroids and Antihistaminesmentioning

confidence: 99%

Prevention of intra-peritoneal adhesions in gynaecological surgery: theory and evidence

Pados

Venetis

Almaloglou³

et al. 2010

Reproductive BioMedicine Online

View full text Add to dashboard Cite

Post-operative adhesions are a significant complication of all abdominal surgical procedures. The major strategies for adhesion prevention in gynaecological surgery are focused on the optimization of surgical technique and use of anti-adhesive agents, which fall into two main categories: pharmacological agents and barriers. Surgical technique that minimizes peritoneal trauma can reduce, but cannot prevent post-operative adhesion formation. Various local and systemic drugs that can alter the local inflammatory response, inhibit the coagulation cascade and promote fibrinolysis have been evaluated. Limited data support the administration of post-operative corticosteroids in addition to systemic intra-operative corticosteroids for the prevention of adhesions after gynaecological surgery. None of the remaining pharmacological agents have been found effective for the reduction of post-operative adhesions. Barriers are currently considered the most useful adjuncts, which may reduce adhesion formation. They act by separating the traumatized peritoneal surfaces during the healing period. The separation can be achieved by solid barriers or fluids. There is limited evidence from randomized clinical trials that support the beneficial effect of most of these barrier agents in the prevention of intra-peritoneal adhesions after gynaecological surgery. However, the evidence is not adequate for definite conclusions to be drawn and further research in this field is warranted.

show abstract

Section: Corticosteroids and Antihistaminesmentioning

confidence: 99%

Prevention of intra-peritoneal adhesions in gynaecological surgery: theory and evidence

Pados

Venetis

Almaloglou³

et al. 2010

Reproductive BioMedicine Online

View full text Add to dashboard Cite

show abstract

“…Previous studies showed reduced fibroblast and keratinocyte viability and metabolic activity with low doses of ZOL and up-regulation of apoptosis associated genes 11,29 . In contrast, DEX increased human fibroblast proliferation 30,31 .…”

Section: Discussionmentioning

confidence: 88%

Endothelial Progenitor Cells inhibit jaw osteonecrosis in a rat model: A major adverse effect of bisphosphonate therapy

Tamari

Elimelech

Cohen

et al. 2019

Sci Rep

View full text Add to dashboard Cite

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse effect of antiresorptive and antiangiogenic therapies. MRONJ is identified by chronic wounds in the oral mucosa associated with exposed necrotic bone. We hypothesized that zoledronic acid (ZOL) impairs keratinocyte and fibroblast function and reduces soft tissue vascularization; therefore, treating MRONJ with proangiogenic cells may benefit MRONJ patients. The effect of ZOL and dexamethasone (DEX) on gingival fibroblasts and keratinocytes was investigated. In-vitro, ZOL inhibited fibroblast and keratinocyte proliferation, delaying scratch healing. In-vivo, exposed bone was detected at tooth extraction sites, mainly in ZOL(+)/DEX(+) rats; and was associated with significantly decreased soft tissue vascularization, serum-VEGF, and tissue-VEGF. Local injection of early and late endothelial progenitor cells (EPCs) healed 13 of 14 MRONJ lesions compared with 2/7 lesions in the mesenchymal stem cells, and 2/6, in culture-medium group. The EPCs reduced necrotic bone area, increased serum and tissue VEGF levels. EPCs engraftment was minimal, suggesting their paracrine role in MRONJ healing. The EPC-conditioned medium improved scratch healing of keratinocytes and fibroblasts via VEGF pathway and elevated mRNA of VEGFA and collagen1A1. In conclusion, a novel MRONJ treatment with EPCs, increased vascularization and improved epithelial and fibroblast functions as well as cured the lesion.

show abstract

“…However, limited data suggest that the addition of postoperative steroids to systemic intra-operative steroids might be associated with a favourable outcome both in terms of adhesion score deterioration (increase) or improvement (reduction) [31]. On the other hand, adverse events such as suppression of the pituitaryadrenal axis, immunosuppression and delayed wound healing have been reported with the use of corticosteroids [19,32,33]. Regarding antihistamines, only one RCT has evaluated the role of oral promethazine in the prevention of adhesion formation after pelvic surgery.…”

Section: Corticosteroids and Antihistaminesmentioning

confidence: 99%

Adhesion Prevention Strategies in Laparoscopic Surgery

Pados¹,

Makedos²,

Tarlatzis³

2013

Endoscopy

View full text Add to dashboard Cite

Adhesions are defined as abnormal attachments between tissues and organs [ ]. Intra-abdominal adhesions may be classified as congenital or acquired [ ]. Congenital adhesions are a consequence of embryological anomaly in the development of the peritoneal cavity. Acquired adhesions result from the inflammatory response of the peritoneum that arises after intra-abdominal inflammatory processes e.g. acute appendicitis, pelvic inflammatory disease, exposure to intestinal contents and previous use of intrauterine contraceptive devices , radiation and surgical trauma [ ]. It has been reported that the majority of acquired adhesions about % are post-surgical [ ].Factors associated with the formation of post-surgical adhesions include tissue trauma, infection, ischaemia,reaction to foreign bodies sutures, powder from gloves, gauze particles etc. , haemorrhage, tissue overheating or desiccation and exposure to irrigation fluids [ ]. The incidence of intra-abdominal adhesions ranges from % to % after general surgical abdominal operations and from % to % after gynecological procedures. Not unexpectedly, adhesion formation is considered one of the most common post-operative complications [ , ]. Post-surgically, many adhesions may be asymptomatic or can lead to a broad spectrum of clinical problems, including intestinal obstruction, chronic pelvic or abdominal pain and female infertility, requiring re-admission and often additional surgery, while at the same time they can complicate future surgical procedures [ ]. Adhesion-related re-operations are a common consequence of gynecological procedures and adhesiolysis is followed by a high incidence of adhesion reformation and de-novo adhesion formation [ ].The major strategies for adhesion prevention in gynecological surgery aim at the optimization of surgical technique and use of adhesion-prevention agents. Laparoscopic surgery in gynecology represents the most innovative surgical approach, compared with laparotomy since it has been shown from a large number of clinical, but also experimental studies, that is associated with less development of de novo adhesions. Without any doubt, the most important factor is the operating surgeon, whose attention to proper surgical technique will serve as a mainstay for adhesion formation.

show abstract

Effects of dexamethasone on proliferation of autologous fibroblasts and on the immune profile in women undergoing pelvic surgery for infertility

Cited by 14 publications

References 14 publications

Prevention of intra-peritoneal adhesions in gynaecological surgery: theory and evidence

Prevention of intra-peritoneal adhesions in gynaecological surgery: theory and evidence

Endothelial Progenitor Cells inhibit jaw osteonecrosis in a rat model: A major adverse effect of bisphosphonate therapy

Adhesion Prevention Strategies in Laparoscopic Surgery

Contact Info

Product

Resources

About