Prevention of postoperative peritoneal adhesions: Effects of lysozyme, polylysine and polyglutamate versus hyaluronic acid

Nehéz, László; Vödrös, Dalma; Axelsson, Jakob; Tingstedt, Bobby; Lindman, Björn; Andersson, Roland

doi:10.1080/00365520510023332

Cited by 29 publications

(29 citation statements)

References 17 publications

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“…We have previously shown that the combination of poly-L-lysine and poly-L-glutamate significantly reduces adhesions in an experimental model on abdominal adhesions 12 . Results from the former study and other pilot studies (data not published)…”

Section: Discussionmentioning

confidence: 95%

“…If so, more poly-L-lysine molecules can adhere to the wound, resulting in an accumulation of the poly-L-lysine/poly-L-glutamate exclusively at the wound site. The poly-L-lysine/poly-L-glutamate amount could rapidly be taken up and digested by phagocytes 12 , although their carrier function in the process is less probable considering the rapid development of the protecting layer (within 1day). This idea is supported by our findings that no visible residual compound was located anywhere else over the surrounding peritoneum.…”

Section: Discussionmentioning

confidence: 99%

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Increasing anastomosis safety and preventing abdominal adhesion formation by the use of polypeptides in the rat

Tingstedt

Nehéz

Axelsson

et al. 2005

Int J Colorectal Dis

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Methods: An ileocolic anastomosis was performed under both "clean" and "septic"conditions in the rat. The treatment group received intraperitoneal poly-L-lysine and poly-Lglutamate while controls received sodium chloride. Abdominal adhesions, anastomosis leakage and burst pressure were analyzed after 1, 3, 5 and 7 days in the "clean" anastomosis model and after 7 days in the "septic" model.Results: A significant decrease (p<0.01) in the amount of adhesions was seen in animals treated with polypeptides after 1, 3, and 5 days, while no difference was seen after 7 days.The anastomosis demonstrated a significantly higher burst pressure as evaluated day 1 and 3 (p<0.05 and p<0.01, respectively) in the polypeptide treated animals while no difference was seen between the groups at days 5 or 7.Conclusion: The use of differently charged polypeptides administered intraperitoneal after surgery resulted in a significant decrease in the extent of postoperative adhesions.Furthermore, an increase in intestinal anastomosis safety, based on improved burst pressure during the first 3 days, i.e. the critical period during the healing process, was noted. No adverse effects were seen in surgery during "septic" conditions.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Increasing anastomosis safety and preventing abdominal adhesion formation by the use of polypeptides in the rat

Tingstedt

Nehéz

Axelsson

et al. 2005

Int J Colorectal Dis

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“…Previous studies have also shown no effect on local immunological functions, i.e. peritoneal macrophages, and a local clearance of this biodegradable matrix within 4 weeks [16,19]. The antiadhesive effect of the polypeptides is based on electrostatic binding between the strong cation poly-L-lysine and the negatively charged damaged peritoneum [29], and thereafter electrostatic bonds between the poly-L-lysine and the anion poly-L-glutamate create a mechanical barrier between damaged and adhesionprone peritoneal tissue.…”

Section: Discussionmentioning

confidence: 99%

“…The positively charged poly-L-lysine binds to the negatively charged damaged peritoneal surface and then attaches the negatively charged poly-Lglutamate to build a neutral matrix preventing adhesion formation [19]. In a recent study we questioned this combination due to the toxicity observed when the ani-mals were treated with α-poly-L-lysine alone [20].…”

Section: Introductionmentioning

confidence: 99%

Cationic polypeptides in a concept of oppositely charged polypeptides as prevention of postsurgical intraabdominal adhesions

Isaksson¹,

Åkerberg²,

Said³

et al. 2011

JBiSE

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Background: Two differently charged polypeptides, α-poly-L-lysine and poly-L-glutamate, have previously been shown to effectively reduce postoperative intraabdominal adhesions. Though α-poly-L-lysine showed toxicity in doses too close to the lowest therapeutic dose, the aim in the present study was to investigate the possible antiadhesive effect of another four cationic polypeptides. Materials/Methods: 125 mice were studied with a standardized and reproducible adhesion model and given epsilon poly-Llysine, lactoferrin, lysozyme and polyarginine respectively in a combination with poly-L-glutamate. Epsilon poly-L-lysine was also tested in different concentrations and as single treatment. Results: All four cationic polypeptides above showed a significantly better anti-adhesive effect than the controls receiving saline (p < 0.05). Epsilon poly-L-lysine had the best antiadhesive effect of the new substances tested in the experiment. Single treatment with the epsilon poly-Llysine showed toxic side effects. Discussion: We have shown that epsilon poly-L-lysine, polyarginine, lysozyme and lactoferrin, in descending order, all can reduce postoperative intraabdominal adhesions in mice when combined with poly-L-glutamate. There were side effects of epsilon poly-L-lysine resembling those of α-poly-L-lysine, although less toxic. The antiadhesive effect of epsilon poly-L-lysine did not reach the level of α-poly-L-lysine. Further studies will concentrate on additional investigation, trying to modify the α-poly-L-lysine to lower its toxicity. The less toxic epsilon poly-L-lysine also needs further attention in our research of antiadhesive bioactive polypeptides.

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“…Сочетание поли-L-лизин-поли-L-глутамат в экс-периментах предотвращает образование спаек с брюшиной без влияния на макрофаги, на прочность и герметичность анастомозов. В экспериментах вы-явлена также способность биоактивных полипепти-дов уменьшить кровотечение [4,21].…”

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Application of modern antiadhesive agents in surgery

Meshkova¹,

Bogdanov²,

Матвеев³

et al. 2015

Endosk. khir.

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В статье проанализированы основные методы, предложенные для предупреждения образования послеоперационных спаек. Наиболее высокий профилактический эффект дают средства для разобщения раневых поверхностей. Противо-спаечные барьеры защищают рану от механических повреждений и склеивания ее с соседними органами, оказывают благоприятное воздействие на репаративную регенерацию тканей. Перспективным методом профилактики образования послеоперационных спаек считается применение барьерных методов из ареактивных, биодеградирующих материалов. Соединения гиалуронидазы широко применяются как противоспаечные средства. Биосовместимые, абсорбируемые гелевые барьеры безопасны и эффективны. Поиски более эффективных противоспаечных компонентов и средств на уровне молекулярной биологии клеток продолжаются. Ключевые слова: спайки, противоспаечные барьеры.In the paper the analysis of the main methods proposed for the prevention of post-surgical adhesions is presented. Medications to isolate the wound surfaces provide the highest preventive effect. Antiadhesive agents protect the wound from mechanical damage and gluing it with adjacent organs, and have a beneficial effect on the reparative regeneration of tissue. A promising method for preventing the formation of post-surgical adhesions is the use of barrier methods of unresponsiveness, biodegradable materials. The compounds of hyaluronidase are widely used as antiadhesive agents. Biocompatible, absorbable gel barriers are safe and effective. The search for more effective antiadhesive components and tools at the level of molecular biology, cell is continued.

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Prevention of postoperative peritoneal adhesions: Effects of lysozyme, polylysine and polyglutamate versus hyaluronic acid

Cited by 29 publications

References 17 publications

Increasing anastomosis safety and preventing abdominal adhesion formation by the use of polypeptides in the rat

Increasing anastomosis safety and preventing abdominal adhesion formation by the use of polypeptides in the rat

Cationic polypeptides in a concept of oppositely charged polypeptides as prevention of postsurgical intraabdominal adhesions

Application of modern antiadhesive agents in surgery

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