Reduced human peritoneal plasminogen activating activity: Possible mechanism of adhesion formation

Thompson, J. N.; Paterson-Brown, Simon; Harbourne, T.; Whawell, Simon A.; Kalodiki, Evi; Dudley, H. A. F.

doi:10.1002/bjs.1800760422

Cited by 139 publications

(49 citation statements)

References 16 publications

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“…Although the administration of rtPA succeeded in reducing adhesion formation when studied in a rabbit model, continued research is needed to establish safety and effectiveness of rtPA use in human subjects. The evidence from clinical and animal trials suggests that all these approaches have had only limited success, impeded by lack of safety, efficacy, and many adverse effects without eliminating the problem of postoperative adhesion formation [6, 11, 68, 69, 70]. …”

Section: Pharmacological Adjuvant Therapymentioning

confidence: 99%

Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance

et al. 2001

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Aim: To summarize the most common etiologic factors and describe the pathophysiology in the formation of peritoneal adhesions, to outline their clinical significance and consequences, and to evaluate the pharmacologic, mechanical, and surgical adjuvant strategies to minimize peritoneal adhesion formation. Methods: We performed an extensive MEDLINE search of the internationally published English literature of all medical and epidemiological journal articles, textbooks, scientific reports, and scientific journals from 1940 to 1997. We also reviewed reference lists in all the articles retrieved in the search as well as those of major texts regarding intraperitoneal postsurgical adhesion formation. All sources identified were reviewed with particular attention to risk factors, pathophysiology, clinical manifestations, various methods, and innovative techniques for effectively and safely reducing the formation of postsurgical adhesions. Results: The formation of postoperative peritoneal adhesions is an important complication following gynecological and general abdominal surgery, leading to clinical and significant economical consequences. Adhesion occur in more than 90% of the patients following major abdominal surgery and in 55–100% of the women undergoing pelvic surgery. Small-bowel obstruction, infertility, chronic abdominal and pelvic pain, and difficult reoperative surgery are the most common consequences of peritoneal adhesions. Despite elaborate efforts to develop effective strategies to reduce or prevent adhesions, their formation remains a frequent occurrence after abdominal surgery. Conclusions: Until additional information and findings from future clinical investigations exist, only a meticulous surgical technique can be advocated in order to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery.

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Section: Pharmacological Adjuvant Therapymentioning

confidence: 99%

Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance

et al. 2001

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“…Fibrinous adhesions are responsible for a major fraction of intestinal obstructions. 50 Mesothelial cells are well known for their active fibrinoh/tic system, 15 but phagocytosis of fibrin as another defense mechanism against adhesion formation has not yet been described for mesothelial cells. In addition, this phagocytic and fibrinolytic activity may be beneficial if mesothelial cells are used for cell seeding procedures on vascular grafts.…”

Section: Discussionmentioning

confidence: 99%

“…Mesothelial cells from the peritoneum are closely related to endothelial cells and are easily harvested in high numbers from pieces of human omentum. 11 Mesothelial cells of animal origin produce prostacyclin, 12 -H have fibrinolytic activity, 15 and have been shown to support blood flow. 1617 We have carried out an investigation on the thrombogenicity and procoagulant activity of human mesothelial cells and its extracellular matrix under static as well as flow conditions.…”

Section: Espite the Significant Improvements In Pros-mentioning

confidence: 99%

Thrombogenicity and procoagulant activity of human mesothelial cells.

Pronk¹,

Groot²,

Papendrecht³

et al. 1992

Arterioscler Thromb

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Cell seeding may decrease the thrombogenicity of implanted vascular grafts, but its application is hampered by the limited availability of autologous endothelial cells. We studied the interaction of alternate cells, human peritoneal mesothelial cells, with whole blood in a flow chamber. When titrated blood was perfused over mesothelial cells, platelet adhesion was seen on the intercellular matrix but not on the cells themselves. Pet-fusions with blood anticoagulated with low-molecular-weight heparin resulted in fibrin formation at the surface of mesothelial cells but not at the surface of human umbilical venous endothelial cells. At shear rates of 200 sec~' fibrin deposition on the mesothelial cell surface increased during the first 5 minutes to 5.7 ±1.06 fi% fibrin per square centimeter, whereafter these values stabilized. The procoagulant activity of cultured mesothelial cells was higher than that of peritoneal membrane studied ex vivo. However, cultured mesothelial cells incubated with polyclonal antibodies against tissue factor showed a significant decrease in procoagulant activity. We conclude that human peritoneal mesothelial cells may be used for cell seeding procedures, provided that their tissue factor expression can be controlled. 1 One of the causes for the inferior performance of prosthetic vascular grafts is thought to be their failure to establish a blood flowsupporting cellular surface.2 After implantation of a graft the lumen may be reduced by deposition of proteinaceous material and aggregated platelets. Consequently, the blood flow drops and may reach a critical level at which occlusion via thrombosis occurs. 3Previous workers have succeeded in seeding endothelial cells on vascular prostheses and have claimed reduced thrombogenicity of the implanted grafts. 4 -5 One of the major problems of endothelial cell seeding, however, is the limited availability of human endothelial cells. With current techniques, the luminal surface area of a donor vein that is needed to effectively seed a graft approximates half the surface area of that graft.67 In most cases it is then better to use the donor vein directly as a vascular conduit rather than as a source of endoFrom the Departments of Haematology (P.G. de G., J.J.S.) and Surgery (A.P., TJ.M.V. van V.), University Hospital Utrecht, and the Departments of Surgery (A.P., A.A.G.M.H. van P., P.L.) and Microbiology (H.A.V.),

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“…Özellikle iskemi ve iltihaplanma durumlarında tPA aktivitesi normal iken, plazminojen aktivatör inhibitörlerinin (PAI) salını-mında artış görülür. Böylece fibrinolitik sistem aktivitesinin azalmasıyla fibrin matriksin lizise (parçalanabilmesi) uğrayabil-mesi için gerekli olan enzimler yeterince sentezlenemez [26,27].…”

Section: Periton Bölgesinde Fibrinolitik Sistem Yetersizliğiunclassified