Standardised pomegranate peel extract lavage prevents postoperative peritoneal adhesion by regulating TGF-β and VEGF levels

Ghadiri, Mobarakeh; Rahimi, Vafa Baradaran; Moradi, Elham; Hasanpour, Maede; Clark, Cain C. T.; Iranshahi, Mehrdad; Rakhshandeh, Hassan; Askari, Vahid Reza

doi:10.1007/s10787-021-00819-6

Cited by 34 publications

(48 citation statements)

References 39 publications

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“…Numerous models have been suggested to evaluate postoperative peritoneal adhesion, including uterine horn damage, bacterial infection, and scarping model [ 47 , 48 ]. In the current study, we used the scraping model due to the most similarity between the adhesion development by this model and abdominopelvic surgery [ 49 , 50 ]. Furthermore, we scored the adhesions from zero to four using the Nair et al and adhesion scheme scoring methods [ 25 , 32 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, we used the scraping model due to the most similarity between the adhesion development by this model and abdominopelvic surgery [ 49 , 50 ]. Furthermore, we scored the adhesions from zero to four using the Nair et al and adhesion scheme scoring methods [ 25 , 32 , 50 ]. Our macroscopic data revealed that the adhesion score was significantly increased in the control group, while C. sativus (0.25 and 0.5% w / v ) concentration-dependently reduced the adhesion formation following postoperational-induced peritoneal adhesion in the rat.…”

Section: Discussionmentioning

confidence: 99%

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Intraperitoneal Lavage with Crocus sativus Prevents Postoperative‐Induced Peritoneal Adhesion in a Rat Model: Evidence from Animal and Cellular Studies

Rahmanian-Devin

Rakhshandeh

Rahimi

et al. 2021

Oxidative Medicine and Cellular Longevity

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Postoperative peritoneal adhesions are considered the major complication following abdominal surgeries. The primary clinical complications of peritoneal adhesion are intestinal obstruction, infertility, pelvic pain, and postoperative mortality. In this study, regarding the anti-inflammatory and antioxidant activities of Crocus sativus, we aimed to evaluate the effects of Crocus sativus on the prevention of postsurgical-induced peritoneal adhesion. Male Wistar-Albino rats were used to investigate the preventive effects of C. sativus extract (0.5%, 0.25% and 0.125% w / v ) against postsurgical-induced peritoneal adhesion compared to pirfenidone (PFD, 7.5% w / v ). We also investigated the protective effects of PFD (100 μg/ml) and C. sativus extract (100, 200, and 400 μg/ml) in TGF-β1-induced fibrotic macrophage polarization. The levels of cell proliferation and oxidative, antioxidative, inflammatory and anti-inflammatory, fibrosis, and angiogenesis biomarkers were evaluated both in vivo and in vitro models. C. sativus extract ameliorates postoperational-induced peritoneal adhesion development by attenuating oxidative stress [malondialdehyde (MDA)]; inflammatory mediators [interleukin- (IL-) 6, tumour necrosis factor- (TNF-) α, and prostaglandin E2 (PGE2)]; fibrosis [transforming growth factor- (TGF-) β1, IL-4, and plasminogen activator inhibitor (PAI)]; and angiogenesis [vascular endothelial growth factor (VEGF)] markers, while propagating antioxidant [glutathione (GSH)], anti-inflammatory (IL-10), and fibrinolytic [tissue plasminogen activator (tPA)] markers and tPA/PAI ratio. In a cellular model, we revealed that the extract, without any toxicity, regulated the levels of cell proliferation and inflammatory (TNF-α), angiogenesis (VEGF), anti-inflammatory (IL-10), M1 [inducible nitric oxide synthase (iNOS)] and M2 [arginase-1 (Arg 1)] biomarkers, and iNOS/Arg-1 ratio towards antifibrotic M1 phenotype of macrophage, in a concentration-dependent manner. Taken together, the current study indicated that C. sativus reduces peritoneal adhesion formation by modulating the macrophage polarization from M2 towards M1 cells.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intraperitoneal Lavage with Crocus sativus Prevents Postoperative‐Induced Peritoneal Adhesion in a Rat Model: Evidence from Animal and Cellular Studies

Rahmanian-Devin

Rakhshandeh

Rahimi

et al. 2021

Oxidative Medicine and Cellular Longevity

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“…4.0. After that, this area was disinfected with a few drops of chloramphenicol [ 31 – 33 ]. At the end of the surgery, the rats received cefazolin 300 mg/kg (i.m.)…”

Section: Methodsmentioning

confidence: 99%

“…According to the manufacturer's instruction, as indices of inflammation, the levels of TNF- α , IL-1 β , and IL-6 were measured in peritoneal lavage fluid using ELISA kits [ 37 , 38 ]. In addition, the levels of VEGF, as an angiogenesis marker, TGF- β , as a fibrosis factor, and IL-10, as an anti-inflammatory and suppressive cytokine, were also measured in the peritoneal fluid sample by ELISA kits according to the manufacturer's instruction [ 31 , 39 ].…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of the Therapeutic Effects of the Hydroethanolic Extract of Portulaca oleracea on Surgical-Induced Peritoneal Adhesion

Jaafari

Rahimi

Vahdati-Mashhadian

et al. 2021

Mediators of Inflammation

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Objective. Peritoneal adhesion (PA) is an abnormal connective tissue that usually occurs between tissues adjacent to damaged organs during processes such as surgery. In this study, the anti-inflammatory and antioxidant effects of Portulaca oleracea (PO) were investigated against postoperative-induced peritoneal adhesion. Methods. Thirty healthy male Wistar rats ( 220 ± 20 g , 6-8 weeks) were randomly divided into four groups: (1) normal, (2) control (induced peritoneal adhesion), and (3) and (4) PO extracts (induced peritoneal adhesion and received 100 or 300 mg/kg/day of PO extract for seven days). Finally, macroscopic and microscopic examinations were performed using different scoring systems and immunoassays in the peritoneal lavage fluid. Results. We found that the levels of adhesion scores and interleukin- (IL-) 1β, IL-6, IL-10, tumour necrosis factor- (TNF-) α, transforming growth factor- (TGF-) β1, vascular endothelial growth factor (VEGF), and malondialdehyde (MDA) were increased in the control group. However, PO extract (100 and 300 mg/kg) notably reduced inflammatory (IL-1β, IL-6, and TNF-α), fibrosis (TGF-β1), angiogenesis (VEGF), and oxidative (MDA) factors, while increased anti-inflammatory cytokine IL-10, antioxidant factor glutathione (GSH), compared to the control group. Conclusion. Oral administration of PO improved postoperational-induced PA by alleviating the oxidative factors, fibrosis, inflammatory cytokines, angiogenesis biomarkers, and stimulating antioxidative factors. Hence, PO can be considered a potential herbal medicine to manage postoperative PA. However, further clinical studies are required to approve the effectiveness of PO.

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Establishments and Evaluations of Post‐Operative Adhesion Animal Models

Wang

Zhai

Yang

et al. 2023

Advanced Therapeutics

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After abdominopelvic surgery, there are 90-93% of patients who develop postoperative adhesions. Post-operative adhesions can occur after various surgical procedures, which not only cause a series of complications but also increase the economic burden of patients. Based on the US FDA rules, anti-adhesive products need to be deeply evaluated for their bio-functionality in animal models before clinic entrance. However, to date, there are few literatures systematically summarizing the establish approaches and evaluation standards of various post-operative adhesion animal models. Therefore, according to the importance of knowledge related to in vivo animal models, in this manuscript, the occurrence mechanism of post-operative adhesion is systematically reviewed, which is followed by summarizing the construction methods of animal adhesion models at different organs, and then the common evaluation indicators including adhesion scores and histological characterization are listed. This review is a reference to the in vivo characterizations of anti-adhesive materials.

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Standardised pomegranate peel extract lavage prevents postoperative peritoneal adhesion by regulating TGF-β and VEGF levels

Cited by 34 publications

References 39 publications

Intraperitoneal Lavage with Crocus sativus Prevents Postoperative‐Induced Peritoneal Adhesion in a Rat Model: Evidence from Animal and Cellular Studies

Intraperitoneal Lavage with Crocus sativus Prevents Postoperative‐Induced Peritoneal Adhesion in a Rat Model: Evidence from Animal and Cellular Studies

Evaluation of the Therapeutic Effects of the Hydroethanolic Extract of Portulaca oleracea on Surgical-Induced Peritoneal Adhesion

Establishments and Evaluations of Post‐Operative Adhesion Animal Models

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