The effect of suramin on inhibiting fibroblast proliferation and preventing epidural fibrosis after laminectomy in rats

Abstract

BackgroundEpidural fibrosis often causes serious complications in patients after lumbar laminectomy and discectomy and is associated with the proliferation of fibroblasts. Suramin is known to have an obvious inhibitory effect on the coactions of many growth factors and their receptors, but little was previously known about the effect of suramin on fibroblast proliferation and the progress of epidural fibrosis.MethodsWe illustrated the effect of suramin on cultured fibroblasts of rats with different concentrations (0, 200, 400, 600 mg/l). The proliferation of suramin-treated fibroblasts was evaluated by CCK-8 and western blot analysis. Additionally, in a rat model of laminectomy, different concentrations of suramin (100, 200, and 300 mg/ml) and saline were applied to the laminectomy sites locally. The effect of suramin on preventing epidural fibrosis was detected by the Rydell classification, hydroxyproline content, histological analysis, and collagen density analyses.ResultsThe results of CCK-8 shown that suramin could significantly inhibit fibroblasts proliferation in a dose-dependent manner. The western blotting shown that the expression levels of the cell proliferation markers such as cyclin D1, cyclin E, and PCNA were down-regulated. Moreover, in a rat model, we found that suramin could reduce epidural fibrosis as well as inhibit fibroblast proliferation, and 300 mg/ml suramin had better effect.ConclusionsTopical application of suramin could reduce epidural fibrosis after laminectomy, and the application of suramin could inhibit the proliferation of fibroblasts in rats. This study indicates that suramin is a potent antifibrotic agent that may have therapeutic potential for patients with epidural fibrosis.

Honokiol protects against epidural fibrosis by inhibiting fibroblast proliferation and extracellular matrix overproduction in rats post‑laminectomy

“…Fibrosis of the local dura mater following laminectomy, which is not uncommon, leads to worse patient outcomes ( 42 , 43 ). The current treatment options, namely, conservative treatment and scar excision, are unsatisfactory ( 44 ).…”

Laminin α5 modulates fibroblast proliferation in epidural fibrosis through the PI3K/AKT/mTOR signaling pathway

“…Previous studies have indicated the epidural fibrosis on dura mater after laminectomy operation, which ultimately results in a negative outcome for patients (8,29). Various studies have attempted to solve this problem by local drug applications (30,31) and biomaterials (32).…”

“…additionally, further studies have illustrated that the excessive proliferation of fibroblasts in the operative region is the most significant element of local fibrosis formation (4,5). Therefore, the methods of inhibiting fibroblast proliferation to reduce fibrosis have become an attractive area of study and previous studies have demonstrated positive results (6)(7)(8). However, there are numerous limitations for clinical application, hence further research is still required to solve the problem completely.…”

Effect of platelet-rich fibrin on epidural fibrosis and comparison to ADCON® Gel and hyaluronic acid

“…Paraspinal muscle dissection and bone removal lead to fibroblast migration from periosteum and muscle tissue to the site of laminectomy. Hematoma resulting from surgical manipulation also transforms into granulation tissue, which is in turn converted into epidural scar tissue 22, 24, 25. Songer et al suggested that epidural fat tissue extends from the posterior epidural compartment to the intervertebral foramen, and that with its semi-viscous nature it replaces epidural fibrosis tissue, which compresses the dural sac and nerve roots 26 …”