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DOI: 10.1055/s-0034-1382877
Prevention of Experimental Postoperative Peritoneal Adhesions through the Intraperitoneal Administration of Tanshinone IIA
Publikationsverlauf
received 08. Mai 2014
revised 09. Juni 2014
accepted 16. Juni 2014
Publikationsdatum:
04. August 2014 (online)
Abstract
Postoperative adhesions develop after nearly every abdominal surgery. The formation of adhesions is associated with the inflammatory response, fibrinolytic system, and extracellular matrix deposition in response to injury. Tanshinone IIA is one of the major extracts obtained from Salvia miltiorrhiza, which has anti-inflammatory effects on many diseases. Postoperative adhesions were induced by injuring the parietal peritoneum and cecum in Wistar rats, followed by the administration of various dosages of tanshinone IIA. The adhesion scores for each group were collected seven days after the initial laparotomy. The activity of the tissue-type plasminogen activator in the peritoneal lavage fluid was measured. The messenger ribonucleic acid expression levels of the tissue-type plasminogen activator, plasminogen activator inhibitor-1, and cyclooxygenase-2 in the ischaemic tissues were measured by quantitative real-time polymerase chain reaction. The intraperitoneal administration of tanshinone IIA is effective for the prevention of the formation of postoperative adhesions in rats. Tanshinone IIA increased fibrinolytic activity in the peritoneal lavage fluid and tissue-type plasminogen activator messenger ribonucleic acid expression in ischaemic peritoneal tissues but decreased the plasminogen activator inhibitor and cyclooxygenase-2 messenger ribonucleic acid expression significantly. These results revealed that tanshinone IIA was a potent postoperative adhesion preventer by enhancing fibrinolytic activity and decreasing cyclooxygenase-2 activity.
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References
- 1 Holmdahl L, Risberg B. Adhesions prevention and complications in general surgery. Eur J Surg 1997; 163: 169-174
- 2 Menzies D, Ellis H. Intestinal obstruction from adhesions–how big is the problem. Ann R Coll Surg Engl 1990; 72: 60-63
- 3 Thompson J. Pathogenesis and prevention of adhesion formation. Dig Surg 1998; 15: 153-157
- 4 Holmdahl L. The role of fibrinolysis in adhesion formation. Eur J Surg Suppl 1997; 577: 24-31
- 5 Lu HR, Wu Z, Pauwels P, Lijnen HR, Collen D. Comparative thrombolytic properties of tissue-type plasminogen activator (t-PA), single-chain urokinase-type plasminogen activator (u-PA) and K1K2Pu (a t-PA/u-PA chimera) in a combined arterial and venous thrombosis model in the dog. J Am Coll Cardiol 1992; 19: 1350-1359
- 6 Runge MS, Quertermous T, Haber E. Plasminogen activators. The old and the new. Circulation 1989; 79: 217-224
- 7 Akyildiz H, Akcan A, Sozuer E, Kucuk C, Yilmaz N, Deniz K. The preventive effect of Met-RANTES on postoperative intraperitoneal adhesion formation in the rat model. Surgery 2008; 144: 404-409
- 8 Hickey MJ. Role of inducible nitric oxide synthesis in the regulation of leukocyte recruitment. Clin Sci 2001; 100: 1-12
- 9 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. J Surg Res 2011; 165: 91-111
- 10 Han JY, Fan JY, Horie Y, Miura S, Cui DH, Ishii H, Hibi T, Tsuneki H, Kimura I. Ameliorating effects of compounds derived from Salvia miltiorrhiza root extract on microcirculatory disturbance and target organ injury by ischemia and reperfusion. Pharmacol Ther 2008; 117: 280-295
- 11 Yin X, Yin Y, Cao FL, Chen YF, Peng Y, Hou WG, Sun SK, Luo ZJ. Tanshinone IIA attenuates the inflammatory response and apoptosis after traumatic injury of the spinal cord in adult rats. PLoS One 2012; 7: e38381
- 12 Ren ZH, Tong YH, Xu W, Ma J, Chen Y. Tanshinone II A attenuates inflammatory responses of rats with myocardial infarction by reducing MCP-1 expression. Phytomedicine 2010; 17: 212-218
- 13 Fu J, Huang H, Liu J, Pi R, Chen J, Liu P. Tanshinone IIA protects cardiac myocytes against oxidative stress-triggered damage and apoptosis. Eur J Pharmacol 2007; 568: 213-221
- 14 Dong X, Dong J, Zhang R, Fan L, Liu L, Wu G. Anti-inflammatory effects of tanshinone IIA on radiation-induced microglia BV-2 cells inflammatory response. Cancer Biother Radiopharm 2009; 24: 681-687
- 15 Xiao M, Chenxi W, Hongfu C, Lianbing H. Effects of tanshinone IIA on fibroblast proliferation and related gene expression in rats with postoperative abdominal adhesion. Chin Tradit Herb Drugs 2012; 43: 1381-1384
- 16 Holmdahl L, Eriksson E, Eriksson BI, Risberg B. Depression of peritoneal fibrinolysis during operation is a local response to trauma. Surgery 1998; 123: 539-544
- 17 Aarons CB, Cohen PA, Gower A, Reed KL, Leeman SE, Stucchi AF, Becker JM. Statins (HMG-CoA reductase inhibitors) decrease postoperative adhesions by increasing peritoneal fibrinolytic activity. Ann Surg 2007; 245: 176-184
- 18 Cetin M, Ak D, Duran B, Cetin A, Guvenal T, Yanar O. Use of methylene blue and N,O-carboxymethylchitosan to prevent postoperative adhesions in a rat uterine horn model. Fertil Steril 2003; 80: 698-701
- 19 Baykal A, Ozdemir A, Renda N, Korkmaz A, Sayek I. The effect of octreotide on postoperative adhesion formation. Can J Surg 2000; 43: 43-47
- 20 de Boer JP, Abbink JJ, Brouwer MC, Meijer C, Roem D, Voorn GP, Lambers JW, van Mourik JA, Hack CE. PAI-1 synthesis in the human hepatoma cell line HepG2 is increased by cytokines–evidence that the liver contributes to acute phase behaviour of PAI-1. Thromb Haemost 1991; 65: 181-185
- 21 Kruithof EK, Tran-Thang C, Ransijn A, Bachmann F. Demonstration of a fast acting inhibitor of plasminogen activators in human plasma. Blood 1984; 64: 907-913
- 22 van Mourik JA, Lawrence DA, Loskutoff DJ. Purification of an inhibitor of plasminogen activator (antiactivator) synthesised by endothelial cells. J Biol Chem 1984; 259: 14914-14921
- 23 Segura T, Schmokel H, Hubbell JA. RNA interference targeting hypoxia inducible factor 1alpha reduces post-operative adhesions in rats. J Surg Res 2007; 141: 162-170
- 24 Muzii L, Marana R, Brunetti L, Margutti F, Vacca M, Mancuso S. Postoperative adhesion prevention with low-dose aspirin: effect through the selective inhibition of thromboxane production. Hum Reprod 1998; 13: 1486-1489
- 25 Lasson B, Svanberg SG, Swolin K. Oxyphenbutazone–an adjuvant to be used in prevention of adhesion in operations for fertility. Fertil Steril 1977; 28: 807-808
- 26 Saed GM, Munkarah AR, Diamond MP. Cyclooxygenase-2 is expressed in human fibroblasts isolated from intraperitoneal adhesions but not from normal peritoneal tissues. Fertil Steril 2003; 79: 1404-1408
- 27 Greene AK, Alwayn IP, Nose V, Flynn E, Sampson D, Zurakowski D, Folkman J, Puder M. Prevention of intraabdominal adhesions using the antiangiogenic COX-2 inhibitor celecoxib. Ann Surg 2005; 242: 140-146
- 28 Guvenal T, Cetin A, Ozdemir H, Yanar O, Kaya T. Prevention of postoperative adhesion formation in rat uterine horn model by nimesulide: a selective COX-2 inhibitor. Hum Reprod 2001; 16: 1732-1735
- 29 Katada J, Saito H, Ohashi A. Significance of cyclooxygenase-2 induced via p 38 mitogen-activated protein kinase in mechanical stimulus-induced peritoneal adhesion in mice. J Pharmacol Exp Ther 2005; 313: 286-292
- 30 Kwak HB, Sun HM, Ha H, Kim HN, Lee JH, Kim HH, Shin HI, Lee ZH. Tanshinone IIA suppresses inflammatory bone loss by inhibiting the synthesis of prostaglandin E2 in osteoblasts. Eur J Pharmacol 2008; 601: 30-37
- 31 Lu Y, Liu X, Liang X, Xiang L, Zhang W. Metabolomic strategy to study therapeutic and synergistic effects of tanshinone IIA, salvianolic acid B and ginsenoside Rb1 in myocardial ischemia rats. J Ethnopharmacol 2011; 134: 45-49
- 32 Wang L, Zhang X, Liu L, Cui L, Yang R, Li M, Du W. Tanshinone II A down-regulates HMGB1, RAGE, TLR4, NF-kappaB expression, ameliorates BBB permeability and endothelial cell function, and protects rat brains against focal ischemia. Brain Res 2009; 1321: 143-151
- 33 Reed KL, Fruin AB, Gower AC, Stucchi AF, Leeman SE, Becker JM. A neurokinin 1 receptor antagonist decreases postoperative peritoneal adhesion formation and increases peritoneal fibrinolytic activity. Proc Natl Acad Sci 2004; 101: 9115-9120
- 34 Corona R, Verguts J, Schonman S, Binda MM, Mailova K, Koninckx PR. Postoperative inflammation in the abdominal cavity increases adhesion formation in a laparoscopic mouse model. Fertil Steril 2011; 95: 1224-1228
- 35 Tanaka Y, Fujiwara T, Hayashi T, Ezumi R. Effect of dexamethasone on the formation of intestinal adhesions following postoperative radiotherapy. Strahlentherapie 1975; 149: 608-620
- 36 OʼBrien WF, Drake TS, Bibro MC. The use of ibuprofen and dexamethasone in the prevention of postoperative adhesion formation. Obstet Gynecol 1982; 60: 373-378
- 37 Replogle RL, Johnson R, Gross RE. Prevention of postoperative intestinal adhesions with combined promethazine and dexamethasone therapy: experimental and clinical studies. Ann Surg 1996; 163: 580-588
- 38 Ito T, Fraser IP, Yeo Y, Highley CB, Bellas E, Kohane DS. Anti-inflammatory function of an in situ cross-linkable conjugate hydrogel of hyaluronic acid and dexamethasone. Biomaterials 2007; 28: 1778-1786
- 39 Peyman S, Ashrafzadeh TM, Amirali J, Amir S. Effects of dexamethasone, piroxicam and sterile aloe vera extract on the prevention of postoperative peritoneal adhesion formation in rat. Adv Environ Biol 2012; 6: 2851-2859
- 40 Cohen PA, Aarons CB, Gower AC, Stucchi AF, Leeman SE, Becker JM, Reed KL. The effectiveness of a single intraperitoneal infusion of a neurokinin-1 receptor antagonist in reducing postoperative adhesion formation is time dependent. Surgery 2007; 141: 368-375
- 41 Nair SK, Bhat IK, Aurora AL. Role of poteolytic enzyme in the prevention of the postoperative intraperitoneal adhesions. Arch Surg 1974; 108: 849-853
- 42 Lim R, Morrill JM, Prushik SG, Reed KL, Gower AC, Leeman SE, Stucchi AF, Becker JM. An FDA approved neurokinin-1 receptor antagonist is effective in reducing intraabdominal adhesions when administered intraperitoneally, but not orally. J Gastrointest Surg 2008; 12: 1754-1761