Abstract
The aim of this paper was to investigate the effect of carboxymethyl chitosan anti-adhesion solution on prevention of postsurgical adhesion. Forty adult male Wistar rats were randomly divided into three groups: 0.9 % normal saline solution (group A), hyaluronic acid gels (group B) and carboxymethyl chitosan anti-adhesion solution (group C). The animals were treated with normal saline, hyaluronic acid gels or carboxymethyl chitosan anti-adhesion solution at the time of surgery. After 2 or 3 weeks, the degree of adhesions and histological effects were determined. The adhesions in groups B and C were significantly decreased, and the levels of TGF-β1 and hydroxyproline in group C were significantly lower than that in group A (P < 0.05). The histopathology in group C showed fewer inflammatory cells and fibroblasts. Carboxymethyl chitosan anti-adhesion solution can effectively prevent postoperative adhesion which is a promising drug delivery system in the context of postsurgical anti-adhesion.
References
Yang B, Gong CY, Zhou ST, Li Z, Qi X, Zhong Q, Luo F, Qian Z. Preventing postoperative abdominal adhesions in a rat model with PEG-PCL-PEG hydrogel. Int J Nanomed. 2012;7:547–57.
Kutlay J, Ozer Y, Isik B, Kargici H. Comparative effectiveness of several agents for preventing postoperative adhesions. World J Surg. 2004;28:662–5.
Mulier KE, Nguyen AH, Delaney JP, Marquez S. Comparison of Permacol™ and Strattice™ for the repair of abdominal wall defects. Hernia. 2011;15(3):315–9.
Sahin M, Cakir M, Avsar FM, Tekin A, Kucukkartallar T, Akoz M. The effects of anti-adhesion materials in preventing postoperative adhesion in abdominal cavity (anti-adhesion materials for postoperative adhesions). Inflammation. 2007;6:244–9.
Wei CZ, Hou CL, Gu QS, Jiang LX, Zhu B, Sheng AL. A thermosensitive chitosan-based hydrogel barrier for post-operative adhesions’ prevention. Biomaterials. 2009;30:5534–40.
Na NH, Kim IK, Han JH, Lee JG, Ton TI, Han DK, Ito Y, Song KS, Jang EC. Synthesis of O-carboxylated low molecular chitosan with azido phenyl group: its application for adhesion prevention. Macromol Res. 2010;10:1001–7.
Lauder CI, Garcea G, Strickland A, Maddern GJ. Use of a modified chitosan-dextran gel to prevent peritoneal adhesions in rat model. J Surg Res. 2011;171:877–82.
Muzzarelli RAA, Muzzarelli C. Chitosan chemistry: relevance to the biomedical sciences. Adv Polym Sci. 2005;186:151–209.
Francesko A, Tzanov T. Chitin, chitosan and derivatives for wound healing and tissue engineering. Adv Biochem Eng Biotechnol. 2011;125:1–27.
Park SH, Seo SY, Na NH, Kim KL, Lee JW, Woo HD, Lee JH, Seok HK, Lee JG, Chung SI, Chung KH, Han DK, Ito Y, Jang EC, Son TI. Preparation of a visible light-reactive low molecular-O-carboxymethyl chitosan (LM-O-CMCS) derivative and applicability as an anti-adhesion agent. Macromol Res. 2011;9:921–7.
Jiang LY, Li YB, Xiong CD. A novel composite membrane of chitosan-carboxymethyl cellulose polyelectrolyte complex membrane filled with nano-hydroxyapatite. I. Preparation and properties. J Mater Sci Mater Med. 2009;20:1645–52.
Zhang ZP, Zhou GW, Wu HP, Zhang DB, Shi RL, Pan YL. Experimental study on carboxymethyl chitosan in preventing peritoneal adhesion in rats. J Clin Res. 2010;27:101–4.
Daroz LRD, Lopes JB, Dallan LAO, Filho SPC, Moreira LFP, Stolf NAG. Prevention of postoperative pericardial adhesions using thermal sterile carboxymethyl chitosan. Rev Bras Cir Cardvasc. 2008;23(4):480–7.
Kennedy R, Costain DJ, Mcalister VC, Lee TDG. Prevention of experiment postoperative peritoneal adhesions by N,O-carboxylmethyl chitosan. Surgery. 1996;120(5):866–70.
Lou W, Zhang H, Ma J, Zhang D, Liu C, Wang S, Deng Z, Xu H, Liu J. In vivo evaluation of in situ polysaccharide based hydrogel for prevention of postoperative adhesion. Carbohydr Polym. 2012;90(2):1024–31.
Zhou J, Elson C, Lee TD. Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N,O-carboxymethyl chitosan. Surgery. 2004;135(3):307–12.
Wang D, Mo J, Pan S, Chen H, Zhen H. Prevention of postoperative peritoneal adhesions by O-carboxymethyl chitosan in a rat cecal abrasion model. Clin Invest Med. 2010;33(4):E254–60.
Harris ES, Morgan RF, Rodeheaver GT. Analysis of the kinetics of peritoneal adhesion formation in the rat and evaluation of potential antiadhesive agents. Surgery. 1995;117:663–9.
Nair SK, Bhat IK, Aurora AL. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions. Arch Surg. 1974;108:849–53.
Dong W, Han B, Feng Y, Song F, Chang J, Jiang H, Tang Y, Liu W. Pharmacokinetics and biodegradation mechanisms of a versatile carboxymethyl derivative of chitosan in rats: in vivo and in vitro evaluation. Biomacromolecules. 2010;11(6):1527–33.
Ryan CK, Sax HC. Evaluation of a carboxymethylcellulose sponge for prevention of postoperative adhesions. Am J Surg. 1995;169(1):154–9.
Chang J, Thunder R, Most D, Longaker MT, Lineaweaver WC. Studies in flexor tendon wound healing: neutralizing antibody to TGF-beta1 increases postoperative range of motion. Plast Reconstr Surg. 2000;105(1):148–55.
Lopes JB, Dallan LA, Moreira LF, Campana Filho SP, Gutierrez PS, Lisboa LA, de Oliveira SA, Stolf NA. Synergism between keratinocyte growth factor and carboxymethyl chitosan reduces pericardial adhesions. Ann Thorac Surg. 2010;90(2):566–72.
Trowbridge JM, Rudisill JA, Ron D, Gallo RL. Dermatan sulfate binds and potentiates activity of keratinocyte growth factor (FGF-7). J Biol Chem. 2002;277(45):42815–20.
Jiang D, Xu C, Li Z, Zhang Y, Han F, Jiang Z. Protective action of hepatocyte growth factor on transforming growth factor beta-1-induced alpha-smooth muscle actin and extracellular matrix in cultured human peritoneal fibroblasts. Med Sci Monit. 2010;16(8):BR250–4.
Hong X, Shen BY, Han BS. Study on the effect of carboxymethyl-chitosan in the prevention of postoperative abdominal adhesion and its mechanism of action. J Surg Concepts Pract. 2009;14:426–9.
Zhou J, Liwski RS, Elson C, Lee TD. Reduction in postsurgical adhesion formation after cardiac surgery in a rabbit model using N, O-carboxymethyl chitosan to block cell adherence. Thorac Cardiovasc Surg. 2008;135(4):777–83.
Pan SR, Chen HF, Mo JC, Wang DJ, Zhang W, Zhang HL. Experimental Study on carboxymethyl chitosan used for prevention of postsurgical adhesions. Chin J Biomed Eng. 2006;25(3):277–82.
Filippo CD, Petronella P, Freda F, Scorzelli M, Ferretti M, Canonico S, Rossi F, D’Amico M. Involvement of the ubiquitin-proteasome system in the formation of experimental postsurgical peritoneal adhesions. Mediat Inflamm. 2012;2012:1–7.
Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL. Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Dig Surg. 2001;18:260–73.
Attard JA, MacLean AR. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg. 2007;50:291–300.
Axel S, Joachim B, Kasper O, Weiß J, Schmidt W, Rolle U. Experimental study evaluating the effect of a barrier method on postoperative intraabdominal adhesions. Dig Dis Sci. 2006;51(3):566–70.
Yang Z, Han BQ, Fu DW, Liu W. Acute toxicity of high dosage carboxymethyl chitosan and its effect on the blood parameters in rats. J Mater Sci Mater Med. 2012;23:457–62.
Acknowledgments
The authors are grateful for the generous financial support from Shandong Provincial Natural Science Foundation, China (Y2008F15; ZR2012CM025) for grant support; The Scientific and Technological Development Project of Shandong Province (2012YD18063); Shandong Province Higher Educational Science, Technology Program (J11LF67) and the Health Department of Shandong Province (2011HZ115) and Weifang Science and Technology Bureau Project (201232112).
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Zheng, Z., Zhang, W., Sun, W. et al. Influence of the carboxymethyl chitosan anti-adhesion solution on the TGF-β1 in a postoperative peritoneal adhesion rat. J Mater Sci: Mater Med 24, 2549–2559 (2013). https://doi.org/10.1007/s10856-013-4981-7
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DOI: https://doi.org/10.1007/s10856-013-4981-7