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Pycnogenol prevents peritoneal adhesions

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

This study tested the ability of pycnogenol, an extract from the bark of the French maritime pine (Pinus pinaster), to prevent intra-abdominal adhesions.

Methods

Thirty female Wistar albino rats were separated randomly into three equal groups: Group (1) the control group, which underwent surgery, but was given no drug; Group (2) given 10 mg/kg of pycnogenol dissolved in normal saline intraperitoneally for 10 days after surgery; and Group (3) given 0.1 mL of normal saline for 10 days intraperitoneally after surgery. On post-operative day 10, all of the animals were killed and any adhesions were evaluated macroscopically and histopathologically.

Results

The macroscopic adhesion scores (mean ± SD) for Groups 1, 2, and 3 were 2.5 ± 0.53, 0.60 ± 0.70, and 2.0 ± 0.82, respectively. The macroscopic adhesion score was significantly lower in Group 2 than in Groups 1 and 3 (p < 0.001). All three components of the histopathological evaluation (inflammation, fibrosis, and neovascularization) were significantly lower in Group 2 than in Groups 1 or 3 (p < 0.001, p < 0.001, and p = 0.004, respectively).

Conclusions

Pycnogenol was found to be effective at preventing surgery-related adhesions in an animal model.

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References

  1. De Wilde RL, Bakkum EA, Brölmann H et al (2014) Consensus recommendations on adhesions (version 2014) for the ESGE adhesions research working group (European Society for Gynecological Endoscopy): an expert opinion. Arch Gynecol Obstet 290(3):581–582

    Article  PubMed  Google Scholar 

  2. Menzies D, Ellis H (1990) Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl 72(1):60–63

    PubMed Central  CAS  PubMed  Google Scholar 

  3. Weibel MA, Majno G (1973) Peritoneal adhesions and their relation to abdominal surgery. A postmortem study. Am J Surg 126(3):345–353

    Article  CAS  PubMed  Google Scholar 

  4. Brochhausen C, Schmitt VH, Planck CN et al (2012) Current strategies and future perspectives for intraperitoneal adhesion prevention. J Gastrointest Surg 16(6):1256–1274

    Article  PubMed  Google Scholar 

  5. Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL (2001) Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management. Dig Surg 18(4):260–273 Review

    Article  CAS  PubMed  Google Scholar 

  6. Kamel Remah M (2010) Prevention of postoperative peritoneal adhesions. Eur J Obstet Gynecol Reprod Biol 150:111–118

    Article  CAS  PubMed  Google Scholar 

  7. Ray NF, Denton WG, Thamer M, Henderson SC, Perry S (1998) Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg 186(1):1–9

    Article  CAS  PubMed  Google Scholar 

  8. Arung W, Meurisse M, Detry O (2011) Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol 17(41):4545–4553

    Article  PubMed Central  PubMed  Google Scholar 

  9. Fletcher NM, Abuanzeh S, Saed MG, Diamond MP, Abu-Soud HM, Saed GM (2014) Nicotinamide adenine dinucleotide phosphate oxidase expression is differentially regulated to favor a pro-oxidant state that contributes to postoperative adhesion development. Reprod Sci 21(8):1050–1059

    Article  CAS  PubMed  Google Scholar 

  10. Maimoona A, Naeem I, Saddiqe Z, Jameel K (2011) A review on biological, nutraceutical and clinical aspects of French maritime pine bark extract. J Ethnopharmacol 133(2):261–277

    Article  PubMed  Google Scholar 

  11. Iravani S, Zolfaghari B (2011) Pharmaceutical and nutraceutical effects of Pinus pinaster bark extract. Res Pharm Sci 6(1):1–11

    PubMed Central  CAS  PubMed  Google Scholar 

  12. Rohdewald PA (2002) review of the French maritime pine bark extract (Pycnogenol), a herbal medication with a diverse clinical pharmacology. Int J Clin Pharmacol Ther 40(4):158–168 Review

    Article  CAS  PubMed  Google Scholar 

  13. Petrassi C, Mastromarino A, Spartera C (2000) PYCNOGENOL in chronic venous insufficiency. Phytomedicine 7(5):383–388

    Article  CAS  PubMed  Google Scholar 

  14. Peng YJ, Lee CH, Wang CC, Salter DM, Lee HS (2012) Pycnogenol attenuates the inflammatory and nitrosative stress on joint inflammation induced by urate crystals. Free Radic Biol Med 52(4):765–774

    Article  CAS  PubMed  Google Scholar 

  15. Torras MA, Faura CA, Schönlau F, Rohdewald P (2005) Antimicrobial activity of Pycnogenol. Phytother Res 19(7):647–648

    Article  CAS  PubMed  Google Scholar 

  16. Evans DM, Mc Aree K, Guyton DP (1993) Dose dependency and wound healing aspects of the use of tissue plasminogen activator in the prevention of intra-abdominal adhesions. Am J Surg 165:229–232

    Article  CAS  PubMed  Google Scholar 

  17. Holmdahl L, Ivarsson ML (1999) The role of cytokines, coagulation, and fibrinolysis in peritoneal tissue repair. Eur J Surg 165(11):1012–1019

    Article  CAS  PubMed  Google Scholar 

  18. Awonuga AO, Belotte J, Abuanzeh S, Fletcher NM, Diamond MP, Saed GM (2014) Advances in the pathogenesis of adhesion development: the role of oxidative stress. Reprod Sci 21(7):823–836

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Fletcher NM, Jiang ZL, Diamond MP, Abu-Soud HM, Saed GM (2008) Hypoxia-generated superoxide induces the development of the adhesion phenotype. Free Radic Biol Med 45(4):530–536

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Herrick SE, Mutsaers SE, Ozua P et al (2000) Human peritoneal adhesions are highly cellular, innervated, and vascularized. J Pathol 192(1):67–72

    Article  CAS  PubMed  Google Scholar 

  21. Epstein JC, Wilson MS, Wilkosz S, Ireland G, O’Dwyer ST, Herrick SE (2006) Human peritoneal adhesions show evidence of tissue remodeling and markers of angiogenesis. Dis Colon Rectum 49(12):1885–1892

    Article  PubMed  Google Scholar 

  22. Binnebösel M, Klink CD, Serno J et al (2011) Chronological evaluation of inflammatory mediators during peritoneal adhesion formation using a rat model. Langenbecks Arch Surg 396(3):371–378

    Article  PubMed  Google Scholar 

  23. Keleidari B, Mahmoudieh M, Bahrami F, Mortazavi P, Aslani RS, Toliyat SA (2014) The effect of vitamin A and vitamin C on postoperative adhesion formation: a rat model study. J Res Med Sci 19(1):28–32

    PubMed Central  PubMed  Google Scholar 

  24. de la Portilla F, Ynfante I, Bejarano D et al (2004) Prevention of peritoneal adhesions by intraperitoneal administration of vitamin E: an experimental study in rats. Dis Colon Rectum 47(12):2157–2161

    Article  PubMed  Google Scholar 

  25. Chu DI, Lim R, Heydrick S et al (2011) N-acetyl-l-cysteine decreases intra-abdominal adhesion formation through the upregulation ofperitoneal fibrinolytic activity and antioxidant defenses. Surgery 149(6):801–812

    Article  PubMed  Google Scholar 

  26. Hızlı D, Hızlı F, Köşüş A et al (2014) Effect of Hypericum perforatum on intraperitoneal adhesion formation in rats. Arch Med Sci. 10(2):396–400

    PubMed Central  PubMed  Google Scholar 

  27. Yetkin G, Uludag M, Citgez B, Karakoc S, Polat N, Kabukcuoglu F (2009) Prevention of peritoneal adhesions by intraperitoneal administration of vitamin E and human amniotic membrane. Int J Surg 7(6):561–565

    Article  PubMed  Google Scholar 

  28. Noda Y, Anzai K, Mori A, Kohno M, Shinmei M, Packer L (1997) Hydroxyl and superoxide anion radical scavenging activities of natural source antioxidants using the computerized JES-FR30 ESR spectrometer system. Biochem Mol Biol Int 42(1):35–44

    CAS  PubMed  Google Scholar 

  29. van Jaarsveld H, Kuyl JM, Schulenburg DH, Wiid NM (1996) Effect of flavonoids on the outcome of myocardial mitochondrial ischemia/reperfusion injury. Res Commun Mol Pathol Pharmacol 91(1):65–75

    PubMed  Google Scholar 

  30. Sivonová M, Zitnanová I, Horáková L et al (2006) The combined effect of pycnogenol with ascorbic acid and trolox on the oxidation of lipids and proteins. Gen Physiol Biophys 25(4):379–396

    PubMed  Google Scholar 

  31. Schäfer A, Chovanová Z, Muchová J, Sumegová K, Liptáková A, Duracková Z, Högger P (2006) Inhibition of COX-1 and COX-2 activity by plasma of human volunteers after ingestion of French maritime pine bark extract (Pycnogenol). Biomed Pharmacother 60(1):5–9

    Article  PubMed  Google Scholar 

  32. Saliou C, Rimbach G, Moini H et al (2001) Solar ultraviolet-induced erythema in human skin and nuclear factor-kappa-B-dependent gene expression in keratinocytes are modulated by a French maritime pine bark extract. Free Radic Biol Med 30(2):154–160

    Article  CAS  PubMed  Google Scholar 

  33. Peng Q, Wei Z, Lau BH (2000) Pycnogenol inhibits tumor necrosis factor-alpha-induced nuclear factor kappa B activation and adhesion molecule expression in human vascular endothelial cells. Cell Mol Life Sci 57(5):834–841

    Article  CAS  PubMed  Google Scholar 

  34. Maia H Jr, Haddad C, Casoy J (2013) Combining oral contraceptives with a natural nuclear factor-kappa B inhibitor for the treatment of endometriosis-related pain. Int J Womens Health 21(6):35–39

    Article  Google Scholar 

  35. Blazsó G, Gábor M, Schönlau F, Rohdewald P (2004) Pycnogenol accelerates wound healing and reduces scar formation. Phytother Res 18(7):579–581

    Article  PubMed  Google Scholar 

  36. Değer KC, Şeker A, Özer I et al (2013) The effects of Pycnogenol® on colon anastomotic healing in rats given preoperative irradiation. Int J Surg 11(9):983–988

    Article  PubMed  Google Scholar 

  37. Belcaro G, Cesarone MR, Errichi BM et al (2005) Venous ulcers microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology 56(6):699–705

    Article  CAS  PubMed  Google Scholar 

  38. http://abc.herbalgram.org/site/DocServer/Pycnog_FullMono120809_LOW.pdf?docID=1741. Accessed 24 Feb 2015

  39. Rodhewald P (2005) Pycnogenol®—scientific file-section 19. Horphag Research, Geneva

    Google Scholar 

  40. Maritim A, Dene BA, Sanders RA, Watkins JB 3rd (2003) Effects of pycnogenol treatment on oxidative stress in streptozotocin-induced diabetic rats. J Biochem Mol Toxicol 17(3):193–199

    Article  CAS  PubMed  Google Scholar 

  41. Taner G, Aydın S, Bacanlı M et al (2014) Modulating effects of pycnogenol® on oxidative stress and DNA damage ınduced by sepsis in rats. Phytother Res 28(11):1692–1700

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Assistant Professor Furuzan Kokturk, Bulent Ecevit University School of Medicine, Department of Biostatistics, for the statistical analysis of the data, and Doctor Humeyra Cicekler for her technical support.

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Correspondence to Ahmet Sahbaz.

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Sahbaz, A., Aynioglu, O., Isik, H. et al. Pycnogenol prevents peritoneal adhesions. Arch Gynecol Obstet 292, 1279–1284 (2015). https://doi.org/10.1007/s00404-015-3764-4

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  • DOI: https://doi.org/10.1007/s00404-015-3764-4

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