Skip to main content
SpringerLink
Log in

Escin: Inhibiting Inflammation and Promoting Gastrointestinal Transit to Attenuate Formation of Postoperative Adhesions

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Postoperative peritoneal adhesions are common, serious complications of general abdominal and gynecologic surgery that can lead to chronic abdominal pain, intestinal obstruction, and infertility. As yet, there are no ideal drugs that may be prescribed for patients to prevent adhesion formation effectively. In this study the effects of escin, a natural drug, on the various steps of adhesion formation were investigated. The effects of escin on increased vascular permeability induced by acetic acid in a mouse model of acute inflammation, granuloma formation in a subchronic inflammatory rat model, gastrointestinal transit in rats with intestinal paralysis, intestinal motility in postoperative patients, and postoperative adhesion formation in a rat model were observed. It was shown that escin could inhibit acute inflammation and granuloma formation, cause acceleration of gastrointestinal transit, help recover intestinal motility, and attenuate the formation of postoperative adhesions. The findings suggest that escin attenuates the formation of postoperative adhesions by inhibiting inflammation and promoting gastrointestinal transit. Thus it may be concluded that both inhibition of inflammation and increased gastrointestinal motility during the early postoperative period have a positive effect on decreasing the formation of adhesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

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

    PubMed  CAS  Google Scholar 

  2. Menzies D. Prospective adhesions: their treatment and relevance in clinical practice. Ann R Coll Surg Engl 1993;75:147–153

    PubMed  CAS  Google Scholar 

  3. Aldemir M, Ozturk H, Erten C, et al. The preventive effect of rofecoxib in postoperative intraperitoneal adhesions. Acta Chir Belg 2004;104:97–100

    PubMed  CAS  Google Scholar 

  4. Guvenal T, Cetin A, Ozdemir H, et al. Prevention of postoperative adhesion formation in rat uterine horn model by nimesulide: a selective COX-2 inhibitor. Hum Reprod 2001;16:1732–1735

    Article  PubMed  CAS  Google Scholar 

  5. LeGrand EK, Rodgers KE, Girgis W, et al. Efficacy of tolmetin sodium for adhesion prevention in rabbit and rat models. J Surg Res 1994;56:67–71

    Article  PubMed  CAS  Google Scholar 

  6. Sirtori CR. Aescin: pharmacology, pharmacokinetics and therapeutic profile. Pharmacol Res 2001;44:183–193

    Article  PubMed  CAS  Google Scholar 

  7. Matsuda H, Li Y, Yoshikawa M. Possible involvement of dopamine and dopamine2 receptors in the inhibitions of gastric emptying by escin Ib in mice. Life Sci 2000;67:2921–2927

    Article  PubMed  CAS  Google Scholar 

  8. Matsuda H, Li Y, Yoshikawa M. Roles of endogenous prostaglandins and nitric oxide in inhibitions of gastric emptying and accelerations of gastrointestinal transit by escins Ia, Ib, IIa, and IIb in mice. Life Sci 2000;66:PL41–PL46

    CAS  Google Scholar 

  9. Matsuda H, Li Y, Yoshikawa M. Effects of escins Ia, Ib, IIa, and IIb from horse chestnuts on gastrointestinal transit and ileus in mice. Bioorg Med Chem 1999;7:1737–1741

    PubMed  CAS  Google Scholar 

  10. Matsuda H, Li Y, Yoshikawa M. Possible involvement of 5-HT and 5-HT2 receptors in acceleration of gastrointestinal transit by escin Ib in mice. Life Sci 2000;66:2233–2238

    PubMed  CAS  Google Scholar 

  11. Olajide OA, Awe SO, Makinde JM, et al. Studies on the anti-inflammatory, antipyretic and analgesic properties of Alstonia boonei stem bark. J Ethnopharmacol 2000;71:179–186

    PubMed  CAS  Google Scholar 

  12. Ismail TS, Gopalakrishnan S, Begum VH, et al. Anti-inflammatory activity of Salacia oblonga Wall and Azima tetracantha Lam. J Ethnopharmacol 1997;56:145–152

    Article  PubMed  CAS  Google Scholar 

  13. Li ZH, Fu FH, Li XH, et al. The anti-inflammatory and analgesic effects of diclofenac sodium liniment. Chin Pharm J 1996;33:525–527

    Google Scholar 

  14. Ar’Rajab A, Ahren B, Rozga J, et al. Phosphatidylcholine prevents postoperative peritoneal adhesions: an experimental study in the rat. J Surg Res 1991;50:212–215

    PubMed  CAS  Google Scholar 

  15. Cetin M, Duran B, Demirkoprulu N, et al. Effects of diazeniumdiolates (NONOates) and methylene blue on the reduction of postoperative adhesion in rats. Gynecol Obstet Invest 2004;57:186–190

    Article  PubMed  CAS  Google Scholar 

  16. Hellebrekers BW, Trimbos-Kemper TC, Trimbos JB, et al. Use of fibrinolytic agents in the prevention of postoperative adhesion formation. Fertil Steril 2000;74:203–212

    Article  PubMed  CAS  Google Scholar 

  17. Oncel M, Kurt N, Remzi FH, et al. The effectiveness of systemic antibiotics in preventing postoperative, intraabdominal adhesions in an animal model. J Surg Res 2001;101:52–55

    Article  PubMed  CAS  Google Scholar 

  18. Okamoto Y, Takai S, Yamada M, et al. Chymase inhibitors may prevent postoperative adhesion formation. Fertil Steril 2002;77:1044–1048

    Article  PubMed  Google Scholar 

  19. Cubukcu A, Alponat A, Gonullu NN, et al. An experimental study evaluating the effect of mitomycin C on the prevention of postoperative intraabdominal adhesions. J Surg Res 2001;96:163–166

    PubMed  CAS  Google Scholar 

  20. Snoj M, Ar’Rajab A, Ahren B, et al. Effect of phosphatidylcholine on postoperative adhesions after small bowel anastomosis in the rat. Br J Surg 1992;79:427–429

    PubMed  CAS  Google Scholar 

  21. Kutlay J, Ozer Y, Isik B, et al. Comparative effectiveness of several agents for preventing postoperative adhesions. World J Surg 2004;28:662–665

    Article  PubMed  Google Scholar 

  22. Holtz G. Prevention of postoperative adhesions. J Reprod Med 1980;24:141–146

    PubMed  CAS  Google Scholar 

  23. Pijlman BM, Dorr PJ, Brommer EJ, et al. Prevention of adhesions. Eur J Obstet Gynecol Reprod Biol 1994;53:155–163

    Article  PubMed  CAS  Google Scholar 

  24. Down RH, Whitehead R, Watts JM. Why do surgical packs cause peritoneal adhesions? Aust N Z J Surg 1980;50:83–85

    PubMed  CAS  Google Scholar 

  25. Eggleston RB, Mueller PO. Prevention and treatment of gastrointestinal adhesions. Vet Clin North Am Equine Pract 2003;19:741–763

    PubMed  Google Scholar 

  26. Springall RG, Spitz L. The prevention of post-operative adhesions using a gastrointestinal prokinetic agent. J Pediatr Surg 1989;24:530–533

    PubMed  CAS  Google Scholar 

  27. Sparnon AL, Spitz L. Pharmacological manipulation of postoperative intestinal adhesions. Aust N Z J Surg 1989;59:725–729

    PubMed  CAS  Google Scholar 

  28. Garcia-Olmo D, Paya J, Lucas FJ, et al. The effects of the pharmacological manipulation of postoperative intestinal motility on colonic anastomoses: an experimental study in a rat model. Int J Colorectal Dis 1997;12:73–77

    PubMed  CAS  Google Scholar 

  29. Saba AA, Godziachvili V, Mavani AK, et al. Serum levels of interleukin 1 and tumor necrosis factor alpha correlate with peritoneal adhesion grades in humans after major abdominal surgery. Am Surg 1998;64:734–736

    PubMed  CAS  Google Scholar 

  30. Saba AA, Kaidi AA, Godziachvili V, et al. Effects of interleukin-6 and its neutralizing antibodies on peritoneal adhesion formation and wound healing. Am Surg 1996;62:569–572

    PubMed  CAS  Google Scholar 

  31. Chegini N. Peritoneal molecular environment, adhesion formation and clinical implication. Front Biosci 2002;7:e91–e115

    PubMed  CAS  Google Scholar 

  32. Roy S, Clark CJ, Mohebali K, et al. Reactive oxygen species and EGR-1 gene expression in surgical postoperative peritoneal adhesions. World J Surg 2004;28:316–320

    PubMed  Google Scholar 

  33. Elkins TE, Warren J, Portz D, et al. Oxygen free radicals and pelvic adhesion formation. II. The interaction of oxygen free radicals and adhesion-preventing solutions. Int J Fertil 1991;36:231–237

    CAS  Google Scholar 

  34. Guillaume M, Padioleau F. Veinotonic effect, vascular protection, antiinflammatory and free radical scavenging properties of horse chestnut extract. Arzneimittelforschung 1994;44:25–35

    PubMed  CAS  Google Scholar 

  35. Bougelet C, Roland IH, Ninane N, et al. Effect of aescine on hypoxia-induced neutrophil adherence to umbilical vein endothelium. Eur J Pharmacol 1998;345:89–95

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pharmacology, School of Pharmacy, Yantai University, Yantai, P.R., 264005, China

    Fenghua Fu MD, PhD & Ke Liu PhD

  2. Shandong Engineering Research Center for Natural Drugs, Shandong, P.R., 264005, China

    Fenghua Fu MD, PhD, Wanglin Jiang MS & Ke Liu PhD

  3. Zhanhua Hospital, Shandong, P.R., 256800, China

    Yuezhi Hou MD

  4. Affiliated Hospital of Binzhou Medical College, Shandong, P.R., 256603, China

    Ronghua Wang MD

Authors
  1. Fenghua Fu MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuezhi Hou MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wanglin Jiang MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ronghua Wang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ke Liu PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fenghua Fu MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fu, F., Hou, Y., Jiang, W. et al. Escin: Inhibiting Inflammation and Promoting Gastrointestinal Transit to Attenuate Formation of Postoperative Adhesions. World J. Surg. 29, 1614–1620 (2005). https://doi.org/10.1007/s00268-005-7870-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-7870-5

Keywords

Search

Navigation