Advances in biomaterials for preventing tissue adhesion

Wu, Wei; Chen, Ruoyu; Neves, José das; Tang, Jincheng; Xiao, Junyuan; Ni, Qing; Liu, Xinnong; Pan, Guoqing; Li, Dechun; Cui, Wenguo; Sarmento, Bruno

doi:10.1016/j.jconrel.2017.06.020

Cited by 121 publications

(102 citation statements)

References 99 publications

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“…It is urgent to understand the underlying mechanism of PPA and identify more effective treatment to prevent adhesion formation. Fortunately, with the development of biology and materials science, various anti-adhesion products such as biological scaffolds, membranes and drugs were applied on animals and in clinics for its prevention or decreasing of tissue adhesion [15] . Among of these strategies, nanoparticles with unique characteristic features were also widely used in adhesion formation [16] , peritoneal brosis [17] and cancer [18] .…”

Section: Introductionmentioning

confidence: 99%

Effect of Ligustrazine Nanoparticles on Th1/Th2 Balance by TLR4/MyD88/NF-κB Pathway in Rats with Postoperative Peritoneal Adhesion

Yang

Lian

Zhang³

et al. 2020

Preprint

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Background Postoperative peritoneal adhesion (PPA) is regarded as fibrous bands connecting both injured abdominal wall and organs or adjacent tissues and associated with T helper (Th)1 and Th2 differentiation. However, the critical role of immunopathogenesis of adhesion formation was precisely unknown. Previously we demonstrated that ligustrazine have positive effects on adhesion formation. And microarray analysis revealed TLR4/MyD88/NF-κB pathway as an important underlying regulatory mechanism in the onset and development of PPA. To further explore the possible mechanism of PPA and enhance the specificity of ligustrazine delivery to injured sites of rodent models, a new agent polylactic acid (PLA) nanoparticles loaded with ligustrazine, that is, ligustrazine nanoparticles (LN) were applied. Methods Twenty-four SD rats were randomly divided into sham, model, LN and sodium hyaluronate (SH) groups. The structure of LN, including entrapment efficiency (EE) and loading capacity (LC), and in vitro drug release were calculated. Adhesions were scored and the masson’s trichrome staining was used to determine the collagen deposition. The expression of TLR4, MyD88 and NF-κB were measured by qPCR, Immunohistochemistry and western blot assay. Moreover, Th1-related cytokines (IFN-γ, IL-12), Th2-related cytokines (IL-4, IL-6) in the cecum tissue and serum were conducted by ELISA. Results LN had good EE, LC and control-release delivery characters with fairly uniform diameter and spherical morphology. It could effectively prevent adhesion formation after surgery. Besides, it could reduce collagen fibers accumulation, downregulate the expression levels of TLR4, MyD88 and NF-κB, and maintain Th1/Th2 balance. Conclusions Ligustrazine nanoparticles had effective effects on Th1/Th2 balance by regualtingTLR4/MyD88/NF-κB pathway in PPA rats. It may be served as a promising therapy on postoperative adhesion formation.

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Section: Introductionmentioning

confidence: 99%

Effect of Ligustrazine Nanoparticles on Th1/Th2 Balance by TLR4/MyD88/NF-κB Pathway in Rats with Postoperative Peritoneal Adhesion

Yang

Lian

Zhang³

et al. 2020

Preprint

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“…Due to lack of sufficient evidence for safety and efficacy, these materials can cause delayed healing/nonhealing or bleeding wound(Robb & Mariette, ). Up to now, no method has been proven effective and safe for prevention and treatment of intraperitoneal adhesion after abdominal surgery (Polymeneas, Theodosopoulos, Stamatiadis, & Kourias, ; Taylor et al, ; Ten Broek et al, ; Wu et al, ). In this study, for the first time, PRF was applied in murine models of abdominal wall defect/cecum damage to explore potential effects on preventing intestinal adhesion.…”

Section: Discussionmentioning

confidence: 99%

“…Strategies for preventing adhesion usually include minimally invasive surgical techniques, drugs, biomaterial-based methods or in combination, of which biomaterial is the most widely applied (Charboneau, Delaney, & Beilman, 2018;Hu et al, 2019;Li et al, 2017). Biomaterials, based on specific physical and chemical properties, can protect patients from developing intestinal adhesion (Li, Ren, & Zhang, 2018;Wu et al, 2017). However, which method is the most effective remains debated (Correa-Rovelo, Villanueva-Lopez, Medina-Santillan, Carrillo-Esper, & Diaz-Giron-Gidi, 2015).…”

Section: Introductionmentioning

confidence: 99%

Platelet‐rich fibrin prevents postoperative intestinal adhesion

Jia

Guo

et al. 2020

J Biomedical Materials Res

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Platelet‐rich fibrin (PRF) was prepared from the blood of BALB/C inbred mice to explore potential effects on postoperative intestinal adhesion. A murine model of intestinal adhesion characterized by abdominal wall defect/and cecum damage was established by scraping caecum serosa and cutting peritoneum and muscles in the abdominal wall. The wound was covered with PRF (group A), sodium hyaluronate (group B), or left alone (blank control; group C). All animals were monitored for 28 days. The incidence of adhesion was 35.0, 66.7, and 73.7% in groups A, B, and C, respectively. The incidence of adhesion in group A was significantly lower than that in group C (p < .05). Histopathologically, severity of fibrosis and the number of fibroblasts or inflammatory cells in group A were lower than those in groups B and C (p < .05), whereas the number of mesothelial cells was higher (p = .001). Furthermore, the severity of fibrosis and number of fibroblasts or inflammatory cells were lower in low grade than those in high grade of adhesion (p < .05), whereas the number of mesothelial cells was higher (p < .05). Collectively, PRF applied to abdominal surgery may reduce the incidence of intestinal adhesion by promoting proliferation of mesothelial cells whereas inhibiting proliferation of fibroblasts and infiltration of inflammatory cells.

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“…Biodegradability is another important factor for the antiadhesion application of physical barriers. 7 In our study, biodegradability of different membranes was analyzed by incubation in PBS or elastase solution for a certain period of time, and their weight losses were calculated and recorded. The general biodegradation rates exhibited a steep increase in elastase solution compared to that in PBS.…”

Section: Discussionmentioning

confidence: 99%

“…Many factors, involving peritoneal injuries, foreign materials, and local inflammation and infection, are thought to be associated with the formation of peritoneal adhesion. 7 , 8 Until now, local inflammation has been considered as the main cause of peritoneal adhesion. 9 , 10 Specifically, our body would probably assume that we are in a severe trauma after undergoing surgeries, which triggers the release of vasodilators, histamine, and various cytokines.…”

Section: Introductionmentioning

confidence: 99%

Porous Polylactide Film Plus Atorvastatin-Loaded Thermogel as an Efficient Device for Peritoneal Adhesion Prevention

Shi

Liu

et al. 2018

ACS Omega

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Peritoneal adhesion is a common postoperative complication that causes many kinds of organ dysfunctions. It can be minimized by the integration of physical isolation and pharmaceutical treatment. However, the gas permeability of traditional medical devices for adhesion prevention is not satisfactory, which increases the risk of infection and inflammation, thus facilitating the formation of peritoneal adhesion. In this study, a device of porous polylactide (PLA) film plus atorvastatin (ATV)-loaded thermogel was developed for peritoneal adhesion prevention. PLA film acted as a physical barrier to prevent the connection of fibrin bridges between the injured tissues and nearby normal organs. Simultaneously, ATV was released to achieve the antifibrin deposition and anti-inflammatory effect. The porous properties of PLA film and thermogel increased the gas permeability and further inhibited the inflammatory responses. The in vivo study demonstrated that the porous PLA film with ATV-loaded thermogel possessed excellent anti-inflammation ability and satisfactory antiadhesion capacity, indicating its great potential for clinical application.

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Advances in biomaterials for preventing tissue adhesion

Cited by 121 publications

References 99 publications

Effect of Ligustrazine Nanoparticles on Th1/Th2 Balance by TLR4/MyD88/NF-κB Pathway in Rats with Postoperative Peritoneal Adhesion

Effect of Ligustrazine Nanoparticles on Th1/Th2 Balance by TLR4/MyD88/NF-κB Pathway in Rats with Postoperative Peritoneal Adhesion

Platelet‐rich fibrin prevents postoperative intestinal adhesion

Porous Polylactide Film Plus Atorvastatin-Loaded Thermogel as an Efficient Device for Peritoneal Adhesion Prevention

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