Abstract
Objective Peritoneal adhesion (PA) is an abnormal connective tissue that usually occurs between tissues adjacent to damaged organs during processes such as surgery. In this study, the anti-inflammatory and antioxidant effects of Portulaca oleracea (PO) were investigated against postoperative-induced peritoneal adhesion. Methods Thirty healthy male Wistar rats (220 ± 20 g, 6-8 weeks) were randomly divided into four groups: (1) normal, (2) control (induced peritoneal adhesion), and (3) and (4) PO extracts (induced peritoneal adhesion and received 100 or 300 mg/kg/day of PO extract for seven days). Finally, macroscopic and microscopic examinations were performed using different scoring systems and immunoassays in the peritoneal lavage fluid. Results We found that the levels of adhesion scores and interleukin- (IL-) 1β, IL-6, IL-10, tumour necrosis factor- (TNF-) α, transforming growth factor- (TGF-) β1, vascular endothelial growth factor (VEGF), and malondialdehyde (MDA) were increased in the control group. However, PO extract (100 and 300 mg/kg) notably reduced inflammatory (IL-1β, IL-6, and TNF-α), fibrosis (TGF-β1), angiogenesis (VEGF), and oxidative (MDA) factors, while increased anti-inflammatory cytokine IL-10, antioxidant factor glutathione (GSH), compared to the control group. Conclusion Oral administration of PO improved postoperational-induced PA by alleviating the oxidative factors, fibrosis, inflammatory cytokines, angiogenesis biomarkers, and stimulating antioxidative factors. Hence, PO can be considered a potential herbal medicine to manage postoperative PA. However, further clinical studies are required to approve the effectiveness of PO.
Highlights
Abnormal connective fibrous tissues join in the surgical area and cause adhesions between the organs and nearby tissues at nonanatomic locations [1]
Our results indicated that the levels of inflammatory mediators, including IL-6 (P < 0:001, Figure 5(b)) and tumour necrosis factor- (TNF-)α (P < 0:001, Figure 5(c)), and antiinflammatory cytokine IL-10 (P < 0:01, Figure 5(d)) were significantly increased in the control group compared to the normal group
We found that Portulaca oleracea (PO) at both doses significantly reduced the adhesion formation score by lowering the inflammatory cytokines (IL-1β, IL-6, and TNF-α), increasing the anti-inflammatory cytokine IL-10, and suppressing transforming growth factor- (TGF-)β1 and vascular endothelial growth factor (VEGF) as fibrotic and angiogenesis factors, respectively
Summary
Abnormal connective fibrous tissues join in the surgical area and cause adhesions between the organs and nearby tissues at nonanatomic locations [1]. Further research proved that upregulation of inducible nitric oxide synthase (iNOS) [9], stress oxidative markers, and myeloperoxidase (MPO) promoted PA progression and development [10] These alterations are considered underlying factors for the generation of collagen type-1 and PA development [11]. The formation and development of the fibrins were inhibited by chemical agents such as glucocorticosteroids, calcium channel blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, histamine antagonists, and fibrinolytic agents [13]. They have no enough effectiveness and efficacy for the prevention or treatment of PA
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