Abstract
BackgroundEpidural fibrosis often causes serious complications in patients after lumbar laminectomy and discectomy and is associated with the proliferation of fibroblasts. Suramin is known to have an obvious inhibitory effect on the coactions of many growth factors and their receptors, but little was previously known about the effect of suramin on fibroblast proliferation and the progress of epidural fibrosis.MethodsWe illustrated the effect of suramin on cultured fibroblasts of rats with different concentrations (0, 200, 400, 600 mg/l). The proliferation of suramin-treated fibroblasts was evaluated by CCK-8 and western blot analysis. Additionally, in a rat model of laminectomy, different concentrations of suramin (100, 200, and 300 mg/ml) and saline were applied to the laminectomy sites locally. The effect of suramin on preventing epidural fibrosis was detected by the Rydell classification, hydroxyproline content, histological analysis, and collagen density analyses.ResultsThe results of CCK-8 shown that suramin could significantly inhibit fibroblasts proliferation in a dose-dependent manner. The western blotting shown that the expression levels of the cell proliferation markers such as cyclin D1, cyclin E, and PCNA were down-regulated. Moreover, in a rat model, we found that suramin could reduce epidural fibrosis as well as inhibit fibroblast proliferation, and 300 mg/ml suramin had better effect.ConclusionsTopical application of suramin could reduce epidural fibrosis after laminectomy, and the application of suramin could inhibit the proliferation of fibroblasts in rats. This study indicates that suramin is a potent antifibrotic agent that may have therapeutic potential for patients with epidural fibrosis.
Highlights
Epidural fibrosis often causes serious complications in patients after lumbar laminectomy and discectomy and is associated with the proliferation of fibroblasts
The effect of suramin on fibroblast proliferation To clarify the effect of suramin on fibroblasts proliferation, we used suramin at concentrations of 0, 200, 400, and 600 mg/l to treat fibroblasts for 48 h
After the fibroblasts were treated with four known concentrations of suramin, the results of the Cell Counting Kit-8 (CCK-8) assay revealed suramin could inhibit fibroblast proliferation and were shown in a dose-dependent manner (Fig. 1a)
Summary
Epidural fibrosis often causes serious complications in patients after lumbar laminectomy and discectomy and is associated with the proliferation of fibroblasts. Epidural fibrosis following lumbar laminectomy and discectomy is a common outcome and remains a challenging clinical problem for surgeons [1, 2]. Various agents or mechanical barriers have been used to prevent epidural fibrosis both in animal models and humans, including Adcon-L, autologous fat grafts, fibrinolytic agents, and polytetrafluoroethylene membrane [6,7,8]. All of these techniques are not without complications
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