Anti-inflammatory Research Articles

Manganese(II) Complexes with Non-Steroidal Anti-Inflammatory Drugs: Structure and Biological Activity

Nine manganese(II) complexes with a series of non-steroidal anti-inflammatory drugs (namely sodium diclofenac, diflunisal, flufenamic acid, sodium meclofenamate, mefenamic acid, and tolfenamic acid) were prepared in the presence of diverse nitrogen donors, i.e., pyridine, 1,10–phenanthroline, 2,2′–bipyridine and neocuproine, as co-ligands and were characterized with spectroscopic techniques and single-crystal X-ray crystallography. The biological profile of the resultant complexes was investigated regarding their antioxidant potency and their interaction with DNA and serum albumins. The complexes interact with calf–thymus DNA in an intercalative mode and bind tightly and reversibly to human and bovine serum albumins studied. In order to assess the antioxidant activity of the Mn(II) complexes, their ability to scavenge 2,2′–azinobis(3–ethylbenzothiazoline–6–sulfonic acid) free radicals was monitored.

Association of Therapies for Axial Spondyloarthritis on the Risk of Hip and Spine Fractures.

People with axial spondyloarthritis (axSpA) have increased fracture risk relative to the general population, possibly related to chronic inflammation. We assessed the impact of treatment with tumor necrosis factor inhibitors (TNFi) and non-biologic conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) on hip and spine fractures in axSpA, relative to nonsteroidal anti-inflammatory drugs (NSAIDs). We conducted a nested case-control study using 2006-2021 data from the MerativeTM MarketScan® Database. We included adults 18-65 years old with ≥1 inpatient or ≥2 outpatient axSpA ICD-9 or 10 diagnosis codes separated by ≥7 days. The primary outcome was hip and/or spine fracture, defined by ICD-9 or 10 diagnosis or procedure codes. For each fracture case, we selected up to 10 controls without fracture. We evaluated medication exposure (TNFi, csDMARDs, NSAIDs [referent], or none) hierarchically using pharmacy claims and procedure codes. We assessed the relation of medication exposure with hip and spine fracture risk using unconditional logistic regression with confounder adjustment. Our main analysis included 13,519 individuals with axSpA, comprising 1,229 cases and 12,290 controls. Individuals on TNFi had 29% lower odds of fracture compared to those on NSAIDs (OR 0.71, 95% CI 0.59-0.85), accounting for age, sex, and diagnosis year. Results were similar in the fully adjusted model (OR 0.75, 95% CI 0.62-0.91) and when stratified by sex. Using a large US insurance claims database, we found evidence for a protective effect of TNFi on fracture risk in axSpA underscoring a potential impact of TNFi in diminishing comorbidities linked with axSpA.

Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study

BackgroundPatients with rheumatic diseases who receive long-term treatment with steroids, immunosuppressants, or biologics are more susceptible to infection with pathogens than the general population. In order to explore the differences in clinical features and prognosis of Corona Virus Disease 2019 (COVID-19) infection between patients with rheumatic diseases and the general population (family members), a retrospective investigative study was used to analyze the differences between the two populations.MethodsThe study was conducted in 13 Grade A Tertiary hospitals in China to investigate the clinical symptoms and prognostic factors of patients with rheumatic diseases who were infected with COVID-19 for the first time and their families.ResultsA total of 2,889 participants were included in this study, including 1,530 patients with rheumatic diseases and 1,359 family members. In terms of clinical symptoms, the complete recovery time from COVID-19 for patients with rheumatic disease patients was 13 days (8.00, 18.00), which was shorter than that of family members (16 days, 11.00, 20.00). The risk of developing moderate to severe cases of COVID-19 was lower in patients with rheumatic disease than in their family members (OR=0.511, P=0.0026). Compared with non-use of non-steroidal anti-inflammatory drugs (NSAIDs), the risk of developing mild cases of COVID-19 was 0.595 times greater with pre-infection use of NSAIDs (P = 0.0003). The use of glucocorticoids and Chinese herbal decoctions before infection increased the probability of developing mild cases of COVID-19 (OR=1.537, 1.773, P<0.05). The risk of developing moderate to severe cases with disease-modifying anti-rheumatic drugs (DMARDs) used before infection was 0.350 times that without such drugs (P<0.001). In terms of prognosis, compared with family members, the complete recovery time of patients with rheumatic diseases was reduced by 2.241 days on average (P<0.001), and the complete recovery time of patients with mild rheumatism was reduced by 4.178 days on average (P<0.001). There was no significant difference in the complete recovery time from COVID-19 in patients with severe rheumatism compared with their family members (P=0.1672). The use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions during the infection period could shorten the recovery time of COVID-19 symptoms (P<0.05).ConclusionsCompared with their family members, patients with rheumatic diseases had milder symptoms after infection with COVID-19, which was related to the use of glucocorticoids, DMARDs, and Chinese herbal decoctions before infection. During the COVID-19 infection phase, the use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions might shorten the recovery time from symptoms of COVID-19.Chinese clinical trial registryChiCTR2300072679

Agarose Hydrogels Enriched by Humic Acids as a Functional Model for the Transport of Pharmaceuticals in Nature Systems

The presence of pharmaceuticals in nature systems poses a threat to the environment, plants, animals, and, last but not least, human health. Their transport in soils, waters, and sediments plays important roles in the toxicity and bioavailability of pharmaceuticals. The mobility of pharmaceuticals can be affected by their interactions with organic matter and other soil and water constituents. In this study, a model agarose hydrogel enriched by humic acid as a representative of organic matter is used as a transport medium for pharmaceuticals. Sulphapyridine (as a representative of sulphonamide antibiotics) and diclofenac (as a representative of widely used non-steroidal anti-inflammatory drugs) were chosen for experiments in diffusion cells. Pharmaceuticals were passed through the hydrogel from the donor solution to the acceptor compartment and could interact with humic acids incorporated in the hydrogel. The lag time was prolonged if the hydrogel was enriched by humic acids from 134 to 390 s for sulphapyridine and from 323 to 606 s for diclofenac. Similarly, the incorporation of humic acids in the hydrogel resulted in a decrease in the determined diffusion coefficients. The decrease was stronger in the first stage of the experiment when diffusing particles could interact with vacant binding sites.

Hyperbilirubinemia and transaminitis in hepatitis A: case report on early remission through ayurveda interventions

Hepatitis A is a common cause for acute hepatitis and jaundice. It is mostly self-limiting requires no or suppurative treatment and very rare cases prolong jaundice, liver failure and death. Prolonged jaundice types of cases are mostly going to folk healers and herbalist. Ayurveda has no recordable evidence of course of treatment in Hepatitis A. Therefore, this case paper will be a notable evidence for Ayurveda in hepatitis A. A 43-year female came to hospital with an one week history of lethargy, anorexia, weight loss and yellow discoloration of urine. The patient has Hepatitis A (HAV) IgM antibody positive with other viral profile negative and elevated bilirubin(6.28mg/dl) and high transaminase (SGOT-824U/L and SGPT 1263 U/L). Arogyavardhini Vati, Liv 52Hb and Phalatrikadi Kwatha were administrated in its standard doses as these regimen have Agnideepak(Carminative), Srotosothaka (channel purifier), Mrudu virechana ( Mild purgative)properties, but no signicant change in liver function test . then ( Siddha Makardwaja Rasa) is added to reduce liver inflammation and possible involvement of cholangitis. The physical strength , appetite was normalised along with normalisation of bilirubin and liver transaminase within three weeks of the therapy. The combination of therapy may reduce the bile acid cytotoxicity of bile and, possibly, decrease of the concentration of hydrophobic bile acids in the cholangiocyte. As Siddha Makardwaja special is in metallic oxide form (Au/HgO), it may be acts as an anti-inflammatory drug by reducing pro inflammatory cytokine expression, blocking leucocyte adhesion and decreasing oxidative stress due to infection. This case report is preliminary evidence for further stresses the significance of Siddha Makardwaja Rasayana along with other Ayurveda formulations in early remission of high bilirubin and liver transaminase in Hepatitis A infection. This treatment regimen can be used for local epidemic of Hepatitis A for appropriate Ayurveda management after randomised clinical trial.

Optimizing acute pain management in oral surgery: Current strategies and emerging approaches

Effective pain management in oral surgery is crucial to improving patient outcomes and satisfaction. Acute pain, a common result of oral surgical procedures such as extractions, implant placements, and bone grafting, can significantly impact patient recovery. However, pain control remains a complex challenge due to individual variability in pain perception, pre-existing medical conditions, and the inherent invasiveness of certain procedures. This article reviews current approaches to acute pain management in oral surgery, focusing on multimodal analgesia, pharmacological interventions, and non-pharmacological techniques. Traditional strategies such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and local anesthetics are discussed alongside newer alternatives, including nerve blocks, patient-controlled analgesia, and adjunct therapies like mindfulness and cryotherapy. The role of personalized pain management plans, which consider patient-specific factors, is explored to minimize side effects and enhance recovery. Advances in minimally invasive techniques, laser therapy, and alternative methods for reducing post-operative pain are also examined. Recent research highlights the importance of reducing opioid dependency while balancing the need for effective pain control. Future directions for pain management, such as precision medicine approaches and the use of digital health technologies for pain monitoring, are also discussed. The article concludes by emphasizing the need for a balanced, patient-centered approach to acute pain management in oral surgery, integrating both traditional and emerging strategies.

Non-steroidal anti-inflammatory drugs for osteoarthritis and non-specific back pain: basic provisions for effective and safe use (Interdisciplinary consensus)

The interdisciplinary council of leading experts has presented recommendations for the effective and safe use of non-steroidal anti-inflammatory drugs in osteoarthritis and non-specific back pain in general outpatient practice.

Development of Hydrogel Delivery Systems for Anti-Inflammatory Action

Hydrogels' biocompatibility, adjustable characteristics, and capacity for controlled drug release have made them attractive delivery systems for anti-inflammatory drugs. These technologies lessen the drawbacks of traditional medication delivery techniques, namely their low bioavailability and systemic side effects. The development, workings, and developments of hydrogel-based delivery methods specifically designed to reduce inflammation are examined in this paper. It explores the various kinds of hydrogels, their potential for therapeutic use, and the present difficulties in bringing these systems from the lab to the clinic.

Prooxidant state in anticancer drugs and prospect use of mitochondrial cofactors and anti-inflammatory agents in cancer prevention.

An extensive body of literature has associated cancer with redox imbalance and inflammatory conditions. Thus, several studies and current clinical practice have relied on the use of anticancer drugs known to be associated with prooxidant state. On the other hand, a number of studies have reported on the effects of several antioxidants, anti-inflammatory agents and of mitochondrial cofactors (also termed mitochondrial nutrients, MNs) in counteracting or slowing carcinogenesis, or in controlling cancer growth. In the available literature, a body of evidence points on the roles of anti-inflammatory agents and of individual MNs against carcinogenesis or in controlling cancer cell proliferation, but only a few reports on the combined use of two or the effect of three MNs. These combinations are proposed as potentially successful tools to counteract carcinogenesis in prospective animal model studies or in adjuvant cancer treatment strategies. A "triad" of MNs are suggested to restore redox balance, mitigate side effects of prooxidative anticancer drugs, or aid in cancer prevention and/or adjuvant therapy. By elucidating their mechanistic underpinnings and appraising their clinical efficacy, we aim to contribute with a comprehensive understanding of these therapeutic modalities.

Research progress on pathogenesis of skin pigmentation in chronic liver disease

Chronic liver disease (CLD) is a significant global health concern that leads to increased morbidity and mortality, and is associated with skin pigmentation changes. Excessive facial pigmentation is a common characteristic of patients with CLD, although the exact mechanism underlying this phenomenon remains unclear. Melanin, which consists of eumelanin and pheomelanin, is synthesized in melanocytes. Its production is influenced by cysteine levels and is regulated by key enzymes such as tyrosinase (TYR), tyrosinase-related protein 1 (TYRP1), and tyrosinase-related protein 2 (TYRP2). The transport of melanosomes within melanocytes relies primarily on the coordinated action of F-actin and microtubules. However, the mechanism of melanin transfer from melanocytes to surrounding dendritic cells requires further investigation. Several factors contribute to liver fibrosis including oxidative stress and inflammatory cytokines. This article discusses the factors that are elevated in the serum of patients with chronic liver disease, which may increase melanin deposition. It also introduces the signaling pathways related to melanin synthesis, providing indirect evidence for the pathological mechanisms underlying increased melanin synthesis in CLD. Additionally, the article points out that pigmentation may serve as an important indicator of liver disease deterioration and suggests the formation of a scoring system that combines related factors to enhance the predictive accuracy. In terms of treatment, antioxidants and anti-inflammatory drugs, such as silymarin and vitamin E, may improve CLD and reduce skin pigmentation, but their specific effects still require further investigation. Future research should focus on validating the mechanisms linking pigmentation changes with CLD progression, and exploring therapeutic methods that can simultaneously improve liver function and skin pigmentation, ultimately aiming for better patient outcomes.

Reusable Ni-immobilized MOF Catalyst for Dehydrogenation of N-heterocycles Under Milder Conditions.

Herein, we have demonstrated the design and synthesis of a novel Ni-immobilized MOF as heterogeneous catalyst for the dehydrogenation of N-heterocycles. A series of five and six-member N-heteroarenes bearing one or more heteroatoms were synthesized in up to 98% yield (> 33 examples). Late stage functionalization to the synthesis of b-glucuronides inhibitor, antimalarial drug quinine, and the nonsteroidal anti-inflammatory drug (NSAID) indomethacin were obtained under milder reactions conditions. A series of mechanistic studies revealed the detection of H2 and H2O2 during the progress of the reactions and suggested the involvement of enamine-imine intermediate species for sequential dehydrogenation. Detailed characterization of the fresh catalyst and reused catalyst were performed using SEM, TEM, BET, PXRD, and EDX elemental mappings. The catalyst could be recycled up to four-times without much loss in catalytic activities. In-situ formed defects, pore size enlargement and additional Lewis acid sites within catalyst nanocrystals assisted in attaining high activity and selectivity to N-heteroarenes.

In Vitro Protective Effects of a Standardized Extract of Opuntia ficus-indica (L.) Mill. Cladodes and Olea europaea L. Leaves Against Indomethacin-Induced Intestinal Epithelial Cell Injury

Nonsteroidal anti-inflammatory drugs (NSAIDs) can induce serious adverse effects in gastrointestinal (GI) mucosa, increasing intestinal permeability and leading to mitochondrial dysfunction, oxidative stress, apoptosis and inflammation. As proton pump inhibitors are effective in protecting against NSAID-induced gastropathy but not NSAID-induced enteropathy, current research is focused on natural products as protective substances for therapy and prevention of intestinal injury. Herein, through the use of an in vitro model based on intestinal epithelial cell (Caco-2) damage caused by indomethacin (INDO), we examined the protective activity of a commercially available standardized extract (OFI+OE) from Opuntia ficus-indica (L.) Mill. cladodes and Olea europaea L. leaves. Pre-treatment with OFI+OE prevented INDO-induced intestinal epithelial barrier damage, as demonstrated by TEER measurement, fluorescein permeability, and tight junction protein expression. The extract showed positive effects against INDO-induced oxidative stress and correlated activation of apoptosis, decreasing pro-apoptotic markers BAX and Caspase-3 and increasing anti-apoptotic factor Bcl-2. Moreover, the extract inhibited the NF-κB pathway and pro-inflammatory cascade. In conclusion, these data support the use of OFI+OE extract as a natural strategy for therapy and prevention of intestinal mucosal damage, demonstrating its beneficial effects against INDO-induced intestinal damage, through modulation of oxidative, apoptotic, and inflammatory pathways.

Canis lupus familiaris and diclofenac: understanding the potential risks of this association

In many homes worldwide, dogs are considered part of the family. Every possible care is given to animals, including drug treatments. However, many animal guardians, in an attempt to minimize pain or improve the quality of life of their dogs, provide drugs without a veterinarian’s prescription. Diclofenac, a non-steroidal anti-inflammatory drug that acts on cyclooxygenase-1 and cyclooxygenase-2 enzymes, is associated with several adverse events, especially related to the gastrointestinal tract, both in humans and pet animals. Therefore, the availability of information about the effects of this drug in different species is always essential. This narrative review aims to present adverse reactions the domestic dog (Canis lupus familiaris) can suffer when exposed to diclofenac. Scientific publications, books, and case reports were consulted, and inquiries were also carried out with regulatory agencies. Many reports of suspected adverse reactions, especially related to the gastrointestinal tract, were found. Other clinical manifestations and lesions were also identified in the cardiovascular system, liver, kidneys, and hematological examinations. Therefore, diclofenac may constitute a hazard to dogs, mainly due to possible damage to the gastrointestinal tract. This fact reinforces the need to seek veterinary advice before providing any drug to animals, in addition to recommendations on ensuring the correct storage of medications to avoid accidental exposure.

Arthroscopy combined with bone tunnel technique for treating Berndt and Harty stage III or IV osteochondral lesions of the talus.

To explore the efficacy and feasibility of arthroscopy combined with bone tunnel technique in treating Berndt and Harty stage III or IV osteochondral lesions of the talus (OLT). A retrospective analysis was conducted on the clinical data of 21 patients with Berndt and Harty stage III or IV OLT who underwent surgical treatment at our institution from September 2017 to September 2022. Under arthroscopy, the displaced talar osteochondral lesion was restored. A 2.0mm Kirschner wire (K-wire) was used to create a bone tunnel from the medial (or lateral) malleolus to the realigned osteochondral lesion. A 1.5mmK-wire was then used to drill through this tunnel into the osteochondral fragment, and a 1.5mm absorbable bone rod was inserted for fixation. Preoperative and final follow-up visual analogue scale (VAS) for pain and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale were recorded and compared. All 21 patients were followed up for an average of 23.95 ± 6.01months. All wounds healed by primary intention, with no nerve, blood vessel, or tendon injuries. All osteochondral lesions healed, with an average healing time of 3.71 ± 0.62months. The VAS score decreased from a preoperative average of 5.38 ± 0.59 to 0.48 ± 0.51 at the final follow-up. The AOFAS ankle-hindfoot scale increased from a preoperative average of 56.29 ± 5.98 to 88.43 ± 2.68 at the final follow-up (P < 0.05), showing statistically significant differences. Two cases experienced medial pain after 12months, which was tolerable with non-steroidal anti-inflammatory drugs. Arthroscopy combined with bone tunnel technique for treating Berndt and Harty stage III or IV OLT has the advantages of minimal injury, visualization of fracture reduction, and fewer complications.

Marginal ulcer causing anastomotic perforation and delayed penetration following one anastomosis gastric bypass

We report the rare clinical case of perforation and delayed penetration of an ulcer at the gastro-jejunal anastomosis following 14 months after laparoscopic one anastomosis gastric bypass in a young female patient. No significant ulcer predictors at baseline: a chronic ulcer formed within the first six months after one anastomosis gastric bypass against the background of continued proton pump inhibitor therapy, regardless of smoking, helicobacter infection or use of non-steroidal anti-inflammatory drugs. Initially the patient underwent the laparotomy with perforation suturing and Roux-jejunojejunostomy formation to exclude the bile reflux into the gastric pouch. The result of the first surgery (non-healing ulcer with the development of delayed penetration six months later) is agree with the recent literature about the possible overstatement of the role of biliary reflux in ulcer formation after one anastomosis gastric bypass. The follow-up surgery was performed by the laparoscopic approach in condition of pronounced adhesion process in abdominal cavity and included adhesiolysis, resection of the gastric pouch with the anastomosis and reconstructive Roux-Y-gastric bypass. Clinical and endoscopic evaluation of the result of the reconstructive surgery 10 months after indicates the patient's recovery.

Sulfasalazine-Loaded Copper-Tannic Acid Coordination Nanozyme Enables ROS Scavenging and Immunomodulation for Inflammatory Bowel Disease Therapy.

Inflammatory bowel disease (IBD) is associated with elevated levels of reactive oxygen species (ROS) and an increased expression of proinflammatory cytokines. Anti-inflammatory drugs, monoclonal antibodies, and immunomodulators are commonly employed to control the inflammatory response in the management of IBD. Here, a copper and tannic acid (TA) coordination nanozyme (CuTA) loaded with sulfasalazine (SSZ-CuTA) is synthesized for the treatment of IBD by simultaneous scavenging ROS and immunosuppression. The CuTA exhibits both dismutase-like activity and catalase-like activity, making it efficient at scavenging ROS. These nanozymes can efficiently traverse gastric acid and subsequently exert their effects within the intestinal tract. It is verified that SSZ-CuTA can restore intestinal mucosal and goblet cells to a healthy state by effectively eliminating ROS and reducing the pro-inflammatory factors in a mouse IBD model. Overall, the SSZ-CuTA will offer a promising alternative treatment for patients suffering from IBD where excessive ROS and high inflammation coexist.

Ayurvedic management of Vranashopha w.r.t. Cellulitis: A Single Case Study

Cellulitis is a spreading inflammation of dermis and subcutaneous tissue. It is commonly due to Streptococcus pyogenes and gram positive organisms. These organisms usually gain access through a wound or scratch. It is generally treated with Antibiotics, anti-inflammatory, antipyretic and analgesic medications. The disease can progress and complicates to Abscess formation, gangrenous cellulitis or necrotizing fascitis. Vrana Shopha can be associated with Cellulitis. According to Ayurveda, Ekadasha/Saptopakrama treatment have been explained. A 36 year old male Right hemiplegic patient presented with indurated swelling and redness over lateral aspect in Right foot region &amp; was treated with Chedana Karma, Lepana and Shamana Aushadi, where he showed good progression in this condition.

Self-Cascade API Nanozyme for Synergistic Anti-Inflammatory, Antioxidant, and Ferroptosis Modulation in the Treatment of Corneal Neovascularization.

Corneal neovascularization is a common pathological ocular change that can severely impairs vision, potentially leading to blindness. Although steroids and non-steroidal anti-inflammatory drugs are the primary treatments, their side effects, such as ocular hypertension, eye irritation, and corneal lysis, limit their widespread use. In the present study, an active pharmaceutical ingredient (API) nanozyme (PC-DS NE) is developed through the metal-organic coordination of ferrous sulfate with the anti-inflammatory agent diclofenac sodium and the natural antioxidant proanthocyanidin. PC-DS NE exhibited a spheroid morphology with a particle size of 39.7 ± 5.2 nm, and could achieve the short-term release of diclofenac sodium and sustained release of proanthocyanidin. Notably, the PC-DS NE possessed favorable biocompatibility, self-cascade redox regulation capacity, and significant anti-inflammatory activity. In corneal alkali burn experiments, PC-DS NE effectively inhibited corneal neovascularization by scavenging reactive oxygen species, inhibiting the expression of inflammatory cytokines and pro-angiogenic factors, and down-regulating ferroptosis. These synergistic effects highlighted the potential of PC-DS NE as a promising treatment for ocular inflammatory diseases.

Proton pump inhibitors - possible side effects of long-term therapy: a review

Introduction and purpose: Proton pump inhibitors (PPIs), which have been on the market for more than 30 years, are widely regarded as safe and effective medications. For this reason, they are very popular with both doctors and patients. PPIs find their use in the treatment of such ailments as gastroesophageal reflux, gastric ulcer disease or as a shielding therapy when taking non-steroidal anti-inflammatory drugs. Nevertheless, their long-term use may be associated with many side effects. The purpose of our review is to summarize the knowledge in the current medical literature on the possible complications of chronic use of PPIs. The review is based on 30 articles from the most recent publications on chronic PPI treatment. Publications were searched for the words PPI chronic therapy, gastric cancer, omeprazole in PubMed databases. Articles from 2018-2024 represent 70% of all publications from the references. A brief description of the state of knowledge: Although the use of PPIs in the short term is relatively safe, the number of people taking these drugs has increased significantly in recent years. They are prescribed not always as indicated, patients often take them for too long - this in turn leads to an increasing incidence of side effects. Some of them can permanently affect health and significantly reduce the comfort of life - such as kidney diseases, cardiovascular disorders or gastric cancer. Summary: Considering the widespread availability and popularity of PPIs, it is important to adequately educate both patients and healthcare professionals of the possible side effects. It is crucial to use medications as prescribed, with an appropriate assessment of the risk-benefit ratio. It might result in reducing health care expenditures to deal with the consequences of IPP therapy.

Engineered Lubricative Lecithin-Based Electrospun Nanofibers for the Prevention of Postoperative Abdominal Adhesion

Background: Postoperative abdominal adhesion is a prevalent complication following abdominal surgery, with the incidence of adhesion reaching up to 90%, which may precipitate a range of adverse outcomes. Although fibrous membranes loaded with various anti-inflammatory or other drugs have been proposed for anti-adhesion, most of them suffer from drug-induced adverse effects. Methods: In this study, a lecithin-based electrospun polylactic acid (PLA) nanofibrous membrane (L/P-NM) was developed for the prevention of postoperative abdominal adhesion, utilizing the hydration lubrication theory. The loaded zwitterionic lecithin allows the nanofiber surface to strongly bind water molecules to create a hydration lubrication interface. Results: As the TGA results show, the content of bound water in the nanofibers increased significantly with the increase in the lecithin content. Tribological test results show that L/P-NM reached a minimum coefficient of friction (COF) of about 0.112. Additionally, the developed nanofibrous membranes possess favorable tensile property and biocompatibility. Rat postoperative abdominal adhesion model evaluation results demonstrated that L/P-NM possesses significant anti-adhesive performance, with an adhesion score of only 1. Conclusions: Therefore, this study offers a promising strategy for efficiently preventing abdominal adhesion.