[New aspects of pathogenesis of adhesive process in the abdominal cavity]

Vestn Khir Im I I Grek. 2009;168(1):45-9.
[Article in Russian]

Abstract

Adhesive process in the abdominal cavity is the leading cause of morbidity and mortality in abdominal surgery. The clinical investigation included 126 children with acute adhesive intestinal obstruction. All patients were divided into two groups: polyenzyme and monoenzyme groups. In the polyenzyme group there was one case of intestinal obstruction. In the monoenzyme group there were 4 children with intestinal obstruction. The experiment included 70 adult rats divided in two equal groups: the main and control groups. The main group animals were given a polyenzyme preparation. The control group had a high incidence of cecal adhesions, which was significantly higher than the number of adhesions in the main group (Chi-square test = 23.1, df=2, p = 0.001). Proteolytic enzymes induce cells to express, de novo, the vascular endothelial growth factor, fibroblast growth factor and Laminin. As a consequence of these effects, activation of T-lymphocytes and macrophages mediating the inflammatory response will be down-regulated. It was found that the levels of VEGF, FGF and Laminin in the abdominal cavity, detected by immunohistochemistry, were different in the rats having high level and having no postoperative abdominal adhesion. The level of angiogenesis factors was also rapidly normalized by means of polyenzyme therapy.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Adjuvants, Immunologic / therapeutic use*
  • Animals
  • Cecal Diseases / etiology*
  • Cecal Diseases / metabolism
  • Cecal Diseases / prevention & control
  • Child
  • Disease Models, Animal
  • Drug Combinations
  • Female
  • Fibroblast Growth Factors / metabolism
  • Follow-Up Studies
  • Humans
  • Hyaluronoglucosaminidase / therapeutic use*
  • Hydrolases / therapeutic use
  • Immunohistochemistry
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / metabolism
  • Intestinal Obstruction / prevention & control
  • Laminin / metabolism
  • Macrophages, Peritoneal / immunology
  • Macrophages, Peritoneal / pathology
  • Male
  • Peritoneal Diseases / complications*
  • Peritoneal Diseases / metabolism
  • Peritoneal Diseases / prevention & control
  • Rats
  • Rutin / therapeutic use
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology
  • Tissue Adhesions / complications
  • Tissue Adhesions / metabolism
  • Tissue Adhesions / prevention & control
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Adjuvants, Immunologic
  • Drug Combinations
  • Laminin
  • Vascular Endothelial Growth Factor A
  • Rutin
  • Fibroblast Growth Factors
  • Wobenzym
  • Hydrolases
  • Hyaluronoglucosaminidase