Evaluation of the effects of gonadotropin-releasing hormone antagonist (GnRH-ant) and agonist (GnRH-a) in the prevention of postoperative adhesion formation in a rat model with immunohistochemical analysis

Fertil Steril. 2011 Nov;96(5):1230-3. doi: 10.1016/j.fertnstert.2011.09.001. Epub 2011 Oct 1.

Abstract

Objective: To investigate the effects of GnRH antagonist (GnRH-ant) and agonist (GnRH-a) in the prevention of postoperative pelvic adhesions by a visual scoring system and immunohistochemical methods in a rat uterine horn model.

Design: Controlled experimental animal study.

Setting: Animal laboratory at an academic research environment.

Animal(s): Twenty-one Wistar albino rats.

Intervention(s): Rats were randomized into three groups. One week before the operation the rats received either GnRH-ant or GnRH-a or saline solution; they then underwent surgical laparotomy, and both uterine horns were traumatized by a scalpel. Three weeks later, all rats were sacrificed and extension and severity of the adhesions in each group were scored by a visual scoring system. Adhesion tissues were evaluated immunohistochemically for vitronectin and u-PAR.

Main outcome measure(s): Scores of extend and severity of adhesions and staining of vitronectin and u-PAR.

Result(s): The extent of adhesion scores were 1.85 ± 0.86, 0.78 ± 1.05, and 0.42 ± 0.64, and the severity of adhesion scores were 1.71 ± 0.91, 0.57 ± 0.85, 0.50 ± 0.75 for control, GnRH-ant, and GnRH-a groups, respectively. The extent and severity of adhesions were significantly lower in both GnRH-ant and GnRH-a groups when compared with the control group. Adhesion extent scores in the GnRH-a group were lower than in the GnRH-ant group, but this difference was not significant. vitronectin and u-PAR staining were significantly greater in both the GnRH-ant and GnRH-a groups than in the control group.

Conclusion(s): GnRH-ant as well as GnRH-a reduced postoperative adhesion formation in a rat model. This finding was supported immunohistochemically by vitronectin and u-PAR staining.

MeSH terms

  • Animals
  • Female
  • Fertility Agents, Female / pharmacology*
  • Gonadotropin-Releasing Hormone / agonists
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors
  • Gonadotropin-Releasing Hormone / pharmacology
  • Hormone Antagonists / pharmacology*
  • Immunohistochemistry*
  • Leuprolide / pharmacology*
  • Postoperative Complications / etiology
  • Postoperative Complications / metabolism
  • Postoperative Complications / pathology
  • Postoperative Complications / prevention & control*
  • Rats
  • Rats, Wistar
  • Receptors, Urokinase Plasminogen Activator / metabolism
  • Severity of Illness Index
  • Time Factors
  • Tissue Adhesions / prevention & control
  • Uterine Diseases / etiology
  • Uterine Diseases / metabolism
  • Uterine Diseases / pathology
  • Uterine Diseases / prevention & control*
  • Uterus / drug effects*
  • Uterus / metabolism
  • Uterus / surgery
  • Vitronectin / metabolism

Substances

  • Fertility Agents, Female
  • Hormone Antagonists
  • Receptors, Urokinase Plasminogen Activator
  • Vitronectin
  • Gonadotropin-Releasing Hormone
  • Leuprolide
  • cetrorelix