Title:The Therapeutic Potential of Targeting Key Signaling Pathways as a Novel
Approach to Ameliorating Post-Surgical Adhesions
Volume: 28
Issue: 45
Author(s): Behzad Ensan, Parsa Bathaei, Mohammadreza Nassiri, Majid Khazaei, Seyed Mahdi Hassanian, Abbas Abdollahi, Hamid Reza Ghorbani, Mohsen Aliakbarian, Gordon A. Ferns and Amir Avan*
Affiliation:
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetics Research
Center, Mashhad University of Medical Sciences, Mashhad, Iran
Keywords:
Signaling pathways, novel therapeutic approach, post-surgical adhesions, peritoneal adhesions, surgical trauma, infertility.
Abstract:
Background: Peritoneal adhesions (PA) are a common complication of abdominal operations. A
growing body of evidence shows that inhibition of inflammation and fibrosis at sites of peritoneal damaging
could prevent the development of intra-abdominal adhesions.
Methods: A search of PubMed, Medline, CINAHL and Embase databases was performed using the keywords
‘postsurgical adhesion’, ‘post-operative adhesion’, ‘peritoneal adhesion’, ‘surgery-induced adhesion’ and ‘abdominal
adhesion’. Studies detailing the use of pharmacological and non-pharmacological agents for peritoneal
adhesion prevention were identified, and their bibliographies were thoroughly reviewed to identify further related
articles.
Results: Several signaling pathways, such as tumor necrosis factor-alpha, tissue plasminogen activator, and
type 1 plasminogen activator inhibitor, macrophages, fibroblasts, and mesothelial cells play a key part in the
development of plasminogen activator. Several therapeutic approaches based on anti-PA drug barriers and traditional
herbal medicines have been developed to prevent and treat adhesion formation. In recent years, the
most promising method to prevent PA is treatment using biomaterial-based barriers.
Conclusion: In this review, we provide an overview of the pathophysiology of adhesion formation and various
agents targeting different pathways, including chemical agents, herbal agents, physical barriers, and clinical trials
concerning this matter.
