Investigation of the effect of Enalapril on postoperative abdominal adhesion
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Sanaz Majnoon,1,* Reyhaneh Sabbaghzadeh,2 Majid Khazaei,3 Amir Avan,4 Mehdi Hoseinian Mehr,5
1. Hakim Sabzevari University
2. hakim sabzevari university
3. hakim sabzevari university
- Introduction: One of the clinical challenges is postoperative adhesions. Renin angiotensin type I receptor antagonists, such as Enalapril, is one of the most important drugs used to treat hypertension and cardiovascular disorders. It reduces TGF-β expression. One of the most important pro-fibrotic factors is TGF-β cytokine, which involved in the mechanism of increased collagen expression, accumulation of extracellular matrix and consequently fibrosis, and postoperative adhesions are also a result of the fibrosis process. Accordingly, the aim of the present study was to investigate the effect of Enalapril on postoperative adhesions by evaluating histological factors, gene expression and biochemical factors.
- Methods: In this experiment, after establishing the adhesion model in the study groups, treatment with Enalapril was performed and after the end of the treatment period and killing the animal, macroscopic examinations of the severity of adhesion carried out using Nair and Leach criteria. The severity of inflammation as well as fibrosis in the adhesive tissues between the cecum and the abdominal wall were evaluated by histopathological examination and H&E and trichrome staining. The expression of collagen 1 and collagen 3 genes was also examined using real time PCR technique. In the continuation of this experiment, the concentration of inflammatory factors IL6, TNF-α and fibrotic factor TGF-β in the homogeneity of adipose tissues was investigated using ELISA method.
- Results: The results of this study showed that treatment with Enalapril reduced the severity of postoperative adhesions. In histological staining studies, the severity of inflammation and fibrosis in the group treated with Enalapril was significantly reduced, and this drug also reduced the fibrotic factor TGF-β and the expression of collagen genes.
- Conclusion: The results of this experiment showed that Enalapril reduced postoperative adhesions and showed that treatment with this drug reduced the concentration of TGF-β and decreased the expression of collagen genes involved in adhesions mechanism so reduced postoperative adhesions. This drug is recommended to prevent postoperative adhesions due to its safety in people who are candidates for surgery.
- Keywords: Postoperative adhesions, Enalapril, TGF-β fibrotic factor
