title: Reduction of experimental adhesion formation by inhibition of plasminogen activator inhibitor type 1.
abstract: BACKGROUND
  Adhesion formation is a common cause of complications following surgery. A reduction in peritoneal fibrinolytic capacity during operation is a key mechanism in the early formation of adhesions. An increase in the main inhibitor of fibrinolysis, plasminogen activator inhibitor type 1 (PAI-1), is a major factor in the loss of fibrinolytic activity. The aim of this study was to investigate if inhibition of PAI-1 could reduce the formation of adhesions after surgery.
  
  
  METHODS
  Mice (n = 53) were subjected to a standard surgical procedure in order to induce adhesion formation to the abdominal side wall. At the conclusion of the operation, fragments for antigen binding of polyclonal rabbit antibody against PAI-1 (PRAP-1) were injected intraperitoneally, at two different concentrations. Control animals received an equal volume of the vehicle (saline). One week after operation adhesion formation was quantified.
  
  
  RESULTS
  Both doses of PRAP-1 significantly reduced adhesion formation compared with the saline control (P = 0.003 and P = 0.002). There were no signs of bleeding in the postoperative period or at reoperation.
  
  
  CONCLUSIONS
  The present observations lend further support to the hypothesis of a pivotal role of fibrinolysis in the early formation of adhesions, and open up new possibilities for adhesion reduction by inhibiting PAI-1.
authors.affiliation: Department of Surgery, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Falk
authors.forename: P
authors.initials: P
authors.lastname: Björquist
authors.forename: M
authors.initials: M
authors.lastname: Strömqvist
authors.forename: L
authors.initials: L
authors.lastname: Holmdahl
mesh_terms: D000818:Animals; D005260:Female; D051379:Mice; D010529:Peritoneal Cavity / Q000601:surgery*; D017395:Plasminogen Activator Inhibitor 1 / Q000008:administration & dosage*; D000267:Tissue Adhesions / Q000517:prevention & control*
chemical_list: D017395:Plasminogen Activator Inhibitor 1