title: Coincidence of connective tissue growth factor expression with fibrosis and angiogenesis in postoperative peritoneal adhesion formation.
abstract: OBJECTIVE
  To investigate the relationship between connective tissue growth factor (CTGF) and fibrosis and angiogenesis in postoperative peritoneal adhesion formation.
  
  
  METHODS
  Adhesions were performed in 35 rats by creation of a peritoneal patch. Animals were sacrificed at 7 different time-points over 3 weeks. Adhesions and uninjured peritoneum from all animals were assessed by Northern blotting for CTGF and collagen-I mRNA and by immunohistochemistry for CTGF localization, degree of fibrosis and angiogenesis.
  
  
  RESULTS
  Persistent adhesions formed in all animals. CTGF and collagen-I mRNA were increased in adhesions compared to uninjured peritoneum (p < 0.05 for both). The temporal expression pattern depicted delayed peak levels of collagen-I mRNA with increasing tendency for both transcripts at the end of the observation period. Fibrosis within adhesions correlated positively with time after surgery (r = 0.85; p < 0.001) and showed typical signs of chronic tissue fibrosis at later time points. Angiogenesis was detected in adhesions but not in uninjured peritoneum (p = 0.001) and coincided with the spatial and temporal expression of CTGF protein in fibroblasts and vascular endothelial cells.
  
  
  CONCLUSIONS
  The co-expression of CTGF with increasing fibrosis and angiogenesis in postoperative peritoneal adhesions suggests a role for CTGF as critical molecule in fibrous adhesive disease and target for future adhesion prevention.
authors.affiliation: Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
authors.forename: K
authors.initials: K
authors.lastname: Thaler
authors.forename: Judith A
authors.initials: JA
authors.lastname: Mack
authors.forename: Mariana
authors.initials: M
authors.lastname: Berho
authors.forename: G
authors.initials: G
authors.lastname: Grotendorst
authors.forename: S D
authors.initials: SD
authors.lastname: Wexner
authors.forename: Susan R
authors.initials: SR
authors.lastname: Abramson
mesh_terms: D000818:Animals; D024042:Collagen Type I / Q000235:genetics / Q000378:metabolism; D055513:Connective Tissue Growth Factor; D005355:Fibrosis / Q000473:pathology*; D006801:Humans; D017874:Immediate-Early Proteins / Q000235:genetics / Q000378:metabolism*; D007150:Immunohistochemistry; D036341:Intercellular Signaling Peptides and Proteins / Q000235:genetics / Q000378:metabolism*; D008297:Male; D009389:Neovascularization, Pathologic; D010537:Peritoneum / Q000098:blood supply / Q000166:cytology / Q000473:pathology; D011184:Postoperative Period; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000473:pathology*
chemical_list: C526317:CCN2 protein, human; C526316:CCN2 protein, rat; D024042:Collagen Type I; D017874:Immediate-Early Proteins; D036341:Intercellular Signaling Peptides and Proteins; D012333:RNA, Messenger; D055513:Connective Tissue Growth Factor