Novel approach to reduce postsurgical adhesions to a minimum: administration of losartan plus atorvastatin intraperitoneally.
BACKGROUND
Intraperitoneal adhesions are the most important cause of intestinal obstruction, pelvic pain, and female infertility.


METHODS
Losartan (1, 5, and 10 mg/kg), atorvastatin (1, 20, and 30 mg/kg), losartan (10 mg/kg) plus atorvastatin (20 mg/kg), and sodium hyaluronate/carboxymethylcellulose (HA/CMC) were administered intraperitoneally in 90 male NMRI mice. After 7 d, the grade of adhesions was scored by two scaling methods and the concentrations of TGF-β1, tPA, and PAI-1 were also evaluated.


RESULTS
Simultaneous intraperitoneal administration of losartan and atorvastatin led to a much higher reduction of adhesions compared with that in the HA/CMC group (P < 0.05). When losartan plus atorvastatin was administered, significant changes in the serum concentration and mRNA expression, including the increase of tPA and the decrease of TGF-β1 and PAI-1, were observed compared with those in other groups.


CONCLUSIONS
Our findings suggest that the simultaneous application of losartan and atorvastatin leads to an enhanced reduction in adhesion bands more than that of HA/CMC treatment, compared with the control group, possibly through balancing the expression of TGF-β1, tPA, and PAI-1.
Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Peyman
P
Dinarvand
Shirin
S
Farhadian
Ehsan
E
Seyedjafari
Abbas
A
Shafiee
Arash
A
Jalali
Parisa
P
Sanaei-Rad
Babak
B
Dinarvand
Masoud
M
Soleimani
D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage*; D000818:Animals; D000069059:Atorvastatin; D006538:Heptanoic Acids / Q000008:administration & dosage*; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007274:Injections, Intraperitoneal; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D051379:Mice; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood / Q000235:genetics; D011183:Postoperative Complications / Q000517:prevention & control*; D011758:Pyrroles / Q000008:administration & dosage*; D012333:RNA, Messenger / Q000032:analysis; D000267:Tissue Adhesions / Q000517:prevention & control*; D010959:Tissue Plasminogen Activator / Q000097:blood; D053773:Transforming Growth Factor beta1 / Q000097:blood / Q000235:genetics
D057911:Angiotensin Receptor Antagonists; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017395:Plasminogen Activator Inhibitor 1; D011758:Pyrroles; D012333:RNA, Messenger; D053773:Transforming Growth Factor beta1; D000069059:Atorvastatin; D010959:Tissue Plasminogen Activator; D019808:Losartan