Trehalose solution protects mesothelium and reduces bowel adhesions.
BACKGROUND
Preventing interbowel adhesions still remains a challenge. Peritoneal mesothelial damage can induce postoperative adhesions. Our study evaluated the effects of 3% trehalose solution on mesothelial protection and adhesion prevention. Also, we compared this novel solution with Seprafilm regarding efficacy.


METHODS
Mesothelial damage was induced on the cultured human mesothelial cell (Met-5A) and rabbit cecum-serosal surface by air-drying for 60 min, and trehalose solution was applied. Cell integrity was tested by measuring lactate dehydrogenase, and serosal-morphologic changes were analyzed using scanning electron microscopy. Intra-abdominal adhesions were induced in rabbits by the combination of abrasion and air-drying procedures. Animals were divided into four groups: control, 3% trehalose solution, Seprafilm, and 3% trehalose solution with Seprafilm. Adhesions were evaluated blindly 7 d later.


RESULTS
Lactate dehydrogenase release from the Met-5A cells was reduced dose-dependently by trehalose (P < 0.05). Morphologic studies clearly showed that mesothelial cells on the serosal surface were kept intact by 3% trehalose solution. In a rabbit adhesion model, 3% trehalose solution reduced adhesions between bowel and bowel or bowel and surrounding structures (P < 0.01 versus control and Seprafilm). Seprafilm reduced adhesions between abdominal wall and underlying viscera (P < 0.01 versus control and 3% trehalose solution). Three-percent trehalose solution with Seprafilm showed additive effects of adhesion prevention, reducing adhesion formation at the previously mentioned sites.


CONCLUSIONS
Three-percent trehalose solution protects mesothelial cells and leads to reduced adhesions between bowel and bowel or bowel and surrounding structures. This effect seems to be resulted from the characteristics of the solution covering most areas that potentially develop adhesions.
Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc, Naruto, Tokushima, Japan. Electronic address: ohhataa@otsuka.jp.
Atsushi
A
Ohata
Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc, Naruto, Tokushima, Japan.
Nozomi
N
Tamura
Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc, Naruto, Tokushima, Japan.
Koushi
K
Iwata
Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc, Naruto, Tokushima, Japan.
Naomi
N
Abe
Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc, Naruto, Tokushima, Japan.
Kazuhisa
K
Doi
Laboratory of Pathology, Toxicology Division, Hatano Research Institute, Food and Drug Safety Center, Hadano, Kanagawa, Japan.
Yoshiaki
Y
Saito
Study Department, Nihon Bioresearch Inc, Hashima, Gifu, Japan.
Masami
M
Katoh
Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc, Naruto, Tokushima, Japan.
Hiroshi
H
Nojima
D000818:Animals; D002432:Cecum / Q000187:drug effects / Q000601:surgery*; D002460:Cell Line; D019610:Cytoprotection; D004195:Disease Models, Animal; D004847:Epithelial Cells / Q000166:cytology / Q000187:drug effects*; D004848:Epithelium / Q000187:drug effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology; D007413:Intestinal Mucosa / Q000187:drug effects / Q000601:surgery; D007422:Intestines / Q000187:drug effects / Q000601:surgery; D007552:Isotonic Solutions / Q000494:pharmacology; D011817:Rabbits; D000077331:Ringer's Solution; D000267:Tissue Adhesions / Q000517:prevention & control*; D014199:Trehalose / Q000494:pharmacology*
D007552:Isotonic Solutions; C118198:Seprafilm; D000077331:Ringer's Solution; D006820:Hyaluronic Acid; D014199:Trehalose
Air-dry; Bowel adhesions; Mesothelial cells; Mesothelial damage; Postoperative adhesions; Trehalose