title: Inhibition of cyclooxygenase-2 prevents intra-abdominal adhesions by decreasing activity of peritoneal fibroblasts.
abstract: BACKGROUND
  Postoperative intra-abdominal adhesions are common complications after abdominal surgery. The exact molecular mechanisms that are responsible for these complications remain unclear, and there are no effective methods for preventing adhesion formation or reformation. The aim of the study reported here was to investigate the preventive effects and underlying potential molecular mechanisms of selective cyclooxygenase-2 (COX-2) inhibitors in a rodent model of postoperative intra-abdominal adhesions.
  
  
  METHODS
  The expression of COX-2 in postoperative intra-abdominal adhesions and normal peritoneal tissue was examined by immunohistochemistry and Western blot analysis. Assays were performed to elucidate the effect of COX-2 inhibition on hypoxia-induced fibroblast activity in vitro and on intra-abdominal adhesion formation in vivo.
  
  
  RESULTS
  Hypoxia-induced COX-2 expression in peritoneal fibroblasts was increased in postoperative intra-abdominal adhesions. Inhibition of COX-2 attenuated the activating effect of hypoxia on normal peritoneal fibroblasts in vitro. Data indicate that selective COX-2 inhibitor prevents in vivo intra-abdominal adhesion by inhibition of basic fibroblast growth factor and transforming growth factor-beta expression, but not through an antiangiogenic mechanism. Furthermore, using selective COX-2 inhibitors to prevent intra-abdominal adhesions did not adversely affect the weight, bowel motility, or healing of intestinal anastomoses in a rat model.
  
  
  CONCLUSIONS
  These results show that hypoxia-induced COX-2 expression in peritoneal fibroblasts is involved in the formation of intra-abdominal adhesions. Inhibition of COX-2 prevents postoperative intra-abdominal adhesions through suppression of inflammatory cytokines.
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China.
authors.forename: Guangbing
authors.initials: G
authors.lastname: Wei
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China ; Department of General Surgery, First People's Hospital of Xianyang City, Xianyang, People's Republic of China.
authors.forename: Pengbo
authors.initials: P
authors.lastname: Jia
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China.
authors.forename: Qinhong
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China.
authors.forename: Gaofeng
authors.initials: G
authors.lastname: Ping
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China.
authors.forename: Kang
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China.
authors.forename: Xuqi
authors.initials: X
authors.lastname: Li
mesh_terms: D034861:Abdominal Wall / Q000473:pathology; D000714:Anastomosis, Surgical; D000818:Animals; D001835:Body Weight; D015687:Cell Hypoxia / Q000187:drug effects; D051546:Cyclooxygenase 2 / Q000096:biosynthesis / Q000235:genetics; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D016222:Fibroblast Growth Factor 2 / Q000037:antagonists & inhibitors; D005347:Fibroblasts / Q000187:drug effects*; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D000860:Hypoxia / Q000473:pathology; D010529:Peritoneal Cavity / Q000166:cytology*; D011183:Postoperative Complications / Q000517:prevention & control; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors; D014945:Wound Healing / Q000187:drug effects
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D016212:Transforming Growth Factor beta; D016222:Fibroblast Growth Factor 2; D051546:Cyclooxygenase 2
keywords: COX-2; COX-2 inhibitors; hypoxia; postoperative adhesions