Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice

BACKGROUND: Adhesion formation contributes to postoperative complications in abdominal and gynaecological surgery. Thus far, the prevention and treatment strategies have focused on mechanical barriers in solid and liquid form, but these methods are not in routine use. As autologous fat grafting has...

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Autores principales: Laukka, Mervi, Hoppela, Erika, Salo, Jemiina, Rantakari, Pia, Gronroos, Tove J., Orte, Katri, Auvinen, Kaisa, Salmi, Marko, Gerke, Heidi, Thol, Kerstin, Peuhu, Emilia, Kauhanen, Saila, Merilahti, Pirjo, Hartiala, Pauliina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674570/
https://www.ncbi.nlm.nih.gov/pubmed/31823326
http://dx.doi.org/10.1007/s11605-019-04425-4
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author Laukka, Mervi
Hoppela, Erika
Salo, Jemiina
Rantakari, Pia
Gronroos, Tove J.
Orte, Katri
Auvinen, Kaisa
Salmi, Marko
Gerke, Heidi
Thol, Kerstin
Peuhu, Emilia
Kauhanen, Saila
Merilahti, Pirjo
Hartiala, Pauliina
author_facet Laukka, Mervi
Hoppela, Erika
Salo, Jemiina
Rantakari, Pia
Gronroos, Tove J.
Orte, Katri
Auvinen, Kaisa
Salmi, Marko
Gerke, Heidi
Thol, Kerstin
Peuhu, Emilia
Kauhanen, Saila
Merilahti, Pirjo
Hartiala, Pauliina
author_sort Laukka, Mervi
collection PubMed
description BACKGROUND: Adhesion formation contributes to postoperative complications in abdominal and gynaecological surgery. Thus far, the prevention and treatment strategies have focused on mechanical barriers in solid and liquid form, but these methods are not in routine use. As autologous fat grafting has become popular in treatment of hypertrophic scars because of its immunomodulatory effects, we postulated that fat grafting could also prevent peritoneal adhesion through similar mechanisms. METHODS: This was a control versus intervention study to evaluate the effect of fat grafting in the prevention on peritoneal adhesion formation. An experimental mouse model for moderate and extensive peritoneal adhesions was used (n = 4–6 mice/group). Adhesions were induced mechanically, and a free epididymal fat graft from wild type or CAG-DsRed mice was injected preperitoneally immediately after adhesion induction. PET/CT imaging and scaling of the adhesions were performed, and samples were taken for further analysis at 7 and 30 days postoperation. Macrophage phenotyping was further performed from peritoneal lavage samples, and the expression of inflammatory cytokines and mesothelial layer recovery were analysed from peritoneal tissue samples. RESULTS: Fat grafting significantly inhibited the formation of adhesions. PET/CT results did not show prolonged inflammation in any of the groups. While the expression of anti-inflammatory and anti-fibrotic IL-10 was significantly increased in the peritoneum of the fat graft–treated group at 7 days, tissue-resident and repairing M2 macrophages could no longer be detected in the fat graft at this time point. The percentage of the continuous, healed peritoneum as shown by Keratin 8 staining was greater in the fat graft–treated group after 7 days. CONCLUSIONS: Fat grafting can inhibit the formation of peritoneal adhesions in mice. Our results suggest that fat grafting promotes the peritoneal healing process in a paracrine manner thereby enabling rapid regeneration of the peritoneal mesothelial cell layer. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11605-019-04425-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-76745702020-11-30 Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice Laukka, Mervi Hoppela, Erika Salo, Jemiina Rantakari, Pia Gronroos, Tove J. Orte, Katri Auvinen, Kaisa Salmi, Marko Gerke, Heidi Thol, Kerstin Peuhu, Emilia Kauhanen, Saila Merilahti, Pirjo Hartiala, Pauliina J Gastrointest Surg Original Article BACKGROUND: Adhesion formation contributes to postoperative complications in abdominal and gynaecological surgery. Thus far, the prevention and treatment strategies have focused on mechanical barriers in solid and liquid form, but these methods are not in routine use. As autologous fat grafting has become popular in treatment of hypertrophic scars because of its immunomodulatory effects, we postulated that fat grafting could also prevent peritoneal adhesion through similar mechanisms. METHODS: This was a control versus intervention study to evaluate the effect of fat grafting in the prevention on peritoneal adhesion formation. An experimental mouse model for moderate and extensive peritoneal adhesions was used (n = 4–6 mice/group). Adhesions were induced mechanically, and a free epididymal fat graft from wild type or CAG-DsRed mice was injected preperitoneally immediately after adhesion induction. PET/CT imaging and scaling of the adhesions were performed, and samples were taken for further analysis at 7 and 30 days postoperation. Macrophage phenotyping was further performed from peritoneal lavage samples, and the expression of inflammatory cytokines and mesothelial layer recovery were analysed from peritoneal tissue samples. RESULTS: Fat grafting significantly inhibited the formation of adhesions. PET/CT results did not show prolonged inflammation in any of the groups. While the expression of anti-inflammatory and anti-fibrotic IL-10 was significantly increased in the peritoneum of the fat graft–treated group at 7 days, tissue-resident and repairing M2 macrophages could no longer be detected in the fat graft at this time point. The percentage of the continuous, healed peritoneum as shown by Keratin 8 staining was greater in the fat graft–treated group after 7 days. CONCLUSIONS: Fat grafting can inhibit the formation of peritoneal adhesions in mice. Our results suggest that fat grafting promotes the peritoneal healing process in a paracrine manner thereby enabling rapid regeneration of the peritoneal mesothelial cell layer. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11605-019-04425-4) contains supplementary material, which is available to authorized users. Springer US 2019-12-10 2020 /pmc/articles/PMC7674570/ /pubmed/31823326 http://dx.doi.org/10.1007/s11605-019-04425-4 Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Laukka, Mervi
Hoppela, Erika
Salo, Jemiina
Rantakari, Pia
Gronroos, Tove J.
Orte, Katri
Auvinen, Kaisa
Salmi, Marko
Gerke, Heidi
Thol, Kerstin
Peuhu, Emilia
Kauhanen, Saila
Merilahti, Pirjo
Hartiala, Pauliina
Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice
title Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice
title_full Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice
title_fullStr Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice
title_full_unstemmed Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice
title_short Preperitoneal Fat Grafting Inhibits the Formation of Intra-abdominal Adhesions in Mice
title_sort preperitoneal fat grafting inhibits the formation of intra-abdominal adhesions in mice
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674570/
https://www.ncbi.nlm.nih.gov/pubmed/31823326
http://dx.doi.org/10.1007/s11605-019-04425-4
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