Authors
Kluiko D.A., Korik V.E., Zhidkov S.A.
Military Medical Institute at the EE «Belarusian State Medical University», Minsk, Republic of Belarus
Abstract
Rationale: adhesive disease of the abdominal cavity is an extremely urgent problem of modern surgery, due to the steadily increasing morbidity, high mortality and a significant decrease in the quality of life of patients.
The aim of the study was to study the influence of the pathological process in the abdominal cavity on the expression of growth factors and the factor induced by hypoxia.
Results: expression of growth factors (GLUT-1, PDGF-AA, and -B, VEGF-C, TGF-α) and hypoxia-inducible factor (HIF-1α) is a biological response to inflammation, hypoxia, exposure to physicochemical factors , destruction of the peritoneal mesothelium and stimulates the formation of blood vessels, extracellular matrix, proliferation and division of mesenchymal cells (fibroblasts), which are the basis of abdominal adhesions.
Conclusion: the leveling of hypoxia, inflammation and physicochemical factors of destruction of the peritoneal mesothelium will normalize the expression of growth factors (GLUT-1, PDGF-AA, and -B, VEGF-C, TGF-α) and hypoxia-inducible factor (HIF-1α), correct differentiation of fibroblasts and mesotheliocytes, thereby reducing the likelihood and severity of the adhesion process in operated patients. The expression of the factor indicated by hypoxia (HIF-1α) is significantly affected by hyperoxia, hypoxia in the abdominal cavity (a decrease by 55% and an increase by 187% from the control group, respectively), in the inhaled air (a decrease by 54% and an increase by 194% of the control group, respectively), the effect of fibrin (by 245%), simulated partial (by 278%) and complete (by 248%) intestinal obstruction, increased intra-abdominal pressure (by 298%), (p <0.001), contributing to the adhesion process.
Keywords: adhesive disease, HIF-1α, GLUT-1, PDGF-AA, and -B, VEGF-C, TGF-α.
References
1. Ong AW, Early postoperative small bowel obstruction: A review. Am J Surg. 2020; 219(3): 535-539. doi: 10.1016/j.amjsurg.2019.11.008.
2. Apte RS, Chen DS, Chen DS, et al. VEGF in Signaling and Disease: Beyond Discovery and Development. Cell. 2019; 176(6): 1248-1264. doi: 10.1016/j.cell.2019.01.021.
3. Moreno Roig E, Groot AJ, et al. HIF-1alpha and HIF-2alpha Differently Regulate the Radiation Sensitivity of NSCLC Cells. Cells. 2019; 8(1):45. doi: 10.3390/cells8010045.
4. Thornblade LW, Verdial FC, Bartek MA, et al. The Safety of Expectant Management for Adhesive Small Bowel Obstruction: A Systematic Review. J Gastrointest Surg. 2019; 23(4): 846-859. doi: 10.1007/s11605-018-4017-1.
5. Bayat Z, Guttman MP, Shiroky J, et al. Non-operative Management of Small Bowel Obstruction in Patients with No Previous Abdominal Surgery: A Systematic Review and Meta-analysis. World J Surg. 2021; 45(7): 2092-2099. doi: 10.1007/s00268-021-06061-z.
6. Tong JWV, Lingam P, Shelat VG, et al. Adhesive small bowel obstruction — an update. Acute Med Surg. 2020; 7(1): 587. doi: 10.1002/ams2.587.
7. Yang TWW, Prabhakaran S, Bell S, et al. Non-operative management for small bowel obstruction in a virgin abdomen: a systematic review. ANZ J Surg. 2020; 91(5): 802-80. doi: 10.1111/ans.16392.
8. Carrica L, Li L, et al. Genetic inactivation of hypoxia inducible factor 1-alpha (HIF-1alpha) in adult hippocampal progenitors impairs neurogenesis and pattern discrimination learning. Neurobiol Learn Mem. 2019; 157: 79-85. doi: 10.1016/j.nlm.2018.12.002.
