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World J Gastroenterol. 2011 Dec 14;17(46):5049-58. doi: 10.3748/wjg.v17.i46.5049.

Prevention of peritoneal adhesions: a promising role for gene therapy.

Abstract

Adhesions are the most frequent complication of abdominopelvic surgery, yet the extent of the problem, and its serious consequences, has not been adequately recognized. Adhesions evolved as a life-saving mechanism to limit the spread of intraperitoneal inflammatory conditions. Three different pathophysiological mechanisms can independently trigger adhesion formation. Mesothelial cell injury and loss during operations, tissue hypoxia and inflammation each promotes adhesion formation separately, and potentiate the effect of each other. Studies have repeatedly demonstrated that interruption of a single pathway does not completely prevent adhesion formation. This review summarizes the pathogenesis of adhesion formation and the results of single gene therapy interventions. It explores the promising role of combinatorial gene therapy and vector modifications for the prevention of adhesion formation in order to stimulate new ideas and encourage rapid advancements in this field.

KEYWORDS:

Gene therapy; Peritoneal adhesions; Plasminogen activator inhibitor; Tissue inhibitor of metalloproteinase; Tissue plasminogen activator; Transforming growth factor β

PMID:
22171139
PMCID:
PMC3235588
DOI:
10.3748/wjg.v17.i46.5049
[Indexed for MEDLINE]
Free PMC Article
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