Peritoneal adhesions are fibrous tissues that tether organs to one another or to the peritoneal wall and represent the major cause of postsurgical morbidity. Enterolysis at repeat surgeries induces adhesion reformation that is more difficult to prevent than primary adhesion. Here we studied the preventive effects of different approaches of berberine treatment for primary adhesion, and its effects on adhesion reformation compared to Interceed. We found the primary adhesion was remarkably prevented by berberine through intraperitoneal injection 30 min before abrasive surgery (pre-berberine) or direct addition into injured cecum immediately after the surgery (inter-berberine). Rats with adhesion reformation had a more deteriorative collagen accumulation and tissue injury in abrasive sites than rats with primary adhesion. The dysregulated TIMP-1/MMP balance was observed in patients after surgery, as well as adhesion tissues from primary adhesion or adhesion reformation rats. Inter-berberine treatment had a better effect for adhesion reformation prevention than Interceed. Berberine promoted the activation of MMP-3 and MMP-8 by directly blocking TIMP-1 activation core, which was reversed by TIMP-1 overexpression in fibroblasts. In conclusion, this study suggests berberine as a reasonable approach for preventing primary adhesion formation and adhesion reformation.

腹膜粘连是一种纤维组织，将器官相互束缚在一起或束缚在腹膜壁上，代表了术后发病的主要原因。重复手术时的肠溶引起的粘连再形成比初次粘连更难预防。在这里，我们研究了黄连素不同方法对初次粘连的预防作用，以及与Interceed相比对黄连素对粘连重建的影响。我们发现在小刀手术前30分钟（小pre碱前）腹膜内注射小ber碱或在手术后立即将小addition碱直接添加到受伤的盲肠中（小）碱）可明显防止黄连素的主要粘连。与初次粘连的大鼠相比，具有粘连再形成的大鼠在磨蚀部位的胶原蛋白积累和组织损伤更严重。术后患者以及原发粘连或粘连再形成大鼠的粘连组织中均观察到TIMP-1 / MMP平衡失调。小Inter碱之间的治疗比Interceed有更好的预防粘连再形成的作用。小ber碱通过直接阻断TIMP-1活化核心来促进MMP-3和MMP-8的活化，而TIMP-1在成纤维细胞中的过度表达则逆转了黄连素的活化。总之，这项研究表明，黄连素是防止初次粘连形成和粘连再形成的合理方法。小ber碱通过直接阻断TIMP-1活化核心来促进MMP-3和MMP-8的活化，而TIMP-1在成纤维细胞中的过度表达则逆转了黄连素的活化。总之，这项研究表明，黄连素是防止初次粘连形成和粘连再形成的合理方法。小ber碱通过直接阻断TIMP-1活化核心来促进MMP-3和MMP-8的活化，而TIMP-1在成纤维细胞中的过度表达则逆转了黄连素的活化。总之，这项研究表明，黄连素是防止初次粘连形成和粘连再形成的合理方法。