Abstract

Post-surgical adhesions are a major complication leading to organ dysfunctions, pain, intestinal obstruction, and infertility. The incidence of post-surgical adhesion is really high. The factors involved in the pathogenesis of post-surgical fibrosis, are largely unknown, for example why two patients with similar abdominal operation have a different risks of adhesion severity? High secretion of pro-inflammatory cytokines and growth factors, includes tumour necrosis factor α (TNF-α), interleukin 6 (IL6), and transforming growth factor β (TGF-β) by persistent recruitment of immune cells and the inappropriate proliferated fibroblast/mesothelial cells can stimulate signalling pathways particularly TGF-β leads to the up-regulation of some pro-fibrotic genes that impair fibrinolytic activity and promote extracellular matrix (ECM) accumulation. In this review, we focus on the role of diabetes and hyperglycaemia on post-surgical fibrosis, including the molecular mechanisms affected by hyperglycaemia that cause inflammation, oxidative stress, and increase the expression of pro-fibrotic molecules.

摘要

术后粘连是导致器官功能障碍、疼痛、肠梗阻和不育的主要并发症。术后粘连的发生率真的很高。涉及术后纤维化发病机制的因素在很大程度上是未知的，例如为什么两个腹部手术相似的患者粘连严重程度不同？通过持续募集免疫细胞和不适当的增殖成纤维细胞/间皮细胞可以刺激信号通路，特别是 TGF-β 会导致一些促纤维化基因上调，这些基因会损害纤维蛋白溶解活性并促进细胞外基质 (ECM) 积累。