Suzuki Tatsuya, Kono Toru, Bochimoto Hiroki, Hira Yoshiki, Watanabe Tsuyoshi, Furukawa Hiroyuki
Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical University, Hokkaido, Japan.
1] Advanced Surgery Center, Sapporo Higashi Tokushukai Hospital, Hokkaido, Japan [2] Faculty of Pharmaceutical Sciences, Hokkaido University, Hokkaido, Japan.
Sci Rep. 2015 Jan 8;5:7668. doi: 10.1038/srep07668.
The pathophysiology of adhesion formation needs to be clarified to reduce the adhesion-related morbidity. The epithelial characteristics of the peritoneum suggest a protective role against adhesion formation, yet how the peritoneum is involved in adhesion formation is not well characterized. We microscopically observed an experimental model of adhesion formation to investigate the effects of an injured tissue on the opposite intact peritoneum. Adhesions were induced between injured and intact hepatic lobes, and the intact peritoneum opposite to the injured tissue was examined for 8 days. The opposite intact peritoneum was denuded of mesothelial cells for 6 hours, and the remnant mesothelial cells changed morphologically for 24 hours. The detachment of mesothelial cells allowed fibrin to attach to the basement membrane of the opposite peritoneum, connecting the two lobes. Moreover, macrophages and myofibroblasts accumulated between the two lobes, and angiogenesis occurred from the opposite intact lobe to the injured lobe. These observations indicate that an injured tissue deprives the opposite intact peritoneum of its epithelial structure and causes fibrous adhesions to the opposite intact tissue. This study implies a possible role of mesothelial cells for barrier function against adhesion formation, that is, keeping mesothelial cells intact might lead to its prophylaxis.
需要阐明粘连形成的病理生理学，以降低与粘连相关的发病率。腹膜的上皮特征表明其对粘连形成具有保护作用，但腹膜如何参与粘连形成尚未得到充分表征。我们通过显微镜观察粘连形成的实验模型，以研究受损组织对相对完整腹膜的影响。在受损和完整的肝叶之间诱导粘连，并对受损组织相对的完整腹膜进行8天的检查。相对的完整腹膜的间皮细胞剥脱6小时，残余的间皮细胞在24小时内发生形态变化。间皮细胞的脱离使纤维蛋白附着在相对腹膜的基底膜上，连接两个叶。此外，巨噬细胞和成肌纤维细胞在两个叶之间积聚，并且从相对的完整叶到受损叶发生血管生成。这些观察结果表明，受损组织剥夺了相对完整腹膜的上皮结构，并导致与相对完整组织的纤维性粘连。本研究暗示间皮细胞在抗粘连形成的屏障功能中可能发挥作用，即保持间皮细胞完整可能有助于预防粘连。
