Abstract：
BACKGROUND: This study evaluated the use of metformin or pioglitazone in preventing or reducing the development of post-operative intra-abdominal adhesion (PIAA) by employing histopathological, immunohistochemical, and biochemical analyses in an experimental adhesion model.
METHODS: Fifty Wistar-Albino rats were divided into five groups: Group I (Control), Group II (Sham Treatment), Group III (Hy-aluronic Acid), Group IV (Metformin), and Group V (Pioglitazone). Adhesions were induced in the experimental groups, except for the sham group, using the scraping method. After 10 days, rats were euthanized for evaluation. Macroscopic adhesion degrees were assessed using Nair\'s scoring system. Immunohistochemical and enzyme-linked immunosorbent assay (ELISA) methods were utilized to assess serum, peritoneal lavage, and intestinal tissue samples. Fructosamine, interleukin-6 (IL-6), transforming growth factor-beta (TGF-β), and fibronectin levels were measured in serum and peritoneal lavage samples.
RESULTS: The groups exhibited similar Nair scores and Type I or Type III Collagen staining scores (all, p>0.05). Pioglitazone significantly reduced serum IL-6 and TGF-β levels compared to controls (p=0.002 and p=0.008, respectively). Both metformin and pioglitazone groups showed elevated IL-6 in peritoneal lavage relative to controls, while fibronectin levels in the lavage were lower in pioglitazone-treated rats compared to the sham group (all, p<0.005).
CONCLUSIONS: Pioglitazone, but not metformin, demonstrated a positive biochemical impact on preventing PIAA formation in an experimental rat model, although histological impacts were not observed. Further experimental studies employing different dose/duration regimens of pioglitazone are needed to enhance our understanding of its effect on PIAA formation.
METHODS: Fifty Wistar-Albino rats were divided into five groups: Group I (Control), Group II (Sham Treatment), Group III (Hy-aluronic Acid), Group IV (Metformin), and Group V (Pioglitazone). Adhesions were induced in the experimental groups, except for the sham group, using the scraping method. After 10 days, rats were euthanized for evaluation. Macroscopic adhesion degrees were assessed using Nair\'s scoring system. Immunohistochemical and enzyme-linked immunosorbent assay (ELISA) methods were utilized to assess serum, peritoneal lavage, and intestinal tissue samples. Fructosamine, interleukin-6 (IL-6), transforming growth factor-beta (TGF-β), and fibronectin levels were measured in serum and peritoneal lavage samples.
RESULTS: The groups exhibited similar Nair scores and Type I or Type III Collagen staining scores (all, p>0.05). Pioglitazone significantly reduced serum IL-6 and TGF-β levels compared to controls (p=0.002 and p=0.008, respectively). Both metformin and pioglitazone groups showed elevated IL-6 in peritoneal lavage relative to controls, while fibronectin levels in the lavage were lower in pioglitazone-treated rats compared to the sham group (all, p<0.005).
CONCLUSIONS: Pioglitazone, but not metformin, demonstrated a positive biochemical impact on preventing PIAA formation in an experimental rat model, although histological impacts were not observed. Further experimental studies employing different dose/duration regimens of pioglitazone are needed to enhance our understanding of its effect on PIAA formation.
摘要：
背景：这项研究通过采用组织病理学评估，评估了二甲双胍或吡格列酮在预防或减少术后腹腔粘连（PIAA）发展中的应用，免疫组织化学，和实验粘附模型中的生化分析。
方法：将50只Wistar-Albino大鼠分为5组：I组（对照组），第二组(假治疗)，III组（透明质酸），第四组（二甲双胍），和第V组(吡格列酮)。实验组诱导粘连，除了假组外,使用刮擦方法。10天后,对大鼠实施安乐死以进行评估。使用Nair评分系统评估宏观粘附度。免疫组织化学和酶联免疫吸附测定（ELISA）方法用于评估血清，腹腔灌洗,和肠道组织样本.果糖胺,白细胞介素-6（IL-6），转化生长因子-β（TGF-β），在血清和腹膜灌洗样本中测量纤连蛋白水平。
结果：各组表现出相似的Nair评分和I型或III型胶原染色评分（所有，p>0.05)。与对照组相比，吡格列酮显着降低了血清IL-6和TGF-β水平（分别为p=0.002和p=0.008）。二甲双胍和吡格列酮组均显示腹腔灌洗中IL-6相对于对照组升高，与假手术组相比，吡格列酮治疗的大鼠灌洗中的纤连蛋白水平较低（所有，p<0.005)。
结论：吡格列酮，但不是二甲双胍,在实验大鼠模型中证明了对预防PIAA形成的积极生化影响，尽管没有观察到组织学影响。需要采用不同剂量/持续时间的吡格列酮方案的进一步实验研究，以增强我们对其对PIAA形成的影响的理解。
方法：将50只Wistar-Albino大鼠分为5组：I组（对照组），第二组(假治疗)，III组（透明质酸），第四组（二甲双胍），和第V组(吡格列酮)。实验组诱导粘连，除了假组外,使用刮擦方法。10天后,对大鼠实施安乐死以进行评估。使用Nair评分系统评估宏观粘附度。免疫组织化学和酶联免疫吸附测定（ELISA）方法用于评估血清，腹腔灌洗,和肠道组织样本.果糖胺,白细胞介素-6（IL-6），转化生长因子-β（TGF-β），在血清和腹膜灌洗样本中测量纤连蛋白水平。
结果：各组表现出相似的Nair评分和I型或III型胶原染色评分（所有，p>0.05)。与对照组相比，吡格列酮显着降低了血清IL-6和TGF-β水平（分别为p=0.002和p=0.008）。二甲双胍和吡格列酮组均显示腹腔灌洗中IL-6相对于对照组升高，与假手术组相比，吡格列酮治疗的大鼠灌洗中的纤连蛋白水平较低（所有，p<0.005)。
结论：吡格列酮，但不是二甲双胍,在实验大鼠模型中证明了对预防PIAA形成的积极生化影响，尽管没有观察到组织学影响。需要采用不同剂量/持续时间的吡格列酮方案的进一步实验研究，以增强我们对其对PIAA形成的影响的理解。
