복강내 NF-κB decoy oligodeoxynucleotide를 이용한 수술 후 복강내 유착 발생 감소
INTRA‐PERITONEAL NF‐κB DECOY OLIGODEOXYNUCLEOTIDE DECREASES POSTOPERATIVE INTRA‐ABDOMINAL ADHESION
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적쥐모델에서 nuclear factor κB decoy oligodeoxynucleotide (NF-κB decoy ODN) 복강내 주입을 이용한 수술 후 복강내 유착 발생 억제 효과를 알아보고자 하였다. 연구방법40마리의 BALB/c 암컷 생쥐를 ketamine과 xylazine 복강내 주사를 이용하여 마취 후 개복하고 cytobrush를 이용하여 복막이 벗겨지는 상처를 입히고, 실험군은(n = 20) NF-κB decoy ODN (10 μg, 500 μL)을 복강내에 채우고, 대조군은(n=20) 생리 식염수 500 μL를 복강내에채운 후 봉합하고 2주 뒤에 유착 정도를 판정하였다. 유착 정도는 유착이 없는 0등급에서 심한 정도에 따라 경증, 중등도, 중증 등급(1-3등급)으로 분류하였다. 결과수술 후 첫날 실험군에서 2마리, 대조군에서 3마리의 생쥐가 사망하였다. 대조군은 경증과 중등도의 유착이 각각 2마리에서 관찰되었고13마리에서 중증의 유착이 관찰되었으나, 실험군에서 4마리는 유착이 관찰되지 않았고, 6마리는 경증의 유착, 8마리는 중등도의 유착이관찰되어 통계적으로 유의한 차이를 나타내었다(P ＜0.001). 결론NF-κB decoy ODN를 복강내에 주입하여 NF-κB 작용을 차단하는 방법은 수술 후 복강내 유착 정도를 줄일 수 있다.
Abstract
Objective The objective of this study was to evaluate the effect of intra-peritoneal nuclear factor κB (NF-κB) decoy oligodeoxynucleotide on the prevention of postoperative intra-abdominal adhesion. Methods Forty female BALB/c mice were randomly assigned into 2 groups. The mice were anesthetized and then midline abdominal incision was made. Peritoneal injury was given using cytobrush until deperitonealization. The experimental group (n = 20) received NF-κB decoy oligodeoxynucleotide (NF-κB decoy ODN) in the peritoneal cavity before abdominal closure, while the control group (n = 20)received saline. At 2 weeks postoperation, after the mice were euthanized, the status of intra-abdominal adhesion was evaluated. The degrees of adhesion were graded into no (grade 0), mild (grade 1), moderate (grade 2), and severe adhesion (grade 3). Results Two mice in the experimental group and 3 mice in the control group were dead within 1 day postoperation. In the control group, 2,2, and 13 mice showed mild, moderate, and severe adhesion, respectively. In the experimental group, 4 mice showed no adhesion,whereas, 6 and 8 mice showed mild and moderate adhesion, respectively. The difference of degrees of adhesion between the groups was statistically signifi cant (P <0.001). Conclusion Intra-peritoneal NF-κB decoy ODN reduced the severity of postoperative intra-abdominal adhesion.
참고문헌 (27)
- Weibel MA, "Peritoneal adhesions and their relation to abdominal surgery. A postmortem study", Am J Surg, 126, pp.345~353 (1973)
- Menzies D, "Intestinal obstruction from adhesions: how big is the problem?", Ann R Coll Surg Engl, 72, pp.60~63 (1990)
- Al-Took S, "Adhesion-related small-bowel obstruction after gynecologic operations", Am J Obstet Gynecol, 180, pp.313~315 (1999)
- Al-Jaroudi D, "Adhesion prevention in gynecologic surgery", Obstet Gynecol Surv, 59, pp.360~367 (2004)
- Tulandi T, "Effects of fi brin sealant on tubal anastomosis and adhesion formation", Fertil Steril, 56, pp.136~138 (1991)
- Zeng Q, "Effi cacy and safety of Seprafi lm for preventing postoperative abdominal adhesion: systematic review and meta-analysis", World J Surg, 31, pp.2125~2131 (2007)
- Vrijland WW, "Fewer intraperitoneal adhesions with use of hyaluronic acid-carboxymethylcellulose membrane: a randomized clinical trial", Ann Surg, 235, pp.193~199 (2002)
- Kayaoglu HA, "An assessment of the effects of two types of bioresorbable barriers to prevent postoperative intra-abdominal adhesions in rats", Surg Today, 35, pp.946~950 (2005)
- Diamond MP, "Reduction of de novo postsurgical adhesions by intraoperative precoating with Sepracoat (HAL-C) solution: a prospective, randomized, blinded, placebo-controlled multicenter study. The Sepracoat Adhesion Study Group", Fertil Steril, 69, pp.1067~1074 (1998)
- Friedman H, "The effect of seprafilm and interceed on capsule formation around silicone discs in a rat model", J Invest Surg, 17, pp.271~281 (2004)
- Keckstein J, "Reduction of postoperative adhesion formation after laparoscopic ovarian cystectomy", Hum Reprod, 11, pp.579~582 (1996)
- Takeuchi H, "Reduction of adhesions with fi brin glue after laparoscopic excision of large ovarian endometriomas", J Am Assoc Gynecol Laparosc, 3, pp.575~579 (1996)
- Sekiba K., "Use of Interceed(TC7) absorbable adhesion barrier to reduce postoperative adhesion reformation in infertility and endometriosis surgery. The Obstetrics and Gynecology Adhesion Prevention Committee", Obstet Gynecol, 79, pp.518~522 (1992)
- "The effi cacy of Interceed(TC7)* for prevention of reformation of postoperative adhesions on ovaries, fallopian tubes, and fi mbriae in microsurgical operations for fertility: a multicenter study. Nordic Adhesion Prevention Study Group", Fertil Steril, 63, pp.709~714 (1995)
- "An expanded polytetrafl uoroethylene barrier (Gore-Tex Surgical Membrane) reduces post-myomectomy adhesion formation. The Myomectomy Adhesion Multicenter Study Group", Fertil Steril, 63, pp.491~493 (1995)
- Haney AF, "Expanded polytetrafl uoroethylene (Gore-Tex Surgical Membrane) is superior to oxidized regenerated cellulose (Interceed TC7+) in preventing adhesions", Fertil Steril, 63, pp.1021~1026 (1995)
- Diamond MP, "Reduction of adhesions after uterine myomectomy by Seprafi lm membrane (HAL-F): a blinded, prospective, randomized, multicenter clinical study. Seprafilm Adhesion Study Group", Fertil Steril, 66, pp.904~910 (1996)
- Duron JJ, "Postoperative intraperitoneal adhesion pathophysiology", Colorectal Dis, 9(2), pp.14~24 (2007)
- Guvenal T, "Prevention of postoperative adhesion formation in rat uterine horn model by nimesulide: a selective COX-2 inhibitor", Hum Reprod, 16, pp.1732~1735 (2001)
- Saed GM, "Cyclooxygenase-2 is expressed in human fi broblasts isolated from intraperitoneal adhesions but not from normal peritoneal tissues", Fertil Steril, 79, pp.1404~1408 (2003)
- Binnebösel M, "Neumann UP, et al. Chronological evaluation of infl ammatory mediators during peritoneal adhesion formation using a rat model", Langenbecks Arch Surg, 396, pp.371~378 (2011)
- Kim SJ, "Effect of NF-kappaB decoy oligodeoxynucleotide on LPS", highfat diet-induced atherosclerosis in an animal model, 2010, pp.107, 925~930
- 박지현, "Transcriptional regulation of NF-κB by ring type decoy oligodeoxynucleotide in an animal model of nephropathy", Experimental and Molecular Pathology, 86(2), pp.114~120, Academic Press
- Yoldemir T, "Comparison of the reduction of postoperative adhesions by two barriers, one solution, and two pharmacologic agents in the rat uterine model", Fertil Steril, 78, pp.335~339 (2002)
- Jarrett JC 2nd, "Adhesion formation and uterine tube healing in the rabbit: a controlled study of the effect of ibuprofen and flurbiprofen", Am J Obstet Gynecol, 155, pp.1186~1192 (1986)
- Muzii L, "Low-dose aspirin to prevent postoperative adhesion formation in the rabbit model", J Am Assoc Gynecol Laparosc, 3, pp.32~33 (1996)
- Muzii L, "Postoperative adhesion prevention with low-dose aspirin: effect through the selective inhibition of thromboxane production", Hum Reprod, 13, pp.1486~1489 (1998)