Prevention of peritoneal adhesions: A promising role for gene therapy

World J Gastroenterol. 2011 December 14; 17(46): 5049–5058.
Published online 2011 December 14. doi: 10.3748/wjg.v17.i46.5049 PMCID: PMC3235588

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Prevention of peritoneal adhesions: A promising role for gene therapy
Hussein M Atta
Hussein M Atta, Department of Surgery, Faculty of Medicine, Minia University, El-Minia 61519, Egypt
Author contributions: Atta HM solely contributed to this paper.
Correspondence to: Hussein M Atta, MD, PhD, Professor, Department of Surgery, Faculty of Medicine, Minia University, Misr-Aswan Road, El-Minia 61519, Egypt. attahm@ems.org.egTelephone: +20-1-001407222 Fax: +20-2-22917077
Received May 15, 2011; Revised July 14, 2011; Accepted July 21, 2011.

Abstract:

Adhesions are the most frequent complication of abdominopelvic surgery, yet the extent of the problem, and its serious consequences, has not been adequately recognized. Adhesions evolved as a life-saving mechanism to limit the spread of intraperitoneal inflammatory conditions. Three different pathophysiological mechanisms can independently trigger adhesion formation. Mesothelial cell injury and loss during operations, tissue hypoxia and inflammation each promotes adhesion formation separately, and potentiate the effect of each other. Studies have repeatedly demonstrated that interruption of a single pathway does not completely prevent adhesion formation. This review summarizes the pathogenesis of adhesion formation and the results of single gene therapy interventions. It explores the promising role of combinatorial gene therapy and vector modifications for the prevention of adhesion formation in order to stimulate new ideas and encourage rapid advancements in this field.

Keywords: Peritoneal adhesions, Tissue plasminogen activator, Gene therapy, Plasminogen activator inhibitor, Tissue inhibitor of metalloproteinase, Transforming growth factor β

Full article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235588/?tool=pubmed