Deneysel epidural fibrosis modelinde dextpanthenol’ün epidural fibrosis oluşumu üzerine etkisi

Öz

Amaç: Spinal cerrahi sonrası gelişen epidural fibrosis dura ve spinal köklerin çevresini sıkıca sararak orta ve uzun vadede cerrahinin balşarı şansını azaltan nedenlerden biridir. Bu nedenle, bu deneysel çalışmada, ratlarda local ve sistemik dekspanthenol uygulamasının epidural fibrosis oluşumu üzerine etkisini karşılaştırmak amaç edinilmiştir.

Yöntemler: Yirmi sekiz adet sıçan rastlantısal olarak 4 eşit gruba ayrıldı (Kontrol, spongostan, local dekspanthenol ve sistemik dekspanthenol) ve bütün sıçanların torakal 11 düzeyine laminektomi yapıldı. Local olarak dexpanthenol 500 mg/kg dan spongostan ile uygulandı. Sistemik olarak dexpanthanol, 500 mg/kg dan günde bir defa olmak üzere 3 hafta boyunca uygulandı. Epidural fibrosis, araknoid tutulum, fibroblast hücre sayısı, vasküler endotelyal büyüme faktörü ve hidroksiprolini çeriği değerlendirildi.

Bulgular: Epidural fibrosis derecesi, fibroblast hücre sayısı ve hidroksiprolin düzeyi istatistiksel olarak anlamlı düzeyde sistemik dekspanthenol grubunda düşüktü (P=0,025).

Sonuç: Dekspanthenol epidural fibrosisi azaltmak için potansiyel bir ajan olabilir, fakat bu etkinin ortaya çıkması için birden fazla sayıda verilmesi gereklidir.

Anahtar Kelimeler

• Laminektomi,Epidural fibrosis,Fibroblast,Dekspanthenol,Sıçan

The effect of dexpanthenol on the formation of epidural fibrosis in an experimental laminectomy model in rats

Abstract

Aim: Epidural fibrosis, which develops after spinal surgery, is one of the factors which reduce the chances of successful surgery in the medium and long term by tightly surrounding the dura and spinal roots. In this experimental study, the aim was to compare the effects of local and systemic administration of dexpanthenol on epidural fibrosis formation in rats.

Methods: Twenty-eight rats were randomly divided into 4 equal groups (control, Spongostan, local dexpanthenol and systemic dexpanthenol) and laminectomy was performed at the T11 level. Local dexpanthenol (500mg/kg) was administered with Spongostan, and systemic dexpanthenol (500 mg/kg) was administered once a day for three weeks. Epidural fibrosis, arachnoidal involvement, fibroblast cell count, vascular endothelial growth factor, and hydroxyproline levels were evaluated. 

Results: The grade of epidural fibrosis, fibroblast cell counts, and hydroxyproline levels were significantly lower in the systemic dexpanthenol groups (P=0.025).

Conclusion: Dexpanthenol may be used as potential agent for reducing epidural fibrosis. However, it should be administered more than once for it to take effect.

Keywords

• Laminectomy,Epidural fibrosis,Fibroblast,Dexpanthenol,Rat

References

1. 1. Lv P, Zhao J, Su W, Liang X, Zhang K. An experimental novel study: hyperbaric oxygen treatment on reduction of epidural fibrosis via a down-regulation of collagen deposition, IL-6, and TGF-β1. Eur J Orthop Surg Traumatol. 2015;25 Suppl 1:S53-8.
2. 2. Sandoval MA, Hernandez-Vaquero D. Preventing epidural fibrosis with nonsteroidal anti-inflammatory drugs. Eur Spine J. 2008;17(3):451-5.
3. 3. Mohi Eldin MM, Albed Razek NM. Epidural fibrosis after lumbar disc surgery: prevention and outcome evaluation. Asian Spine J. 2015;9(3):370-85.
4. 4. Ozkan U, Osun A, Samancioglu A, Ercan S, Firat U, Kemaloglu S. The effect of bevacizumab and 5-fluorouracil combination on epidural fibrosis in a rat laminectomy model. Eur Rev Med Pharmacol Sci. 2014;18(1):95-100.
5. 5. Masopust V, Hackel M, Netuka D, Bradac O, Rokyta R, Vrabec M. Postoperative epidural fibrosis. Clin J Pain. 2009; 25(7):600-06.
6. 6. Golan A, Maymon R, Winograd I, Bukovsky I. Prevention of post-surgical adhesion formation using aspirin in a rodent model: a preliminary report. Hum Reprod. 1995;10(7):1797-800.
7. 7. Henderson R, Weir B, Davis L, Mielke B, Grace M. Attempted experimental modification of the postlaminectomy membrane by local instillation of recombinant tissue-plasminogen activator gel. Spine. 1983;18(10):1268-72.
8. 8. Gil GG, Scheck M, Kelley ET, Rodrigo JJ. Pedicle fat grafts for the prevention of scar in low-back surgery. A preliminary report on the first 92 cases. Spine (Phila Pa 1976). 1985;10(7):662-7.

9. 9. Chen H, Yan L, Wang J, Sun Y, Li X, Zhao S, et al. Methotrexate prevents epidural fibrosis through endoplasmic reticulum stress signalling pathway. Eur J Pharmacol. 2017;796:131-8.
10. 10. Kurt G, Aytar MH, Dogulu F, Cemil B, Erdem O, Baykaner MK, et al. A comparison of the local effectiveness of mitomycin C, aprotinin, and Adcon-L in an experimental peridural fibrosis. Surg Neurol. 2008;70(6):608-13.
11. 11. Kasımcan MO, Bakar B, AktaşS, Alhan A, Yılmaz A, Caydere M, et al. Effectiveness of the biophysical barriers on the peridural fibrosis of a postlaminectomy rat model: An experimental research. Injury. 2011;42(8):778-81.
12. 12. Karadag A, Ozdemir R, Kurt A, Parlakpinar A, Polat A, Vardi N, et al. Protective effects of dexpanthenol in an experimental model of necrotizing enterocolitis. J Pediatr Surg. 2015;50(7):1119-24.
13. 13. Ermis H, Parlakpinar A, Gulbas G, Vardi N, Polat A, Cetin A, et al. Protective effect of dexpanthenol on bleomycin-induced pulmonary fibrosis in rats. Naunyn Schmiedebergs Arch Pharmacol. 2013;386(12):1103-10.
14. 14. Zakaria MM, Hajipour B, Khodadadi A, Afshari F. Ameliorating effects of dexpanthenol in cerebral ischaemia reperfusion-induced injury in rat brain. J Park Med Assoc. 2011;61(9):889-92.
15. 15. Li-Mei W, Jie T, Shan-He W, Dong-Mei M, Peng-Jiu Y. Anti-inflammatory and anti-oxidative effects of dexpanthenol on lipopolysaccharide-induced acute lung injury in mice. Inflammation. 2016;39(5):1757-63.
16. 16. He Y, Revel M, Loty B. A quantitative model of postlaminectomy scar formation.Effects of a nonsteroidalantiinflammatory drug. Spine (PhilaPa 1976). 1995;20(5):557-63.
17. 17. Reddy GK, Enwemeka CS. A simplified method for the analysis of hydroxyproline in biological tissues. ClinBiochem. 1996;29(3):225-9.
18. 18. Mantawy EM, Tadros MG, Awad AS, Hassan DA, El-Demerdash E. Insights antifibrotic mechanism of methyl palmitate: impact on nuclear factor kappa B and proinflammatory cytokines. Toxicol Appl Pharmacol. 2012;258:134-44.
19. 19. Battegay EJ, Raines EW, Colbert T, Ross R. TNF-alpha stimulation of fibroblast proliferation. Dependence on platelet-derived growth factor (PDGF) secretion and alteration of PDGF receptor expression. J Immunol. 1995; 154(11):6040-7.
20. 20. Pierce GF, Mustoe TA, Lingelbach J, Masakowski VR, Griffin GL, Senior RM, et al. Platelet-derived growth factor and transforming growth factor-beta enhance tissue repair activities by unique mechanisms. J Cell Biol. 1989;109(1):429-40.
21. 21. Ulger BV, Kapan M, Uslukaya O, Bozdag Z, Turkoglu A, Alabalık U, et al. A. Comparing the effects of nebivolol and dexpanthenol on wound healing: an experimental study. Int Wound J. 2016;13(3):367-71.
22. 22. Yardimci I, Karakan T, Resorlu B, Doluoglu OG, Ozcan S, Aydin A, et al. The effect of intraurethral dexpanthenol on healing and fibrosis in rats with experimentally induced urethral trauma. Urology. 2015;85(1):274.e9-13.
23. 23. Ozdemir R, Demirtas G, Parlakpinar H, Polat A, Tanbag K, Taslidere E, et al. Dexpanthenol therapy reduces lung damage in a hyperoxic lung injury in neonatal rats. J Matern Fetal Neonatal Med. 2016;29(11):1801-7.