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Methylene blue reduces intraabdominal adhesions by decreasing peritoneal oxidative stress and increasing peritoneal fibrinolytic activity
Author(s) -
Heydrick Stanley J,
Reed Karen L,
Cohen Philip A,
Aarons Cary B,
Gower Adam C,
Stuchi Arthur F,
Becker James M
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.5.a1454-c
Subject(s) - oxidative stress , myeloperoxidase , peritoneal cavity , adhesion , medicine , peritoneum , superoxide , peritoneal fluid , inflammation , pharmacology , fibrinolysis , chemistry , pathology , surgery , biochemistry , enzyme , organic chemistry
Intraabdominal adhesions are a major complication of abdominal surgery. Studies in this lab have suggested that peritoneal inflammation and oxidative stress may compromise peritoneal fibrinolytic activity and underlie postoperative adhesion formation. Others have shown that methylene blue (MB), a superoxide scavenger, reduced adhesion formation although the mechanism(s) are unknown. The aim of this study was to determine whether MB administration affects oxidative stress and fibrinolytic activity in the postoperative peritoneum. Methods Adhesions were surgically induced in rats that received MB (30 mg/ kg) or saline, and quantified at 7 days. Fibrinolytic activity was measured by determining tissue plasminogen activator (tPA) activity in peritoneal fluid collected at 24 hrs. Peritoneal tissue markers of oxidative stress including NADPH oxidase (NOX), myeloperoxidase (MPO), and 8‐isoprostanes (8‐IP) were analyzed at 24 hr and 7 days. Results Compared to non‐operated controls, NOX, MPO, and 8‐IP levels at 24 hrs after surgery were significantly (p≤0.05) increased by 3, 91 and 2.5‐fold, respectively, and remained elevated through 7 days. Administration of MB significantly (p≤0.05) reduced adhesion formation by 60%, 8‐IP levels by 66% and MPO activity by 73% while increasing peritoneal tPA levels by 160%. Conclusion These data support a role for oxidative stress in adhesion formation and suggest that MB may reduce intraabdominal adhesion formation by both decreasing peritoneal oxidative stress and increasing peritoneal fibrinolytic activity.