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Published in: Journal of Cardiothoracic Surgery 1/2010

Open Access 01-12-2010 | Research article

Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent, ankaferd blood stopper, on vascular tissue in a rat aortic bleeding model

Authors: Ozer Kandemir, Mustafa Buyukates, Nilufer Onak Kandemir, Erol Aktunc, Aylin Ege Gul, Sanser Gul, S. Akin Turan

Published in: Journal of Cardiothoracic Surgery | Issue 1/2010

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Abstract

Background

Ankaferd Blood Stopper® (ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding.

Methods

Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.

Results

The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.

Conclusions

In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required.
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Literature
1.
go back to reference Kaplan M, Bozkurt S, Kut MS, Kullu S, Demirtas MM: Histopathological effects of ethyl 2-cyanoacrylate tissue adhesive following surgical application: an experimental study. Eur J Cardiothorac Surg. 2004, 25 (2): 167-72. 10.1016/j.ejcts.2003.11.016.CrossRefPubMed Kaplan M, Bozkurt S, Kut MS, Kullu S, Demirtas MM: Histopathological effects of ethyl 2-cyanoacrylate tissue adhesive following surgical application: an experimental study. Eur J Cardiothorac Surg. 2004, 25 (2): 167-72. 10.1016/j.ejcts.2003.11.016.CrossRefPubMed
2.
go back to reference Björses K, Holst J: Various local hemostatic agents with different modes of action; an in vivo comparative randomized vascular surgical experimental study. Eur J Vasc Endovasc Surg. 2007, 33 (3): 363-70. 10.1016/j.ejvs.2006.10.011. Epub 2006 Nov 28CrossRefPubMed Björses K, Holst J: Various local hemostatic agents with different modes of action; an in vivo comparative randomized vascular surgical experimental study. Eur J Vasc Endovasc Surg. 2007, 33 (3): 363-70. 10.1016/j.ejvs.2006.10.011. Epub 2006 Nov 28CrossRefPubMed
3.
go back to reference Unlü Y, Vural U, Koçak H, Ceviz M, Becit N, Akbulut O: Comparison of the topical haemostatic agents for the prevention of suture hole bleeding. An experimental study. Eur J Vasc Endovasc Surg. 2002, 23 (5): 441-4. 10.1053/ejvs.2002.1619.CrossRefPubMed Unlü Y, Vural U, Koçak H, Ceviz M, Becit N, Akbulut O: Comparison of the topical haemostatic agents for the prevention of suture hole bleeding. An experimental study. Eur J Vasc Endovasc Surg. 2002, 23 (5): 441-4. 10.1053/ejvs.2002.1619.CrossRefPubMed
4.
go back to reference Kheirabadi BS, Pearson R, Rudnicka K, Somwaru L, MacPhee M, Drohan W, Tuthill D: Development of an animal model for assessment of the hemostatic efficacy of fibrin sealant in vascular surgery. J Surg Res. 2001, 100 (1): 84-92. 10.1006/jsre.2001.6226.CrossRefPubMed Kheirabadi BS, Pearson R, Rudnicka K, Somwaru L, MacPhee M, Drohan W, Tuthill D: Development of an animal model for assessment of the hemostatic efficacy of fibrin sealant in vascular surgery. J Surg Res. 2001, 100 (1): 84-92. 10.1006/jsre.2001.6226.CrossRefPubMed
5.
go back to reference Werker PM, Kon M: Review of facilitated approaches to vascular anastomosis surgery. Ann Thorac Surg. 1997, 63 (6 Suppl): S122-7. 10.1016/S0003-4975(97)00340-8.CrossRefPubMed Werker PM, Kon M: Review of facilitated approaches to vascular anastomosis surgery. Ann Thorac Surg. 1997, 63 (6 Suppl): S122-7. 10.1016/S0003-4975(97)00340-8.CrossRefPubMed
6.
go back to reference Bilgili H, Kosar A, Kurt M, Onal IK, Goker H, Captug O, Shorbagi A, Turgut M, Kekilli M, Kurt OK, Kirazli S, Aksu S, Haznedaroglu IC: Hemostatic efficacy of Ankaferd Blood Stopper in a swine bleeding model. Med Princ Pract. 2009, 18 (3): 165-9. 10.1159/000204344. Epub 2009 Apr 6CrossRefPubMed Bilgili H, Kosar A, Kurt M, Onal IK, Goker H, Captug O, Shorbagi A, Turgut M, Kekilli M, Kurt OK, Kirazli S, Aksu S, Haznedaroglu IC: Hemostatic efficacy of Ankaferd Blood Stopper in a swine bleeding model. Med Princ Pract. 2009, 18 (3): 165-9. 10.1159/000204344. Epub 2009 Apr 6CrossRefPubMed
7.
go back to reference Göker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U, Ozturk Y, Firat HC: Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper®. J Int Med Res. 2008, 36: 163-170.CrossRefPubMed Göker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U, Ozturk Y, Firat HC: Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper®. J Int Med Res. 2008, 36: 163-170.CrossRefPubMed
8.
go back to reference Lee SJ, Umano K, Shibamato T, Lee KG: Identification of volatile components in basil (Ocimum basilicum L.) and thyme leaves (Thymus vulgaris L.) and their antioxidant properties. Food Chem. 2007, 91: 131-137. 10.1016/j.foodchem.2004.05.056.CrossRef Lee SJ, Umano K, Shibamato T, Lee KG: Identification of volatile components in basil (Ocimum basilicum L.) and thyme leaves (Thymus vulgaris L.) and their antioxidant properties. Food Chem. 2007, 91: 131-137. 10.1016/j.foodchem.2004.05.056.CrossRef
9.
go back to reference Yamakoshi J, Kataoka S, Koga T, Ariga T: Proanthocyanidin-rich extracts form grape seede attenutaee the development of aortic atherosclerosis in cholesterol-fed rabbits. Atherosclerosis. 1999, 142: 139-149. 10.1016/S0021-9150(98)00230-5.CrossRefPubMed Yamakoshi J, Kataoka S, Koga T, Ariga T: Proanthocyanidin-rich extracts form grape seede attenutaee the development of aortic atherosclerosis in cholesterol-fed rabbits. Atherosclerosis. 1999, 142: 139-149. 10.1016/S0021-9150(98)00230-5.CrossRefPubMed
10.
go back to reference Ramakrishna MK, Salimath BP: Angiogenic and proliferative effects if the cytokine VEGF in Ehrlich ascites tumor cells is inhibited by Glycyrrhiza glabra. Int Immunopharmacol. 2006, 6: 494-498. 10.1016/j.intimp.2005.07.002.CrossRefPubMed Ramakrishna MK, Salimath BP: Angiogenic and proliferative effects if the cytokine VEGF in Ehrlich ascites tumor cells is inhibited by Glycyrrhiza glabra. Int Immunopharmacol. 2006, 6: 494-498. 10.1016/j.intimp.2005.07.002.CrossRefPubMed
11.
go back to reference Matsuda H, Ando S, Kato T, Morikawa T, Yoshikawa M: Inhibitors from the rhizomes of Alpina officinarum on production of nitric oxide in lipopolysaccharide-activated macrophages and the structural requirements of diarrylheptanoids for the activity. Bioorg med Chem. 2006, 14: 138-142. 10.1016/j.bmc.2005.08.003.CrossRefPubMed Matsuda H, Ando S, Kato T, Morikawa T, Yoshikawa M: Inhibitors from the rhizomes of Alpina officinarum on production of nitric oxide in lipopolysaccharide-activated macrophages and the structural requirements of diarrylheptanoids for the activity. Bioorg med Chem. 2006, 14: 138-142. 10.1016/j.bmc.2005.08.003.CrossRefPubMed
12.
go back to reference Haznedaroglu BZ, Haznedaroglu IC, Walker SL, Bilgili H, Goker H, Kosar A, Aktas A, Captug O, Kurt M, Ozdemir O, Kirazli S, Firat HC: Ultrastructural and Morphological Analyses of the In Vitro and In Vivo Hemostatic Effects of Ankaferd Blood Stopper. Clin Appl Thromb Hemost. 2010, 6 (4): 446-453. 10.1177/1076029609343706.CrossRef Haznedaroglu BZ, Haznedaroglu IC, Walker SL, Bilgili H, Goker H, Kosar A, Aktas A, Captug O, Kurt M, Ozdemir O, Kirazli S, Firat HC: Ultrastructural and Morphological Analyses of the In Vitro and In Vivo Hemostatic Effects of Ankaferd Blood Stopper. Clin Appl Thromb Hemost. 2010, 6 (4): 446-453. 10.1177/1076029609343706.CrossRef
13.
go back to reference Cipil HS, Kosar A, Kaya A, Uz B, Haznedaroglu IC, Goker H, Ozdemir O, Koroglu M, Kirazli S, Firat HC: In vivo hemostatic effect of the medicinal plant extract Ankaferd Blood Stopper in rats pretreated with warfarin. Clin Appl Thromb hemost. 2009, 15: 270-276. 10.1177/1076029608329578.CrossRefPubMed Cipil HS, Kosar A, Kaya A, Uz B, Haznedaroglu IC, Goker H, Ozdemir O, Koroglu M, Kirazli S, Firat HC: In vivo hemostatic effect of the medicinal plant extract Ankaferd Blood Stopper in rats pretreated with warfarin. Clin Appl Thromb hemost. 2009, 15: 270-276. 10.1177/1076029608329578.CrossRefPubMed
14.
go back to reference Kosar A, Cipil HS, Kaya A, Uz B, Haznedaroglu IC, Goker H, Ozdemir O, Ercetin S, Kirazli S, Firat HC: The efficacy of Ankaferd Blood Stopper in antithrombotic drug-induced primary and secondary hemostatic abnormalities of a rat-bleeding model. Blood Coagul Fibrinolysis. 2009, 20 (3): 185-90. 10.1097/MBC.0b013e32831c4cb0.CrossRefPubMed Kosar A, Cipil HS, Kaya A, Uz B, Haznedaroglu IC, Goker H, Ozdemir O, Ercetin S, Kirazli S, Firat HC: The efficacy of Ankaferd Blood Stopper in antithrombotic drug-induced primary and secondary hemostatic abnormalities of a rat-bleeding model. Blood Coagul Fibrinolysis. 2009, 20 (3): 185-90. 10.1097/MBC.0b013e32831c4cb0.CrossRefPubMed
15.
go back to reference Karakaya K, Ucan HB, Tascilar O, Emre AU, Cakmak GK, Irkorucu O, Ankarali H, Comert M: Evaluation of a new hemostatic agent Ankaferd Blood Stopper in experimental liver laceration. J Invest Surg. 2009, 22: 201-206. 10.1080/08941930902866246.CrossRefPubMed Karakaya K, Ucan HB, Tascilar O, Emre AU, Cakmak GK, Irkorucu O, Ankarali H, Comert M: Evaluation of a new hemostatic agent Ankaferd Blood Stopper in experimental liver laceration. J Invest Surg. 2009, 22: 201-206. 10.1080/08941930902866246.CrossRefPubMed
16.
go back to reference Dogan OF, Ozyurda U, Uymaz OK, Ercetin S, Haznedaroglu I: New anticoagulant for CABG surgery. 4th Clinical Vascular Biology Congress. 2008, , Antalya, Turkey Dogan OF, Ozyurda U, Uymaz OK, Ercetin S, Haznedaroglu I: New anticoagulant for CABG surgery. 4th Clinical Vascular Biology Congress. 2008, , Antalya, Turkey
17.
go back to reference Kurt M, Onal I, Akdogan M, Kekilli M, Arhan M, Sayilir A, Oztas E, Haznedaroglu I: Ankaferd Blood Stopper for controlling gastrointestinal bleeding due to distinct benign lesions refractory to conventional antihemorrhagic measures. Can J Gastroenterol. 2010, 24 (6): 380-4.CrossRefPubMedPubMedCentral Kurt M, Onal I, Akdogan M, Kekilli M, Arhan M, Sayilir A, Oztas E, Haznedaroglu I: Ankaferd Blood Stopper for controlling gastrointestinal bleeding due to distinct benign lesions refractory to conventional antihemorrhagic measures. Can J Gastroenterol. 2010, 24 (6): 380-4.CrossRefPubMedPubMedCentral
18.
go back to reference Kurt M, Disibeyaz S, Akdogan M, Sasmaz N, Aksu S, Haznedaroglu IC: Endoscopic application of ankaferd blood stopper as a novel experimental treatment modality for upper gastrointestinal bleeding: a case report. Am J Gastroenterol. 2008, 103 (8): 2156-8. 10.1111/j.1572-0241.2008.01982_15.x.CrossRefPubMed Kurt M, Disibeyaz S, Akdogan M, Sasmaz N, Aksu S, Haznedaroglu IC: Endoscopic application of ankaferd blood stopper as a novel experimental treatment modality for upper gastrointestinal bleeding: a case report. Am J Gastroenterol. 2008, 103 (8): 2156-8. 10.1111/j.1572-0241.2008.01982_15.x.CrossRefPubMed
19.
go back to reference Teker AM, Korkut AY, Kahya V, Gedikli O: Prospective, randomized, controlled clinical trial of Ankaferd Blood Stopper in patients with acute anterior epistaxis. Eur Arch Otorhinolaryngol. 2010, 267 (9): 1377-1381. 10.1007/s00405-010-1208-0.CrossRef Teker AM, Korkut AY, Kahya V, Gedikli O: Prospective, randomized, controlled clinical trial of Ankaferd Blood Stopper in patients with acute anterior epistaxis. Eur Arch Otorhinolaryngol. 2010, 267 (9): 1377-1381. 10.1007/s00405-010-1208-0.CrossRef
20.
go back to reference Ibis M, Kurt M, Onal IK, Haznedaroglu IC: Successful management of bleeding due to solitary rectal ulcer via topical application of Ankaferd blood stopper. J Altern Complement Med. 2008, 14 (9): 1073-4. 10.1089/acm.2008.0314.CrossRefPubMed Ibis M, Kurt M, Onal IK, Haznedaroglu IC: Successful management of bleeding due to solitary rectal ulcer via topical application of Ankaferd blood stopper. J Altern Complement Med. 2008, 14 (9): 1073-4. 10.1089/acm.2008.0314.CrossRefPubMed
21.
go back to reference Tokgöz H, Karakaya K, Hanci V, Abdusoglu M, Erol B, Turksoy O, Akduman B, Mungan NA: Protective value of a folkloric medicinal plant extract against mortality and hemorrhage in a life-threatining renal trauma model. Urology. 2010, 75: 1515.e9-1515.e14. 10.1016/j.urology.2009.12.016.CrossRef Tokgöz H, Karakaya K, Hanci V, Abdusoglu M, Erol B, Turksoy O, Akduman B, Mungan NA: Protective value of a folkloric medicinal plant extract against mortality and hemorrhage in a life-threatining renal trauma model. Urology. 2010, 75: 1515.e9-1515.e14. 10.1016/j.urology.2009.12.016.CrossRef
22.
go back to reference Testai L, Chericoni S, Calderone V, Nencioni G, Nieri P, Morelli I, Martinotti E: Cardiovascular effects of Urtica dioica L. (Urticaceae) roots extracts: in vitro and in vivo pharmacological studies. J Ethnopharmacol. 2002, 81 (1): 105-9. 10.1016/S0378-8741(02)00055-7.CrossRefPubMed Testai L, Chericoni S, Calderone V, Nencioni G, Nieri P, Morelli I, Martinotti E: Cardiovascular effects of Urtica dioica L. (Urticaceae) roots extracts: in vitro and in vivo pharmacological studies. J Ethnopharmacol. 2002, 81 (1): 105-9. 10.1016/S0378-8741(02)00055-7.CrossRefPubMed
Metadata
Title
Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent, ankaferd blood stopper, on vascular tissue in a rat aortic bleeding model
Authors
Ozer Kandemir
Mustafa Buyukates
Nilufer Onak Kandemir
Erol Aktunc
Aylin Ege Gul
Sanser Gul
S. Akin Turan
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2010
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/1749-8090-5-110

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