Top

Published in:

01-11-2012 | General Gynecology

Medical ozone therapy decreases postoperative uterine adhesion formation in rats

Authors: Bulent Uysal, Suzi Demirbag, Yavuz Poyrazoglu, Tuncer Cayci, Narter Yesildaglar, Ahmet Guven, Ilhami Sürer, Ahmet Korkmaz

Published in: Archives of Gynecology and Obstetrics | Issue 5/2012

Abstract

Purpose

Various studies have been performed to find out novel treatment strategies to prevent postoperative adhesion formation. Ozone therapy (OT) is shown to reduce inflammation in several pathological conditions. Therefore, we aimed to evaluate the efficacy of OT in a rat model of experimental uterine adhesion (EUA).

Methods

Thirty female Wistar rats (200–250 g) were divided into three groups: sham, EUA and EUA+OT. EUA and EUA+OT groups were subjected to the postoperative adhesion procedure by bipolar coagulation on the uterine horns and corresponding pelvic sidewall parietal peritoneum. EUA+OT group received 0.7 mg/kg daily single dose for 3 days of ozone/oxygen mixture intraperitoneally after adhesion induction. All animals were killed on the 7th day and uterine adhesions were scored. Uterine tissues and peritoneal washing fluid were harvested for all analyses.

Results

Uterine malondialdehyde levels in the EUA group were significantly higher compared to the other groups. However, in the EUA group, uterine superoxide dismutase and glutathione peroxidase activities were lower than in other groups. Peritoneal fluid TNF-α levels were found to be significantly different for all groups (p < 0.001). Macroscopic total adhesion score was significantly higher in the EUA group compared to the other groups (p < 0.001). But, total score in the EUA+OT group was lower than in the EUA group (p = 0.006).

Conclusions

Medical OT prevents postoperative uterine adhesions by modulating TNF-α levels and oxidative/antioxidative status in an experimental uterine adhesion model.

Binda MM, Molinas CR, Koninckx PR (2003) Reactive oxygen species and adhesion formation: clinical implications in adhesion prevention. Hum Reprod 18:2503–2507PubMedCrossRef

Rajab TK, Ahmad UN, Kelly E (2010) Implications of late complications from adhesions for preoperative informed consent. J R Soc Med 103:317–321PubMedCrossRef

Kelekci S, Uygur D, Yilmaz B et al (2007) Comparison of human amniotic membrane and hyaluronate/carboxymethylcellulose membrane for prevention of adhesion formation in rats. Arch Gynecol Obstet 276:355–359PubMedCrossRef

Roy S, Clark CJ, Mohebali K et al (2004) Reactive oxygen species and EGR-1 gene expression in surgical postoperative peritoneal adhesions. World J Surg 28:316–320PubMedCrossRef

ten Raa S, van den Tol MP, Sluiter W et al (2006) The role of neutrophils and oxygen free radicals in post-operative adhesions. J Surg Res 136:45–52PubMedCrossRef

Gotloib L, Wajsbrot V, Cuperman Y et al (2004) Acute oxidative stress induces peritoneal hyperpermeability, mesothelial loss, and fibrosis. J Lab Clin Med 143:31–40PubMedCrossRef

Kaidi AA, Nazzal M, Gurchumelidze T et al (1995) Preoperative administration of antibodies against tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) and their impact on peritoneal adhesion formation. Am Surg 61:569–572PubMed

Mirastschijski U, Johannesson K, Jeppsson B et al (2005) Effect of a matrix metalloproteinase activity and TNF-alpha converting enzyme inhibitor on intra-abdominal adhesions. Eur Surg Res 37:68–75PubMedCrossRef

Saba AA, Godziachvili V, Mavani AK et al (1998) Serum levels of interleukin 1 and tumor necrosis factor alpha correlate with peritoneal adhesion grades in humans after major abdominal surgery. Am Surg 64:734–736 discussion 737PubMed

10.

Williams RS, Rossi AM, Chegini N et al (1992) Effect of transforming growth factor beta on postoperative adhesion formation and intact peritoneum. J Surg Res 52:65–70PubMedCrossRef

11.

Cheong YC, Laird SM, Shelton JB et al (2002) The correlation of adhesions and peritoneal fluid cytokine concentrations: a pilot study. Hum Reprod 17:1039–1045PubMedCrossRef

12.

Kurukahvecioglu O, Koksal H, Gulbahar O et al (2007) Infliximab “TNF-alpha antagonist” decreases intraabdominal adhesions. Saudi Med J 28:1830–1835PubMed

13.

Bocci V (2004) Ozone as Janus: this controversial gas can be either toxic or medically useful. Mediators Inflamm 13:3–11PubMedCrossRef

14.

Bocci VA (2006) Scientific and medical aspects of ozone therapy. State of the art. Arch Med Res 37:425–435PubMedCrossRef

15.

Oter S, Korkmaz A (2006) Relevance of hyperbaric oxygen to ozone therapy. Arch Med Res 37:917–918 author reply 919PubMedCrossRef

16.

Bocci V (1996) Does ozone therapy normalize the cellular redox balance? Implications for therapy of human immunodeficiency virus infection and several other diseases. Med Hypotheses 46:150–154PubMedCrossRef

17.

Guven A, Gundogdu G, Vurucu S et al (2009) Medical ozone therapy reduces oxidative stress and intestinal damage in an experimental model of necrotizing enterocolitis in neonatal rats. J Pediatr Surg 44:1730–1735PubMedCrossRef

18.

Kesik V, Uysal B, Kurt B et al (2009) Ozone ameliorates methotrexate-induced intestinal injury in rats. Cancer Biol Ther 8:1623–1628PubMedCrossRef

19.

Uysal B, Yasar M, Ersoz N et al (2010) Efficacy of hyperbaric oxygen therapy and medical ozone therapy in experimental acute necrotizing pancreatitis. Pancreas 39:9–15PubMedCrossRef

20.

Di Filippo C, Luongo M, Marfella R, Ferraraccio F, Lettieri B, Capuano A, Rossi F, D’Amico M (2010) Oxygen/ozone protects the heart from acute myocardial infarction through local increase of eNOS activity and endothelial progenitor cells recruitment. Naunyn Schmiedebergs Arch Pharmacol 382:287–291PubMedCrossRef

21.

Chu DI, Lim R, Heydrick S et al (2011) N-acetyl-l-cysteine decreases intra-abdominal adhesion formation through the upregulation of peritoneal fibrinolytic activity and antioxidant defenses. Surgery 149:801–812PubMedCrossRef

22.

Cetinkursun S, Demirbag S, Tasdemir U et al (2005) Comparison of hyaluronate/carboxymethylcellulose membrane and melatonin for prevention of adhesion formation in a rat model. Hum Reprod 20:2021–2024PubMedCrossRef

23.

Basbug M, Aygen E, Tayyar M et al (1998) Hyaluronic acid plus heparin for improved efficacy in prevention of adhesion formation in rat uterine horn model. Eur J Obstet Gynecol Reprod Biol 78:109–112PubMedCrossRef

24.

Lowry OH, Rosebrough NJ, Farr AL et al (1951) Protein measurement with the Folin phenol reagent. J Biol Chem 193:265–275PubMed

25.

Ohkawa H, Ohishi N, Yagi K (1979) Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem 95:351–358PubMedCrossRef

26.

Durak I, Yurtarslanl Z, Canbolat O et al (1993) A methodological approach to superoxide dismutase (SOD) activity assay based on inhibition of nitroblue tetrazolium (NBT) reduction. Clin Chim Acta 214:103–104PubMedCrossRef

27.

Paglia DE, Valentine WN (1967) Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase. J Lab Clin Med 70:158–169PubMed

28.

Leach RE, Burns JW, Dawe EJ et al (1998) Reduction of postsurgical adhesion formation in the rabbit uterine horn model with use of hyaluronate/carboxymethylcellulose gel. Fertil Steril 69:415–418PubMedCrossRef

29.

Di Filippo C, Capuano A, Rinaldi B et al (2011) Intraperitoneal oxygen/ozone treatment decreases the formation of experimental postsurgical peritoneal adhesions and the levels/activity of the local ubiquitin–proteasome system. Mediators Inflamm 2011:606718PubMed

30.

Di Domenico I, Dimarzio G, Pepe L, Lettieri B (2011) Comparision between O₂ and oxygen/ozone mixture treatment in decreasing postsurgical peritoneal adhesion and the levels/activity of local ubiquitine–proteasome system.Translational Medicine @ UniSa, Special Issues 1(4 Poster)

31.

Yesildaglar N, Ordonez JL, Laermans I et al (1999) The mouse as a model to study adhesion formation following endoscopic surgery: a preliminary report. Hum Reprod 14:55–59PubMedCrossRef

32.

Yesildaglar N, Koninckx PR (2000) Adhesion formation in intubated rabbits increases with high insufflation pressure during endoscopic surgery. Hum Reprod 15:687–691PubMedCrossRef

33.

Fantone JC, Ward PA (1982) Role of oxygen-derived free radicals and metabolites in leukocyte-dependent inflammatory reactions. Am J Pathol 107:395–418PubMed

34.

Dijkgraaf LC, Zardeneta G, Cordewener FW et al (2003) Crosslinking of fibrinogen and fibronectin by free radicals: a possible initial step in adhesion formation in osteoarthritis of the temporomandibular joint. J Oral Maxillofac Surg 61:101–111PubMedCrossRef

35.

Bertuglia S, Colantuoni A, Intaglietta M (1993) Effect of leukocyte adhesion and microvascular permeability on capillary perfusion during ischemia–reperfusion injury in hamster cheek pouch. Int J Microcirc Clin Exp 13:13–26PubMed

36.

Demirbag S, Uysal B, Guven A et al (2010) Effects of medical ozone therapy on acetaminophen-induced nephrotoxicity in rats. Ren Fail 32:493–497PubMedCrossRef

37.

Bocci V, Zanardi I, Travagli V (2011) Has oxygen–ozone therapy a future in medicine? J Exp Integr Med 1:5–11CrossRef

38.

Souza YM, Fontes B, Martins JO, Sannomiya P, Brito GS, Younes RN, Rasslan S (2010) Evaluation of the effects of ozone therapy in the treatment of intra-abdominal infection in rats. Clinics (Sao Paulo) 65:195–202CrossRef

39.

Rodríguez ZZ, Guanche D, Alvarez RG, Martinez Y, Alonso Y, Schulz S (2011) Effects of ozone oxidative preconditioning on different hepatic biomarkers of oxidative stress in endotoxic shock in mice. Toxicol Mech Methods 21:236–240PubMedCrossRef

40.

Guven A, Gundogdu G, Sadir S et al (2008) The efficacy of ozone therapy in experimental caustic esophageal burn. J Pediatr Surg 43:1679–1684PubMedCrossRef

Title: Medical ozone therapy decreases postoperative uterine adhesion formation in rats
Authors: Bulent Uysal
Suzi Demirbag
Yavuz Poyrazoglu
Tuncer Cayci
Narter Yesildaglar
Ahmet Guven
Ilhami Sürer
Ahmet Korkmaz
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 5/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-012-2435-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Medical ozone therapy decreases postoperative uterine adhesion formation in rats

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2012

Which is the best technique for endometrial sampling? Aspiration (pipelle) versus dilatation and curettage (D&C)

The effects of 17β-estradiol plus drospirenone on anthropometric and biochemical measures of adiposity in menopausal women

Prophylactic adnexectomy along with vaginal hysterectomy for benign pathology

The role of gynecological, urological, and psychiatric factors in chronic pelvic pain

Environmental tobacco smoke and stress as risk factors for miscarriage and preterm births

Three cases of laparoscopic myomectomy performed during pregnancy for pedunculated uterine myomas