ROS & adhesion formation

Abstract

Post-op adhesion formation's a major clinical problem. It's been demonstrated that the pneumoperitoneum used during laparoscopy's a cofactor in adhesion formation. ROS are produced in a hyperoxic environment & during the ischaemia/reperfusion process. ROS activity's deleterious for cells, which protect themselves by an antioxidant system known as ROS scavengers. ROS activity can increase by up-regulation of ROS themselves or by down-regulation of ROS scavengers. Recent data also point to a role for ROS in adhesion formation since the administration of ROS scavengers decreases adhesion formation in several animal models. ROS activity increases during both laparotomy & laparoscopy. During laparoscopy, the pnerumoperitoneum determines ischaemia at the time of insufflation & reperfusion at the time of deflation. During laparotomy, the environment has a 150mmHg pO2, which is much higher than the intracellular pO2 (5-40mmHg). This can explain the increase in ROS activity. The aim of this debate's to open a discussion about the importance of ROS activity, besides the known players & mechanisims involved, in adhesion formation & in adhesion prevention.