Human Reproduction, Vol. 14, No. 1, 49-54,
January 1999
© 1999 European Society of Human Reproduction and Embryology
The role of neutrophils in the formation of peritoneal adhesions
1 Department of Gynecology and Obstetrics, 2 Department of General Surgery and 3 Department of Physiology, School of Medicine, Kocaeli University, Kocaeli 41900, 4 Department of Histology and Embryology, School of Medicine, Istanbul University, Ciapa, Istanbul 34891, 5 Department of Internal Medicine, School of Medicine, Cumhuriyet University, Sivas 58040, 6 Department of Biochemistry, School of Medicine, Dokuz Eylül University, Izmir 35048 and 7 Department of Pathology, School of Medicine, Hacettepe University, Ankara 06912, Turkey
The most common cause of intraperitoneal adhesions which may result in infertility and intestinal obstruction is previous abdominal surgery. Surgical trauma of the peritoneum in the absence of infection elicits a rapid and transient influx of polymorphonuclear leukocytes (PMN) into the peritoneal cavity. The role of neutrophils in intraperitoneal adhesion formation has not been studied. We aimed to study the effects of PMN counts and PMN functions on peritoneal adhesion formation. Forty peritoneal adhesion-induced rats were randomly divided into three groups; group I, receiving saline; group II, receiving cyclophosphamide; and group III, receiving granulocyte–macrophage colony-stimulating factor (GM-CSF). In all groups, peritoneal lavage was performed to determine PMN counts the day after adhesion induction. Blood neutrophil counts and neutrophil functions were also determined. Adhesions were evaluated blindly 14 days after the operation. Adhesion tissue samples were microscopically evaluated. Tissue hydroxyproline and collagen concentrations were measured. The neutrophil counts and phagocytosis significantly increased in group III and neutrophil counts decreased in group II (P < 0.05). The score of adhesion formation in group II was significantly less than that in groups I and III (P < 0.05). Hydroxyproline concentrations of adhesion tissue were significantly decreased in group II when compared with group III (P < 0.05). The present study shows that neutropenia lowers the degree of postoperative adhesion formation. It is concluded that PMN may have a role to play in modulating postoperative adhesion formation.
Key words: cyclophosphamide/granulocyte–macrophage colonystimulating factor/neutrophils/peritoneum/postoperative complications
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