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Nowa metoda zapobiegania zrostom pooperacyjnym

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Naukowcy z Uniwersytetu Berneńskiego odkryli mechanizm, który prowadzi do powstawania zrostów pooperacyjnych w obrębie jamy brzusznej. Odkrycie to może stanowić pierwszy krok do opracowania metody zapobiegania powstawaniu zrostów.

Zrosty pooperacyjne (adhezje) to włókniste pasma, które tworzą się między tkankami i narządami w wyniku urazu. Stanowią najczęstsze powikłanie operacji chirurgicznych w obrębie jamy brzusznej i miednicy małej. Mogą one prowadzić do długotrwałych dolegliwości bólowych i zaburzeń w funkcjonowaniu poszczególnych narządów, w tym do niepłodności oraz niedrożności jelit. Naukowcy ze Szwajcarii odkryli, w jaki sposób dochodzi do powstawania zrostów.

Rola makrofagów w powstawaniu zrostów pooperacyjnych

Badania odbywały się pod kierunkiem prof. Daniela Candinasa, dyrektora Kliniki Chirurgii Trzewnej i Medycyny Uniwersytetu Berneńskiego, oraz dr. Joela Zindela z Departamentu Badań Biomedycznych w tym samym ośrodku naukowym. Zespół szwajcarskich naukowców odkrył, że kluczową rolę w powstawaniu zrostów odgrywają makrofagi, czyli komórki będące ważnym elementem nieswoistej i swoistej odpowiedzi immunologicznej. Makrofagi są również odpowiedzialne za rozwój stanów zapalnych w organizmie.

Naukowcy z Uniwersytetu Berneńskiego we współpracy z badaczami z Uniwersytetu Calgary w Kanadzie opracowali nowatorską metodę obrazowania. Dzięki wykorzystaniu nowoczesnej techniki mikroskopowej naukowcy wykorzystali najcieńszy fragment ściany brzucha jako „okno” do wnętrza jamy otrzewnej. To pozwoliło zaobserwować, w jaki sposób makrofagi tworzą w naturalnym środowisku struktury prowadzące do powstania zrostów. Wyniki badań zostały opublikowane w czasopiśmie naukowym „Science”.

Niekontrolowane skrzepy

Autorzy projektu porównują makrofagi pływające w płynie otrzewnowym do planktonu unoszącego się w morzu. Do ich zadań należy m.in. eliminacja patogenów, ale również jak najszybsze zamykanie urazów w obrębie jamy brzusznej.

Kiedy dochodzi do urazu, makrofagi gromadzą się, tworząc strukturę przypominającą skrzep. Jak wyjaśnia dr Joel Zindel, w przypadku rozległych urazów, spowodowanych np. chirurgicznym otwarciem jamy brzusznej lub wszczepieniem implantu, działanie makrofagów może wymknąć się spod kontroli. W efekcie tworzone przez makrofagi skrzepy nie przestają rosnąć i tworzą długie pasma, co prowadzi do powstawania zrostów.

Skuteczna profilaktyka zrostów

Naukowcy odkryli, że zablokowanie receptorów, które stymulują gromadzenie się makrofagów w miejscu zranienia, prowadzi do ograniczenia liczby zrostów. Zespół pod kierunkiem prof. Candinasa i dr. Zindela złożył wniosek patentowy dotyczący stosowania substancji czynnej przeciwko zrostom.

Jak podkreśla prof. Daniel Candinas, zrealizowany przez jego zespół projekt badawczy to przykład tego, że badania laboratoryjne mają duże znaczenie dla współczesnej medycyny. Poczynione odkrycia mogą mieć znaczenie dla wielu dziedzin badań. Według szwajcarskich naukowców podobne mechanizmy mogą występować w pozostałych jamach organizmu i odgrywać ważną rolę nie tylko w leczeniu urazów, ale również przy powstawaniu guzów.

Jeżeli dalsze badania potwierdzą skuteczność opracowanego przez naukowców związku przeciwko zrostom na tkankach ludzkich, w przyszłości pacjenci mogliby rutynowo otrzymywać przed zabiegami operacyjnymi leki hamujące reakcję makrofagów i tworzenie się zrostów.

Źródło: sciencedaily.com

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