Topically Applied Cross-Linked Hyaluronan Attenuates the Formation of Spinal Epidural Fibrosis in a Swine Model of Laminectomy

doi:10.1038/s41598-019-50882-x

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Title:	Topically Applied Cross-Linked Hyaluronan Attenuates the Formation of Spinal Epidural Fibrosis in a Swine Model of Laminectomy
Authors:	Lin, Cheng-Li Jou, I-Ming Wu, Cheng-Yi Kuo, Yuh-Ruey Yang, Shih-Chieh Lee, Jung-Shun Tu, Yuan-Kun Chen, Sung-Ching Yi-Hung Huang(黃儀鴻)
Contributors:	Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Orthopaed Surg Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Res Ctr Clin Med,Skeleton Mat & Biocompatibl Core I Shou Univ, E Da Hosp, Dept Orthopaed ChiaYi Christian Hosp, Dept Orthopaed Natl Cheng Kung Univ Hosp, Dept Surg, Div Neurosurg Maxigen Biotech Inc Chia Nan Univ Pharm & Sci, Dept Sports Management
Keywords:	MATRIX METALLOPROTEINASES EXPRESSION CD44 ACID FIBROBLASTS MODULATORS MIGRATION CYTOKINES SURGERY SYSTEM
Date:	2019-10
Issue Date:	2020-07-29 13:54:49 (UTC+8)
Publisher:	NATURE PUBLISHING GROUP
Abstract:	Epidural fibrosis is an inevitable aspect of the postoperative healing process which is one of the causes of failed back surgery syndrome following spinal surgery. The aim of the present study was to examine the inhibitory effect of 1,4-butanediol diglycidyl ether-crosslinked hyaluronan (cHA) on spinal epidural fibrosis in a swine model. Epidural fibrosis was induced through conduction of hemi-laminotomy (L2 and L3) or laminectomy (L4 and L5), while Ll was assigned as the control group in six pigs. The cHA was applied to L3 and L5 surgical sites. MRI evaluation, histologic examination, expressions of matrix metalloproteinases (MMPs), and cytokines in scar tissue were assessed four months after surgery. cHA treatment significantly decreased the scar formation in both hemi-laminotomy and laminectomy sites. cHA also significantly increased MMP-3 and MMP-9 expression in scar tissue. Further, the epithelial-mesenchyma I transition -related factors (transforming growth factor-beta and vimentin) were suppressed and the anti-inflammatory cytokines (CD44 and interleukin-6) were increasingly expressed in cHA-treated sites. The current study demonstrated that cHA may attenuate spinal epidural fibrosis formation after laminectomy surgery by enhancing the expression of MMPs and anti-inflammatory pathways.
Relation:	Scientific Reports, v.9, 14613
Appears in Collections:	[Dept. of Sports Management] Periodical Articles

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