Novel approach to reduce postsurgical adhesions to a minimum: administration of losartan plus atorvastatin intraperitoneally.

BACKGROUND: Intraperitoneal adhesions are the most important cause of intestinal obstruction, pelvic pain, and female infertility.

MATERIALS AND METHODS: Losartan (1, 5, and 10 mg/kg), atorvastatin (1, 20, and 30 mg/kg), losartan (10 mg/kg) plus atorvastatin (20 mg/kg), and sodium hyaluronate/carboxymethylcellulose (HA/CMC) were administered intraperitoneally in 90 male NMRI mice. After 7 d, the grade of adhesions was scored by two scaling methods and the concentrations of TGF-β1, tPA, and PAI-1 were also evaluated.

RESULTS: Simultaneous intraperitoneal administration of losartan and atorvastatin led to a much higher reduction of adhesions compared with that in the HA/CMC group (P < 0.05). When losartan plus atorvastatin was administered, significant changes in the serum concentration and mRNA expression, including the increase of tPA and the decrease of TGF-β1 and PAI-1, were observed compared with those in other groups.

CONCLUSIONS: Our findings suggest that the simultaneous application of losartan and atorvastatin leads to an enhanced reduction in adhesion bands more than that of HA/CMC treatment, compared with the control group, possibly through balancing the expression of TGF-β1, tPA, and PAI-1.