Canadian scientists and Swiss surgeons discover the cause of excessive scarring after surgery

The body is amazing at healing itself. However, sometimes it can do too much. Excessive scarring after abdominal and pelvic surgery within the peritoneal cavity can lead to severe complications and sometimes death. The peritoneal cavity contains a protective lining that contains organs within our abdomen. There is also beer to keep the organs lubricated. When the lining is damaged, cloth and separation can form, creating problems. Researchers at the University of Calgary and the University of Bern, Switzerland, have discovered the causes of excessive scarring and options to try to prevent it.

“This is a worldwide concern. Problems from these peritoneal hats cause pain and can lead to life-threatening small bowel obstruction, and infertility in women, ”says Dr. Joel Zindel, MD, University of Bern, Switzerland, and the first author of the study who worked on this research as a researcher at the Swiss National Science Foundation at the University of Calgary. “People sometimes need a second surgery.”

The research published in Science, produced in mice and showing excessive scarring caused by macrophages, a type of white blood cell that runs to the surgical site to begin repairing the injury.

“Joel developed a new method using the highly specialized imaging equipment in my laboratory that gave scientists the first insight into what these macrophages do in real time,” says Dr. Paul Kubes, PhD, researched principal and professor at the School of Cumming Medicine. “We are still working to understand why the macrophages accept this repair work as they are notorious for invading pathogens. Whatever they respond to, it is clear that they are involved in causing the scarring problem. ”

The researchers also found two ways to suppress this natural response. They removed the macrophages, or introduced a drug to prevent macrophage sticking. Both processes were very effective in stopping the adhesions.

“We believe that the macrophage response has not made the evolutionary leap to understand that surgery is beneficial and not a threat to survival,” Kubes said. “It is possible, that the body is undergoing the surgery, that the organs that are exposed to the environment are defined as a threat, as an attack from a predator. The body does not understand that the surgeon in the emergency repair work. “

Macrophages are also present in humans, and the research team believes that the response seen in mice is likely to translate into adults and children. They hope to move to human cell trials, soon, and finally clinical trials.

“All surgeons perform operations for people who have those abdominal hats,” Zindel says. “It would be amazing to be able to prevent this surgical problem. It would not only benefit individuals, it would create huge savings for the health care system, by reducing hospital costs. for readmission and surgery. ”

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The basic research was funded by the Natural Sciences and Engineering Research Council while the clinical application was funded by the Canadian Institutes of Health Research Institute (CIHR). Kubes is supported by the Heart & Stroke and CIHR Canada Research Chairs Program and Zindel is supported by an alliance from the Swiss National Science Foundation.

This research was made possible with the support of Nicole Perkins Core Communities Microbial Lab, the Live Cell Imaging Resource Laboratory at the School of Cumming Medicine, and the University of Bern Microscopy (MIC) Imaging Center.