beta-escin and Granuloma

Postoperative peritoneal adhesions are common, serious complications of general abdominal and gynecologic surgery that can lead to chronic abdominal pain, intestinal obstruction, and infertility. As yet, there are no ideal drugs that may be prescribed for patients to prevent adhesion formation effectively. In this study the effects of escin, a natural drug, on the various steps of adhesion formation were investigated. The effects of escin on increased vascular permeability induced by acetic acid in a mouse model of acute inflammation, granuloma formation in a subchronic inflammatory rat model, gastrointestinal transit in rats with intestinal paralysis, intestinal motility in postoperative patients, and postoperative adhesion formation in a rat model were observed. It was shown that escin could inhibit acute inflammation and granuloma formation, cause acceleration of gastrointestinal transit, help recover intestinal motility, and attenuate the formation of postoperative adhesions. The findings suggest that escin attenuates the formation of postoperative adhesions by inhibiting inflammation and promoting gastrointestinal transit. Thus it may be concluded that both inhibition of inflammation and increased gastrointestinal motility during the early postoperative period have a positive effect on decreasing the formation of adhesions.

Topics: Adult; Animals; Capillary Permeability; Disease Models, Animal; Escin; Female; Gastrointestinal Transit; Granuloma; Humans; Ileus; Injections, Intravenous; Male; Mice; Middle Aged; Postoperative Complications; Rats; Rats, Sprague-Dawley; Tissue Adhesions

Contrary to the almost water insoluble crystalline beta-escinic acid, the water soluble forms of escin -- such as alpha-escinic acid or its salts, Na-b-escinate and the amorphous beta-escinic acid -- are so well absorbed by the gastro-intestinal tract that the effects after oral application could be compared with those of the reference substances furosemide, hydrocortisone, acetylsalicylic acid, azapropazone and phenylbutazone. Escin was tested in the stasis edema, cotton-pellet-granuloma, and UV-erythema, i.e., in test models which seem specially suited to characterize the properties of this substance. In these tests which reflect both the prophylactic and the therapeutic treatment escin has proven antiexudative-antiphlogistic effects. They are based on a favorable influence of permeability and diuresis.

Topics: Animals; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Diuresis; Edema; Erythema; Escin; Furosemide; Granuloma; Guinea Pigs; Hydrocortisone; Lethal Dose 50; Male; Rats; Saponins