icodextrin and Fibrosis

The aim of this experimental study was to investigate whether spinal epidural 4% glucose polymer solution is effective in the prevention of postoperative fibrosis.. Twenty eight adult Wistar albino rats were randomly divided into two equal groups, including treatment and control. Both groups underwent L1 vertebral total laminectomy to expose the dura. Topical treatment group received 4% icodextrin. Four weeks later, epidural fibrosis was examined in both groups histologically, biochemically and macroscopically.. Topical use of 4% icodextrin prevented significantly epidural fibrosis following the laminectomy operation.. Topical 4% icodextrin application inhibits postoperative epidural fibrosis with various mechanisms and prevents adhesions by playing barrier role between tissue surfaces through flotation. Our study is first to present evidence of experimental epidural fibrosis prevention with 4% icodextrin.

Topics: Animals; Dialysis Solutions; Disease Models, Animal; Epidural Space; Fibrosis; Glucans; Glucose; Icodextrin; Laminectomy; Male; Postoperative Complications; Rats; Rats, Wistar; Spinal Diseases

Application of icodextrin-based peritoneal dialysis fluid (PDF) provides a potential benefit in patients with diabetes and end-stage renal failure treated with continuous ambulatory peritoneal dialysis (CAPD) because of better ultrafiltration capacity and avoidance of direct glucose exposure. We examined the effect of glucose and icodextrin-based PDF on histological alterations of peritoneal membranes.. Thirty-two male Wistar rats were divided into four groups: control Wistar rats with non-treated (n = 8), streptozotocin (STZ)-induced diabetic rats with 5/6 kidney ablation (n = 8), STZ-induced diabetic rats with 5/6 kidney ablation injected with a standard lactate-buffered 4.25% glucose-based PDF (Dianeal; n = 8) and STZ-induced diabetic rats with 5/6 kidney ablation injected with 7.5% icodextrin-based PDF (Extraneal; n = 8). Intraperitoneal injection was performed once daily with an instillation volume of 20 ml per injection during 8 weeks.. Chronic high-glucose-based PDF exposure resulted in increased vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) expression, accumulation of advanced glycation end-products (AGEs), and up-regulation of the receptor for AGE (RAGE), which were ameliorated in the icodextrin-based PDF group. The peritoneal damages, such as neoangiogenesis and submesothelial fibrosis, were significantly reduced in icodextrin-based PDF compared to high-glucose-based PDF.. Long-term in vivo exposure to high glucose-based PDF promotes the fibrosing process of peritoneal membranes. Icodextrin-based PDF may be helpful in slowing the PDF-induced deterioration of peritoneal function and prolonging the use of peritoneal dialysis in patients with diabetes.

Topics: Animals; Diabetes Mellitus, Experimental; Diabetic Nephropathies; Fibroblast Growth Factor 2; Fibrosis; Glucans; Glucose; Glycation End Products, Advanced; Hemodialysis Solutions; Icodextrin; Immunohistochemistry; Male; Nephrectomy; Peritoneum; Rats; Rats, Wistar; Streptozocin; Vascular Endothelial Growth Factor A

Topics: Animals; Diabetes Mellitus, Experimental; Fibrosis; Glucans; Glucose; Hemodialysis Solutions; Humans; Icodextrin; Peritoneal Dialysis; Peritoneum; Rats