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Frontiers in Immunology 2021Most multicellular organisms have a major body cavity containing vital organs. This cavity is lined by a mucosa-like serosal surface and filled with serous fluid which... (Review)
Review
Most multicellular organisms have a major body cavity containing vital organs. This cavity is lined by a mucosa-like serosal surface and filled with serous fluid which suspends many immune cells. Injuries affecting the major body cavity are potentially life-threatening. Here we summarize evidence that unique damage detection and repair mechanisms have evolved to ensure immediate and swift repair of injuries at serosal surfaces. Furthermore, thousands of patients undergo surgery within the abdominal and thoracic cavities each day. While these surgeries are potentially lifesaving, some patients will suffer complications due to inappropriate scar formation when wound healing at serosal surfaces defects. These scars called adhesions cause profound challenges for health care systems and patients. Therefore, reviewing the mechanisms of wound repair at serosal surfaces is of clinical importance. Serosal surfaces will be introduced with a short embryological and microanatomical perspective followed by a discussion of the mechanisms of damage recognition and initiation of sterile inflammation at serosal surfaces. Distinct immune cells populations are free floating within the coelomic (peritoneal) cavity and contribute towards damage recognition and initiation of wound repair. We will highlight the emerging role of resident cavity GATA6+ macrophages in repairing serosal injuries and compare serosal (mesothelial) injuries with injuries to the blood vessel walls. This allows to draw some parallels such as the critical role of the mesothelium in regulating fibrin deposition and how peritoneal macrophages can aggregate in a platelet-like fashion in response to sterile injury. Then, we discuss how serosal wound healing can go wrong, causing adhesions. The current pathogenetic understanding of and potential future therapeutic avenues against adhesions are discussed.
Topics: Animals; Ascitic Fluid; Blood Platelets; Cell Aggregation; GATA6 Transcription Factor; Humans; Macrophages, Peritoneal; Peritoneum; Serous Membrane; Tissue Adhesions; Wounds and Injuries
PubMed: 34054877
DOI: 10.3389/fimmu.2021.684967 -
Peritoneal Dialysis International :... 2014Peritoneal dialysis (PD) is associated with functional and structural changes of the peritoneal membrane, also known as peritoneal remodeling. The peritoneal membrane is... (Review)
Review
Peritoneal dialysis (PD) is associated with functional and structural changes of the peritoneal membrane, also known as peritoneal remodeling. The peritoneal membrane is affected by many endogenous and exogenous factors such as cytokines, PD fluids, and therapeutic interventions. Here, we present an overview of various studies that have investigated pharmacologic interventions aimed at regression of peritoneal damage and prolongation of PD treatment.
Topics: Humans; Neovascularization, Pathologic; Peritoneal Dialysis; Peritoneal Fibrosis; Peritoneum; Peritonitis
PubMed: 24525599
DOI: 10.3747/pdi.2011.00332 -
Surgical Endoscopy Jan 2011Laparoscopic surgery has been incorporated into common surgical practice. The peritoneum is an organ with various biologic functions that may be affected in different... (Review)
Review
BACKGROUND
Laparoscopic surgery has been incorporated into common surgical practice. The peritoneum is an organ with various biologic functions that may be affected in different ways by laparoscopic and open techniques. Clinically, these alterations may be important in issues such as peritoneal metastasis and adhesion formation.
METHODS
A literature search using the Pubmed and Cochrane databases identified articles focusing on the key issues of laparoscopy, peritoneum, inflammation, morphology, immunology, and fibrinolysis.
RESULTS
Laparoscopic surgery induces alterations in the peritoneal integrity and causes local acidosis, probably due to peritoneal hypoxia. The local immune system and inflammation are modulated by a pneumoperitoneum. Additionally, the peritoneal plasmin system is inhibited, leading to peritoneal hypofibrinolysis.
CONCLUSION
Similar to open surgery, laparoscopic surgery affects both the integrity and biology of the peritoneum. These observations may have implications for various clinical conditions.
Topics: Acidosis; Animals; Carbon Dioxide; Cell Adhesion Molecules; Cell Hypoxia; Cytokines; Epithelium; Fibrinolysin; Fibrinolysis; Humans; Intercellular Signaling Peptides and Proteins; Laparoscopy; Macrophages, Peritoneal; Mice; Neoplasm Seeding; Peritoneal Cavity; Peritoneal Neoplasms; Peritoneum; Peritonitis; Pneumoperitoneum, Artificial; Tissue Adhesions; Wound Healing
PubMed: 20552372
DOI: 10.1007/s00464-010-1139-2 -
Kidney & Blood Pressure Research 2018Fibrosis and angiogenesis are the most common processes that result in progressive peritoneal tissue remodeling and, eventually, peritoneal membrane dysfunction. The... (Review)
Review
Fibrosis and angiogenesis are the most common processes that result in progressive peritoneal tissue remodeling and, eventually, peritoneal membrane dysfunction. The role of exosomes, which contributes to intercellular communication, in these processes has been neglected. Various biomolecules, including DNA, mRNA, proteins, lipids, and particular certain miRNAs, can be transferred by exosomes to local, neighboring and distal cells. Upon stimulation by cytokines or other microenvironment stimuli, donor cells release a mass of exosomes to peritoneal mesothelial cells, further affecting fibrosis and angiogenesis. This important exosomes-mediated intracellular communication is thought to regulate peritoneal membrane function. Understanding the molecular mechanisms of these processes, targeting changes in exosomes and regulating exosomal miRNAs will advance therapeutic methods for protecting peritoneal membrane function.
Topics: Cell Communication; Exosomes; Fibrosis; Humans; Membranes; Neovascularization, Pathologic; Peritoneum
PubMed: 29940564
DOI: 10.1159/000490821 -
Annals of Surgery Jan 1995New surgical procedures designed to assist in the treatment of peritoneal surface malignancy were sought.
OBJECTIVE
New surgical procedures designed to assist in the treatment of peritoneal surface malignancy were sought.
BACKGROUND
Decisions regarding the treatment of cancer depend on the anatomic location of the malignancy and the biologic aggressiveness of the disease. Some patients may have isolated intra-abdominal seeding of malignancy of limited extent or of low biologic grade. In the past, these clinical situations have been regarded as lethal.
METHODS
The cytoreductive approach may require six peritonectomy procedures to resect or strip cancer from all intra-abdominal surfaces.
RESULTS
These are greater omentectomy-splenectomy; left upper quadrant peritonectomy; right upper quadrant peritonectomy; lesser omentectomy-cholecystectomy with stripping of the omental bursa; pelvic peritonectomy with sleeve resection of the sigmoid colon; and antrectomy.
CONCLUSIONS
Peritonectomy procedures and preparation of the abdomen for early postoperative intraperitoneal chemotherapy were described. The author has used the cytoreductive approach to achieve long-term, disease-free survival in selected patients with peritoneal carcinomatosis, peritoneal sarcomatosis or mesothelioma.
Topics: Humans; Methods; Peritoneal Neoplasms; Peritoneum
PubMed: 7826158
DOI: 10.1097/00000658-199501000-00004 -
BioMed Research International 2015Hyaluronan (HA) is a ubiquitous extracellular matrix glycosaminoglycan composed of repeated disaccharide units of alternating D-glucuronic acid and D-N-acetylglucosamine... (Review)
Review
Hyaluronan (HA) is a ubiquitous extracellular matrix glycosaminoglycan composed of repeated disaccharide units of alternating D-glucuronic acid and D-N-acetylglucosamine residues linked via alternating β-1,4 and β-1,3 glycosidic bonds. HA is synthesized in humans by HA synthase (HAS) enzymes 1, 2, and 3, which are encoded by the corresponding HAS genes. Previous in vitro studies have shown characteristic changes in HAS expression and increased HA synthesis in response to wounding and proinflammatory cytokines in human peritoneal mesothelial cells. In addition, in vivo models and human peritoneal biopsy samples have provided evidence of changes in HA metabolism in the fibrosis that at present accompanies peritoneal dialysis treatment. This review discusses these published observations and how they might contribute to improvement in peritoneal dialysis.
Topics: Dialysis Solutions; Epithelium; Extracellular Matrix; Fibroblasts; Humans; Hyaluronic Acid; Models, Biological; Peritoneal Dialysis; Peritoneum
PubMed: 26550568
DOI: 10.1155/2015/427038 -
Biomolecules Dec 2021Formation of peritoneal adhesions (PA) is one of the major complications following intra-abdominal surgery. It is primarily caused by activation of the mesothelial layer... (Review)
Review
Formation of peritoneal adhesions (PA) is one of the major complications following intra-abdominal surgery. It is primarily caused by activation of the mesothelial layer and underlying tissues in the peritoneal membrane resulting in the transition of mesothelial cells (MCs) and fibroblasts to a pro-fibrotic phenotype. Pro-fibrotic transition of MCs-mesothelial-to-mesenchymal transition (MMT), and fibroblasts activation to myofibroblasts are interconnected to changes in cellular metabolism and culminate in the deposition of extracellular matrix (ECM) in the form of fibrotic tissue between injured sides in the abdominal cavity. However, ECM is not only a mechanical scaffold of the newly synthetized tissue but reciprocally affects fibrosis development. Hyaluronan (HA), an important component of ECM, is a non-sulfated glycosaminoglycan consisting of N-acetyl-D-glucosamine (GlcNAc) and D-glucuronic acid (GlcUA) that can affect the majority of processes involved in PA formation. This review considers the role of endogenously produced HA in the context of different fibrosis-related pathologies and its overlap in the development of PA.
Topics: Epithelium; Fibroblasts; Hyaluronic Acid; Myofibroblasts; Peritoneum
PubMed: 35053193
DOI: 10.3390/biom12010045 -
The British Journal of Radiology Mar 2021Pathologic involvement of the peritoneum can result from a wide variety of conditions, including both neoplastic and non-neoplastic entities. Neoplastic involvement of... (Review)
Review
Pathologic involvement of the peritoneum can result from a wide variety of conditions, including both neoplastic and non-neoplastic entities. Neoplastic involvement of the peritoneal ligaments, mesenteries, and spaces from malignant spread of epithelial cancers, termed peritoneal carcinomatosis, is frequently encountered at CT evaluation. However, a host of other more unusual benign and malignant neoplasms can manifest with peritoneal disease, including both primary and secondary peritoneal processes, many of which can closely mimic peritoneal carcinomatosis at CT. In this review, we discuss a wide array of unusual peritoneal-based neoplasms that can resemble the more common peritoneal carcinomatosis. Beyond reviewing the salient features for each of these entities, particular emphasis is placed on any specific clinical and CT imaging clues that may allow the interpreting radiologist to appropriately narrow the differential diagnosis and, in some cases, make an imaging-specific diagnosis.
Topics: Diagnosis, Differential; Humans; Peritoneal Neoplasms; Peritoneum; Tomography, X-Ray Computed
PubMed: 33353398
DOI: 10.1259/bjr.20201288 -
British Medical Journal Mar 1969
Topics: Hernia, Inguinal; Humans; Methods; Peritoneum
PubMed: 5769876
DOI: 10.1136/bmj.1.5646.780-c -
World Journal of Gastroenterology May 2019Congenital peritoneal encapsulation (CPE) is a very rare, congenital condition characterised by the presence of an accessory peritoneal membrane which encases a variable... (Review)
Review
Congenital peritoneal encapsulation (CPE) is a very rare, congenital condition characterised by the presence of an accessory peritoneal membrane which encases a variable extent of the small bowel. It is unclear how CPE develops, however it is currently understood to be a result of an aberrant adhesion in the peritoneal lining of the physiological hernia in foetal mid-gut development. The condition was first described in 1868, and subsequently there have been only 45 case reports of the phenomenon. No formal, systematised review of CPE has yet been performed, meaning the condition remains poorly understood, underdiagnosed and mismanaged. Diagnosis of CPE remains clinical with important adjuncts provided by imaging and diagnostic laparoscopy. Two thirds of patients present with abdominal pain, likely secondary to sub-acute bowel obstruction. A fixed, asymmetrical distension of the abdomen and differential consistency on abdominal palpation are more specific clinical features present in approximately 10% of cases. CPE is virtually undetectable on plain imaging, and is only detected on 40% of patients with computed tomography scan. Most patients will undergo diagnostic laparotomy to confirm the diagnosis. Management of CPE includes both medical management of the critically-unstable patient and surgical laparotomy, partial peritonectomy and adhesiolysis. Prognosis following prompt surgical treatment is excellent, with a majority of patients being symptom free at follow up. This review summarises the current literature on the aetiology, diagnosis and treatment of this rare disease. We also introduce a novel classification system for encapsulating bowel diseases, which may distinguish CPE from the commoner, more morbid conditions of abdominal cocoon and encapsulating peritoneal sclerosis.
Topics: Humans; Intestinal Obstruction; Intestine, Small; Peritoneal Fibrosis; Peritoneum; Prognosis; Treatment Outcome
PubMed: 31148901
DOI: 10.3748/wjg.v25.i19.2294