Overproduction of transforming growth factor-beta1 (TGF-beta1) is associated with adhesion formation and peritoneal fibrinolytic impairment.

BACKGROUND Reduction in peritoneal fibrinolytic capacity and increased transforming growth factor-beta1 (TGF-beta1) production are associated with adhesion development. This study investigated the expression of TGF-beta1 in peritoneal tissue, and possible correlation with components of the fibrinolytic system locally in peritoneal tissue. MATERIALS AND METHODS Peritoneal samples were taken from 22 patients at relaparotomy. Samples of adhesions were collected from 10 patients. The patients were categorized into different groups depending on the quantity and the quality of adhesions. TGF-beta1 and components of the fibrinolytic system in tissue extracts were assayed using enzyme-linked immunosorbent assays. RESULTS The concentration of active TGF-beta1 in peritoneal samples from patients with extensive adhesions was double (P <.01) that of healthy subjects, but the total levels of TGF-beta1 were similar (P =.63). In adhesion tissue, both active (P <.003) and total (P <.008) TGF-beta1 concentrations were more than twice as high as unaffected peritoneum. There was a significant correlation between the concentration of plasminogen activator inhibitor type 1 in peritoneal samples with active TGF-beta1 (P <.03, r = 0.693) and adhesion tissue with total TGF-beta1 (P =.001, r = 0.872). The other components of the fibrinolytic system did not correlate significantly with TGF-beta1. CONCLUSIONS These data indicate that an overexpression of TGF-beta1 is associated with adhesion formation, possibly through a mechanism involving local regulation of plasminogen activator inhibitor type 1.

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