Viable cryopreserved umbilical tissue (vCUT) reduces post-operative adhesions in a rabbit abdominal adhesion model

• Published in: Bioactive materials Vol. 4; no. 1; pp. 97 - 106
• Main Authors: Dhall, Sandeep, Coksaygan, Turhan, Hoffman, Tyler, Moorman, Matthew, Lerch, Anne, Kuang, Jin-Qiang, Sathyamoorthy, Malathi, Danilkovitch, Alla
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.12.2019; KeAi Publishing; KeAi Communications Co., Ltd
• Subjects: Adhesiolysis; Cryopreserved; Fibrosis; Inflammation; Placental; Post-surgical; Post-surgical; TIMP-1; DMSO; Adhesiolysis; HRP; Placental; IGFBP-1; FBS; iNOS; UT; mm; PBS; IL-1RA; H&E; HGF; MT; VEGF-D; IV; bFGF; IL-10; ASTM; Cryopreserved; Fibrosis; Ang; FDA; C; CO2; IgG; EtHd-1; cAM; DMEM; SD; SDF-1α; vCUT; mg/kg; PDGF-AA; CD; ANGPT2; ANGPT1; DAB; EGF; Inflammation; cm; ECM; rpm; PLGA; DPBS; PLGF; PDGF-BB; mg/kg, milligram/kilogram; EGF, epidermal growth factor; ECM, extracellular matrix; DPBS, Dulbecco’s phosphate-buffered saline; HRP, horseradish peroxidase; EtHd-1, ethidium homodimer-1; H&E, hematoxylin and eosin; IGFBP-1, insulin-like growth factor binding protein-1; MT, Masson’s trichrome; C, Celsius; vCUT, viable cryopreserved umbilical tissue; PLGA, poly(lactic-co-glycolic acid); TIMP-1, tissue inhibitor of metalloproteinases-1; rpm, revolutions per minute; IL-1RA, interleukin-1 receptor antagonist; UT, umbilical cord tissue; ANGPT2, angiopoietin-2; bFGF, basic fibroblast growth factor; DAB, 3,3′-Diaminobenzidine; cAM, calcein acetoxymethyl; IL-10, interleukin 10; cm, centimeter; Ang, angiogenin; FDA, United States Food & Drug Administration; ASTM, American Society for Testing and Materials; PDGF-BB, platelet-derived growth factor BB; PLGF, placental growth factor; PBS, phosphate-buffered saline; CD, cluster of differentiation; SD, standard deviation; mm, millimeter; ANGPT1, angiopoietin-1; SDF-1α, stromal cell-derived factor 1 alpha; FBS, fetal bovine serum; IV, intravenous; VEGF-D, vascular endothelial growth factor-D; CO2, carbon dioxide; DMEM, Dulbecco’s modified Eagle’s medium; IgG, immunoglobulin; iNOS, inducible nitric oxide synthase; DMSO, dimethyl sulfoxide; PDGF-AA, platelet-derived growth factor AA; HGF, hepatocyte growth factor
• ISSN: 2452-199X; 2452-199X
• DOI: 10.1016/j.bioactmat.2018.09.002

Post-operative adhesions, a common complication of surgery, cause pain, impair organ functionality, and often require additional surgical interventions. Control of inflammation, protection of injured tissue, and rapid tissue repair are critical for adhesion prevention. Adhesion barriers are biomaterials used to prevent adhesions by physical separation of opposing injured tissues. Current adhesion barriers have poor anti-inflammatory and tissue regenerative properties. Umbilical cord tissue (UT), a part of the placenta, is inherently soft, conforming, biocompatible, and biodegradable, with antimicrobial, anti-inflammatory, and antifibrotic properties, making it an attractive alternative to currently available adhesion barriers. While use of fresh tissue is preferable, availability and short storage time limit its clinical use. A viable cryopreserved UT (vCUT) “point of care” allograft has recently become available. vCUT retains the extracellular matrix, growth factors, and native viable cells with the added advantage of a long shelf life at −80 °C. In this study, vCUT's anti-adhesion property was evaluated in a rabbit abdominal adhesion model. The cecum was abraded on two opposing sides, and vCUT was sutured to the abdominal wall on the treatment side; whereas the contralateral side of the abdomen served as an internal untreated control. Gross and histological evaluation was performed at 7, 28, and 67 days post-surgery. No adhesions were detectable on the vCUT treated side at all time points. Histological scores for adhesion, inflammation, and fibrosis were lower on the vCUT treated side as compared to the control side. In conclusion, the data supports the use of vCUT as an adhesion barrier in surgical procedures. •Umbilical tissue (UT) has properties desirable for an adhesion barrier biomaterial.•Study shows viable cryopreserved umbilical tissue (vCUT) retains components of fresh UT in their native state.•vCUT prevents post-operative adhesions in vivo, suggesting vCUT could be used as an adhesion-barrier in surgical procedures.