Getting adhesions unstuck
Peritoneal adhesions are ectopic fibrotic tissues induced by surgical perturbations that result in postoperative morbidities such as small bowel obstruction. The cellular origin of adhesions remains unclear. Now, Tsai et al. show that mesothelial cells overlying organs and the abdominal wall give rise to adhesions after surgery in mice. The injured mesothelium up-regulated mesothelium-specific genes that were known to be highly expressed during fetal development. Targeting adhesions with antibodies against the mesothelial marker mesothelin eliminated adhesions that had formed after surgery. Injured mesothelium responded to hypoxia, and this was mediated by the HIF1α pathway. Blocking HIF1α with small-molecule inhibitors prevented adhesion formation in mice after surgery.
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