NEW ROLES OF MAST CELLS IN POSTOPERATIVE WOUND HEALING AND ADHESION FORMATION. Mast hücrelerinin cerrahi sonras? yara iyile?mesi ve adezyon olu?umunda yeni tan?mlanan rolleri.

摘要

In the past, mast cells (MCs) in human were well-known cells with their significant roles in allergic diseases and anaphylaxis; but lately it became obvious that they have many other functions, especially as a part of the innate immune system. Today, it is known that mast cells involve in various events such as, bacterial infections, angiogenesis, autoimmune diseases (e.g. rheumatoid arthritis), tissue repair, and cancer. Additionally, MCs have important roles in processes of postoperative wound healing, adhesion formation, infection control, and inflammation. Recently, many studies were conducted proving the importance of MCs in surgical diseases. For instance, it was lately understood that mast cells and their mediators vascular permeability/endothelial growth factor (VEGF) may be central to the formation of postoperative intra-abdominal adhesions. In tandem with the recent clinical success of anti-VEGF monoclonal antibodies in oncologic practice, some authors suggest an avenue for the development of anti-adhesion strategy with these antibodies. Similiarly, recent studies indicate that chymase content of MCs involve in adhesion formation. Thus, chymase inhibitors are presented by some researchers as a potential beneficial drug for prevention of adhesion formation. In this review, we will discuss the importance of MCs in terms of postoperative wound healing, adhesion formation, inflammation, and infection control in the light of recent literature.??ZETMast hücreleri (MH), ge?mi?te insanda, ?zellikle allerjik hastal?klar ve anaflaksideki belirgin rolleri ile iyi bilinen hücreler iken; son y?llarda, ?zellikle do?al ba????kl?k sisteminin bir par?as? olmak üzere, bir?ok fonksiyona sahip olduklar? ortaya ??kar?lm??t?r. Günümüzde, MH’nin bakteriyel enfeksiyonlar, anjiyogenez, otoimmün hastal?klar (?rn. romatoid artrit), doku tamiri ve kanser gibi bir?ok farkl? olayda rol oynad??? bilinmektedir. MH ayn? zamanda cerrahi sonras? yara iyile?mesi, adezyon olu?umu, enfeksiyon kontrolü, inflamasyon vb. süre?lerinde de ?nemli rollere sahiptir. Son y?llarda, MH’nin cerrahi hastal?klardaki ?nemini g?steren bir?ok ara?t?rma yap?lm??t?r. ?rn., MH’nin ve salg?lad??? vascular permeability/endothelial growth factor (VEGF)’in intraabdominal adezyonlar?n olu?umunda merkezi role sahip oldu?u anla??lm??t?r. Anti-VEGF monoklonal antikorlar?n onkolojideki klinik ba?ar?lar?ndan yola ??karak, bu antikorlar ile anti-adezyon stratejisi geli?tirmeyi ?neren ara?t?rmac?lar mevcuttur. Benzer ?ekilde, son ?al??malar MH’nin i?erdi?i kimaz?n adezyon formasyonuna kat?ld???n? g?stermi?tir. Kimaz inhibit?rünün adezyon formasyonunun ?nlenmesinde yararl? bir ila? olabilece?i baz? ara?t?rmac?lar taraf?ndan ?ne sürülmü?tür. Bu yaz?m?zda, MH’nin cerrahi sonras? yara iyile?mesi, adezyon olu?umu, inflamasyon ve enfeksiyon kontrolündeki ?nemi son literatür verileri ?????nda tart???lacakt?r.