Fibrose postopératoire : aspects physiopathologiques et perspectives thérapeutiques
Autor: | S Delanian |
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Rok vydání: | 2008 |
Předmět: |
Pathology
medicine.medical_specialty business.industry Mechanism (biology) Hyperbaric oxygenation Growth factor medicine.medical_treatment Inflammation General Medicine medicine.disease Extracellular matrix Fibrosis Medicine Orthopedics and Sports Medicine Surgery medicine.symptom business Myofibroblast Histopathological aspects |
Zdroj: | Chirurgie de la Main. 27:256-265 |
ISSN: | 1297-3203 |
Popis: | Postoperative fibrosis (POF) is a rare, localized, and irreversible delayed effect of surgery, described in numerous tissues and organs. Is this fibrotic process amenable to therapeutic intervention? A synthesis of various clinical and histopathological aspects, and of cellular and molecular process regulation is described. In summary, there exists a prefibrotic chronic inflammatory phase, a constituted and cellular phase, and lastly a matricial densification and remodelling phase. The respective phases and the roles played over time by the main protagonists, namely myofibroblasts, extracellular matrix and growth factor (TGFbeta1) are clarified. Understanding the mechanism of POF leads logically to treatments derived from our knowledge of the treatment of radiation-induced fibrosis: anti-inflammatory drugs help in the prefibrotic phase, pentoxifylline-tocopherol combination (PE) in the organized fibrotic phase, and pentoclo (PE-clodronate) in the late fibronecrotic phase. Randomized trials are necessary to validate the preliminary results of phase II trials. |
Databáze: | OpenAIRE |
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