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Reproductive Sciences
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Review: Cellular Metabolism: Contribution to Postoperative Adhesion Development

Valerie I. Shavell, MD

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan

Ghassan M. Saed, PhD

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan

Michael P. Diamond, MD

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, mdiamond{at}med.wayne.edu

Postoperative adhesions are a significant source of morbidity, including contributions to pelvic pain, bowel obstruction, and infertility. While the mechanisms of postoperative adhesion development are complex and incompletely understood, hypoxia appears to trigger a cascade of intracellular responses involving hypoxia-inducible factors, lactate, reactive oxygen species, reactive nitrogen species, and insulin-like growth factors that results in manifestation of the adhesion phenotype. Thus, substantial evidence exists to implicate the direct role of cellular metabolism in wound repair and adhesion development.

Key Words: Adhesions • hypoxia • hypoxia-inducible factor (HIF) • lactate • reactive oxygen species • apoptosis.

This version was published on July 1, 2009

Reproductive Sciences, Vol. 16, No. 7, 627-634 (2009)
DOI: 10.1177/1933719109332826
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