Mustafa Alper Akay1, Mustafa Akduman2, Ahmet Çağrı Tataroğlu2, Ceyla Eraldemir3, Tuğba Kum2, Çiğdem Vural4, Gülşen Ekingen Yıldız5. 1. Department of Pediatric Surgery, Kocaeli University Medical Faculty, Umuttepe, 41380, Kocaeli, Turkey. pedcerr@gmail.com. 2. Republic of Turkey Ministry of Health, Ankara, Turkey. 3. Department of Biochemistry, Kocaeli University Medical Faculty, Kocaeli, Turkey. 4. Department of Pathology, Kocaeli University Medical Faculty, Kocaeli, Turkey. 5. Department of Pediatric Surgery, Kocaeli University Medical Faculty, Umuttepe, 41380, Kocaeli, Turkey.
Abstract
BACKGROUND/ PURPOSE: The inflammatory response that follows the caustic burns results in fibrosis on the esophageal wall leading to esophageal stricture, dysphagia, and malnutrition. The controversy over the use of corticosteroids warrants alternative therapeutic interventions. We investigated the effect of extracts from St. John's wort (SJW) with known wound-healing activity on stricture formation in rat esophageal injury models. METHODS: Five experimental groups were involved: sham group with no injury, control group with injury without treatment, and three different treatment groups (methylprednisolone, SJW extract, and combination of the two). Histopathological examination of esophageal damage and collagen accumulation, stenosis index, and tissue hydroxyproline levels were used to assess stricture and the effect of treatments. RESULTS: There was a significant weight loss in all groups except for those without injury and those treated with SJW extract, the latter gained weight albeit not significant. Stenosis index was increased in all groups compared to sham but not significantly in those treated with SJW extract. Histopathological and biochemical analyses produced mixed results. CONCLUSIONS: Some of the experimental indicators such as weight gain and stenosis index suggested the treatment of esophageal injury models using extracts of St. John's wort effective while other histopathological indicators show no significant benefit.
BACKGROUND/ PURPOSE: The inflammatory response that follows the caustic burns results in fibrosis on the esophageal wall leading to esophageal stricture, dysphagia, and malnutrition. The controversy over the use of corticosteroids warrants alternative therapeutic interventions. We investigated the effect of extracts from St. John's wort (SJW) with known wound-healing activity on stricture formation in ratesophageal injury models. METHODS: Five experimental groups were involved: sham group with no injury, control group with injury without treatment, and three different treatment groups (methylprednisolone, SJW extract, and combination of the two). Histopathological examination of esophageal damage and collagen accumulation, stenosis index, and tissue hydroxyproline levels were used to assess stricture and the effect of treatments. RESULTS: There was a significant weight loss in all groups except for those without injury and those treated with SJW extract, the latter gained weight albeit not significant. Stenosis index was increased in all groups compared to sham but not significantly in those treated with SJW extract. Histopathological and biochemical analyses produced mixed results. CONCLUSIONS: Some of the experimental indicators such as weight gain and stenosis index suggested the treatment of esophageal injury models using extracts of St. John's wort effective while other histopathological indicators show no significant benefit.
Entities:
Keywords:
Corrosive burns; Esophageal stricture; St. John’s wort; Stenosis
Authors: U Koltuksuz; H M Mutuş; R Kutlu; H Ozyurt; S Cetin; A Karaman; N Gürbüz; O Akyol; N E Aydin Journal: J Pediatr Surg Date: 2001-10 Impact factor: 2.545