Effects of silk solution against laminectomy-induced dural adhesion formation and inflammation in a rat model

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The authors investigated the effects of a silk solution against laminectomy-induced dural adhesion formation and inflammation in a rat model. They found that it significantly reduced postlaminectomy dural adhesion formation and inflammation. Dural adhesion formation, thought to be an inevitable consequence of laminectomy, is one of the most common complications following spinal surgery, and the authors' results indicate that the silk solution might be a potential novel therapeutic agent for dural adhesion formation.

ABBREVIATIONS COX-2 = cyclooxygenase-2; IL = interleukin; iNOS = inducible nitric oxide synthase; MMP = matrix metalloproteinase.

Article Information

Correspondence Soo Young Choi: Hallym University, Chuncheon, Korea. sychoi@hallym.ac.kr.

INCLUDE WHEN CITING Published online August 24, 2018; DOI: 10.3171/2018.4.SPINE171164.

Y.J.C., C.H.L., and D.W.K. contributed equally to this work.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Effects of silk solution against postlaminectomy rat dural adhesion formation. A: Photographs showing the dura exposed and the application of silk solution or MediShield in the rats. B: Representative images of dural adhesion formation in the sham control and vehicle-, silk solution–, MediShield-, and silk+MediShield–treated groups. Black arrows indicate the spinal dura mater; white arrows indicate dural adhesion; and asterisks indicate inflammation. Masson’s trichrome staining. AP = articular process; CE = cauda equina; La = lamina; Pe = pedicle; SaS = subarachnoid space; SDM = spinal dura matter; SP = spinal cord; TP = transverse process; VC = vertebral cavity. Graph shows histological assessment scores: 0 points are in Grade 0, ≤1 point is in Grade 1, ≤2 points are in Grade 2, and ≤3 points are in Grade 3. High-magnification images are shown in bottom panels. Scale bar = 1 mm (upper) and 200 μm (lower).

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    Inhibitory effects of silk solution against MMP-2 and MMP-9 expression in the rat dural adhesion model. Histological and Western blot analysis of silk solution treatment of dural adhesion. Photomicrographs: MMP-2 (A) and MMP-9 (B) staining. Western blot analysis (C). Black arrows indicate the epidural adhesions; white arrows indicate the MMP-2 and MMP-9 immunoreactive cells. ROD = relative optimal density. High-magnification images are shown in lower panels. Scale bar = 200 μm (upper) and 100 μm (lower). The difference between the vehicle group and the silk solution–treated treated group was statistically significant (graphs: *p < 0.05 and **p < 0.01).

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    Effects of silk solution on ED1 expression in rat dural adhesion model. Histological and Western blot analysis on silk solution treatment of dural adhesion. ED1 staining (A). Western blot analysis (B). High-magnification images are shown in bottom panels. Scale bar = 150 μm (upper) and 50 μm (lower). The difference between the vehicle group and the silk solution–treated group was statistically significant (graphs: *p < 0.05 and **p < 0.01).

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    Effects of silk solution on inflammatory response in rat dural adhesion model. The changes in inflammatory response expression levels were determined by Western blotting: changes of CD34, COX-2, and iNOS expression levels between the experimental groups (A) and changes in IL-1β, IL-6, and IL-12 expression levels between the experimental groups (B). The difference between the vehicle group and the silk solution–treated group was statistically significant (graphs in A and B: *p < 0.05 and **p < 0.01).

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