Does TGF beta suppressing effect of simvastatin lead to protection against surgical adhesion band formation?

Abstract

Intra-abdominal adhesions are the most common cause of small bowel obstruction. Infertility in women and chronic abdominal-pelvic pain are the other problems of adhesiogenesis which impose a great economic burden on the population health. On the other hand, increased levels of transforming growth factor beta1 (TGF-β) are shown to play a role in formation of adhesion bands and can impair peritoneal fibrinolysis. Moreover, simvastatin, an immunomodulator agent, can down-regulate TGF-β. Although it is shown in previous studies that simvastatin antagonizes the interaction between TGF-β and connective tissue growth factor (CTGF), no human study exists on the effect of simvastatin on surgical adhesion band formation. We hypothesize that simvastatin, through its effect on reducing the level of TGF-β, may be useful in preventing adhesion band formation after surgical procedures. Surely, this hypothesis should be assessed in several experimental and clinical trials.