Standardised pomegranate peel extract lavage prevents postoperative peritoneal adhesion by regulating TGF-β and VEGF levels

Mobarakeh Ghadiri, Vafa Baradaran Rahimi, Elham Moradi, Maede Hasanpour, Cain C T Clark, Mehrdad Iranshahi, Hassan Rakhshandeh, Vahid Reza Askari

    Research output: Contribution to journalArticlepeer-review

    26 Citations (Scopus)


    Peritoneal adhesion represents a severe complication following surgery. Punica granatum (pomegranate) possesses several anti-oxidative and anti-inflammatory properties. Pomegranate peel extract (PPEx) can alleviate the production of various inflammatory factors and cytokines. Thus, we sought to evaluate the anti-adhesion effects of pomegranate in rats. Thirty male Wistar rats (6-week-old, 220 ± 20 g) were divided into five groups (n = 6): normal group without any surgical procedures, control group, and experimental groups receiving 2 ml of 1%, 2%, and 4% w/v PPEx, respectively. Peritoneal adhesions were examined macroscopically. Furthermore, we evaluated inflammatory cytokines levels [interleukin 6 (IL-6), and tumour necrosis factor-α (TNF-α)], growth factors [transforming growth factor- β1 (TGF-β1), and vascular endothelial growth factor (VEGF)], and oxidative stress parameters [nitric oxide metabolites (NO), and malondialdehyde (MDA), and glutathione (GSH)] using biochemical methods. Our results showed that the adhesion score and IL-6, TNF-α, TGF-β1, VEGF, NO, and MDA levels were increased in the control group. In contrast, the GSH level was diminished in the control group compared with the normal group (P < 0.001). PPEx (1 and 2% w/v) markedly reduced all measured parameters compared with the control group (P < 0.001-0.05). PPEx may reduce peritoneal adhesion by alleviating adhesion formation, IL-6, TNF-α, TGF-β1, VEGF, NO, and MDA, and stimulating anti-oxidative factors. Therefore, PPEx may be considered an appropriate candidate for the treatment of postoperative peritoneal adhesion.

    Original languageEnglish
    Pages (from-to)855-868
    Number of pages14
    Issue number3
    Early online date15 May 2021
    Publication statusPublished - Jun 2021


    Mashhad University of Medical Sciences (Grant Number: 961726).


    • Punica granatum
    • Pomegranate
    • Peritoneal adhesion
    • Anti-inflammatory
    • Antioxidant

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Pharmacology
    • Immunology


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