Prevention of post-surgical adhesion bands by local administration of frankincense n-hexane extract

Fatemeh Jamshidi-Adegani; Saeid Vakilian; Juhaina Al-Kindi; Najeeb Ur Rehman; Laila Alkalbani; Mohammed Al-Broumi; Nasar Al-Wahaibi; Asem Shalaby; Jamal Al-Sabahi; Ahmed Al-Harrasi; Sulaiman Al-Hashmi

doi:10.1016/j.jtcme.2021.10.004

Prevention of post-surgical adhesion bands by local administration of frankincense n-hexane extract

J Tradit Complement Med. 2021 Oct 15;12(4):367-374. doi: 10.1016/j.jtcme.2021.10.004. eCollection 2022 Jul.

Affiliations

¹ Laboratory for Stem Cell & Regenerative Medicine, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, P. O. Box: 33, PC 616, Oman.
² Natural Products Laboratory, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, P. O. Box: 33, PC 616, Oman.
³ Department of Allied Health Sciences, College of Medicine & Health Sciences, Sultan Qaboos University, P. O. Box: 35, Alkoudh.123, Oman.
⁴ Department of Pathology, College of Medicine & Health Sciences, Sultan Qaboos University, P. O. Box: 35, Alkoudh.123, Oman.
⁵ Central Instrument Laboratory, College of Agriculture and Marine Sciences, Sultan Qaboos University, Oman.

Abstract

Background: and purpose: The formation of postoperative intra-abdominal adhesion band formation may lead to severe complications. This study aimed to evaluate the preventive effect of local administration of frankincense n-hexane extract (FHE) on the formation of postsurgical adhesion bands.

Materials and methods: FHE was extracted from the resin of a Boswellia sacra tree and its components were identified by gas chromatography-mass spectrometry (GC-MS). In an animal model, the expression levels of TNF-α and TGF-β1 cytokines after application of FHE were assessed to check the inflammatory and fibrotic cues, respectively.

Results: Following FHE compound analysis, in vivo experiments demonstrated that intraoperative local administration of FHE resulted in the prevention of adhesion band formation. The adhesion grades in the FHE-treated group were significantly lower than those in the negative control (NC) and the positive control (Interceed). The infiltration of inflammatory cells observed by histopathology revealed a significant anti-inflammatory potential of FHE. Furthermore, the gene expression results proved that significant suppression of TNF-α and TGF-β1 was responsible for its antiadhesion properties.

Conclusions: The study reported the potential of FHE as an ointment for the prevention of adhesion bands.

Keywords: Anti-inflammation; Boswellia sacra resin; FHE, Frankincense n-Hexane extract; Frankincense n-hexane extract; GC-MS, gas chromatography-mass spectrometry; Intra-abdominal adhesion; NC, negative control; PC, positive control; TGF-β1; TNF-α.