Adhesion phenotype manifests an altered metabolic profile favoring glycolysis

Nicole M. Fletcher, Awoniyi O. Awonuga, Mohammed S. Abusamaan, Mohammed G. Saed, Michael P. Diamond, Ghassan M. Saed

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective To determine whether metabolic markers are differentially expressed in normal and adhesion fibroblasts with and without hypoxia exposure. Design Prospective experimental study. Setting University research laboratory. Patient(s) Fibroblasts established from normal peritoneum and adhesion tissues from the same patients. Intervention(s) In vitro experiments on normal peritoneal and adhesion fibroblasts under normal and hypoxic (2% O2) conditions. Main Outcome Measure(s) Expression of metabolic markers, glyceraldehyde 3-phosphate dehydrogenase (GAPDH), glucose transporter 1 (GLUT1), hypoxia inducible factor (HIF)-1α, hexokinase 2 (HK2), lactose dehydrogenase A (LDHA), and pyruvate dehydrogenase alpha 1 (PDHA1) were measured using real-time reverse transcription polymerase chain reaction; adenosine triphosphate (ATP), HIF-1α, and lactate levels were assessed with ELISAs. Result(s) Baseline mRNA levels of GAPDH and HIF-1α were increased, while GLUT1 and PDHA1 were decreased in adhesion as compared with in normal peritoneal fibroblasts. There was no change in baseline levels of HK2 or LDHA between the cell lines. Hypoxia increased protein levels of HIF-1α and mRNA levels of GAPDH, GLUT1, and HK2 and decreased levels of PDHA1 in both cell lines. Hypoxia increased LDHA mRNA levels in normal peritoneal fibroblasts. Baseline levels of lactate and ATP were lower in adhesion as compared with in normal peritoneal fibroblasts. In response to hypoxia, there was an increase in lactate in both cell lines and a decrease in ATP in normal fibroblasts. Conclusion(s) Adhesion fibroblasts manifested an altered metabolic profile, which favors the glycolytic pathway, and is further altered by hypoxia. Targeting these specific metabolic markers during surgery can be an important therapeutic intervention minimizing the development of postoperative adhesions.

Original languageEnglish (US)
Pages (from-to)1628-1637.e1
JournalFertility and sterility
Issue number6
StatePublished - Jun 1 2016


  • Postoperative adhesions
  • adhesion phenotype
  • glycolysis
  • hypoxia
  • metabolic markers

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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