Multifactorial protective effects of boric acid against postoperative intra-abdominal adhesions in a rat model

Postoperative intra-abdominal adhesions (IAAs) remain a significant clinical challenge, contributing to complications such as bowel obstruction, infertility, and chronic pain. This study investigated the therapeutic potential of boric acid (BA) in mitigating adhesion formation through its antioxidative, anti-inflammatory, anti-apoptotic, and anti-fibrotic properties. A total of Twenty-four adult male Sprague Dawley rats were randomly divided into three groups: Control, IAA (adhesion model), and IAA+BA (adhesion model treated with boric acid). The main indicators of adhesion severity-macroscopic adhesion score, histopathological fibrosis and inflammation grades, and systemic TGF-β1 levels-were markedly improved in the IAA+BA group compared with the untreated IAA group, indicating a clear reduction in adhesion formation and fibrotic progression. In parallel, supporting mechanistic readouts showed that BA significantly modulated oxidative stress (TAS, TOS, OSI), pro-inflammatory cytokines (IL-1β, IL-6, TNF-α, CRP), and apoptotic markers (CASP3, CYCS, Bcl-2). BA effectively suppressed CASP3 and CYCS while restoring Bcl-2 expression, suggesting reduced apoptotic activity. These preliminary findings demonstrate that BA exerts anti-adhesive effects through a multifactorial mechanism involving the regulation of oxidative stress, inflammation, apoptosis, and fibrosis. Collectively, the data highlight BA's promise as a safe and potentially effective adjunctive therapy for preventing IAAs in postoperative settings.