Biological in vitro effects of fibrin glue: Fibroblast proliferation, expression and binding of growth factors

Background: Fibrin glue is used in the endoscopic therapy of bleeding ulcerations. Accelerated closure of ulcers has been documented for this treatment in comparison with other injection techniques; the biological reason, however, remains unclear. Methods: In an in vitro model the effects of fibrin glue on the expression and secretion of growth factors by gastric epithelial (AGS, KATO III) and mesenchymal cells ( fibroblasts) as well as their proliferative response and their interaction were compared with those of other matrices. Results: Native fibrin glue does not release vascular endothelial growth factor ( VEGF) but is able to bind this growth factor in biologically relevant concentrations of 152.6 pg/mL. The addition of fibrin glue to a collagen type I matrix led to an increased proliferation rate of gastric wall fibroblasts. The transcription of VEGF and platelet-derived growth factor ( PDGF) mRNA was significantly increased in epithelial cells. Co-culture of fibroblasts grown on fibrin glue containing matrix and epithelial cells resulted in an increased secretion of VEGF by both cell lines. Conclusions: Fibrin glue leads to increased proliferation of fibroblasts and local accumulation of VEGF. These findings might at least partly explain the accelerated closure of bleeding ulcers treated by fibrin glue injection.