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A peritoneal adhesion (PA) is a fibrotic tissue connecting the abdominal or visceral organs to the peritoneum. The formation of PAs can induce a variety of clinical diseases. However, there is currently no effective strategy for the prevention and treatment of PAs. Damage to peritoneal mesothelial cells (PMCs) is believed to cause PAs by promoting inflammation, fibrin deposition, and fibrosis formation. In the early stages of PA formation, PMCs undergo mesothelial–mesenchymal transition and have the ability to produce an extracellular matrix. The PMCs may transdifferentiate into myofibroblasts and accelerate the formation of PAs. Therefore, the aim of this review was to understand the mechanism of action of PMCs in PAs, and to offer a theoretical foundation for the treatment and prevention of PAs. [ABSTRACT FROM AUTHOR]

Simple Summary: Peritoneal mesothelial cells (PMCs) are the first cell layer to encounter peritoneal tumors, thereby affecting their progression. In the past, PMCs were considered a barrier to the intraperitoneal implantation and metastasis of tumors. However, the specific role of PMCs in local tumor progression remains controversial, with evidence demonstrating both inhibiting or promoting effects. The epithelial phenotype of PMCs exhibits an inhibitory effect on abdominal cavity metastasis, whereas the mesenchymal phenotype of PMCs significantly promotes the progression of abdominal cavity tumors. Nevertheless, the details of the interaction between PMCs and tumors to promote local progression and peritoneal dissemination require further study. This article presents a review of the role of PMCs in the progression of abdominal tumors. Based on existing evidence, maintaining the stability of the PMC epithelial phenotype may be a valuable target for inhibiting peritoneal tumor dissemination and local progression. Peritoneal metastatic cancer comprises a heterogeneous group of primary tumors that originate in the peritoneal cavity or metastasize into the peritoneal cavity from a different origin. Metastasis is a characteristic of end-stage disease, often indicative of a poor prognosis with limited treatment options. Peritoneal mesothelial cells (PMCs) are a thin layer of cells present on the surface of the peritoneum. They display differentiated characteristics in embryonic development and adults, representing the first cell layer encountering peritoneal tumors to affect their progression. PMCs have been traditionally considered a barrier to the intraperitoneal implantation and metastasis of tumors; however, recent studies indicate that PMCs can either inhibit or actively promote tumor progression through distinct mechanisms. This article presents a review of the role of PMCs in the progression of peritoneum implanted tumors, offering new ideas for therapeutic targets and related research. [ABSTRACT FROM AUTHOR]

Peritoneal metastasis is a manifestation of advanced cancer often associated with a poor prognosis and poor response to treatment. Astragalus membranaceus (Fisch.) Bunge is a commonly used medicinal material in traditional Chinese medicine with various biological activities. In patients with cancer, Astragalus membranaceus has demonstrated anti-tumor effects, immune regulation, postoperative recurrence and metastasis prevention, and survival prolongation. Peritoneal metastasis results from tumor cell and peritoneal microenvironment co-evolution. We aimed to introduce and discuss the specific mechanism of action of Astragalus membranaceus in peritoneal metastasis treatment to provide a new perspective for treatment and further research. We consulted reports on the anti-peritoneal metastases effects of Astragalus membranaceus from PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang databases, as well as Google Scholar. Meanwhile, we also obtained data from published medical works and doctoral and master's theses. Then, we focused on the research progress of Astragalus membranaceus in peritoneal metastatic cancer treatment. Plant names are provided in accordance with "The Plant List" (www.theplantlist.org). To date, more than 200 compounds have been isolated from Astragalus membranaceus. Among them, Astragalus polysaccharides, saponins, and flavonoids are the main bioactive components, and their effects on cancer have been extensively studied. In this review, we systematically summarize the effects of Astragalus membranaceus on the peritoneal metastasis microenvironment and related mechanisms, including maintaining the integrity of peritoneal mesothelial cells, restoring the peritoneal immune microenvironment, and inhibiting the formation of tumor blood vessels, matrix metalloproteinase, and dense tumor spheroids. Our analysis demonstrates that Astragalus membranaceus could be a potential therapeutic for preventing the occurrence of peritoneal metastasis. However, it might be too early to recommend its use owing to the paucity of reliable in vivo experiment, clinical data, and evidence of clinical efficacy. In addition, previous studies of Astragalus membranaceus report inconsistent and contradictory findings. Therefore, detailed in vitro , in vivo , and clinical studies on the mechanism of Astragalus membranaceus in peritoneal metastatic cancer treatment are warranted. [Display omitted] • Astragalus membranaceus improves the microenvironment of peritoneal metastases. • Astragalus membranaceus can restore the integrity of peritoneal mesothelial layer and the immune phenotype of M1 macrophages. • Astragalus membranaceus can inhibit the formation of tumor blood vessel, matrix metalloproteinases, and dense tumor spheroids. • Bioactive components of Astragalus membranaceus are expected to be potential therapeutic for peritoneal metastatic cancer. • Clinical research based on Astragalus membranaceus should be conducted. [ABSTRACT FROM AUTHOR]