Department of Vascular Surgery, RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany.
Int J Colorectal Dis. 2011 Mar;26(3):295-301. doi: 10.1007/s00384-010-1070-y. Epub 2010 Oct 16.
In colorectal surgery, anastomotic leakage is a relevant complication. The aim of this study was to investigate whether intraperitoneally (i.p.) administered zinc improves the healing of colon anastomosis in rats.
Male Wistar rats (66) received zinc-deficient diet for 21 days. To determine the effective dose of zinc which is necessary to compensate this deficiency, preliminary analysis in 30 rats were performed. In these rats, analysis by atom-absorption spectrophotometry revealed a dose of 1.0 mg zinc aspartate/kg body weight to be the compensatory dosage. In the remaining zinc-deficient rats (n= 36), a transverse colonic anastomosis was performed. Eighteen rats received either a zinc supplementation i.p. or 0.9% NaCl i.p. (n = 18; control group). On postoperative days 3, 5, and 14, the surface of the mucosal villi, expression of MMP 2, MMP 8, MMP 13, TIMP 1, as well as the collagen types I/III ratio were analyzed.
Protein expression of MMP 2 and MMP 8 was significantly higher in the anastomosis of the zinc group on day 3 and on day 5. The collagen types I/III ratio was significantly increased in the zinc group on days 5 and 14.
Balancing zinc deficiency benefits wound healing of colonic anastomosis qualitatively due to an increased collagen type I/III ratio. Surprisingly, these zinc supplements, however, increased the expression of MMP 2 and MMP 8 that are supposed to impair wound healing in case of an over-expression. Thus, further investigations are needed to elucidate the influence of zinc supplementation on regulation of MMPs.
在结直肠手术中,吻合口漏是一种相关的并发症。本研究旨在探讨腹腔内(i.p.)给予锌是否能改善大鼠结肠吻合口的愈合。
雄性 Wistar 大鼠(66 只)接受缺锌饮食 21 天。为了确定补偿这种缺乏所需的有效锌剂量,在 30 只大鼠中进行了初步分析。在这些大鼠中,原子吸收分光光度法分析显示,1.0 mg 天冬氨酸锌/kg 体重是补偿剂量。在其余缺锌大鼠(n=36)中,进行横结肠吻合术。18 只大鼠分别接受腹腔内锌补充或 0.9%生理盐水腹腔内注射(n=18;对照组)。在术后第 3、5 和 14 天,分析了黏膜绒毛的表面、MMP 2、MMP 8、MMP 13、TIMP 1 的表达以及胶原 I/III 比值。
在第 3 天和第 5 天,锌组吻合口的 MMP 2 和 MMP 8 蛋白表达明显升高。在第 5 天和第 14 天,锌组的胶原 I/III 比值显著增加。
平衡锌缺乏通过增加胶原 I/III 比值,从质量上有益于结肠吻合口的愈合。令人惊讶的是,这些锌补充剂反而增加了 MMP 2 和 MMP 8 的表达,这在过度表达的情况下可能会损害伤口愈合。因此,需要进一步研究来阐明锌补充对 MMP 调节的影响。