Teke Zafer, Bostanci Erdal Birol, Yenisey Cigdem, Kelten Esra Canan, Sacar Mustafa, Simsek Nilufer Genc, Duzcan Suleyman Ender, Akoglu Musa
Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey.
J Invest Surg. 2013 Feb;26(1):16-29. doi: 10.3109/08941939.2012.687434. Epub 2012 May 30.
We aimed to investigate whether caffeic acid phenethyl ester (CAPE) prevents detrimental systemic effects of intestinal ischemia-reperfusion (IR) injury on colonic anastomotic wound healing.
This experimental study was conducted on 48 male Wistar albino rats. The rats were randomly allocated into four groups and a left colonic anastomosis was performed in all rats: (i) sham-operated group (n = 12), laparatomy without intestinal IR injury; (ii) sham + CAPE group (n = 12), identical to Group 1 except for CAPE treatment (10 μmol/kg, intravenously); (iii) intestinal IR group (n = 12), 60 min of superior mesenteric ischemia followed by reperfusion; and (iv) IR + CAPE-treated group (n = 12) (10 μmol/kg, intravenously, 30 min before the construction of colonic anastomosis). On the postoperative day 7, the rats were subjected to relaparotomy for in vivo measurement of the colonic anastomotic bursting pressure. A colonic segment including the anastomotic site was resected for histopathological evaluation and biochemical analyses. The plasma proinflammatory cytokine levels were measured. Body weight changes were examined.
CAPE treatment significantly increased colonic anastomotic bursting pressures, and colonic anastomotic tissue hydroxyproline contents and antioxidant parameters (p < .05), and significantly decreased oxidative stress markers in colonic anastomotic tissues and plasma proinflammatory cytokine levels (p < .05). Histopathological scores were significantly better due to CAPE administration (p < .05).
This study clearly showed that CAPE treatment prevented the delaying effects of remote IR injury on colonic anastomotic wound healing. Further clinical studies are required to determine whether CAPE has a useful role in the enhancement of gastrointestinal anastomotic wound healing during particular surgeries in which IR-induced organ injury occurs.
我们旨在研究咖啡酸苯乙酯(CAPE)是否能预防肠道缺血再灌注(IR)损伤对结肠吻合口伤口愈合产生的有害全身影响。
本实验研究以48只雄性Wistar白化大鼠为对象。将大鼠随机分为四组,所有大鼠均进行左结肠吻合术:(i)假手术组(n = 12),仅行剖腹术,无肠道IR损伤;(ii)假手术 + CAPE组(n = 12),除给予CAPE治疗(10 μmol/kg,静脉注射)外,其余与第1组相同;(iii)肠道IR组(n = 12),肠系膜上动脉缺血60分钟后再灌注;(iv)IR + CAPE治疗组(n = 12)(10 μmol/kg,静脉注射,在结肠吻合术构建前30分钟给药)。术后第7天,对大鼠再次进行剖腹术,以在体内测量结肠吻合口破裂压力。切除包含吻合部位的结肠段进行组织病理学评估和生化分析。测量血浆促炎细胞因子水平。检查体重变化。
CAPE治疗显著提高了结肠吻合口破裂压力、结肠吻合组织羟脯氨酸含量和抗氧化参数(p < 0.05),并显著降低了结肠吻合组织中的氧化应激标志物和血浆促炎细胞因子水平(p < 0.05)。由于给予CAPE,组织病理学评分明显更好(p < 0.05)。
本研究清楚地表明,CAPE治疗可预防远处IR损伤对结肠吻合口伤口愈合的延迟作用。需要进一步的临床研究来确定CAPE在特定手术中增强胃肠道吻合口伤口愈合方面是否具有有益作用,这些手术中会发生IR诱导的器官损伤。