Buch Anastasia S, Schjerling Peter, Kjaer Marie, Jorgensen Lars Nannestad, Krarup Peter-Martin, Ågren Magnus S
Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Orthopedic Surgery M, Faculty of Health and Medical Sciences, Institute of Sports Medicine, Bispebjerg Hospital and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
Wound Repair Regen. 2017 May;25(3):532-535. doi: 10.1111/wrr.12535. Epub 2017 Jun 21.
The underlying molecular mechanisms for anastomotic leakage (AL) after colorectal surgery are unknown and there are no therapeutics for AL prevention. Our aim was to correlate endogenous matrix metalloproteinase (MMP) activity, collagen concentration, and collagen/MMP/cytokine mRNA levels with anatomic location in human colorectal tissue. We enrolled 22 patients in this prospective study: 7 underwent elective laparoscopic sigmoid resection and 15 underwent low anterior resection for colorectal cancer. Full-thickness intestinal tissue rings from anastomoses constructed with a circular stapler were used for the determination of the MMP activity, tissue collagen concentration and mRNA levels. COL1A1 (p = 0.017) and COL3A1 (p = 0.0013) mRNA levels were lower in rectal tissue than in colonic samples. Neither MMP activities nor collagen concentrations differed significantly between the two anatomic locations. By elucidating the factors responsible for the decreased collagen production we may identify specific molecular targets in AL prophylaxis.
结直肠手术后吻合口漏（AL）的潜在分子机制尚不清楚，且尚无预防AL的治疗方法。我们的目的是将内源性基质金属蛋白酶（MMP）活性、胶原蛋白浓度以及胶原蛋白/MMP/细胞因子mRNA水平与人类结直肠组织的解剖位置相关联。我们招募了22名患者参与这项前瞻性研究：7例接受择期腹腔镜乙状结肠切除术，15例接受低位前切除术治疗结直肠癌。使用圆形吻合器构建的吻合口全层肠组织环来测定MMP活性、组织胶原蛋白浓度和mRNA水平。直肠组织中COL1A1（p = 0.017）和COL3A1（p = 0.0013）mRNA水平低于结肠样本。两个解剖位置之间的MMP活性和胶原蛋白浓度均无显著差异。通过阐明导致胶原蛋白产生减少的因素，我们可能确定AL预防中的特定分子靶点。
