Trauma Research Department, Swedish Medical Center, 501 E. Hampden, Englewood, CO 80113, United States; Trauma Research Department, St. Anthony Hospital, 11600 W 2nd Pl, Lakewood, CO 80228, United States; Trauma Research Department, Penrose Hospital, 2222 N Nevada Ave, Colorado Springs, CO 80907, United States.
Trauma Services Department, St. Anthony Hospital, 11600 W 2nd Pl, Lakewood, CO 80228, United States.
Clin Chim Acta. 2022 Jun 1;531:126-136. doi: 10.1016/j.cca.2022.03.022. Epub 2022 Mar 26.
Pathological abdominal adhesions can cause bowel obstructions. A history of appendectomy (appy) increases patient rehospitalization risk directly related to adhesions. To potentially identify strategies for adhesion treatment, we characterized reactive ascites (rA) collected during appy or adhesiolysis for small bowel obstruction (SBO).
This is a non-randomized, prospective observational study recruiting patients with non-perforated appendicitis or SBO from three Level 1 trauma centers in the United States. rA were analyzed via liquid chromatography-mass spectrometry (LC-MS) (n = 31), bead-based quantification cytokines and chemokines (n = 32) and soluble receptors (n = 30), and LC-MS metabolomics (n = 18).
LC-MS showed that samples contained albumin, apolipoprotein A1, and transthyretin and that metabolites increased in SBO vs appy rA were biomarkers of oxidative stress. Multi-plex analyses showed levels of 17 cytokines/chemokines and 6 soluble receptors were significantly different in appy vs SBO rA. Top increased proteins in appy compared to SBO rA by 20.14-, 11.53-, and 8.18-fold were granulocyte-colony stimulating factor, C-X-C motif chemokine ligand 10, and interleukin-10, respectively.
These data further define pro- and anti-inflammatory mediators and metabolites that may drive formation or perpetuate chronic abdominal adhesions. Future research is to further explore whether attenuation of these factors may decrease pathologic adhesion formation.
病理性腹部粘连可导致肠梗阻。阑尾切除术（appy）病史会直接增加与粘连相关的患者再次住院风险。为了确定潜在的粘连治疗策略，我们对阑尾切除术或粘连松解术治疗小肠梗阻（SBO）时收集的反应性腹水（rA）进行了特征分析。
这是一项非随机、前瞻性观察性研究，在美国三家一级创伤中心招募了非穿孔性阑尾炎或 SBO 患者。通过液相色谱-质谱（LC-MS）（n=31）、基于珠子的细胞因子和趋化因子（n=32）和可溶性受体（n=30）定量分析 rA，并进行 LC-MS 代谢组学分析（n=18）。
LC-MS 显示样本中含有白蛋白、载脂蛋白 A1 和转甲状腺素蛋白，SBO 与 appy rA 相比，代谢物增加是氧化应激的生物标志物。多重分析显示，appy 与 SBO rA 相比，17 种细胞因子/趋化因子和 6 种可溶性受体的水平存在显著差异。与 SBO rA 相比，appy rA 中增加最多的蛋白分别为粒细胞集落刺激因子、C-X-C 基序趋化因子配体 10 和白细胞介素-10，增加了 20.14、11.53 和 8.18 倍。
这些数据进一步定义了可能导致形成或持续慢性腹部粘连的促炎和抗炎介质和代谢物。未来的研究将进一步探讨是否可以减轻这些因素以减少病理性粘连的形成。
