Journal article
Insulin-like growth factor I improves aspects of mycophenolate mofetil-impaired anastomotic healing in an experimental model.
- Inglin RA Department of Visceral and Transplantation Surgery, Inselspital, University of Berne, CH-3010 Berne, Switzerland.
- Baumann G
- Wagner OJ
- Candinas D
- Egger B
- 2008-04-18
Published in:
- The British journal of surgery. - 2008
Anastomosis, Surgical
Animals
Antimetabolites
Bromodeoxyuridine
Cell Proliferation
Colon, Sigmoid
Immunohistochemistry
Immunosuppressive Agents
Insulin-Like Growth Factor I
Intestinal Mucosa
Ki-67 Antigen
Male
Mycophenolic Acid
Pressure
Rats
Rats, Sprague-Dawley
Surgical Wound Dehiscence
Wound Healing
English
BACKGROUND
Patients taking immunosuppressants after transplantation may require intestinal surgery. Mycophenolate mofetil (MMF) has been found to impair the healing of colonic anastomoses in rats. This study examined whether insulin-like growth factor (IGF) I prevents MMF impairment of anastomotic healing.
METHODS
Sixty-three rats were divided into three groups (MMF, MMF/IGF and control). Animals underwent a sigmoid colon anastomosis with a 6/0 suture, and were killed on days 2, 4 and 6 after surgery. Investigations included bursting pressure measurement, morphometric analysis, and assessment of mucosal proliferation by 5-bromo-2'-deoxyuridine and Ki67 immunohistochemistry of the anastomoses.
RESULTS
The leak rate was three of 21, one of 20 and two of 20 in the MMF, MMF/IGF-I and control groups respectively. Anastomotic bursting pressures were significantly lower in the MMF group than in the control group on days 2 and 4, but there was no significant difference by day 6. Values in the MMF/IGF-I and control groups were similar. Colonic crypt depth was significantly reduced in MMF-treated animals on days 2 and 4, but this impairment was attenuated by IGF-I on day 4. Similarly, IGF-I reduced the negative impact of MMF on mucosal proliferation on days 2 and 6.
CONCLUSION
Exogenous IGF-I improves some aspects of MMF-impaired anastomotic healing.
Patients taking immunosuppressants after transplantation may require intestinal surgery. Mycophenolate mofetil (MMF) has been found to impair the healing of colonic anastomoses in rats. This study examined whether insulin-like growth factor (IGF) I prevents MMF impairment of anastomotic healing.
METHODS
Sixty-three rats were divided into three groups (MMF, MMF/IGF and control). Animals underwent a sigmoid colon anastomosis with a 6/0 suture, and were killed on days 2, 4 and 6 after surgery. Investigations included bursting pressure measurement, morphometric analysis, and assessment of mucosal proliferation by 5-bromo-2'-deoxyuridine and Ki67 immunohistochemistry of the anastomoses.
RESULTS
The leak rate was three of 21, one of 20 and two of 20 in the MMF, MMF/IGF-I and control groups respectively. Anastomotic bursting pressures were significantly lower in the MMF group than in the control group on days 2 and 4, but there was no significant difference by day 6. Values in the MMF/IGF-I and control groups were similar. Colonic crypt depth was significantly reduced in MMF-treated animals on days 2 and 4, but this impairment was attenuated by IGF-I on day 4. Similarly, IGF-I reduced the negative impact of MMF on mucosal proliferation on days 2 and 6.
CONCLUSION
Exogenous IGF-I improves some aspects of MMF-impaired anastomotic healing.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1002/bjs.6053
- PMID 18418858
- Persistent URL
- https://sonar.ch/global/documents/1046
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