Immune mediators of postoperative ileus

Wehner, Sven; Vilz, Tim O.; Stoffels, Burkhard; Kalff, Joerg C.

doi:10.1007/s00423-012-0915-y

Cited by 66 publications

(59 citation statements)

References 79 publications

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“…Substantial experimental studies demonstrated that POI severity was correlated with levels of inflammatory cytokines such as TNF-α, IL-1, and IL-6, and the activation level of inflammatory cells (e.g. macrophages, mast cells) [27,28,29,30,31,32,33,34]. A pilot study from The et al [35] revealed promising results in the prevention of POI with mast cell stabilization treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical Endpoint, Early Detection, and Differential Diagnosis of Postoperative Ileus: A Systematic Review of the Literature

Wu¹,

Boersema²,

Dereci³

et al. 2014

Eur Surg Res

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Background: This systematic review summarizes evidence regarding clinical endpoints, early detection, and differential diagnosis of postoperative ileus (POI). Methods: Using MEDLINE, EMBASE, Cochrane, and Web-of-Science, we identified 2,084 articles. Risk of bias and level of evidence (LOE) of the included articles were determined, and relevant results were summarized. Results: Eleven articles were included, most of which with substantial risks of bias. Bowel motility studies revealed that defecation together with solid food tolerance is the most representative clinical endpoint of POI (LOE: 2b); other clinical signs (e.g. bowel sounds, passage of flatus) did not correlate with a full recovery of bowel motility. Inflammatory parameters including interleukin (IL)-6, IL-1, and TNF-α might assist in an early detection of prolonged POI (LOE: 4). Clinical manifestations (e.g. nausea, vomiting, abdominal distension, bowel sounds, flatus) and X-ray examinations provided limited aid to the differential diagnosis of POI, while CT with Gastrografin had the best specificity and sensitivity (both 100%; LOE: 1c). Conclusions: Postoperative defecation together with tolerance of solid food intake seems to be the best clinical endpoint of POI. CT has the best differential diagnostic value between POI and other complications. Prospective studies with a high LOE are in great need. © 2014 S. Karger AG, Basel

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Section: Discussionmentioning

confidence: 99%

Clinical Endpoint, Early Detection, and Differential Diagnosis of Postoperative Ileus: A Systematic Review of the Literature

Wu¹,

Boersema²,

Dereci³

et al. 2014

Eur Surg Res

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“…27,37,38) These cytokines act as inhibitors and contribute to the gastrointestinal dysmotility through their direct cytotoxic action or their effect on the production of nitric oxide and prostanoids. 24) In contrast to these pro-inflammatory cytokines, anti-inflammatory cytokine IL-10 actively down-regulates intestinal inflammatory process to prevent an excessive and prolonged inflammation. 24) In addition, it is reported that IL-10 deficiency could lead to a prolonged gastrointestinal dysmotility after surgery and abnormal high gene expression of pro-inflammatory cytokines in the animal model of POI.…”

Section: Discussionmentioning

confidence: 99%

“…24) In contrast to these pro-inflammatory cytokines, anti-inflammatory cytokine IL-10 actively down-regulates intestinal inflammatory process to prevent an excessive and prolonged inflammation. 24) In addition, it is reported that IL-10 deficiency could lead to a prolonged gastrointestinal dysmotility after surgery and abnormal high gene expression of pro-inflammatory cytokines in the animal model of POI. 39) In the present study, we found that POI rats showed significantly higher levels of pro-inflammatory cytokine TNF-α, IL-1β and IL-6 in serum and the ileum tissue, while these elevated levels were significantly reduced by GRb1 in a dose-dependent manner, as well as their gene expression in the ileum tissue.…”

Section: Discussionmentioning

confidence: 99%

“…16,21,22) Among these factors, accumulating evidence indicates that intestinal inflammation plays an important role in the pathophysiology of POI. 16,23,24) The extent of intestinal manipulation during abdominal surgery causes the degree of intestinal inflammation and further determines the duration and severity of gastrointestinal dysmotility. 25) Therefore, methods to reduce intestinal inflammation and shorten postoperative rehabilitation course are popular pursuits in modern surgery.…”

Section: Anti-inflammatory Effect Of Ginsenoside Rb1 Contributes To Tmentioning

confidence: 99%

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Anti-inflammatory Effect of Ginsenoside Rb1 Contributes to the Recovery of Gastrointestinal Motility in the Rat Model of Postoperative Ileus

Tan

Zhou

et al. 2014

Biological & Pharmaceutical Bulletin

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Ginsenoside Rb1 (GRb1), one of the principle active components of Panax ginseng, has been reported to reduce inflammation in various diseases. In the present study, we investigated whether GRb1 has an antiinflammatory effect on postoperative ileus (POI) and further contributes to the recovery of gastrointestinal motility. POI was induced in rats by intestinal manipulation. The POI rats received 5, 10 and 20 mg/kg GRb1 orally via gavage four times before and after surgery. Gastrointestinal motility was assessed by charcoal transport. Systemic inflammation was assessed by serum tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and IL-10 concentrations, whereas intestinal inflammation was assessed by the activity of myeloperoxidase, and concentrations and gene expression of TNF-α, IL-1β, IL-6 and IL-10 in the ileum tissue. The results revealed that GRb1 increased rat gastrointestinal transit with POI. The increased levels of systemic and intestinal inflammatory parameters in POI rats were also reduced by GRb1. In addition, GRb1 reduced systemic and intestinal inflammation and increased the gastrointestinal transit of POI rats in a dose-dependent manner, and with significance at doses of 10 and 20 mg/kg. These results suggest that GRb1 has a potent anti-inflammatory effect on POI and further contributes to the recovery of gastrointestinal motility. GRb1 may be a promising treatment for POI prophylaxis.

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“…How, for instance, might genetic and molecular characteristics of cancer cells be exploited for the prevention of pancreatic cancer [3], to bypass the resistance of colorectal tumours against chemoand radiation therapy [4], or to develop suitable biomarkers for oncologic treatment [5]? What are immune mechanisms underlying postoperative intestinal dysmotility-and how can they be influenced to devise innovative strategies for the treatment of postoperative ileus [6]? How do alterations in hepatic blood flow impact on liver regeneration and, thus, on clinical outcomes following surgical liver resection [7]?…”

mentioning

confidence: 99%

A cycle of success: the interdependence of surgery and science

Schneider

Welsch

Kremer

et al. 2012

Langenbecks Arch Surg

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Immune mediators of postoperative ileus

Abstract: The present manuscript will give an update on the inflammatory responses, the involved cell types, and participating immune mediators in POI.

Cited by 66 publications

References 79 publications

Clinical Endpoint, Early Detection, and Differential Diagnosis of Postoperative Ileus: A Systematic Review of the Literature

Clinical Endpoint, Early Detection, and Differential Diagnosis of Postoperative Ileus: A Systematic Review of the Literature

Anti-inflammatory Effect of Ginsenoside Rb1 Contributes to the Recovery of Gastrointestinal Motility in the Rat Model of Postoperative Ileus

A cycle of success: the interdependence of surgery and science

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