The immunologic changes during different phases of intestinal anastomotic healing

zhang, Feng; Qiao, Songlin; Li, Chunqiao; Wu, Bo; Reischl, Stefan

doi:10.1002/jcla.23493

Cited by 6 publications

(2 citation statements)

References 147 publications

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“…Several mechanisms may explain the detrimental effect of intraoperative hypothermia on the healing of PJ anastomosis. First, intraoperative hypothermia suppresses the perioperative immune response required for proper intestinal anastomotic healing, 13,14 and a recent study has also reported that impairment of the immune response during the early postoperative period is associated with the occurrence of CR‐POPF 15 . Second, the immunologic impairment can promote microbial growth, 16 which could be an important contributing factor for gastrointestinal anastomotic leakage, including POPF 17,18 .…”

Section: Discussionmentioning

confidence: 99%

Detrimental effect of intraoperative hypothermia on pancreatic fistula after pancreaticoduodenectomy: A single‐centre retrospective study

Park

Yoon

et al. 2021

J Hepato Biliary Pancreat

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Background Although perioperative hypothermia was found to be associated with gastrointestinal anastomotic leakage in preclinical studies, its association with postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy was never evaluated. We investigated the association between intraoperative hypothermia and clinically relevant (CR)‐POPF following pancreaticoduodenectomy. Methods We retrospectively reviewed 2163 consecutive patients who underwent pancreaticoduodenectomy during 2007‐2019. Based on intraoperative time‐weighted average core temperature, patients were grouped into normothermia (36.0‐37.5°C), mild hypothermia (35.0‐<36.0°C), and severe hypothermia (<35°C). We conducted multivariable logistic regression analysis for CR‐POPF, a propensity score analysis using inverse probability of treatment weighting (IPTW) to adjust the baseline differences between the three groups, followed by multivariable logistic regression with IPTW for CR‐POPF. Results Among the 2008 patients analysed, 1118 (55.7%) and 120 (6.0%) had mild and severe hypothermia, respectively, and 14.2% overall incidence of CR‐POPF. Severe intraoperative hypothermia was significantly associated with CR‐POPF before and after IPTW (before: odds ratio [OR] 1.79, 95% confidence interval [CI]: 1.03‐3.09, P = .038; after: OR 2.48, 95% CI: 1.28‐4.81, P = .007); however, mild hypothermia had no significant associations. Conclusion Severe intraoperative hypothermia is significantly associated with the occurrence of CR‐POPF following pancreaticoduodenectomy, suggesting that hypothermia is deleterious on pancreaticojejunal anastomotic healing.

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Section: Discussionmentioning

confidence: 99%

Detrimental effect of intraoperative hypothermia on pancreatic fistula after pancreaticoduodenectomy: A single‐centre retrospective study

Park

Yoon

et al. 2021

J Hepato Biliary Pancreat

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“…The 3D cell culture models or co-culture models would better mimic the interaction of cells that are relevant for intestinal wound healing. Thereby, not only fibroblast and IECs should be evaluated but also neutrophils and platelets, which are known to be involved in intestinal wound healing [22,56,57] and a potential target of Apremilast [58,59]. Besides cell differentiation and proliferation, angiogenesis plays a crucial part in intestinal wound healing [60].…”

Section: Positive Effects On Wound Healing In Vitro and Fibroblast Mi...mentioning

confidence: 99%

The Influence of Apremilast-Induced Macrophage Polarization on Intestinal Wound Healing

Mohr,

Besser,

Broichhausen

et al. 2023

JCM

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There is compelling evidence suggesting a pivotal role played by macrophages in orchestrating intestinal wound healing. Since macrophages display significant plasticity and heterogeneity, exhibiting an either classically activated (M1-like) or alternatively activated (M2-like) phenotype, they can aggravate or attenuate intestinal wound healing. Growing evidence also demonstrates a causal link between impaired mucosal healing in inflammatory bowel disease (IBD) and defects in the polarization of pro-resolving macrophages. By targeting the switch from M1 to M2 macrophages, the phosphodiesterase-4 inhibitor Apremilast has gained recent attention as a potential IBD drug. However, there is a gap in our current knowledge regarding the impact of Apremilast-induced macrophages’ polarization on intestinal wound healing. The THP-1 cells were differentiated and polarized into M1 and M2 macrophages, and subsequently treated with Apremilast. Gene expression analysis was performed to characterize macrophage M1 and M2 phenotypes, and to identify possible target genes of Apremilast and the involved pathways. Next, intestinal fibroblast (CCD-18) and epithelial (CaCo-2) cell lines were scratch-wounded and exposed to a conditioned medium of Apremilast-treated macrophages. Apremilast had a clear effect on macrophage polarization, inducing an M1 to M2 phenotype switch, which was associated with NF-κB signaling. In addition, the wound-healing assays revealed an indirect influence of Apremilast on fibroblast migration. Our results support the hypothesis of Apremilast acting through the NF-κB-pathway and provide new insights into the interaction with fibroblast during intestinal wound healing.

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Laparoscopic single-layer running “trapezoid-shaped” suture versus mechanical stapling for esophagojejunostomy after total gastrectomy for gastric cancer: cost-effect analysis of propensity score-matched study cohorts

Tang

Wang

et al. 2022

Langenbecks Arch Surg

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The immunologic changes during different phases of intestinal anastomotic healing

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 147 publications

Detrimental effect of intraoperative hypothermia on pancreatic fistula after pancreaticoduodenectomy: A single‐centre retrospective study

Detrimental effect of intraoperative hypothermia on pancreatic fistula after pancreaticoduodenectomy: A single‐centre retrospective study

The Influence of Apremilast-Induced Macrophage Polarization on Intestinal Wound Healing

Laparoscopic single-layer running “trapezoid-shaped” suture versus mechanical stapling for esophagojejunostomy after total gastrectomy for gastric cancer: cost-effect analysis of propensity score-matched study cohorts

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