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Elahimanesh M, Najafi M. Cross talk between bacterial and human gene networks enriched using ncRNAs in IBD disease. Sci Rep 2023; 13:7704. [PMID: 37169818 PMCID: PMC10175251 DOI: 10.1038/s41598-023-34780-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a long-term inflammatory immune-mediated gut illness with several extra-intestinal complications. The aims of this study were to identify a novel network-based meta-analysis approach on the basis of the combinations of the differentially expressed genes (DEGs) from microarray data, to enrich the functional modules from human protein-protein interaction (PPI) and gene ontology (GO) data, and to profile the ncRNAs on the genes involved in IBD. The gene expression profiles of GSE126124, GSE87473, GSE75214, and GSE95095 are obtained from the Gene Expression Omnibus (GEO) database based on the study criteria between 2017 and 2022. The DEGs were screened by the R software. DEGs were then used to examine gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The ncRNAs including the miRNAs and ceRNAs were predicted on the PPIs visualized using Cytoscape. Enrichment analysis of genes with differential expression (n = 342) using KEGG and GO showed that the signaling pathways related with staphylococcus aureus and pertussis bacterial infections may stimulate the immune system and exacerbate IBD via the interaction with human proteins including Fibrinogen gamma chain (FGG), Keratin 10 (KRT10), and Toll like receptor 4 (TLR4). By building a ceRNA network, lncRNA XIST and NEAT1 were determined by affecting common miRNAs, hsa-miR-6875-5p, hsa-miR-1908-5p, hsa-miR-186-5p, hsa-miR-6763-5p, hsa-miR-4436a, and hsa-miR-520a-5p. Additionally, the chromosome regions including NM_001039703 and NM_006267, which produce the most potent circRNAs play a significant role in the ceRNA network of IBD. Also, we predicted the siRNAs that would be most effective against the bacterial genes in staphylococcus aureus and pertussis infections. These findings suggested that three genes (FGG, KRT10, and TLR4), six miRNAs (hsa-miR-6875-5p, hsa-miR-1908-5p, hsa-miR-186-5p, hsa-miR-4436a, hsa-miR-520a-5p, and hsa-miR-6763-5p), two lncRNAs (XIST and NEAT1), and chromosomal regions including NM_001039703 and NM_006267 with the production of the most effective circRNAs are involved in the ncRNA-associated ceRNA network of IBD. These ncRNA profiles are related to the described gene functions and may play therapeutic targets in controlling inflammatory bowel disease.
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Affiliation(s)
- Mohammad Elahimanesh
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Najafi
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
- Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran.
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The Effect of Genistein on Anastomotic Healing in Intestinal Ischemia/Reperfusion Injury. J Surg Res 2022; 280:389-395. [PMID: 36037616 DOI: 10.1016/j.jss.2022.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/22/2022] [Accepted: 07/30/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Genistein is a natural isoflavonoid and has several pharmacological effects, such as antioxidant, antitumor activity, and improvement of glucose metabolism. The safety of intestinal anastomosis after ischemia-reperfusion (I/R) injury is a critical issue for surgeons. This experimental study aimed to investigate the effects of genistein on anastomotic healing after intestinal I/R injury. METHODS A total of 36 male Wistar Albino rats were divided into four groups: control, I/R, genistein, and genistein + I/R. The control group received segmental ileal resection and ileoileal anastomosis. The I/R group received resection + anastomosis after intestinal I/R. The genistein group was administered subcutaneous injection of 1 mg/kg genistein 12 h and 1 h before the procedure and received ileal resection + anastomosis. The genistein + I/R group received I/R + ileal resection + anastomosis after genistein injection. Anastomotic bursting pressure, hydroxyproline, superoxide dismutase, and glutathione peroxidase levels and histopathological wound healing scores of all rats were measured on postoperative day 5. RESULTS The anastomotic bursting pressure was significantly higher in the genistein and genistein + I/R groups (P < 0.001). Genistein increased the hydroxyproline concentration and the superoxide dismutase and glutathione peroxidase levels in the intestinal anastomosis (P < 0.001). In histopathological assessment, the mean wound healing score was significantly higher in the genistein group than in the other groups (P < 0.001). CONCLUSIONS Genistein, with its anti-inflammatory and antioxidant properties, shows protective effects against increased oxidative stress after intestinal I/R injury and contributes positively to intestinal anastomotic healing.
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de Paula Freitas BZ, Campos FG, Kanno DT, Delben AG, Pereira JA, Dos Santos Mendonça RL, Martinez CAR. Infliximab Increases the Tissue Contents of Type-I and Type-III Collagen in Colorectal Segments Without Fecal Stream After Hartmann's Procedure. J Gastrointest Surg 2022; 26:662-664. [PMID: 34561770 DOI: 10.1007/s11605-021-05138-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/17/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Bruna Zini de Paula Freitas
- Postgraduate Program in Health Sciences, São Francisco University Medical School, Av. São Francisco de Assis, 218, Bragança Paulista, São Paulo, CEP 12916-900, Brazil
| | - Fábio Guilherme Campos
- Department of Gastroenterology, Faculty of Medicine of University of São Paulo, Av. Dr Arnaldo, 455, São Paulo, CEP 01246-903, Brazil
| | - Danilo Toshio Kanno
- Postgraduate Program in Health Sciences, São Francisco University Medical School, Av. São Francisco de Assis, 218, Bragança Paulista, São Paulo, CEP 12916-900, Brazil
| | - Andress Godoy Delben
- Department of Surgery, Campinas State University, Av. Tessália Vieira de Camargo, 126, Campinas, São Paulo, CEP 13083-887, Brazil.
| | - José Aires Pereira
- Department of Pathology, São Francisco University Medical School, Av. São Francisco de Assis, 218, Bragança Paulista, São Paulo, CEP 12916-900, Brazil
| | - Roberta Laís Dos Santos Mendonça
- Postgraduate Program in Health Sciences, São Francisco University Medical School, Av. São Francisco de Assis, 218, Bragança Paulista, São Paulo, CEP 12916-900, Brazil
| | - Carlos Augusto Real Martinez
- Postgraduate Program in Health Sciences, São Francisco University Medical School, Av. São Francisco de Assis, 218, Bragança Paulista, São Paulo, CEP 12916-900, Brazil.,Department of Surgery, Campinas State University, Av. Tessália Vieira de Camargo, 126, Campinas, São Paulo, CEP 13083-887, Brazil
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Witte M, Reiner J, Bannert K, Jaster R, Maschmeier C, Schafmayer C, Lamprecht G, Berlin P. Ileocolonic Healing After Extended Small Bowel Resection in Mice: NOD2 Deficiency Impairs Anastomotic Healing and Postoperative Outcome. Inflamm Bowel Dis 2021; 27:1503-1512. [PMID: 33555306 PMCID: PMC8376130 DOI: 10.1093/ibd/izab022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Nucleotide-binding oligomerization domain-containing protein 2 (NOD2) mutations are a genetic risk factor for Crohn disease. Ileocecal resection is the most often performed surgery in Crohn disease. We investigated the effect of Nod2 knockout (KO) status on anastomotic healing after extended ileocecal resection (ICR) in mice. METHODS Male C57BL6/J wild-type and Nod2 KO mice underwent an 11 cm resection of the terminal ileum including the cecum. An end-to-end jejuno-colostomy was performed. Animals were killed after 5 days investigating bursting pressure, hydroxyproline content, and expression of matrix metabolism genes, key cytokines, and histology of the anastomosis. RESULTS Mortality was higher in the Nod2 KO group but not because of local or septic complications. Bursting pressure was significantly reduced in the Nod2 KO mice (32.5 vs 78.0 mmHg, P < 0.0024), whereas hydroxyprolin content was equal. The amount of granulation tissue at the anastomosis was similar but more unstructured in the Nod2 KO mice. Gene expression measured by real-time polymerase chain reaction showed significantly increased expression for Collagen 1alpha and for collagen degradation as measured by matrix metalloproteinase-2, -9, and -13 in the Nod2 KO mice. Gelatinase activity from anastomotic tissue was enhanced by Nod2 status. Gene expression of arginase I, tumor necrosis factor-α, and transforming growth factor-ß but not inducible nitric oxide synthase were also increased at the anastomosis in the Nod2 KO mice compared with the control mice. CONCLUSIONS We found that Nod2 deficiency results in significantly reduced bursting pressure after ileocecal resection. This effect is mediated via an increased matrix turnover. Patients with genetic NOD2 variations may be prone to anastomotic failure after bowel resection.
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Affiliation(s)
- Maria Witte
- Department of General, Visceral, Vascular and Transplant Surgery, Rostock University Medical Center, Rostock, Germany
| | - Johannes Reiner
- Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany
| | - Karen Bannert
- Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany
| | - Robert Jaster
- Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany
| | - Christian Maschmeier
- Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany
| | - Clemens Schafmayer
- Department of General, Visceral, Vascular and Transplant Surgery, Rostock University Medical Center, Rostock, Germany
| | - Georg Lamprecht
- Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany
| | - Peggy Berlin
- Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany
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Impact of anti-TNF agents in postoperative complications in Crohn's disease: a review. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1016/j.jcol.2015.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AbstractThe real impact of biological therapy (anti-TNF agents) in abdominal operations secondary to Crohn's disease is a matter of debate in the international literature. Several studies demonstrated that there can be an increase in postoperative complications in patients previously treated with these agents. On the other hand, the majority of studies published over the last years question this effect, and did not demonstrate any relationship between biologics and outcomes related to surgical postoperative complications. Some meta-analyses were published, with different outcomes and different conclusions. Experimental studies in animals were also recently published, with opposite results, despite similar methodology. In this review, the authors resume all the relevant papers in the international literature with respect to the theme, and demonstrate the heterogeneity of the studies, as well as the disparity of their results and outcomes. The real impact of anti-TNF agents on postoperative complications in Crohn's disease is still controversial, and needs to be better elucidated. Controlled trials must be performed to better address this issue.
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Johnson K, Monroe N, Protyniak B. The Other Double Bubble Sign: Gastric Parastomal Hernia. CRSLS : MIS CASE REPORTS FROM SLS 2021; 8:e2020.00092. [PMID: 36017470 PMCID: PMC9387391 DOI: 10.4293/crsls.2020.00092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction: A parastomal hernia (PSH) is an abnormal herniation of an intra-abdominal organ or other tissue through an intentionally created fascial defect at an ostomy site. PSHs commonly involve reducible mobile segments of omentum, intra-abdominal fat, and bowel. However, PSHs may rarely involve fixed intra-abdominal organs such as the stomach. Case Description: A 68-year-old female underwent emergent Hartmann procedure for Hinchey III diverticulitis and subsequently developed a large reducible parastomal hernia. She was scheduled for an elective laparoscopic colostomy reversal. Prior to her scheduled reversal, the patient presented to the ED with anorexia, lack of colostomy output, emesis, and pain localized to her left lower quadrant. She was found to have gastric outlet obstruction secondary to herniation of the stomach through the left lower quadrant colostomy site. The patient was admitted and treated conservatively with resolution of her symptoms, but due to the high likelihood of recurrence, the decision was made to proceed with laparoscopic Hartmann colostomy reversal with coloproctostomy and primary closure of the fascia without mesh. Conclusion: The contents of a PSH can become incarcerated causing obstruction, strangulation, necrosis and even perforation over time. Fortunately, in this case, herniation of the stomach was recognized early. The patient underwent repair of the hernia defect in order to prevent recurrence of gastric herniation and its potential detrimental complications. The decision regarding the technical aspects of ostomy reversal in terms of mesh selection require further study. In our case, mesh was not used due to patient-specific factors and comorbidities.
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Affiliation(s)
- Kelly Johnson
- Geisinger Wyoming Valley General Surgery Residency Program, Wilkes-Barre, PA
| | - Natalie Monroe
- Geisinger Wyoming Valley General Surgery Residency Program, Wilkes-Barre, PA
| | - Bogdan Protyniak
- Geisinger Wyoming Valley General Surgery Residency Program, Wilkes-Barre, PA
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Yamamoto T, Teixeira FV, Saad-Hossne R, Kotze PG, Danese S. Anti-TNF and Postoperative Complications in Abdominal Crohn's Disease Surgery. Curr Drug Targets 2019; 20:1339-1348. [DOI: 10.2174/1389450120666190404144048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/09/2019] [Accepted: 03/14/2019] [Indexed: 12/21/2022]
Abstract
Background: :
Biological therapy with anti-Tumour Necrosis Factor (TNF)-α agents
revolutionised the treatment of inflammatory bowel disease over the last decades. However,
there may be an increased risk of postoperative complications in Crohn’s disease (CD) patients
treated with anti-TNF-α agents prior to abdominal surgery.
Objective::
To evaluate the effects of preoperative anti-TNF-α therapy on the incidence of complications
after surgery.
Methods: :
A critical assessment of the results of clinical trial outcomes and meta-analyses on the
available data was conducted.
Results: :
Based on the outcomes of previous reports including meta-analyses, preoperative use of anti-
TNF-α agents modestly increased the risk of overall complications and particularly infectious
complications after abdominal surgery for CD. Nevertheless, previous studies have several limitations.
The majority of them were retrospective research with heterogeneous outcome measures and
single centre trials with relatively small sample size. In retrospective studies, the standard protocol
for assessing various types of postoperative complications was not used. The most serious limitation
of the previous studies was that multiple confounding factors such as malnutrition, use of
corticosteroids, and preoperative sepsis were not taken into consideration.
Conclusion::
Among patients treated with preoperative anti-TNF-α therapy, the risk of overall complications
and infectious complications may slightly increase after abdominal surgery for CD.
Nevertheless, the previous reports reviewed in this study suffered from limitations. To rigorously
evaluate the risk of anti-TNF-α therapy prior to surgery, large prospective studies with standardised
criteria for assessing surgical complications and with proper adjustment for confounding
variables are warranted.
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Affiliation(s)
- Takayuki Yamamoto
- Department of Surgery and IBD Centre, Yokkaichi Hazu Medical Centre, Yokkaichi, Japan
| | | | - Rogerio Saad-Hossne
- Digestive Surgery Department, Sao Paulo State University (UNESP), Botucatu, Brazil
| | - Paulo Gustavo Kotze
- Colorectal Surgery Unit, Catholic University of Parana (PUCPR), Curitiba, Brazil
| | - Silvio Danese
- IBD Centre, Department of Gastroenterology, Humanitas Clinical and Research Centre, Rozzano, Milan, Italy
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Kotze PG, Magro DO, Martinez CAR, Saab B, Saab MP, Pinheiro LV, Olandoski M, Yamamoto T, Coy CSR. Adalimumab and postoperative complications of elective intestinal resections in Crohn's disease: a propensity score case-matched study. Colorectal Dis 2017; 20:211-218. [PMID: 29053220 DOI: 10.1111/codi.13929] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/21/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND data are scarce regarding the effect of preoperative Adalimumab (ADA) in postoperative complications in Crohn's disease (CD) patients. AIM to compare the rates of postoperative complications after intestinal resections in CD, with and without previous exposure to ADA. METHOD case-matched retrospective observational study of patients submitted to intestinal resections for CD. The patients were allocated to 2 groups, according to their previous exposure to ADA before surgery. The patients under ADA therapy were matched with controls (patients without previous biologics) with the propensity score method (PSM), according to age at surgery, CD location (Montreal L) and phenotype (Montreal B). Medical and surgical complications were compared. RESULTS 123 patients were initially considered, 71 with previous biologics (32 under ADA therapy) and 52 without. The PSM selected 25 ADA patients to be matched with 25 controls from the non-biologics group. There was no difference regarding overall surgical complications (40% in the control vs 36% in the ADA group; p = 1.0000) or medical complications (36% vs 12% in the control and ADA groups, respectively; p = 0.095). In univariate analysis, previous ADA was not considered a risk factor for higher postoperative complication rates. Stomas were considered a risk factor for surgical complications, and previous steroids were associated to higher medical complication rates. CONCLUSIONS preoperative ADA did not influence the rates of medical and surgical complications after elective intestinal resections for CD. This was the first study to include exclusively patients under ADA therapy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Paulo Gustavo Kotze
- Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | | | | | - Barbara Saab
- Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Mansur Paulo Saab
- Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | | | - Marcia Olandoski
- Biostatistics department, Catholic University of Paraná (PUCPR), Curitiba, Brazil
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Kotze PG, Saab MP, Saab B, da Silva Kotze LM, Olandoski M, Pinheiro LV, Martinez CAR, Ayrizono MDLS, Magro DDO, Coy CSR. Tumor Necrosis Factor Alpha Inhibitors Did Not Influence Postoperative Morbidity After Elective Surgical Resections in Crohn's Disease. Dig Dis Sci 2017; 62:456-464. [PMID: 27933472 DOI: 10.1007/s10620-016-4400-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/29/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND The real impact of anti-tumor necrosis alpha (TNF) therapy in postoperative complications after intestinal resections in Crohn's disease (CD) still needs to be determined. AIMS To compare the postoperative complication rates after elective intestinal resections in CD patients, with or without previous exposure to anti-TNF therapy. METHODS This was a retrospective and observational study, with elective intestinal resections for CD (emergency procedures were excluded). Patients were allocated in two groups according to preoperative anti-TNF status. Surgical and medical complications were analyzed and subsequently compared between the groups. RESULTS A total of 123 patients were included (71 with and 52 without preoperative anti-TNF). The groups were considered homogeneous, except for perianal CD, previous azathioprine, and stomas. There was no significant difference between the groups regarding overall surgical complications (32.69% in anti-TNF- vs. 39.44% in anti-TNF+ patients, p = 0.457) or overall medical complications (21.15 vs. 21.13%, respectively, p = 1.000). In univariate analysis, previous steroids, perianal CD, and stomas were considered risk factors for surgical complications, and previous steroids and hypoalbuminemia for medical complications. In multivariate analysis, previous steroids were associated with higher rates of surgical and medical complications, while hypoalbuminemia was associated with higher medical complication rates. CONCLUSIONS There was no influence of the previous use of anti-TNF agents in postoperative surgical and medical complication rates in elective intestinal resections for CD. Previous steroids and hypoalbuminemia were associated with higher complication rates. This was the first case series of the literature describing outcomes in exclusively elective operations.
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Affiliation(s)
- Paulo Gustavo Kotze
- Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Paraná, Rua Bruno Filgueira, 369-cj, 1205, Curitiba, PR, CEP 80240-220, Brazil.
| | - Mansur Paulo Saab
- Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Paraná, Rua Bruno Filgueira, 369-cj, 1205, Curitiba, PR, CEP 80240-220, Brazil
| | - Bárbara Saab
- Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Paraná, Rua Bruno Filgueira, 369-cj, 1205, Curitiba, PR, CEP 80240-220, Brazil
| | - Lorete Maria da Silva Kotze
- Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Paraná, Rua Bruno Filgueira, 369-cj, 1205, Curitiba, PR, CEP 80240-220, Brazil
| | - Marcia Olandoski
- Biostatistics Department, Catholic University of Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, CEP 80215-901, Brazil
| | - Lilian Vital Pinheiro
- Colorectal Surgery Unit, Campinas State University (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13083-887, Brazil
| | - Carlos Augusto Real Martinez
- Colorectal Surgery Unit, Campinas State University (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13083-887, Brazil
| | - Maria de Lourdes Setsuko Ayrizono
- Colorectal Surgery Unit, Campinas State University (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13083-887, Brazil
| | - Daniela de Oliveira Magro
- Colorectal Surgery Unit, Campinas State University (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13083-887, Brazil
| | - Claudio Saddy Rodrigues Coy
- Colorectal Surgery Unit, Campinas State University (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13083-887, Brazil
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Karaköse O, Eken H, Ulusoy AN, Topgül HK, Bilgin M, Yürüker SS, Gülbahar MY. The Effect of Infliximab on Intestinal Anastomosis Healing in Rats. Prague Med Rep 2016; 117:108-116. [DOI: 10.14712/23362936.2016.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Intestinal anastomosis healing is a complex physiological process in which many local and systemic factors play a role. One of the significant cytokines in this process is TNF-α. Infliximab is a chimeric monoclonal antibody which binds to TNF-α with high affinity. Although this agent is used in ulcerative colitis and Crohn’s disease, intestinal surgery may be required in these patients. In this study it was aimed to determine whether or not there was any negative effect of preoperative single dose infliximab treatment on intestinal anastomosis healing. Two groups of 10 rats were formed. One of these groups was administered with a single dose of infliximab 8 mg/kg as a 20-minute intravenous infusion from the femoral vein. Four days after the infusion, a full layer incision was made to the colon and anastomosis was applied to all the rats. At 7 days after anastomosis, the subjects were sacrificed. The anastomosis segment was removed and the bursting pressure was measured. Tissue samples were taken from this segment for hydroxyproline concentration and histopathological examination. A blood sample was taken to measure TNF-α values. No statistically significant difference was determined between the groups in terms of bursting pressure, tissue hydroxyproline concentration or histopathological scoring. A single dose of 8 mg/kg infliximab administered 4 days preoperatively was not found to have any negative effect on intestinal anastomosis healing in rats.
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de Paula-Silva M, Barrios BE, Macció-Maretto L, Sena AA, Farsky SHP, Correa SG, Oliani SM. Role of the protein annexin A1 on the efficacy of anti-TNF treatment in a murine model of acute colitis. Biochem Pharmacol 2016; 115:104-13. [PMID: 27343762 DOI: 10.1016/j.bcp.2016.06.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/17/2016] [Indexed: 02/08/2023]
Abstract
TNF-α is involved in the mechanisms that initiate inflammatory bowel diseases (IBDs). Anti-TNF-α drugs, such as infliximab (IFX), cause non-responsiveness and side effects, indicating the need to investigate alternative therapies for these diseases. The anti-inflammatory protein, annexin A1 (AnxA1), has been associated with the protection of the gastrointestinal mucosa. To further address the role of endogenous AnxA1 on the TNF-α blockade efficacy in a murine model, we assessed colitis induced by Dextran Sulfate Sodium (DSS) in wild-type (WT) and AnxA1(-/-) Balb/c mice treated with IFX. We consistently observed endogenous AnxA1 prevented clinical and physiological manifestations of experimental colitis treated with IFX, additionally the manifestation of the disease was observed earlier in AnxA1(-)(/-) mice. Rectal bleeding, diarrhea, histological score, epithelial damages and collagen degradation caused by DSS were prevented following IFX treatment only in WT mice. IL-6 increased during colitis in WT and AnxA1(-)(/-) mice, decreasing under IFX treatment in WT. The influx of neutrophils and TNF-α secretion were largely elevated in AnxA1(-)(/-) mice when compared to WT mice. In the group WT/DSS+IFX, phagocytes were more susceptible to apoptosis following treatment with IFX. Endogenous expression of AnxA1 increased after DSS and decreased with IFX treatment, demonstrating an attenuated inflammatory response. The data indicate that AnxA1 contributes to the establishment of intestinal homeostasis after blocking of TNF-α was used as a treatment of IBD, constituting a key molecule in the mechanism of action and a potential biomarker of therapeutic efficacy.
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Affiliation(s)
- Marina de Paula-Silva
- Post-graduation in Structural and Functional Biology, São Paulo Federal University (UNIFESP), São Paulo, São Paulo, Brazil
| | - Bibiana Elisabeth Barrios
- Center of Investigation in Biochemistry and Clinical Immunology, Cordoba National University (UNC), Córdoba, Córdoba, Argentina
| | - Lisa Macció-Maretto
- Center of Investigation in Biochemistry and Clinical Immunology, Cordoba National University (UNC), Córdoba, Córdoba, Argentina
| | - Angela Aparecida Sena
- Department of Biology, Laboratory of Immunomorphology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | | | - Silvia Graciela Correa
- Center of Investigation in Biochemistry and Clinical Immunology, Cordoba National University (UNC), Córdoba, Córdoba, Argentina
| | - Sonia Maria Oliani
- Post-graduation in Structural and Functional Biology, São Paulo Federal University (UNIFESP), São Paulo, São Paulo, Brazil; Department of Biology, Laboratory of Immunomorphology, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil.
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Sozutek A, Ozyazici S, Colak T, Cetınkunar S, Irkorucu O, Bobusoglu O, Cennet A. Evaluating the effect of infliximab on the healing of left colonic anastomosis in the presence of intra-abdominal sepsis. Arab J Gastroenterol 2016; 17:84-9. [DOI: 10.1016/j.ajg.2016.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
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Rehn M, Krarup PM, Christensen LH, Seidelin JB, Ågren MS, Syk I. GM6001 Increases Anastomotic Leakage following Colonic Obstruction Possibly by Impeding Epithelialization. Surg Infect (Larchmt) 2015; 16:702-8. [PMID: 26171681 DOI: 10.1089/sur.2014.248] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Emergency operations performed on an obstructed colon are accompanied by an increased risk of anastomotic insufficiency. Tissue-destructive matrix metalloproteinase (MMP) activity is elevated in the obstructed colon and contributes to a loss of suture-holding submucosal collagen, which may be mediated by tumor necrosis factor (TNF)-α. Our aim was to study the effect of the non-selective MMP and TNF-α converting enzyme (TACE) inhibitor GM6001 (30 mg/kg) on anastomosis repair in obstructed left colon. GM6001 has been proved to be highly efficacious in elective anastomosis rodent models. METHODS A partial obstruction of the distal colon was induced in male Sprague-Dawley rats. After 4 d the obstructed colonic segment was resected, and an end-to-end anastomosis was constructed. Seven days later, the anastomoses were evaluated for clinical leakage. Histopathological and immunohistochemical assessments were also performed. Finally, the direct effect of GM6001 on epithelialization was studied in cultured colonic epithelial cells. RESULTS Unlike the robust beneficial effect on anastomosis under uncomplicated conditions, here GM6001 had a negative impact on anastomotic wound healing following colonic obstruction and substantially (p=0.004) more rats in the GM6001 group (75%) than in the control group (11%) had developed anastomotic leakage. In the anastomotic wounds, the myofibroblast abundance and cell proliferation were similar in the two groups. Histologically, GM6001 treatment resulted in wider and minimally epithelialized wounds that were commonly necrotic on the luminal side and infiltrated with numerous granulocytes. In vitro, GM6001 also delayed (p=0.026) epithelialization of denuded intestinal epithelium grown on type I collagen. CONCLUSIONS Non-selective MMP/TACE inhibition with GM6001 increased the anastomotic complications following colon obstruction. Inhibition of epithelialization is one possible mechanism responsible for the increased leakage following GM6001 treatment.
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Affiliation(s)
- Martin Rehn
- 1 Department of Surgery, Skåne University Hospital , Malmö, Sweden
| | - Peter-Martin Krarup
- 2 Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen , Copenhagen, Denmark
| | - Lise H Christensen
- 3 Department of Pathology, Bispebjerg Hospital, University of Copenhagen , Copenhagen, Denmark
| | - Jakob B Seidelin
- 2 Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen , Copenhagen, Denmark
| | - Magnus S Ågren
- 2 Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen , Copenhagen, Denmark .,4 Copenhagen Wound Healing Center, Bispebjerg Hospital, University of Copenhagen , Copenhagen, Denmark .,5 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Ingvar Syk
- 1 Department of Surgery, Skåne University Hospital , Malmö, Sweden
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