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Tsai PL, Chen JS, Lin CH, Hsu TC, Lin YW, Chen MJ. Abdominal wound length influences the postoperative serum level of interleukin-6 and recovery of flatus passage among patients with colorectal cancer. Front Surg 2024; 11:1400264. [PMID: 38978990 PMCID: PMC11228254 DOI: 10.3389/fsurg.2024.1400264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
Introduction A mini-laparotomy for colorectal cancer (CRC) has been reported to shorten postoperative ileus (POI) and hospital stay. Interleukin-6 (IL-6) plays a role in intestinal tissue inflammation, leading to POI. This study investigated the effects of abdominal wounds and IL-6 levels on POI in patients having CRC surgery. Materials and methods Forty-three patients with CRC underwent bowel resection. Serum samples were collected preoperatively and at 2, 24, and 48 h after surgery for cytokine quantification by ELISA. Clinical data, including time from surgery to first passage of flatus and postoperative hospital stay, demographic and pathological data, and routine blood tests, were compared statistically with abdominal wound length and the postoperative increments of cytokines (designated as Δ). Results The length of the abdominal wound showed a significant correlation with clinical variables (length of operation time, time of first flatus passage, and length of postoperative hospital stay) and cytokine variables (IL-6(Δ2 h), IL-8(Δ2 h) and IL-10(Δ2 h). Linear regression analysis showed that the abdominal wound length significantly influenced the operation time, time of first flatus passage, and length of postoperative hospital stay (p < 0.001). The length of the abdominal wound showed a significant influence on the IL-6(Δ2 h) and IL-8(Δ2 h) (p < 0.001, respectively) but no influence on IL-10(Δ2 h). IL-6(Δ2 h), but not IL-8(Δ2 h), significantly influenced the time to first flatus passage and length of hospital stay (p = 0.007, p = 0.006, respectively). The mini-laparotomy approach (wound length <7 cm) led to significantly shortened operation time, time of first flatus passage, length of postoperative stay (p = 0.004, p = 0.003, p = 0.006, respectively) as well as reduced postoperative increment of IL-6(Δ2 h) (p = 0.015). The mini-laparotomy for anterior resection surgery significantly influenced operation time, time of first passage of flatus, length of postoperative stay, and IL-6(Δ2 h). Conclusion Our study is the first to report the complex interaction among the length of the abdominal wound, IL-6 serum level, recovery of the first passage of flatus, and postoperative hospital stay. These results suggest that smaller abdominal wounds and smaller postoperative IL-6 increments were associated with faster recovery of flatus passage and shorter hospital stays.
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Affiliation(s)
- Po-Li Tsai
- Department of Surgery, Division of Colorectal Surgery, Mackay Memorial Hospital, New Taipei City, Taiwan
- Department of Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan
| | - Jian-Syun Chen
- Department of Surgery, Division of Colorectal Surgery, Mackay Memorial Hospital, New Taipei City, Taiwan
- Department of Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan
| | - Chi-Hsin Lin
- Department of Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Tzu-Chi Hsu
- Department of Surgery, Division of Colorectal Surgery, Mackay Memorial Hospital, New Taipei City, Taiwan
| | - Yu-Wen Lin
- Department of Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan
| | - Ming-Jen Chen
- Department of Surgery, Division of Colorectal Surgery, Mackay Memorial Hospital, New Taipei City, Taiwan
- Department of Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan
- Department of Medicine and Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan
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Okdahl T, Wegeberg AM, Jensen ABH, Jensen ST, Andersen HRP, Størling J, Brock B, Brock C. Systemic Cytokine Expression in Diabetes Is Associated with Prolonged Gastrointestinal Transit Times and Cardinal Gastroparesis Symptoms. Biomedicines 2023; 11:biomedicines11041027. [PMID: 37189645 DOI: 10.3390/biomedicines11041027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Gastroenteropathy is a common complication in diabetes associated with damages to the enteric nervous system. Systemic low-grade inflammation facilitates neurotoxicity, and associations with peripheral and autonomic neuropathy have been reported. However, less is known of associations with gastroenteropathy. To explore the area cross-sectionally, we included individuals with diabetes (type 1: 56, type 2: 100) and 21 healthy controls. Serum levels of interleukin (IL)-6, IL-8, IL-10, tumour necrosis factor (TNF)-α, and interferon (IFN)-γ were measured by multiplex technology. Segmental gastrointestinal transit times were assessed by wireless motility capsule investigations. Symptoms of gastroparesis were rated on Gastroparesis Cardinal Symptom Index questionnaires. Compared to healthy, levels of TNF-α were decreased in type 1 diabetes and increased in type 2 diabetes, while colonic transit time was increased (all p < 0.05). In diabetes, associations between IL-8 and prolonged gastric emptying (odds ratio (OR) 1.07, p = 0.027) and between IL-10 and prolonged colonic transit (OR 29.99, p = 0.013) were seen. Inverse correlations between IL-6 and nausea/vomiting (rho = −0.19, p = 0.026) and bloating (rho = −0.29; p < 0.001) were found. These findings indicate a plausible interaction between inflammation and the enteric nervous system in diabetes, which raises the question of whether anti-inflammatory strategies could be applied in management of diabetic gastroenteropathy.
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Affiliation(s)
- Tina Okdahl
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Anne-Marie Wegeberg
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
- Thisted Research Unit, Aalborg University Hospital Thisted, 7700 Thisted, Denmark
- Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
| | - Anne Birthe Helweg Jensen
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Sarah Thorius Jensen
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | | | - Joachim Størling
- Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
- Department of Biomedical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | | | - Christina Brock
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
- Steno Diabetes Center Northern Jutland, 9000 Aalborg, Denmark
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Docsa T, Sipos A, Cox CS, Uray K. The Role of Inflammatory Mediators in the Development of Gastrointestinal Motility Disorders. Int J Mol Sci 2022; 23:6917. [PMID: 35805922 PMCID: PMC9266627 DOI: 10.3390/ijms23136917] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 02/04/2023] Open
Abstract
Feeding intolerance and the development of ileus is a common complication affecting critically ill, surgical, and trauma patients, resulting in prolonged intensive care unit and hospital stays, increased infectious complications, a higher rate of hospital readmission, and higher medical care costs. Medical treatment for ileus is ineffective and many of the available prokinetic drugs have serious side effects that limit their use. Despite the large number of patients affected and the consequences of ileus, little progress has been made in identifying new drug targets for the treatment of ileus. Inflammatory mediators play a critical role in the development of ileus, but surprisingly little is known about the direct effects of inflammatory mediators on cells of the gastrointestinal tract, and many of the studies are conflicting. Understanding the effects of inflammatory cytokines/chemokines on the development of ileus will facilitate the early identification of patients who will develop ileus and the identification of new drug targets to treat ileus. Thus, herein, we review the published literature concerning the effects of inflammatory mediators on gastrointestinal motility.
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Affiliation(s)
- Tibor Docsa
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (T.D.); (A.S.)
| | - Adám Sipos
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (T.D.); (A.S.)
| | - Charles S. Cox
- Department of Pediatric Surgery, University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX 77204, USA;
| | - Karen Uray
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (T.D.); (A.S.)
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Ryšánek P, Grus T, Lukáč P, Kozlík P, Křížek T, Pozniak J, Roušarová J, Královičová J, Kutinová Canová N, Boleslavská T, Bosák J, Štěpánek F, Šíma M, Slanař O. Validity of cycloheximide chylomicron flow blocking method for the evaluation of lymphatic transport of drugs. Br J Pharmacol 2021; 178:4663-4674. [PMID: 34365639 DOI: 10.1111/bph.15644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/14/2021] [Accepted: 07/24/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Lymphatic transport of drugs after oral administration is an important mechanism for absorption of highly lipophilic compounds. Direct measurement in lymph duct cannulated animals is the gold standard method, but non-invasive cycloheximide chylomicron flow blocking method has gained popularity recently. However, concerns about its reliability have been raised. The aim of this work was to investigate the validity of cycloheximide chylomicron flow blocking method for the evaluation of lymphatic transport using model compounds with high to very high lipophilicity, that is, abiraterone and cinacalcet. EXPERIMENTAL APPROACH Series of pharmacokinetic studies were conducted with abiraterone acetate and cinacalcet hydrochloride after enteral/intravenous administration to intact, lymph duct cannulated and/or cycloheximide pre-treated rats. KEY RESULTS Mean total absolute oral bioavailability of abiraterone and cinacalcet was 7.0% and 28.7%, respectively. There was a large and significant overestimation of the lymphatic transport extent by the cycloheximide method. Mean relative lymphatic bioavailability of abiraterone and cinacalcet in cycloheximide method was 28-fold and 3-fold higher than in cannulation method, respectively. CONCLUSION AND IMPLICATIONS Cycloheximide chylomicron flow blocking method did not provide reliable results on lymphatic absorption and substantially overestimated lymphatic transport for both molecules, that is, abiraterone and cinacalcet. This non-invasive method should not be used for the assessment of lymphatic transport and previously obtained data should be critically revised.
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Affiliation(s)
- Pavel Ryšánek
- Institute of Pharmacology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Tomáš Grus
- Department of Cardiovascular Surgery, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Peter Lukáč
- Department of Cardiovascular Surgery, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Petr Kozlík
- Department of Analytical Chemistry, Faculty of Science, Charles University, Prague, Czech Republic
| | - Tomáš Křížek
- Department of Analytical Chemistry, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jiří Pozniak
- Third Department of Surgery, First Faculty of Medicine, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Jaroslava Roušarová
- Institute of Pharmacology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Jana Královičová
- Institute of Pharmacology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Nikolina Kutinová Canová
- Institute of Pharmacology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Tereza Boleslavská
- Preformulation and Biopharmacy Department/Clinical Development Department, Zentiva, k.s, Prague, Czech Republic.,Department of Chemical Engineering, University of Chemistry and Technology, Prague, Czech Republic
| | - Jan Bosák
- Preformulation and Biopharmacy Department/Clinical Development Department, Zentiva, k.s, Prague, Czech Republic
| | - František Štěpánek
- Department of Chemical Engineering, University of Chemistry and Technology, Prague, Czech Republic
| | - Martin Šíma
- Institute of Pharmacology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Ondřej Slanař
- Institute of Pharmacology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
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Tawfik DI, Osman AS, Tolba HM, Khattab A, Abdel-Salam LO, Kamel MM. Evaluation of therapeutic effect of low dose naltrexone in experimentally-induced Crohn's disease in rats. Neuropeptides 2016; 59:39-45. [PMID: 27392602 DOI: 10.1016/j.npep.2016.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/17/2016] [Accepted: 06/20/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIM Crohn's disease is a relapsing inflammatory condition afflicting the digestive tract. Drugs used for treatment of Crohn's disease may be associated with serious side effects. Endogenous opioid peptides modulate inflammatory cytokine production. Opioid antagonists have been shown to play a role in healing and repair of tissues. This work was designed to detect the possible beneficial effects of opioid antagonist naltrexone in indomethacin-induced Crohn's disease in rats. EXPERIMENTAL APPROACH Enteritis was induced in male albino rats by two subcutaneous injection of indomethacin in a dose of 7.5mg/kg 24h apart started on day one. Salfasalazine, naltrexone and their combination were administered orally from day one of induction of enteritis to day 10. Disease activity index, serum levels of C-reactive protein and tumor necrosis factor-α, macroscopic and microscopic pathological scores and in vitro motility studies were evaluated. RESULTS Induction of enteritis resulted in significant increase of disease activity index, significant elevation of serum levels of C-reactive protein and tumor necrosis factor-α, significant deterioration of pathological scores and significant increase in the mean contractility response of the isolated ileal segments compared with normal untreated rats. Treatment with sulfasalazine, low dose of natrexone or their combination resulted in significant improvement of all measured parameters compared with enteritis group. CONCLUSION The current finding could provide new interesting opportunity for developing new therapeutic approaches for treatment of Crohn's disease. Use of naltrexone, especially in small dose, has little side effects making it of interest for treatment of Crohn's disease. Also, it provides the possibility of reduced doses of other drugs if it is used as combined therapy.
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Affiliation(s)
| | - Afaf Sayed Osman
- Medical Pharmacology Department, Faculty of Medicine, Cairo University, Eqypt.
| | | | - Aida Khattab
- Medical Pharmacology Department, Faculty of Medicine, Cairo University, Eqypt
| | | | - Mahmoud M Kamel
- Clinical Pathology Department, National Cancer Institute, Cairo University, Egypt
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Govindaraju V, Michoud MC, Al-Chalabi M, Ferraro P, Powell WS, Martin JG. Interleukin-8: novel roles in human airway smooth muscle cell contraction and migration. Am J Physiol Cell Physiol 2006; 291:C957-65. [PMID: 16822944 DOI: 10.1152/ajpcell.00451.2005] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In patients with cystic fibrosis (CF) and asthma, elevated levels of interleukin-8 (IL-8) are found in the airways. IL-8 is a CXC chemokine that is a chemoattractant for neutrophils through CXCR1 and CXCR2 G protein-coupled receptors. We hypothesized that IL-8 acts directly on airway smooth muscle cells (ASMC) in a way that may contribute to the enhanced airway responsiveness and airway remodeling observed in CF and asthma. The aim of this study was to determine whether human ASMC (HASMC) express functional IL-8 receptors (CXCR1 and CXCR2) linked to cell contraction and migration. Experiments were conducted on cells harvested from human lung specimens. Real-time PCR and fluorescence-activated cell sorting analysis showed that HASMC expressed mRNA and protein for both CXCR1 and CXCR2. Intracellular Ca2+ concentration ([Ca2+]i) increased from 115 to 170 nM in response to IL-8 (100 nM) and decreased after inhibition of phospholipase C (PLC) with U-73122. On blocking the receptors with specific neutralizing antibodies, changes in [Ca2+]i were abrogated. IL-8 also contracted the HASMC, decreasing the length of cells by 15%, and induced a 2.5-fold increase in migration. These results indicate that HASMC constitutively express functional CXCR1 and CXCR2 that mediate IL-8-triggered Ca2+ release, contraction, and migration. These data suggest a potential role for IL-8 in causing abnormal airway structure and function in asthma and CF.
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MESH Headings
- Antibodies/immunology
- Calcium/metabolism
- Cell Movement/drug effects
- Cells, Cultured
- Estrenes/pharmacology
- Flow Cytometry
- Gene Expression Regulation/drug effects
- Humans
- Inositol 1,4,5-Trisphosphate Receptors/antagonists & inhibitors
- Interleukin-8/pharmacology
- Macrocyclic Compounds/pharmacology
- Muscle Contraction/drug effects
- Myocytes, Smooth Muscle/cytology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/physiology
- Neutralization Tests
- Oxazoles/pharmacology
- Pyrrolidinones/pharmacology
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptors, Interleukin-8A/genetics
- Receptors, Interleukin-8B/genetics
- Respiratory System/cytology
- Type C Phospholipases/antagonists & inhibitors
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Affiliation(s)
- Vasanthi Govindaraju
- Seymoure Heisler Laboratory of the Montreal Chest Institute Research Center, McGill University, Montreal, Quebec, Canada H2X 2P2
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Xie DP, Li W, Qu SY, Zheng TZ, Yang YL, Ding YH, Wei YL, Chen LB. Effect of areca on contraction of colonic muscle strips in rats. World J Gastroenterol 2002; 8:350-2. [PMID: 11925623 PMCID: PMC4658382 DOI: 10.3748/wjg.v8.i2.350] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effects of areca on the contractile activity of isolated colonic muscle strips in rats and mechanism involved.
METHODS: Each strip (LMPC, longitudinal muscle of proximal colon; CMPC, circular muscle of proximal colon; LMDC, longitudinal muscle of distal colon; CMDC, circular muscle of distal colon.) was suspended in a tissue chamber containing 5 mL Krebs solution (37 °C), bubbled continuously with 950 mL•L⁻¹ O2 and 50 mL•L⁻¹ CO2. The mean contractile amplitude (A), the resting tension (T), and the contractile frequency (F) were simultaneously recorded on recorders.
RESULTS: Areca dose dependently increased the mean contractile amplitude, the resting tension of proximal and distal colonic smooth muscle strips in rats (P < 0.05). It also partly increased the contractile frequency of colonic smooth muscle strips in rats (P < 0.05). The effects were partly inhibited by atropine (the resting tension of LMPC decreased from 0.44 ± 0.12 to 0.17 ± 0.03; the resting tension of LMDC decreased from 0.71 ± 0.14 to 0.03 ± 0.01; the mean contractile amplitude of LMPC increased from -45.8 ± 7.2 to -30.5 ± 2.9; the motility index of CMDC decreased from 86.6 ± 17.3 to 32.8 ± 9.3; P < 0.05 vs areca), but the effects were not inhibited by hexamethonium (P > 0.05).
CONCLUSION: Areca stimulated the motility of isolated colonic smooth muscle strips in rats. The stimulation of areca might be relevant with M receptor partly.
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Affiliation(s)
- Dong-Ping Xie
- Department of Physiology, Medical College, Shandong University, Jinan 250012, Shandong Province, China.
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