Effects of Nuclear Factor-kappaB Inhibitors on Colon Anastomotic Healing in Rats.
J Surg Res. 2010 Feb 11. Epub 2010 Feb 11. PMID: 20605167
Department of General Surgery, Gazi University Medical School, Ankara, Turkey.
BACKGROUND: Nuclear factor (NF)-kappaB plays an essential role in inflammation. We tested this role by administering NF-kappaB-inhibitors into rats undergoing a well-established model of colonic anastomotic healing. METHODS: Wistar rats underwent laparotomy, descending colonic transection, and handsewn reanastomosis. The animals were randomized to receive either a selective NF-kappaB inhibitor (parthenolide 0.5 mg/kg or resveratrol 0.5 mg/kg) or an equal volume of water by gavages before operation and then daily after surgery. Animals were sacrificed either immediately after anastomotic construction (d 0) or at the third, fifth, or seventh postoperative day. RESULTS: Both parthenolide and resveratrol treatment led to early significant increases in plasma levels of IL-6. On d 7, hydroxyproline levels were significantly higher in the parthenolide and resveratrol groups. A similar pattern was observed with the bursting pressure. In contrast, gelatinase activity (MMP-2 and MMP-9 expression) was significantly higher in the control group on postoperative d 3. On d 3, expression of NF-kappaB activity was up-regulated in the anastomotic area. Both parthenolide and resveratrol completely attenuated NF-kappaB activity. Study groups also developed more marked inflammatory cell infiltration and collagen deposition on histology analysis. CONCLUSIONS: Parthenolide and resveratrol significantly improved healing and mechanical stability of colonic anastomoses in rats during the early postoperative period. Both agents may be acting to accelerate the host reparative process as well as to enhance protection of the anastomotic wound bed.