Abstract
ObjectiveTo examine pasireotide’s effect on intestinal anastomotic healing under physiological conditions and following preoperative whole-body irradiation.Material and methodsForty-five male Wistar rats received an ileoileal end-to-end anastomosis. Group 1 (Co, n = 9) served as control. Group 2 (SOM, n = 10) received pasireotide (60 mg/kg) 6 days preoperatively. Group 3 (R-Co, n = 13) was subjected to 8 Gy whole-body irradiation 4 days preoperatively. Finally, group 4 (R-SOM, n = 13) received pasireotide 6 days preoperatively and whole-body irradiation 4 days preoperatively. On postoperative day 4, anastomotic bursting pressure, histology, IGF-1 staining, and collagen density were examined.ResultsMortality was higher in irradiated animals (30.8% vs. 5.3%, p = 0.021), and anastomotic bursting pressure was significantly lower (median, R-Co = 83 mmHg; R-SOM = 101 mmHg; Co = 149.5 mmHg; SOM = 169 mmHg). Inflammation measured by leukocyte infiltration following irradiation was reduced (p = 0.023), and less collagen was observed, though this was not statistically significant. Bursting pressure did not significantly differ between Co and SOM and between R-Co and R-SOM animals respectively. Semi-quantitative scoring of IGF-1, fibroblast bridging, or collagen density did not reveal significant differences among the groups.ConclusionWhole-body irradiation decreases the quality of intestinal anastomotic wound healing and increases mortality. Pasireotide does not significantly lessen this detrimental effect.
Highlights
Intestinal anastomotic healing is a complex process that involves intense genetic regulation of a large set of genes and the coordinated interaction of multiple cell types
Fu et al demonstrated that pasireotide reduces mortality, mitigates intestinal injury, and largely prevents subsequent bacteraemia given before or shortly after whole-body irradiation (WBI) in mice
To shed light on the influence of pasireotide on intestinal healing, we examined its effect under control conditions as well as following WBI irradiation in a rat model of intestinal anastomotic healing
Summary
Intestinal anastomotic healing is a complex process that involves intense genetic regulation of a large set of genes and the coordinated interaction of multiple cell types. Application transiently and effectively decreases growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels across species [27]. It drastically throttles exocrine pancreatic function [2]. Fu et al demonstrated that pasireotide reduces mortality, mitigates intestinal injury, and largely prevents subsequent bacteraemia given before or shortly after whole-body irradiation (WBI) in mice. These effects were largely reversible upon substitution of pancreatic enzymes [9]
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