Opposite effects of interleukin-2 on normal and transfusion-suppressed healing of experimental intestinal anastomoses.
OBJECTIVE
This study was done to investigate whether administration of interleukin-2 (IL-2) can abrogate the negative effects of blood transfusions on anastomotic healing.


BACKGROUND
Recently, the authors showed that blood transfusion severely impairs anastomotic repair and significantly increases the susceptibility to intra-abdominal septic complications in rats. It has been reported that blood transfusions suppress IL-2 production and that IL-2 may stimulate wound healing.


METHODS
Lewis rats underwent resection and anastomosis of both the ileum and colon. Subsequently, they received either 3 mL of saline (control and IL-2 groups) or 3 mL of blood from brown Norway donors (transfusion and transfusion/IL-2 groups) intravenously. From the operation onward, the animals in the IL-2 and transfusion/IL-2 groups received daily injections of 5.4 x 10(5) IU of IL-2 in dextrose solution subcutaneously; the rats in the other groups received only the dextrose solution. The animals were killed 3 or 7 days after the operation and examined for septic complications and anastomotic repair.


RESULTS
Transfusion led to an enhanced incidence of anastomotic abscesses, which was almost completely abrogated after IL-2 administration. The anastomotic strength was consistently and significantly reduced after transfusion. Seven days after surgery, the anastomotic strength was completely restored by IL-2 treatment. For instance, the average bursting pressure (+/- the standard deviation) of the ileal anastomoses in the control, transfusion, and transfusion/IL-2 groups were 86 +/- 15, 32 +/- 8,* and 63 +/- 10 mmHg* [symbol: see text] on day 3 and 293 +/- 36, 227 +/- 16,* and 299 +/- 19 mmHg on day 7, respectively (where * = significant vs. control group and [symbol: see text] = significant vs. transfusion group). In addition, IL-2 administration elevated the anastomotic hydroxyproline content, which was significantly decreased by transfusion alone, to the level found in the control group. The administration of IL-2 to control animals resulted unexpectedly in a significant reduction in anastomotic strength.


CONCLUSIONS
Exogenous IL-2 reverses the negative effects of blood transfusions on anastomotic repair, but it impairs healing under normal conditions.
Tadros
T
T
Department of General Surgery, University Hospital Nijmegen, The Netherlands.
Wobbes
T
T
Hendriks
T
T
D000038:Abscess / Q000209:etiology / Q000517:prevention & control*; D000714:Anastomosis, Surgical; D000818:Animals; D001835:Body Weight; D003106:Colon / Q000737:chemistry / Q000601:surgery*; D006909:Hydroxyproline / Q000032:analysis; D007082:Ileum / Q000737:chemistry / Q000601:surgery*; D007376:Interleukin-2 / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control*; D011312:Pressure; D051381:Rats; D011917:Rats, Inbred Lew; D065227:Transfusion Reaction; D014945:Wound Healing / Q000187:drug effects*
D007376:Interleukin-2; D006909:Hydroxyproline