title: Preoperative oral application of immunoglobulin-enriched colostrum milk and mediator response during abdominal surgery.
abstract: Our objective was to evaluate the influence of pre-operative oral application of an immunoglobulin-enriched milk preparation on endotoxin translocation and mediator release during and after abdominal surgery. Forty patients who had been treated by partial (n = 4) or total gastrectomy (n = 8) or pancreatic resection (n = 28) were enrolled in a placebo-controlled pilot study. Pre-operatively, patients were randomly treated for 3 days by oral application of a bovine milk preparation (lactobin 56g/day, n = 20) or placebo (n = 20). In both groups, endotoxin translocation and mediator release was studied pre- and intraoperatively by measuring endotoxin, endotoxin-neutralizing capacity (ENC), interleukin 6, C-reactive protein, transferrin, alpha-2-macroglobulin, albumin, apoliprotein-A1/-B, IgG, IgA, and IgM. The clinical course was followed up by daily evaluation of the Apache-II-score. Clinical data were comparable in both groups. The lactobin group showed significantly lower levels of endotoxin and ENC compared to the placebo group. Acute phase response, endotoxin-binding proteins, and clinical outcome did not differ between both groups. We conclude that prophylactic oral application of lactobin reduces perioperative endotoxemia and prevents reduction of ENC, suggesting a stabilization of gut barrier during abdominal surgery.
authors.affiliation: Department of Surgery, University of Ulm, Germany.
authors.forename: Edwin
authors.initials: E
authors.lastname: Bölke
authors.forename: Peter M
authors.initials: PM
authors.lastname: Jehle
authors.forename: Frieder
authors.initials: F
authors.lastname: Hausmann
authors.forename: Armin
authors.initials: A
authors.lastname: Däubler
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Wiedeck
authors.forename: Gerald
authors.initials: G
authors.lastname: Steinbach
authors.forename: Martin
authors.initials: M
authors.lastname: Storck
authors.forename: Klaus
authors.initials: K
authors.lastname: Orth
mesh_terms: D018806:APACHE; D000210:Acute-Phase Reaction / Q000276:immunology*; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001426:Bacterial Proteins / Q000008:administration & dosage* / Q000494:pharmacology*; D001430:Bacteriocins / Q000008:administration & dosage* / Q000494:pharmacology*; D002097:C-Reactive Protein / Q000378:metabolism; D002417:Cattle; D003126:Colostrum / Q000276:immunology*; D004731:Endotoxins / Q000097:blood / Q000378:metabolism; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage / Q000276:immunology*; D015850:Interleukin-6 / Q000378:metabolism; D008033:Limulus Test; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000276:immunology*; D010179:Pancreas / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D013997:Time Factors
chemical_list: D001426:Bacterial Proteins; D001430:Bacteriocins; D004731:Endotoxins; D007136:Immunoglobulins; D015850:Interleukin-6; C103950:lactobin A protein, Lactobacillus; D002097:C-Reactive Protein