Does granulocyte-macrophage colony-stimulating factor prevent bacterial translocation in rats with surgical trauma and obstructive jaundice?
OBJECTIVE
The incidence of sepsis can be decreased by preventing bacterial translocation, as the first step in enhanced host defense. The aim of this study was to prevent translocation and to increase Kupffer cell incidence by using granulocytemacrophage colony-stimulating factor in rats with surgical trauma and obstructive jaundice.


METHODS
Seventy-five Sprague- Dawley rats were randomized into 8 groups. After calibration of laboratory conditions by Group 0, SHAM operations in Groups I, II, IIA and common bile duct ligations in Groups III, IV, IVA and V were performed. Granulocyte-macrophage colony- stimulating factor doses were 6 microg/kg/d in Groups II, IV; 1 microg/kg/d in IIA, IVA postoperatively; and 6 microg/kg/d in Group V preoperatively, for 7 days. After one week, all rats were reoperated for cecal lymph node, liver and spleen biopsies for culture and histopathology. All culture specimens were identified as positive/negative/contaminated. Survivals were recorded, and after the 21st day surviving rats were sacrificed by decapitation.


RESULTS
There was no translocation in Group 0 in the three specimens of liver, cecal lymph node and spleen. Group V showed minimal (10%) positivity in only liver, and other groups ranged between 20-70% in cecal lymph node, liver and spleen tissues, respectively (p<0.05). Kupffer cell incidences were higher in the granulocyte-macrophage colony-stimulating factor given groups than in controls, and lower in common bile duct ligation groups than in SHAM groups (p<0.001). Groups 0 and V showed the best (median 20 days) and Group III the worst (median 11.7 days) survival (p<0.001).


CONCLUSIONS
Not only surgical trauma but also obstructive jaundice caused high incidence of translocation, decreased number of Kupffer cells and shortened survival. Translocation ratios were decreased by granulocyte- macrophage colony-stimulating factor in the SHAM and common bile duct ligation groups. Granulocyte-macrophage colony- stimulating factor prevented the decrease in Kupffer cell incidence caused by jaundice and prolonged the survival by preventing translocation at the first step.
Demirbağ
Ali E
AE
Department of Gastrointestinal Surgery, Türkiye Yüksek Ihtisas Post-Graduate Research and Teaching Hospital, Ankara, Turkey. alidemirbag@superonline.com
Turhan
Nesrin
N
Ercis
Serpil
S
Hamaloğlu
Erhan
E