Caffeic acid phenethyl ester prevents detrimental effects of remote ischemia-reperfusion injury on healing of colonic anastomoses.
OBJECTIVE
We aimed to investigate whether caffeic acid phenethyl ester (CAPE) prevents detrimental systemic effects of intestinal ischemia-reperfusion (IR) injury on colonic anastomotic wound healing.


METHODS
This experimental study was conducted on 48 male Wistar albino rats. The rats were randomly allocated into four groups and a left colonic anastomosis was performed in all rats: (i) sham-operated group (n = 12), laparatomy without intestinal IR injury; (ii) sham + CAPE group (n = 12), identical to Group 1 except for CAPE treatment (10 μmol/kg, intravenously); (iii) intestinal IR group (n = 12), 60 min of superior mesenteric ischemia followed by reperfusion; and (iv) IR + CAPE-treated group (n = 12) (10 μmol/kg, intravenously, 30 min before the construction of colonic anastomosis). On the postoperative day 7, the rats were subjected to relaparotomy for in vivo measurement of the colonic anastomotic bursting pressure. A colonic segment including the anastomotic site was resected for histopathological evaluation and biochemical analyses. The plasma proinflammatory cytokine levels were measured. Body weight changes were examined.


RESULTS
CAPE treatment significantly increased colonic anastomotic bursting pressures, and colonic anastomotic tissue hydroxyproline contents and antioxidant parameters (p < .05), and significantly decreased oxidative stress markers in colonic anastomotic tissues and plasma proinflammatory cytokine levels (p < .05). Histopathological scores were significantly better due to CAPE administration (p < .05).


CONCLUSIONS
This study clearly showed that CAPE treatment prevented the delaying effects of remote IR injury on colonic anastomotic wound healing. Further clinical studies are required to determine whether CAPE has a useful role in the enhancement of gastrointestinal anastomotic wound healing during particular surgeries in which IR-induced organ injury occurs.
Department of Gastroenterological Surgery, Turkey Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey. zteke_md@hotmail.com
Zafer
Z
Teke
Erdal Birol
EB
Bostanci
Cigdem
C
Yenisey
Esra Canan
EC
Kelten
Mustafa
M
Sacar
Nilufer Genc
NG
Simsek
Suleyman Ender
SE
Duzcan
Musa
M
Akoglu
D000714:Anastomosis, Surgical; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use*; D002109:Caffeic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D003106:Colon / Q000098:blood supply / Q000737:chemistry / Q000601:surgery*; D016207:Cytokines / Q000097:blood; D004353:Drug Evaluation, Preclinical; D006909:Hydroxyproline / Q000032:analysis; D007813:Laparotomy; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D017538:Mesenteric Artery, Superior / Q000503:physiopathology; D018384:Oxidative Stress / Q000187:drug effects; D010626:Phenylethyl Alcohol / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D013529:Surgical Wound Dehiscence; D014945:Wound Healing / Q000187:drug effects*; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002109:Caffeic Acids; D016207:Cytokines; D008315:Malondialdehyde; D014969:Xanthine Oxidase; C055494:caffeic acid phenethyl ester; D010626:Phenylethyl Alcohol; D006909:Hydroxyproline