title: Effect of infliximab on the healing of intestinal anastomosis. An experimental study in rats.
abstract: OBJECTIVE
  Infliximab is effective in the induction and maintenance of remission in Crohn's disease. Whether, the perioperative administration of anti-TNF-a compromises intestinal healing leading to anastomotic failure and increased risk of postoperative complications, remains controversial. The aim of the study was to evaluate the effect of Infliximab on intestinal anastomosis healing.
  
  
  METHODS
  Fifty six wistar rats were divided into 4 groups: (a) 20 rats were subjected to excision of part of the terminal ileum followed by anastomosis which was evaluated on the 3rd or 7th postoperative day; (b) 20 rats received Infliximab and thereafter, the same surgical protocol as group (a) was followed; (c) 8 rats received Infliximab and served as relative control group; and (d) 8 served as absolute control group. Bursting pressure was used for testing intestinal healing. Additionally, the anastomoses were examined macroscopically, histologically and immunohistochemically for TGFb1, MMP1, MMP2 and Collagen V. The results were confirmed by Western blot analysis.
  
  
  RESULTS
  There were no significant differences in bursting pressures and septic intra-abdominal events among non-Infliximab (a) and Infliximab-treated (b) groups. Infliximab-treated (b) group showed mild to moderate inflammation, whereas the non-Infliximab (a) group exhibited severe inflammation. Expression of TGFb1, MMP2 and collagen V was significantly higher in the Infliximab-treated (b) group.
  
  
  CONCLUSIONS
  Infliximab seems to influence intestinal healing in terms of less inflammatory activity and higher tissue remodeling activity.
authors.affiliation: Second Department of Surgery, Aretaieion Hospital, Medical School, University of Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papaconstantinou
authors.affiliation: Department of Gastroenterology, Tzaneio General Hospital, Piraeus, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Zeglinas
authors.affiliation: Molecular Carcinogenesis Group, Laboratory of Histology and Embryology, School of Medicine, University of Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Gazouli
authors.affiliation: Second Department of Surgery, Aretaieion Hospital, Medical School, University of Athens, Greece. Electronic address: kosnastos@yahoo.gr.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Nastos
authors.affiliation: Second Department of Surgery, Aretaieion Hospital, Medical School, University of Athens, Greece.
authors.forename: Anneza
authors.initials: A
authors.lastname: Yiallourou
authors.affiliation: Second Department of Surgery, Aretaieion Hospital, Medical School, University of Athens, Greece.
authors.forename: Panagis
authors.initials: P
authors.lastname: Lykoudis
authors.affiliation: Molecular Carcinogenesis Group, Laboratory of Histology and Embryology, School of Medicine, University of Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Evangelou
authors.affiliation: Experimental-Research Center, ELPEN Pharmaceuticals, Pikermi, Attikis, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Papalois
authors.affiliation: Molecular Carcinogenesis Group, Laboratory of Histology and Embryology, School of Medicine, University of Athens, Greece.
authors.forename: Marilena
authors.initials: M
authors.lastname: Papaioannou
authors.affiliation: Second Department of Pathology, Laikon Hospital, University of Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Vlachogiannakos
authors.affiliation: Department of Gastroenterology, Tzaneio General Hospital, Piraeus, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Tzathas
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D024062:Collagen Type V / Q000032:analysis; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D007082:Ileum / Q000601:surgery*; D007249:Inflammation / Q000175:diagnosis; D000069285:Infliximab; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000032:analysis; D020778:Matrix Metalloproteinase 2 / Q000032:analysis; D051381:Rats; D017208:Rats, Wistar; D013529:Surgical Wound Dehiscence / Q000209:etiology; D053773:Transforming Growth Factor beta1 / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000911:Antibodies, Monoclonal; D024062:Collagen Type V; D005765:Gastrointestinal Agents; C508962:Tgfb1 protein, rat; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D020778:Matrix Metalloproteinase 2; C522363:Mmp2 protein, rat; C576840:MMP1 protein, rat; D020781:Matrix Metalloproteinase 1
keywords: Anastomosis; Crohn's disease; Infliximab; Wound healing