title: High-Purity Magnesium Staples Suppress Inflammatory Response in Rectal Anastomoses.
abstract: Magnesium-based materials are promising biodegradable implants, although the impact of magnesium on rectal anastomotic inflammation is poorly understood. Thus, we investigated the inflammatory effects of high-purity Mg staples in rectal anastomoses by in vivo luciferase reporter gene expression in transgenic mice, hematoxylin-eosin staining, immunohistochemistry, and Western blotting. As expected, strong IL-1β-mediated inflammation and inflammatory cell infiltration were observed 1 day after rectal anastomoses were stapled with high-purity Mg or Ti. However, inflammation and inflammatory cell infiltration decreased more robustly 4-7 days postoperation in tissues stapled with high-purity Mg. This rapid reduction in inflammation was confirmed by immunohistochemical analysis of IL-6 and TNF-α. Western blot also suggested that the reduced inflammatory response is due to suppressed TLR4/NF-κB signaling. In contrast, MCP-1, uPAR, and VEGF were abundantly expressed, in line with the notion that expression of these proteins is regulated by feedback between the VEGF and NF-κB pathways. In vitro expression of MCP-1, uPAR, and VEGF was also similarly high in primary rectal mucosal epithelial cells exposed to extracts from Mg staples, as measured by antibody array. Collectively, the results suggest that high-purity Mg staples suppress the inflammatory response during rectal anastomoses via TLR4/NF-κB and VEGF signaling.
authors.affiliation: Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China.
authors.forename: Jiazeng
authors.initials: J
authors.lastname: Xia
authors.affiliation: Department of Pathology, Nanjing General Hospital , Jiangsu 210002, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai 200233, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.affiliation: State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University , Shanghai 200240, People's Republic of China.
authors.forename: Hongliu
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University , Shanghai 200240, People's Republic of China.
authors.forename: Xiaonong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Suzhou Origin Medical Technology Company Ltd. , 2 Haicheng Road, Changshu Economic and Technology Development Zone, Jiangsu 215513, People's Republic of China.
authors.forename: Shaoxiang
authors.initials: S
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University , Shanghai 200240, People's Republic of China.
authors.forename: Changli
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China.
authors.forename: Yigang
authors.identifier: http://orcid.org/0000-0002-3036-3537
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D016207:Cytokines; D007249:Inflammation; D008274:Magnesium / Q000737:chemistry*; D051379:Mice; D016328:NF-kappa B; D012002:Rectal Diseases; D015398:Signal Transduction
chemical_list: D016207:Cytokines; D016328:NF-kappa B; D008274:Magnesium
keywords: anastomoses; biodegradable materials; inflammation; magnesium; staples