Perioperative low-dose prednisolone treatment has beneficial effects on postoperative recovery and anastomotic healing in a murine colitis model

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Marie-Christin Weber - , Technische Universität München (Autor:in)
  • Jannick Bauer - , Technische Universität München (Autor:in)
  • Annalisa Buck - , Technische Universität München (Autor:in)
  • Zoé Clees - , Technische Universität München (Autor:in)
  • Reinhard Oertel - , Institut für Klinische Pharmakologie (Autor:in)
  • Atsuko Kasajima - , Technische Universität München (Autor:in)
  • Stefan Reischl - , Technische Universität München (Autor:in)
  • Dirk Wilhelm - , Technische Universität München (Autor:in)
  • Helmut Friess - , Technische Universität München (Autor:in)
  • Philipp-Alexander Neumann - , Technische Universität München (Autor:in)

Abstract

BACKGROUND AND AIMS: High-dose glucocorticoid treatment has been identified as a risk factor for anastomotic leakage in patients with inflammatory bowel disease (IBD) undergoing bowel resection surgery. On the contrary, active disease during surgery is also associated with elevated morbidity. Perioperative low-dose treatment might be beneficial regarding postoperative outcomes by controlling disease activity. The present study is the first to investigate the dose-dependent effect of perioperative prednisolone therapy in a murine IBD model combining dextran-sodium sulfate (DSS) colitis with intestinal anastomosis surgery.

METHODS: In 84 ten-week-old wild-type mice a colorectal anastomosis was performed using microsurgical technique. Half the animals received induction of chemical colitis with 2% DSS via drinking water prior to surgery. In both groups, one third of the animals received daily oral administration of high-dose (0.533 mg/kg) and one third low-dose (0.133 mg/kg) prednisolone. Evaluation was performed on postoperative day 3 and 7.

RESULTS: While high-dose prednisolone treatment led to an increased anastomotic leakage rate in mice under colitis, low-dose prednisolone treatment limited preoperative disease activity and did not influence the leakage rate. Histologic examination showed a beneficial effect of low-dose prednisolone treatment on microscopic abscess formation at the anastomotic site in DSS mice as well as an increased anastomotic healing score.

CONCLUSIONS: We could demonstrate a beneficial effect of perioperative short-term low-dose prednisolone treatment on intestinal anastomotic healing in the context of colitis. Perioperative use of short-term low-dose prednisolone treatment might be beneficial in IBD patients that need to undergo surgery during active disease.

Details

OriginalspracheEnglisch
Seiten (von - bis)950-959
Seitenumfang10
FachzeitschriftJournal of Crohn's and Colitis
Jahrgang17
Ausgabenummer6
Frühes Online-Datum13 Jan. 2023
PublikationsstatusVeröffentlicht - 16 Juni 2023
Peer-Review-StatusJa

Externe IDs

Mendeley 1dbfdedf-55b1-3b0f-a790-023fd0970f99
unpaywall 10.1093/ecco-jcc/jjad002
WOS 000941528300001
Scopus 85163725823
ORCID /0000-0003-1526-997X/work/142247246

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Anastomosis, Surgical/adverse effects, Anastomotic Leak/drug therapy, Animals, Colitis/chemically induced, Inflammatory Bowel Diseases/drug therapy, Mice, Prednisolone/therapeutic use, Glucocorticoids, Anastomotic healing, Intra-abdominal septic complications