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

Research output: Contribution to journalResearch articleContributedpeer-review


  • Marie-Christin Weber - , Technical University of Munich (Author)
  • Jannick Bauer - , Technical University of Munich (Author)
  • Annalisa Buck - , Technical University of Munich (Author)
  • Zoé Clees - , Technical University of Munich (Author)
  • Reinhard Oertel - , Institute of Clinical Pharmacology (Author)
  • Atsuko Kasajima - , Technical University of Munich (Author)
  • Stefan Reischl - , Technical University of Munich (Author)
  • Dirk Wilhelm - , Technical University of Munich (Author)
  • Helmut Friess - , Technical University of Munich (Author)
  • Philipp-Alexander Neumann - , Technical University of Munich (Author)


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.


Original languageEnglish
Pages (from-to)950-959
Number of pages10
JournalJournal of Crohn's and Colitis
Issue number6
Early online date13 Jan 2023
Publication statusPublished - 16 Jun 2023

External IDs

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


ASJC Scopus subject areas


  • 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