The effects of ghrelin on colonic anastomosis healing in rats

Abstract

OBJECTIVES:In addition to its roles in the stimulation of growth hormone secretion and the regulation of appetite and metabolism, ghrelin exerts immunomodulatory, anti-inflammatory and antioxidant actions in several organ systems. In this study, we investigated the effects of ghrelin on the healing of experimental colonic anastomoses.METHODS:Wistar rats were randomly divided into two groups (n = 10 in each). A segment of colon was excised, and an end-to-end anastomosis was performed in the distal colon. The Ghrelin Group received 10 ng/kg/day IP ghrelin for seven days postoperatively, whereas the Control Group received an identical volume of saline. On the seventh postoperative day, the anastomotic bursting pressures and hydroxyproline levels were measured, and adhesion formation around the anastomoses was examined. Histopathological analyses were performed to evaluate inflammatory cell infiltration, fibroblast infiltration, collagen density and neovascularization.RESULTS:In the Ghrelin Group, the bursting pressure and hydroxyproline levels were significantly higher than in the Control Group. The adhesion formation scores were lower in the Ghrelin Group than in the Control Group. Although the inflammatory cell infiltration was diminished in the Ghrelin Group, the degrees of fibroblast infiltration, collagen density and neovascularization were not significantly different between the groups.CONCLUSION:Our results indicate that ghrelin improves the healing of colonic anastomoses in rats.

Effects of autologous platelet-rich plasma coated sutures on intestinal anastomotic healing in rabbits

“…Three different sections were taken from each subject and examined using light microscope at X40. The inflammatory cell infiltration, fibroblast proliferation and capillary vascular proliferation were scored using a scale of 0–4 according to previously published methods (Ceran et al., 2013). Histopathological evaluation was performed by one pathologist who was blinded to group assignments.…”

Ghrelin and gastrointestinal wound healing. A new perspective for colorectal surgery

“…The improvement of postsurgical outcomes were confirmed by measuring collagen I protein levels via Western blot analysis and demonstrating that this effect is mediated by the GHSR-1a receptor 80 . Recently, Ceran et al 42 in an experimental study have reported another promising clinical effect of ghrelin. They have assessed a beneficial effect of postoperative ghrelin administration on the healing of colonic anastomoses in rats when compared with controls.…”

“…Exogenous GH and IGF-1 increase the collagen levels in anastomotic area, but can presents local collateral effects as increasing the granulation tissue, leading a healing deficit and consequently an anastomotic leak 28 . Recently, the exogenous administration ghrelin, an orexigenic peptide, was evaluated in the healing of colon anastomosis of rats resulting in a significant burst pressure improvement when compared with control group without collateral effects 42 . These new approaches require further studies to determinate pathophysiology mechanisms and clinical applicability.…”

Use of Antioxidant Substances in Intestinal Anastomosis in Rats

“…Wheeless et al [30] pointed out the positive effects of GH on terminal ileal anastomosis in radiation-treated rats, while Karahasanoglu et al [31] also suggested that GH strengthens left colon anastomosis in rats. Based on the pathophysiological basis that ghrelin stimulates GH in humans, Ceran et al [32] applied ghrelin, which did not affect fibroblast infiltration or neovascularization at the anastomotic site of the colon, but tests for resistance to rupture showed improvement.…”