Abstract
The majority of intra-abdominal adhesions develop postoperatively or following peritonitis. We have previously shown thatl-phosphatidylcholine reduces postoperative peritoneal adhesions in rats. In the present study, we examined whether adhesion formation after bacterial peritonitis is also reduced byl-phosphatidylcholine or bydl-α-phosphatidylcholine, which is degraded only 50% by phospholipase A2. Peritonitis was induced in the rat by caecal ligation and double puncture; cecotomy was performed 12, 15, or 18h later. Adhesions were assessed blindly by a scoring system 7 days after cecotomy. When cecotomy was scheduled for 18h after caecal ligation and puncture, the 7-day mortality was 90% (n=20). When cecotomy was performed at 12h, no mortality was seen; however, the adhesion score was low (2.3±0.7). When cecotomy was performed 15h after caecal ligation and puncture, the mortality was 25% and the adhesion score was 4.3±0.9. This figure was reduced significantly by intraperitoneal instillation ofl-phosphatidylcholine ordl-α-phosphatidylcholine for 3 subsequent days. However, the mortality increased byl-phosphatidylcholine (P<0.01), whereas mortality afterdl-α-phosphatidylcholine remained at 30%. We conclude that administration of bothl-phosphatidylcholine anddl-α-phosphatidylcholine decrease adhesion formation after bacterial peritonitis.
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Almdahl SM, Nordstrand K, Melby K, Osterud B, Gierecky KE (1985) Faecal peritonitis in the rat. Acta Chir Scand 151:213–216
Ar'Rajab A, Ahrén B, Rozga J, Bengmark S (1991) Phosphatidylcholine prevents post-operative peritoneal adhesions. J Surg Res 50:212–215
Bartlett JG, Onderdonk AB, Louie T, et al (1978) Lessons from an animal model of intraabdominal sepsis. Arch Surg 113:853–857
Brolin J, Lahnborg G, Nord CE (1984) The effect of one prophylactic dosage of antibiotics on experimentally induced lethal intra-abdominal sepsis. Acta Chir Scand 150:239–244
Chalkiadakis GE, Kostakis A, Karydakis P, et al (1985) Effect of aprotinin on fibropurulent peritonitis in rats. Am J Surg 150:550–553
Chang J, Musser JH, McGregor H (1987) Phospholipase A2: function and pharmacologic regulation. Biochem Pharmacol 36:2429–2436
Chi LM, Wu WG, Sung KLP, Chien S (1990) Biophysical correlates of lysophosphatidylcholine-and ethanol-mediated shape transformation and hemolysis of human erythrocytes. Membrane viscoelasticity and NMR measurement. Biochim Biophys Acta 1027:163–171
Ellis H (1971) The cause and prevention of postoperative intraperitoneal adhesions. Surg Gynecol Obstet 133:497–510
Garcia MC, Fernandez-Gallardo S, Gijon MA, Garcia C, Nieto ML, Sanchez-Crespo M (1990) Biosynthesis of platelet-activating factor (PAF) in human polymorphonuclear leukocytes. Biochem J 268:91–98
Grahame GR, Torchia MG, Dakewich KA, Ferguson IA (1985) Surface active material in peritoneal effuent of CAPD patients. Bull Periton Dial 5:109–111
Hazed LA, Stuppy RJ, Gross RW (1990) Purification and characterisation of canine myocardial cytosoloic phospholipase A2. J Biol Chem 266:10622–10630
Holtz G (1984) Prevention and management of peritoneal adhesions. Fertil Steril 41:497–507.
Menzies D, Ellis H (1990) Intestinal obstruction from adhesions-how big is the problem? Ann R Coll Surg Engl 172:60–63
O'Leary JP, Wickbom G, Cha SO, Wickborn A (1987) The role of faeces, necrotic tissue, and various blocking agents in the prevention of adhesions. Ann Surg 207:693–698
Snoj M, Ar'Rajab A, Ahrén B, Bengmark S (1992) Phosphatidylcholine prevents postoperative adhesion formation after small bowel anastomosis in the rat. Br J Surg (in press)
Van Deenen LLM, De Haas GH (1963) The substrate specificity of phospholipase A. Biochim Biophys Acta 70:538–553
Weibel MA, Majno G (1973) Peritoneal adhesions and their relation to abdominal surgery. Am J Surg 126:345–353
Wichterman KA, Baue AE, Chaudry IH (1980) Sepsis and septic shock—a review of laboratory models and proposal. J Surg Res 29:189–201
Wright GW, Ooi CE, Weiss J, Elsbach P (1990) Purification of a cellular (granulocyte) and extracellular (serum) phospholipase A2 that participate in the destruction of E. coli in rabbit inflammatory exudate. J Biol Chem 265:6675–6681
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Snoj, M., Ar'Rajab, A., Ahrén, B. et al. Phospholipase-resistant phosphatidylcholine reduces intra-abdominal adhesions induced by bacterial peritonitis. Res. Exp. Med. 193, 117–122 (1993). https://doi.org/10.1007/BF02576218
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DOI: https://doi.org/10.1007/BF02576218