Absence of circulating aldosterone attenuates foreign body reaction around surgical sutures.

Abstract

BACKGROUND AND AIMS:

Adrenal hormones influence inflammatory and fibrotic activity and thereby are involved in wound-healing process. Any excess as well as any shortage of glucocorticoids leads to a delayed wound healing. Mineralocorticoids like aldosterone have a pro-fibrotic and pro-inflammatory impact; thus, reduction of circulating aldosterone should result in an attenuated inflammatory response to implanted foreign bodies.

MATERIAL AND METHODS:

Eighteen rats were bilaterally adrenalectomized and substituted with dexamethasone (12 microg/kg per day) and 1% salt in their drinking water; 22 rats were sham-operated. The surgical suture material was removed after 3 weeks and analyzed for size of granuloma, ratio of collagen type I/III, apoptotic cells (terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling), expression of matrix metalloproteinase (MMP)-2, cyclooxygenase 2, tumor necrosis factor receptor 2 (TNF-R2), cluster of differentiation 68 (CD68), Ki67, and cold shock protein Y box binding protein 1 (YB-1). Cell expression was scored according to Remmele.

RESULTS:

All animals developed foreign body granulomas around the sutures. Absence of circulating aldosterone after adrenalectomy (ADX) was associated with smaller granuloma size and a reduced ratio of collagen type I/III. Ki67 and MMP-2 showed the strongest expression in cells of the infiltrate around suture. In adrenalectomized rats, we observed significantly less CD68-positive macrophages and less Ki67-positive cells but no significant differences in the expression of YB-1, TNF-R2, or MMP-2. Looking for correlations and co-expressions of proteins, the number of significant Spearman correlations was reduced in the ADX group compared to controls (one and four, respectively).

CONCLUSION:

The absence of circulating aldosterone attenuates inflammatory intensity around suture material. Foreign body granuloma seems to be an appropriate model to study chronic inflammatory process.

• Authors: Uwe Klinge, Stefanie Theuer, Ellen Krott, Anette Fiebeler
• Journal: Langenbeck's archives of surgery (Langenbecks Arch Surg) Vol. 395 Issue 4 Pg. 429-35 (Apr 2010) ISSN: 1435-2451 [Electronic] Germany
• PMID: 19277698 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Aldosterone

Topics

• Adrenalectomy
• Aldosterone (metabolism)
• Animals
• Disease Models, Animal
• Granuloma, Foreign-Body (metabolism)
• Inflammation (metabolism)
• Male
• Rats
• Rats, Wistar
• Sutures (adverse effects)
• Wound Healing (physiology)