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Surgery ; 155(2): 217-27, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24287143

RESUMO

AIM: We sought to investigate whether mammalian or ascidian Styela plicata heparin enemas could diminish inflammation in experimental diversion colitis. METHODS: Wistar-specific pathogen-free rats were submitted to a Hartmann's end colostomy and treated with enemas containing mammalian or Styela plicata heparin, or saline. Enemas were administered 3 times a week in the excluded colon segment from 4 to 8 weeks after operation. The effect of treatment was evaluated using video-endoscopic and histologic scores, measuring the cytokines interleukin (IL)-1ß, IL-6, tumor necrosis factor (TNF)-α, and transforming growth factor-ß production in organ cultures by enzyme-linked immunosorbent assay, quantifying T cells and macrophages, and investigating nuclear factor-kappa B (NF-κB) and external mitogen-activated protein kinase (pERK) activation. RESULTS: Treatment with either mammalian or Styela plicata heparins decreased colonoscopic and histologic scores (P < .02) and restored the densities of collagen fibers and the number of goblet cells (P < .03) in the diverted colon. Both heparin treatments decreased the accumulation of T cells and macrophages (P < .03), and the activation of NF-κB and pERK (P < .04) in the diverted colon. The high levels of cytokines IL-1ß, TNF-α, and IL-6 from the diversion colitis explants decreased (P < .05) to near normal values with heparin treatments. CONCLUSION: The improvement of experimental diversion colitis with heparin treatments indicates the anti-inflammatory effect of these compounds, even after topical administration. Further studies with the nonhemorrhagic heparin obtained from the invertebrate Styela plicata will be necessary to confirm its efficacy for the treatment of human diversion colitis and possibly other forms of colitis.


Assuntos
Anticoagulantes/administração & dosagem , Colite/tratamento farmacológico , Enema , Heparina/administração & dosagem , Urocordados , Animais , Colite/patologia , Colágeno/metabolismo , Colo/metabolismo , Colo/patologia , Colonoscopia , Modelos Animais de Doenças , Feminino , Masculino , Distribuição Aleatória , Ratos , Ratos Wistar
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