L-Tiroksinin Insulin Like Growth Factor–I İle Etkileşimi İle Kolon Anastomozu İyileşmesine Üzerindeki Etkisi
Amaç: Tiroid hormonları yara iyileşmesinde ve gastrointestinal mukozal hücrelerinin biyokimya ve morfolojisinde düzenleyici ve gelişimsel bir rol oynarlar. Bu çalışmanın amacı L-Tiroksinin kolon anastomozu iyileşmesine etkisini belirlemektir. Yöntem: Otuz adet erkek Wistar-Albino sıçan eşit olarak üç gruba ayrıldı. Grup-1 sham grubu iken grup-2 ve grup-3, 10mg/kg/gün propiltiyoürasil verilerek hipotiroid yapılmış hayvanlardan oluşmakta idi. Hipotiroidi serbest T3 ve T4 ölçülerek kesinleştirildi. Bütün gruplara sol kolonik transeksiyon ve anastomoz yapıldı. Grup-3’teki ratlara L-tiroksin intraperitoneal olarak 5 g, 1 cc izotonik içinde yedi gün verildi. Postoperatif yedinci günde anastomoz patlama basınçları, hidroksipirolin düzeyleri, IGF-I Ab-1 ölçümleri yapıldı. Bulgular: Grup-3’ün anastomoz patlama basınçları grup-1 (p=0,03) ve grup-2’den (p=0,002) belirgin olarak yüksek idi. Hidroksiprolin düzeyleri grup-3’de grup-1ve grup-2’den anlamlı yüksek izlendi (Grup3 ile Grup-1 p=0,003; grup-3 ile grup-2 p=0,002). IGF-1 Ab-1 boyanma oranı grup-1 (p=0,008) ve grup-2’ye (p=0,005) göre grup 3’te daha yüksek bulundu Sonuç: Yüksek anastomoz patlama basınçları ve hidroksipirolin düzeyleri ile gösterildiği üzere tiroid hormonu verilmesi kolon anastomozunun iyileşmesini olumlu etkilemektedir
Anahtar Kelimeler:
Hipotiroidi, L-Tiroksin, Kolon Anastomoz
-
Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology and biochemistry of gastrointestinal mucosal cells and wound healing. The aim of this study is to determine the effect of L-Thyroxin on colonic anastomosis healing. Method: Thirty male Wistar Albino rats were equally divided (n=10) in to three groups. Group 1 was the sham group whereas groups 2 and 3 were made hypothyroid by administration of propylthiouracil 10mg/kg/day per oral for four weeks. Hypothyrodism was confirmed with measurement of free-T3 and free T4 levels. All groups were subjected to left colonic transection and anastomosis. Group 3 rats have taken L-thyroxin therapy intraperitoneally 5g in 1cc saline daily for seven days. Anastomosis bursting pressure, hydroxyproline and IGF-I Ab-1 measurements were done on postoperative 7th day. Results: The anastomosis bursting pressure levels of group 3 were significantly higher than both group1 (p=0,03) and group2 (p=0,002). Hydroxyproline levels were significantly higher in group 3 than both group1 and group 2 (Group3 versus group1 p=0,003 and group 3 versus group 2 p=0,002). The IGF-1 Ab-1 staining integrity were higher in group3 versus group1 (P=0,008) and group2 (P=0,005) respectively. Conclusions: Thyroid hormones improve anastomosis healing as documented increased hydroxiproline levels and anastomotic bursting pressure
Keywords:
-,
___
- Moertel CG, Fleming TR, Macdonald JS, et all. Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: A final report. Ann Intern Med 1995;122(5):321-6.
- Jiborn H, Ahonen J, Zederfeldt B. Healing of experimental colonic anastomosis. I. Bursting strength of the colon after left colon resection and anastomosis. Am J Surg 1978;136(5):587-94.
- Hernandez DE, Walker CH, Mason GA. Influence of thyroid states on stress gastric ulcer formation. Life Sci 1988; 42(18):1757-64.
- Lennox J, Johnston ID. The effect of thyroid status on nitrogen balance and the rate of wound healing after injury in rats. Br J Surg 1973; 60(4):309.
- Verhofstad MHJ, Langr WP, van der Laak JAWM, Verhofstad AAJ, Hendriks T. Microscopic analysis of anastomotic healing in the intestine of normal and diabetic rats. Dis Col Rec 2001; 44(3):423-31.
- Reddy GK, Enwemeka CS. A simplified method for the analysis of hydroxyproline in biological tissues. Clin Biochem 1996; 29(3):225-9.
- Morgenstren L, Yamakawa T, Ben-Shoshan M, Lippman H. Anastomotic leakage after low colonic anastomosis. Am J Surg 1972; 123(1):104-9.
- Demirer S, Sengul N, Inan A, Eroglu A, Bumin C, Kuterdem E. Effect of recombinant human granulocyte/macrophage colony-stimulating factor on the healing of colonic anastomosis in rats. J Invest Surg 2001; 14(4):221-5.
- Fukuchi SG, Seeburger JL, Parquet G, Rolandelli RH. Influence of 5-Fluorouracil on Colonic Healing and Expression of Transforming Growth Factor-Beta 1. J Surg Res 1999: 84(2):121-6.
- Jiborn H, Ahonen J, Zederfeldt B. Healing of experimental colonic anastomosiss. III. Collagen metabolism in the colon after left colon resection. Am J Surg 1980; 139(3):398-405.
- Zuidewijn DBW de Roy van, Hendriks T, Wobbes T, de Boer HHM. Cytostatics and anastomotic healing in the intestine: an experimental study on the effect of parenteral nutrition. Eur Surg Res 1992;24(2):103-11.
- Hervas FG, Morreale de Escobar F, Escobar del Rey. Rapid effects of single small dose of L-Throxine and triiyodo-L-thyroxine on growth hormone as studied in the rat by radioimmunoassay. Endocrinology 1975: 97(1):91-101.
- Coiro V, Braverman LE, Christianson D, Fang SL, Goodman HM. Effect of hypothyrodism and thyroxine replacement on growth in the rat. Endocrinology 1979; 105(3):641-6.
- Froesch ER, Schmid C, Schwander J, Zapf J. Action of insulin-like growth factors. Annu Rev Physiol 1985;47:433-67.
- Dieguez C, Page MD, Scanlon MF. Growth hormone neuroregulation and its alterations in disease states. Clin Endoc 1988; 28(1):109-43.
- Melmed S, Yamashita S. Insulin-like growth factor I action on hypothyroid rat and pituitary cells; suppression of triiyodothyronine-induced growth hormone secretion and messenger ribonucleic acid levels. Endocrinology 1986; 118(4):1483-90.
- Tarkkinen P, Hagren V, Palenius T, Lovgren T. One-step quantitative thyrotropin assay for the detection of hypothyroidism in point-of-care conditions. Clin Biochem 2003;36(2):121-8.
- Bergeron E, Mitchell A, Heyen F, Dube S. Acute colonic surgery and unrecognized hypothyroidism: a warning. Report of six cases. Dis Col Rec 1997: 40(7):859-61.
- ISSN: 1309-3878
- Yayın Aralığı: Yılda 3 Sayı
- Başlangıç: 2009
- Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez
Sayıdaki Diğer Makaleler
Çevik A, Aydan ÇEVİK, Okcan BASAT, Sema UÇAK
Ürolojik Sorunlu Pediatrik Hasta Grubundaki İdrar Kültür Antibiyogramların Değerlendirilmesi
Tıp Fakültesi Öğrencilerinin Sigara İçme Durumu ve Sigara İle İlgili Tutumları
Nöro Linguistik Programlama ve Aile Hekimliğinde Kullanımı
Yılmaz M, Muammer YILMAZ, İsmail Hamdi KARA, Bayram POYRAZ, Atilla Senih MAYDA