engleski

Postsplenectomy complications including portal venous system thrombosis and hypertension, liver damage, gastric mucosal lesions, and cerebral edema. Therapy with pentadecapeptide BPC 157

AIM Thromboembolic complications of splenectomy include both caval and portal venous systems (J Visc Surg 2016 ; 153(4):277-286). It was recently established that pentadecapeptide BPC 157 resolves Pringle maneuver related organ damage (World J Hepatol 2020 ; 12(5):184-206), inferior vena cava (IVC) ligation (Vascul Pharmacol 2018 ; 106:54- 66), and bile duct ligation (Eur J Pharmacol 2019 ; 847:130-142) in rats. We introduce BPC 157 as therapy for complications taking place after splenectomy in rats, including portal vein (PV), superior mesenteric vein (SMV), lienal vein (LV) and IVC thrombosis, severe venous hypertension (PV, IVC), abdominal aorta (AA) hypotension, gastric mucosal lesions, liver damage and subsequent cerebral edema. METHODS Female albino Wistar rats weighing 250-300g were deeply anesthetized using thiopental (40 mg/kg) and diazepam (10 mg/kg). Rats underwent complete laparotomy followed by splenectomy. Splenectomy consisted of the mobilization of the spleen, ligation of aa. et vv. gastrice breve and then ligation of lienal artery and vein at the splenic hilum, followed by the removal of the spleen. Immediately after splenectomy, VP was clamped using a vascular clamp for 15 min to induce thrombosis of VP and its contributories. Medication (/kg) (BPC 157 (10 µg or 10 ng)(treated group) or saline (5 ml)(control group)) was applied as an abdominal bath right after the vascular clamp removal. 10 min and 24h after medication application rats were assessed via USB microcamera, blood pressure measurement via intravascular cannulation, and thrombi extraction and weighing. Brain volumes and their ratio (V(con)/V(BPC)) were determined using ImageJ software area (A) measurement option and a model of volume approximation using the square-cube law. Gastric mucosal lesions’ areas were measured as described and compeared via ratios (A(con)/A(BPC)). RESULTS Control rats exhibited PV and IVC hypertension, aortic hypotension (mmHg) (10min: 34±3 PV, 25±2 IVC, 82±4 AA ; 24h: 40±3 PV, 35±3 IVC, 60±4 AA) and thrombosis (thrombus weight, mg) (10min: 0.0±0.0 IVC, 19.4±0.8 PV, 38.8±1.2 SMV, 13.2±0.4 LV, 24h: 27.9±1.1 IVC, 35.1±1.4 PV, 10.8±0.8 SMV, 19.7±0.5 LV). BPC 157 normalized the blood pressure (10min: 11±4 PV, 18±2 IVC, 110±5 AA, 24h: 21±3 PV, 21±3 IVC, 81±4 AA) and reduced the thrombus weight (10 min: 0.0±0.0 IVC, 10.3±0.7 PV, 15.4±0.9 SMV, 7.9±0.5 LV ; 24h: 11.4±0.9 IVC, 10.4±1.0 PV, 3.4±0.3 SMV, 8.7±0.8 LV). The control group presented with PV congestion and thrombosis, liver congestion and damage and cerebral edema (V(con)/V(BPC):10min 1.10±0.01 ; 24h 1.23±0.02), whereas the treated group showed none of the above (Fig.1). Treated rats showed significantly smaller gastric mucosal lesions compared to control rats (A(con)/A(BPC)=13.45±1.27) (Fig.1). CONCLUSION BPC 157 is a potential therapy for postsplenectomy portal venous system thrombosis.

BPC 157 ; splenectomy

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