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Effects of major liver resection, with or without recombinant bactericidal/permeability‐increasing protein (rBPI 21 ), on the angiogenic profile of patients with metastatic colorectal carcinoma
Author(s) -
Wu Francis P.K.,
Boelens Petra G.,
van Leeuwen Paul A.M.,
Hoekman Klaas,
Hansma Annemarie H.G.,
Wiezer Marinus J.,
Meijer Catharina,
Meijer Sybren,
Scotté Michel,
Cuesta Miguel A.
Publication year - 2003
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.10307
Subject(s) - medicine , endostatin , angiogenesis , vascular endothelial growth factor , perioperative , wound healing , gastroenterology , placebo , surgery , vegf receptors , pathology , alternative medicine
Background Surgery induces a process of wound healing, which has immunological and angiogenic aspects. Bactericidal/permeability‐increasing protein (BPI) is found in azurophilic granules of human neutrophils, which is bactericidal and neutralizes lipo‐polysaccharide (LPS). This may reduce postoperative infectious complications. In addition, BPI has been shown to be an inhibitor of angiogenesis. Methods A total of 18 patients with metastasized colorectal carcinoma to the liver were double blind randomized. The levels of the pro‐angiogenic factors interleukin‐6 (IL‐6) and vascular endothelial growth factor (VEGF) and the angiogenesis inhibitor endostatin were investigated after liver surgery with perioperative administration of either rBPI 21 or placebo. Results The highest IL‐6 levels were found during the first 24 hr and reached peak levels already at 2 hr postoperatively in both groups. In both groups VEGF levels decreased sharply in the postoperative hours, returning to baseline levels in the days afterwards. In both groups, an immediate decrease in endostatin levels was observed which remained significantly low. RBPI 21 transiently influenced IL‐6 and VEGF. Conclusions RBPI 21 only marginally affected IL‐6 and VEGF levels. Surgery per se induced an immediate immune response (IL‐6) and an immediate angiogenic response, reflected in an initial VEGF decrease and a longer lasting decrease of endostatin. These findings demonstrate the dynamics of tissue responses in the first phase of wound healing. J. Surg. Oncol. 2003;84:137–142. © 2003 Wiley‐Liss, Inc.