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132. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

28.04. - 01.05.2015, München

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The anti-inflammatory pathway in burns – Influence of physostigmine and cdp-choline administration in rats

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  • Jochen-Frederick Hernekamp - BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktion Chirurgie, Schwerbrandverletztenzentrum, Ludwigshafen, Deutschland
  • Sissi Hu - BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktion Chirurgie, Schwerbrandverletztenzentrum, Ludwigshafen, Deutschland
  • Volker Schmidt - BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktion Chirurgie, Schwerbrandverletztenzentrum, Ludwigshafen, Deutschland
  • Julian Vogelpohl - BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktion Chirurgie, Schwerbrandverletztenzentrum, Ludwigshafen, Deutschland
  • Ulrich Kneser - BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktion Chirurgie, Schwerbrandverletztenzentrum, Ludwigshafen, Deutschland
  • Thomas Kremer - BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktion Chirurgie, Schwerbrandverletztenzentrum, Ludwigshafen, Deutschland

Deutsche Gesellschaft für Chirurgie. 132. Kongress der Deutschen Gesellschaft für Chirurgie. München, 28.04.-01.05.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15dgch289

doi: 10.3205/15dgch289, urn:nbn:de:0183-15dgch2897

Published: April 24, 2015

© 2015 Hernekamp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Introduction: The cholinergic anti-inflammatory pathway (CAP) may play an important role in early burn edema. Comparable to classic autonomous nerve reflexes stimulation of the vagus nerve lead to anti-inflammatory effects in sepsis. To further understand the CAP in burn injuries we evaluated the influence of physostigmine and cdp-choline on early systemic burn edema using intravital microscopy (IVM). Furthermore we observed leukocyte activation in shock in rat mesenteries after burn plasma transfer.

Material and methods: Burn plasma harvested from donor rats 4 hours after thermal injury (30% TBSA, 100° water, 12 sec) was administered intravenously to healthy animals during two hours of IVM. Shamburn plasma (same procedure but water at 37°) was transferred for negative controls. In the choline-group (BP-CDP) bolus injection of 100mg/Kg body weight cdp-choline was undertaken 15 minutes before examination. In the physostigmine group (BP-PT) 70ug/KG PT was administered 15 minutes prior to IVM. IVM was performed in the ileal portion of rat mesenteries at 0, 60 and 120 min. Capillary leakage was assessed by FITC-albumin extravasation and leukocyte-endothelial-interaction were observed via transillumination microscopy. To assure comparable hemodynamic conditions, microhemodynamic parameters, foremost venular wall shear rate was assessed.

Results: Capillary leakage increased significantly after burn plasma transfer when compared to the shamburn group. Blocking of the choline-esterase via PT administration as well as increased choline availability after additional cdp-choline administration attenuates macromolecular efflux to shamburn levels. Leukocyte activation is reduced after cdp-choline and physostigmine treatment.

Conclusion: The significant increase of albumin efflux in rat mesenteries after burn plasma transfer is decreased by additional cdp-choline bolus administration. Furthermore blocking of the choline esterase by PT administration leads to comparable results. These findings may strengthen the role of the CAP in early burn trauma pathophysiology. Further investigations to proof the relevance of the CAP in early burn trauma are strongly required.