Effect of hepatectomy on intestinal permeability, tight junctionproteins and immune response

Aim: Liver is one of the main organs of the reticuloendothelial system. Studies have shown that intestinal permeability and infectious complications are increasing after hepatectomy. Many mechanisms are responsible for these complications, and should be known for the prevention of infectious complications after hepatectomy.The aim of this study is to reveal the role of granulocyte-myeloid derived supressor cells (immature neutrophyls) and tight junction proteins on intestinal permeability and infectious complications after %70 hepatectomy in an experimental mouse model . Material and method: Residual liver, peripheral blood, bone marrow and intestinal samples had been evaluated for granulocyte-myeloid derived supressor cells, mature neutrophils in flow cytometry. Intestinal permeability was assessed by fluorescein isothiocyanate dextrane in 40 male BALB/c mice on the 2. and 5. days after %70 hepatectomy or only laparatomy. Cla-3 and ZO-1 proteins were assessed in proximal jejunum with spesific immunohistochemistry. Results: We have found that intestinal permeability is increased after hepatectomy (3,6mg/ml ) and decreased on 5th day (2,2mg/ml). Major hepatectomy resulted in immature (%19.5 ± 1.5 vs. %3.1 ± 0.5 P:0.0110) and mature (%7 ± 1 vs. %2.7 ± 0.8, P:0.046) neutrophil proliferation in bone marrow and releasing from bone marrow to peripheral blood. Mature neutrophils might be causing increasing of intestinal permeability and immature neutrophils might be causing decreasing of intestinal permeability. In proximal jejenum samples, cla-3 and ZO-1 are decreased compared to control group. In hepatectomy post operation 2nd day group TJ distibution decreased significantly. Conclusion: In normal mice there is no immature neutrophils in peripheric blood but after hepatectomy immature neutrophils are seen in peripheric blood. On the early days after hepatectomy increase in mature neutrophil levels might be parallel to intestinal permeability changes and after 5 days immature neutrophils are still increasing but intestinal permeability is decreased. We conclude that major hepatectomy caused; increase in intestinal permeability, neutrophil proliferation and decrease in TJ distribution on mice.