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Preventively enteral application of immunoglobulin enriched colostrums milk can modulate postoperative inflammatory response.

Preventively enteral application of immunoglobulin enriched colostrums milk can modulate postoperative inflammatory response.

No. Divisions/Titles for Abstract Details

1 Abstract Title Preventively enteral application of immunoglobulin enriched colostrums milk can modulate postoperative inflammatory response.

2 Abstract Source European Journal of Medical Research, 18, 50.

3 Abstract Author(s) Orth, K., Knoefel, W. T., Van Griensven, M., Matuschek, C., Peiper, M., Schrumpf, H., Gerber, P. A., Budach, W., Bölke, E., Buhren, B. A. & Schauer, M.

4 Article Affiliation Medical Faculty, Department of General, Visceral-, and Pediatric Surgery, Heinrich Heine Universität Düsseldorf, Germany University of Düsseldorf, Dusseldorf, Germany.

5 Abstract Several studies demonstrated acute inflammatory response ( begins within seconds to minutes following the injury of tissues. The damage may be purely physical, or it may involve the activation of an immune response) following traumatic (relating to or denoting physical injury)injury. Inflammatory response during surgical interventions was verified by a significant increase of endotoxin (a toxin present inside a bacterial cell that is released when it disintegrates)plasma levels and a decrease of the endotoxin neutralizing capacity (ENC). However, the incidence of elevated endotoxin levels was significantly higher (89%) than detected bacterial translocation (35%). Thus parts or products of Gram-negative bacteria seem to translocate more easily into the blood circulation than whole bacteria. Along with the bacterial translocation, the inflammatory response correlated directly with the severity of the surgical intervention. In comparison after major and minor surgery Interleukin-6 (IL-6) and C-reactive protein (CRP) was also significantly different. Similar effects in mediator release were shown during endovascular stent graft placement and open surgery in infrarenal aortic aneurysm. Open surgery demonstrated a significant stronger endotoxin translocation and a decrease of ENC. Strategies to prevent translocation seem to be sensible. Colostrum is the first milk produced by the mammary glands within the first days after birth. It contains a complex system of immune factors and has a long history of use in traditional medicine. Placebo-controlled studies verified that prophylactic oral application of immunoglobulin-enriched colostrum milk preparation diminishes perioperative endotoxemia, prevents reduction of ENC and reduces postoperative CRP-levels, suggesting a stabilization of the gut barrier. This effect may be caused by immunoglobulin transportation by the neonatal receptor FcRn of the mucosal epithelium.In conclusion, there is an association of perioperative endotoxemia and the subsequent increase in mediators of the acute phase reaction in surgical patients. A prophylactic oral application of colostrum milk is likely to stabilize the gut barrier i.e. reduces the influx of lipopolysaccharides arising from Gram-negative bacterial pathogens and inhibits enterogenic endotoxemia. This appears to be a major mechanism underlying the therapeutic effect in patients at risk for Gram-negative septic shock.

6 Summary IgA (Immunoglobulin A is an antibody that plays a crucial role in the immune function of mucous membranes)has a major role in the immunosuppressive (substance partially or completely suppressing the immune response of an individual.)mechanisms in the intestine wall that inhibit proinflammatory (Capable of promoting inflammation) responses to oral antigens (a toxin or other foreign substance which induces an immune response in the body, especially the production of antibodies). This suppression is compensated by systemic immune factors (small molecule polypeptide which mainly were secreted the biological activity immunocyte, such as transfer factor, distinguishing factor and so on), including systemic IgG ( is a type of antibody. Each IgG has two antigen binding sites. Representing approximately 75% of serum antibodies in humans), which results in inflammation and tissue damage once an antigen crosses the epithelial barrier to the lamina propria (a thin layer of loose areolar connective tissue, which lies beneath the epithelium and together with the epithelium and basement membrane constitutes the mucosa). Any IgG localized in the lamina propria, whether from systemic sources or from the intestinal lumen, initates proinflammatory responses in the intestine wall . In this context, balancing IgG-antigen immune complexes to the lamina propria for immune processing were investigated .Secretory IgA (sIgA), which is present in milk and colostrum, is the primary Ig for immune protection of the mucosal membranes, such as the intestine. This may contribute to the protective effects of these secretions , which have antimicrobial properties such as agglutination (process that occurs if an antigen is mixed with its corresponding antibody called isoagglutinin)of microbes and neutralization of viruses. Furthermore, a non-inflammatory extracellular and intracellular immune defense by inhibition of adherence and invasion of mucosal epithelial cells has been observed . Secretory IgA neutralizes pathogens in the intestinal lumen . Bacterial enterotoxins (a toxin produced in or affecting the intestines, such as those causing food poisoning or cholera) can be neutralized by binding and internalization of sIgA into intestinal epithelial cells . Intracellular immunity is based on transcytosed ( type of transcellular transport in which various macromolecules are transported across the interior of a cell) sIgA by the enterocytes, neutralizing viral particles within the endosomic (a membrane-bound compartment inside eukaryotic cells. It is a compartment of the endocytic membrane transport pathway originating from the trans Golgi membrane)system.

7 Article Published Date 23-nov-2003.

8 Study Type Review.

9 Substances Colostrum.

10 Diseases Inflammation (post operative).

11 Pharmacological Actions Antiinflammatory.

12 Link

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