The effects of erythropoietin on bacterial translocation and inflammatory response in an experimental intestinal obstruction model in rats

Background: Intestinal obstruction results in distortion of balance of anti-inflammatory cytokines and release of oxidants, and also leads to bacterial translocation, sepsis and multiple organ failure. Asymmetric dimethylarginine is related to multiple organ failure as a new prognostic marker. Erythropoietin reduces the inflammatory response by decreasing the levels of pro-inflammatory cytokines and cytokine-induced apoptosis. In this study, we aimed to investigate the effectiveness of erythropoietin in reducing the severity of bacterial translocation and inflammatory response after intestinal obstruction and the relation between asymmetric dimethylarginine and inflammatory markers. Methods: Forty Wistar albino rats (200-250 g) were divided into 4 groups as follows: Group 1 (Sham), only ileocaecal junction dissection; Group 2 (Erythropoietin), ileocaecal junction dissection and 3000 lU/kg erythropoietin subcuta­neously; Group 3 (Intestinal Obstruction), complete ileal ligation; Group 4 (Intestinal Obstruction + Erythropoietin), complete ileal ligation and 3000 IU/kg erythropoietin subcutaneously. After 24 hours, the rats were sacrificed by taking blood from the heart for biochemical analyses. Peritoneal swab culture, liver, mesenteric lymph nodes, spleen and ileum were collected for microbiological and histopathological examinations. Results: Erythropoietin reduced the secretion of inflammatory cytokines, oxidative damage and bacterial translocation, prevented the formation of inflammatory changes in the intestine, liver, spleen and mesenteric lymph nodes, and also significantly prevented the formation of intestinal damage after intestinal obstruction (p<0.05). Conclusions: Asymmetric dimethylarginine levels did not dif­fer between the groups. Erythropoietin may be useful to pre­serve from intestinal injury and related sepsis in patients with intestinal obstruction. Asymmetric dimethylarginine is not a suitable prognostic marker.