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Open Access 01-12-2013 | Review

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

Authors: Klaus Orth, Wolfram Trudo Knoefel, Martijn van Griensven, Christiane Matuschek, Matthias Peiper, Holger Schrumpf, Peter Arne Gerber, Wilfried Budach, Edwin Bölke, Bettina Alexandra Buhren, Matthias Schauer

Published in: European Journal of Medical Research | Issue 1/2013

Abstract

Several studies demonstrated acute inflammatory response following traumatic injury. Inflammatory response during surgical interventions was verified by a significant increase of endotoxin 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.

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Title: Preventively enteral application of immunoglobulin enriched colostrums milk can modulate postoperative inflammatory response
Authors: Klaus Orth
Wolfram Trudo Knoefel
Martijn van Griensven
Christiane Matuschek
Matthias Peiper
Holger Schrumpf
Peter Arne Gerber
Wilfried Budach
Edwin Bölke
Bettina Alexandra Buhren
Matthias Schauer
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: European Journal of Medical Research / Issue 1/2013
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/2047-783X-18-50

Keynote webinar | Spotlight on medication adherence

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

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Keynote webinar | Spotlight on medication adherence

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