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Upregulation of VEGFR1 in a rat model of esophagogastric anastomotic healing
Authors:Laura Christina Landes  Daniel Drescher  Evangelos Tagkalos  Peter P. Grimminger  René Thieme  Boris Jansen-Winkeln
Affiliation:1. Department of General, Visceral and Transplantation Surgery, University Medical Center of Mainz, Mainz, Germany;2. Department of General and Visceral Surgery, St. Juliusspital, Würzburg, Germany;3. Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Medical Center of Leipzig, Leipzig, Germany;4. Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Medical Center of Leipzig, Leipzig, Germany
Abstract:
Introduction: Anastomotic leakage after gastrointestinal surgery is a significant cause of morbidity and mortality. Esophagogastric and colorectal anastomoses are vulnerable to leakage. Extended knowledge of growth factors and their receptors is needed to understand anatomic healing.

Methods: The expression pattern of vascular growth factor receptor (VEGFR1-3), epidermal growth factor receptor (EGFR), platelet-derived growth factor receptor (PDGFRα/β) and keratinocyte growth factor receptor (KGFR) were analyzed by semiquantitative-PCR in the rat intestinal tract and in esophagogastric anastomosis 5d after surgery.

Results: VEGFR1, VEGFR2, EGFR, KGFR and PDGFRα expression was observed throughout the intestinal tract including esophagus, stomach, small bowl and colon. VEGFR3 was not found in gastric samples and PDGFRβ expression was not detected in the small bowl.

Semiquantitative analyses of the VEGFR1, PDGFRα and EGFR expression in esophagogastric anastomotic tissues revealed a 2-fold upregulation of the VEGFR1 in gastric samples, while no change was observed in the esophageal anastomotic side.

Conclusion: Our results revealed a distinct expression pattern of the investigated growth factor receptors in rat intestinal tract. Showing higher expression levels of growth factor receptors at the gastric anastomotic tissue at the fifth postoperative day suggests a different contribution of the gastric and the esophageal side to the anastomotic healing.

Keywords:Gastrointestinal anastomosis  growth factor receptors  anastomotic leakage  wound healing  experimental surgery  stomach
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