Postsurgical intraperitoneal exposure to glove powders modulates inflammatory and immune-related cytokine production

The objective of the present study was to determine whether intraperitoneal exposure to glove powders modulates the inflammatory and immune responses by altering the influx of inflammatory and immune cells and peritoneal fluid cytokines and thus the outcome of surgically induced peritoneal wound healing. Peritoneal wall injuries were made by scraping the tissue until bleeding occurred in 360 mice. One of the following fluids was then introduced into the peritoneal cavity: phosphate-buffered saline solution, phosphate-buffered saline solution containing glove powders (Biosorb and Keoflo, 100 microg/ml), Hydrocote (Hydrogel film, Biogel 100 microg/ml), latex proteins (1 mg/ml), or lipopolysaccharides (12.5 microg/ml). At intervals of 1 to 28 days after injury, 10 mice per treatment per day and 10 uninjured mice were killed, peritoneal fluids were collected to determine the cytokine levels, the rate of fibrous adhesions formed at the site of injuries was graded, and peritoneal walls with attached fibrous adhesions were removed to determine the degree of inflammatory and immune cell infiltration into the wound. The results indicated that, with the exception of interferon-gamma, the peritoneal fluid levels of transforming growth factor-beta1, tumor necrosis factor-alpha, interleukin-1beta, and granulocyte-macrophage-colony stimulating factor in the phosphate-buffered saline solution-treated injured group significantly increased, reaching maximum between days 4 and 7 (p < 0.05) compared with the uninjured group and returned to uninjured values by day 14 after injury. The level of transforming growth factor-beta1 was higher in glove powders and Hydrocote-treated groups than in latex, lipo-saccharides, or phosphate-buffered saline solution-treated groups until day 14 after surgery (p < 0.05). The levels of tumor necrosis factor-alpha and interleukin-1beta increased in all treatment groups during the first week after injury compared with uninjured controls, with the exception of Hydrocote. The number of T helper/inducers (CD4), total leukocytes (CD11a), B lymphocytes (CD45R), granulocytes (Gr-1), and mononuclear phagocytes (Mac-3) in the wound increased during the first week after peritoneal wounding with no significant difference between treated and untreated groups. The rate of adhesion formation was not significantly altered in treated compared with untreated groups. These data suggest that a mechanism which mediates glove powder-induced peritoneal inflammatory and immune reactions in the postsurgical setting involves augmentation of cytokine production without influencing the influx of inflammatory and immune cells or adhesion formation.