Beta-1 blocker reduces inflammation and preserves intestinal barrier function after open abdominal surgery

Area of Science:

• Surgical Inflammation and Gut Health
• Pharmacology and Autonomic Nervous System

Background:

• Open abdominal surgery often triggers significant inflammation and compromises intestinal barrier function, leading to adverse patient outcomes.
• Beta-1 blockers have demonstrated efficacy in mitigating inflammation and preserving intestinal integrity in critical illness.
• The protective mechanisms may involve the autonomic nervous system via cholecystokinin receptors.

Purpose of the Study:

• To investigate the impact of beta-1 blocker administration on systemic and local inflammatory markers.
• To assess the effect of beta-1 blockers on intestinal barrier integrity following open abdominal surgery.
• To explore the role of cholecystokinin receptors in mediating these effects.

Main Methods:

• A rat model of open abdominal surgery was established.
• Animals were treated with metoprolol (a beta-1 blocker) or saline, with some receiving cholecystokinin-receptor antagonists.
• Systemic and local inflammatory markers, intestinal permeability, bacterial translocation, and mucosal injury were evaluated.

Main Results:

• Metoprolol significantly reduced key inflammatory cytokines (TNF-alpha, IL-6) and neutrophil infiltration.
• The beta-1 blocker markedly decreased intestinal permeability, bacterial translocation, and mucosal damage (Chiu's score).
• Blockade of cholecystokinin receptors abolished the protective effects of metoprolol.

Conclusions:

• Beta-1 blockers attenuate systemic and local inflammation and preserve intestinal barrier function post-open abdominal surgery.
• These beneficial effects are dependent on the cholecystokinin receptor pathway.
• Perioperative beta-1 blocker intervention presents a promising therapeutic strategy to improve surgical recovery.