Eur J Pediatr Surg 2011; 21(1): 65-69
DOI: 10.1055/s-0029-1246197
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Postsplenectomy Sepsis in Splenectomized, Partially Splenectomized and Non-splenectomized Rats after Streptococcus Pneumoniae Challenge

O. Volrats1 , M. Pilmane2 , A. Petersons3
  • 1University Children's Hospital, Pediatrics Surgery, Riga, Latvia
  • 2Riga Stradins University, Institute of Anatomy and Anthropology, Riga, Latvia
  • 3University Children's Hospital, Department of Pediatric Surgery, Riga, Latvia
Further Information

Publication History

received November 11, 2009

accepted after revision December 01, 2009

Publication Date:
09 April 2010 (online)

Abstract

Introduction: Purpose of the study was the evaluation of the role of 1/3 of the spleen in host defense after a challenge with Streptococcus pneumoniae.

Materials and methods: Forty Wistar rats divided into four groups underwent splenectomy (SPR), partial splenectomy (PSR) or sham operation (SOR). Healthy rats were used as controls (CGR). Operations were performed under general anesthesia. Ten weeks after operation the rats were challenged with 6×107 cfu/ml Streptococcus pneumoniae administered intravenously. All surviving animals were sacrificed 12 days after intravenous injection Interleukin-10, tumor necrosis factor-α and human β-defensin-2 containing cells were detected in the parenchymatous organs (spleen, lungs, liver and kidneys) of all groups. Kaplan-Meier and Mann-Whitney tests were used for statistical analysis.

Results: Survival after Streptococcus pneumoniae challenge was longer in animals with a greater amount of splenic tissue, with mortality increased proportionately to the reduction in splenic tissue. In the SOR group survival was 11.6±1.3 days (10% mortality). In the PSR group survival was 6.0±2.5 days (90% mortality). In the SPR group survival was 1.6±0.8 days (100% mortality). In splenic tissue the levels of HβD-2, IL-10 and TNF-α-containing cells did not differ statistically (z=5.021; p<0.01) and were higher than in other parenchymatous organs (PSR, SOR, CGR). Levels of IL-10-containing cells were higher in parenchymatous organs of the SPR group (z=7.919; p<0.001), similar in the PSR and SOR groups (z=1.020; p=0.308) and lower in the CGR group (z=4.366; p<0.01). There were no statistically significant differences in the levels of IL-10 containing cells in the lungs of all group rats with spleen (z=4.266; p<0.01). Levels of TNF-α-containing cells were similar in PSR and SOR groups (z=1.004; p=0.315). Relative levels of HβD-2 in kidney differed between all groups (z=2.916; p=0.004).

Conclusions: All of the splenectomized animals (100%) and 90% of the partially splenectomized animals died. Partial splenectomy (with 1/3 of splenic tissues remaining) does not offer full protection against Streptococcus pneumoniae sepsis. In all groups, the amounts of HβD-2, IL-10 and TNF-α-containing cells in the spleen were higher than in other parenchymatous organs (lungs, liver and kidneys).

References

  • 1 Altman DG. Practical Statistics for Medical Research. London: Chapman & Hall; 1999: 611
  • 2 Anderson R, Alwmark A, Bengmark S. Influence of dextran on pneumococcal septicemia in splenic artery-ligated or splenectomized rats.  Res Exp Med. 1987;  187 423-427
  • 3 Braithwaite JL, Adams DJ. The venous drainage of the rat spleen.  J Anat. 1957;  91 352-357
  • 4 Chong TC, Thangavel RR, Tang X. Enhanced expression of murine β- defensins (MBD-1,-2,-3 and -4) in upper and lower airway mucosa of influenza virus infected mice.  J Virology. 2008;  DOI: doi:10.1016/j.virol.2008.07.024
  • 5 Hegarty PK, Tan B, O’Sullivan R. et al . Prevention of postsplenectomy sepsis: how much do patients know?.  Hematology J. 2000;  1 357-359
  • 6 Hsu SM, Raine L, Fanger H. The use of antiavidin antibody and avidin-biotin-peroxidase complex in immunoperoxidase technics.  Am J Clin Pathol. 1981;  75 816-821
  • 7 Kaufman S, Levasseur J. Effect of portal hypertension on splenic blood flow, intrasplenic extravasation and systemic blood pressure.  Am J Physiol Regul Integr Comp Physiol. 2003;  284 R1580-R1585
  • 8 Kaur K, Dhingra S, Slezak J. Biology of TNF-α and IL-10, and their imbalance in heart failure.  Heart Fail Rev. 2008;  doi 10.1007/s10741-008-9104-z
  • 9 Kimura F, Itoh H, Ambiru S. Long-term results of initial and repeated partial splenic embolization for the treatment of chronic idiopathic thrombocytopenic purpura.  AJR Am J Roentgenol. 2002;  179 1323-1326
  • 10 Lee HY, Andalibi A, Webster P. et al . Antimicrobial activity of innate immune molecules against Streptococcus pneumoniae, Moraxella catarrhalis and nontypeable Haemophilus influenzae.  BMC Infect Dis. 2004;  4 12
  • 11 Livingston CD, Barray A. et al . Penicillin and natural immunity protect against postsplenectomy sepsis.  J Surg Research. 1983;  34 332-336
  • 12 Mendez-Samperio P, Miranda E, Trejo A. Regulation of human β-defensin-2 by Mycobacterium bovis bacillus Calmette-Guerin (BCG): involvement of PFC, JNK and P13 in human lung epithelial cell line (A549).  J Peptides. 2008;  DOI: doi:10.1016/j.peptides.05.019
  • 13 Muftuogly T, Koksal N, Ozkultu D. Evalution of phagocytic function of macrophages in rats after partial splenectomy.  J Am Coll Surg. 2000;  191 668
  • 14 Nio M, Hayashi Y, Sano N. et al . Long-term efficacy of partial splenic embolization in children.  J Pediatr Surg. 2003;  38 1760-1762
  • 15 Offenbartl K, Christensen P, Gullstrand P. Treatment of pneumococcal postsplenectomy sepsis in the rat with human γ-globulin.  J Surg Research. 1986;  40 198-201
  • 16 Petersons A, Volrats O, Bernsteins A. The first experience with non-operative treatment of hypersplenism in children with portal hypertension.  Eur J Pediatr Surg. 2002;  12 289-360
  • 17 Pratl B, Benesch M, Lackner H. et al . Partial splenic embolization in children with hereditary spherocytosis.  Eur J Haematol. 2008;  80 76-80
  • 18 Riffenburgh RH. Statistics in Medicine. Amsterdam: Elsevier Academic Press; 2006: 322
  • 19 Scher KS, Wroczynski AF, Jones CW. Protection from postsplenectomy sepsis: Effect of prophylactic penicillin and pneumococcal vaccine on clearance of type 3 pneumococcus.  Surgery. 1982;  93 792-797
  • 20 Singh PK, Jia HP, Wiles K. et al . Production of β-defensins by human airway epithelia.  Proc Natl Acad Sci. 1998;  95 14961-14966
  • 21 Torres MB, Vega VL, Bedri M. IL-10 plasma levels are elevated after LPS injection in splenectomized A/J mice.  J Surg Res. 2005;  129 101-106
  • 22 van der Poll TA, Marchant A, Keogh CV. et al . Interleukin-10 impairs host defense in murine pneumococcal pneumonia.  J Infect Dis. 1996;  174 994
  • 23 van der Sluijs KF, Elden LJR, Nijhuis M. et al . IL-10 is an important mediator of the enhanced susceptibility to pneumococcal pneumonia after influenza infection.  J Immunol. 2004;  15 ((172)) 7603-7609
  • 24 Yuang D, Biragyn A, Kwak LW. et al . Mammalian defensins in immunity: more than just microbicidal.  Trends Immunol. 2002;  23 291-296
  • 25 Zhu K, Meng X, Li Z. et al . Partial splenic embolization using polyvinyl alcohol particles for hypersplenism in cirrhosis: a prospective randomized study.  Eur J Radiol. 2008;  66 100-106

Correspondence

Dr. Olaf Volrats

University Children's Hospital

Pediatrics Surgery

Vienibas gatve 45

LV-1004 Riga

Latvia

Phone: +371 29477212

Fax: +371 67064473

Email: olafsvolrats@hotmail.com

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