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Inhibition of macrophage function prevents intestinal inflammation and postoperative ileus in rodents
  1. Sven Wehner1,
  2. Florian F Behrendt1,
  3. Boris N Lyutenski1,
  4. Mariola Lysson1,
  5. Anthony J Bauer2,
  6. Andreas Hirner1,
  7. Jörg C Kalff1
  1. 1Department of Surgery, University of Bonn, Bonn, Germany
  2. 2Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to:
    Dr J C Kalff
    Department of Surgery, Rheinische Friedrich-Wilhelms-University Bonn, Sigmund Freud Strasse 25, Bonn 53105, Germany;kalff{at}


Background: Abdominal surgery results in a molecular and cellular inflammatory response in the intestine, leading to postoperative ileus. It was hypothesised that resident macrophages within the intestinal muscularis have an important role in this local inflammation.

Aims: To investigate whether chemical or genetic depletion of resident muscularis macrophages would lead to a reduction in the local inflammation and smooth-muscle dysfunction.

Methods: Two rodent models were used to deplete and inactivate macrophages: (1) a rat model in which resident macrophages were depleted by chlodronate liposomes; (2) a model of mice with osteopetrosis mice, completely lacking the resident muscularis macrophages, used as an additional genetic approach. Animals with normal or altered intestinal macrophages underwent surgical intestinal manipulation. The inflammatory response was investigated by quantitative reverse transcriptase-polymerase chain reaction for mRNA of MIP-1α, interleukin (IL)1β, IL6, intracellular adhesion molecule 1 (ICAM-1) and monocyte chemotractant protein 1 (MCP)-1 in the isolated small bowel muscularis. In addition, muscularis whole mounts were used for histochemical and immunohistochemical analysis to quantify leucocyte infiltration and detect cytokine expression. Subsequently, in vitro muscle contractility and in vivo gastrointestinal transit were measured.

Results: Both models resulted in markedly decreased expression of MIP-1α, IL1β, IL6, ICAM-1 and MCP-1 after manipulation compared with controls. In addition to this decrease in inflammatory mediators, recruitment of leucocytes into the muscularis was also diminished. Macrophage-altered animals had near normal in vitro jejunal circular muscle function and gastrointestinal transit despite surgical manipulation.

Conclusions: Resident intestinal muscularis macrophages are initially involved in inflammatory responses resulting in postoperative ileus. Depletion and inactivation of the muscularis macrophage network prevents postoperative ileus.

  • Cl2MDP, liposome-encapsulated dichloromethylene diphosphonate (clodronate)
  • GdCl3, gadolinium chloride
  • ICAM, intracellular adhesion molecule
  • KRB, Krebs–Ringer buffer
  • MCP, monocyte chemotractant protein 1
  • MPO, myeloperoxidase
  • PBS, phosphate-buffered saline
  • OP, osteopetrosis
  • PCR, polymerase chain reaction
  • PMN, polymorphonuclear neutrophils

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  • Published Online First 26 June 2006

  • Funding: This work was supported, partly, by a grant from the German Research Council (DFG) to the Clinical Research Group (KFO 115), and through BONFOR grants O-112.0018 and O-112.0025.

  • Competing interests: None.

  • Clodronate was a generous gift of Roche Diagnostics GmbH, Mannheim, Germany.

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