PREOPERATIVE ADMINISTRATION OF ANTIBODIES AGAINST TUMOR-NECROSIS-FACTOR-ALPHA (TNF-ALPHA) AND INTERLEUKIN-1 (IL-1) AND THEIR IMPACT ON PERITONEAL ADHESION FORMATION

This study investigates the effects of preoperative intravenous admini stration of antibodies against TNF-alpha and IL-1 on peritoneal adhesi on formation. Fifty-six Sprague-Dawley rats (350-400 gm) were used in this study. Eight rats were used to empirically determine the amount o f anti TNF-alpha and anti IL-1 needed for complete in vivo neutralizat ion. This amount was used for preoperative treatment of selected group s. Forty-eight rats were divided into four equal groups (n = 12). All rats underwent a midline laparotomy. Ten cm square of cecal serosa was abraded, the peritoneal cavity was irrigated with normal saline, and the incision was closed in layers. Cultures were obtained intraoperati vely and rats with positive cultures were excluded. Rats in Group 1 we re not treated (control), while rats in Groups 2, 3, and 4 were treate d with anti TNF-alpha; anti IL-1, and a combination of anti TNF-alpha and IL-1 respectively. All rats were killed at 3 weeks, and peritoneal adhesions were graded using a scale of 0 (none) to 3 (extensive, dens e). Rats treated with anti IL-1 (Group 3) and those treated with a com bination of anti TNF-alpha and anti IL-1 (Group 4) had significantly f ewer adhesions when compared with Group 1 (control) (P <0.01 and <0.00 5, respectively). Least adhesion formation was associated with Group 4 rats. In conclusion, selective immunosuppression, at a molecular leve l, appears to have a significant impact on rates of postoperative peri toneal adhesion formation.