Postoperative ileus—Immune mechanisms and potential therapeutic interventions
Zheng Wang, Nathalie Stakenborg, Guy E. Boeckxstaens
Abstract
BACKGROUND: Postoperative ileus (POI) is a condition marked by a temporary suppression of gastrointestinal motility following abdominal surgery. The mechanism of POI encompasses various factors and is characterized by two phases: the early neurogenic phase involving both adrenergic and non-adrenergic neural pathways; the later immune-mediated phase is characterized by a sterile inflammatory response that lasts several days. Activation of muscularis macrophages triggers a sterile inflammatory process that results in dysfunction of the enteric nervous system (ENS) and a reversible inhibition of gastrointestinal motility. PURPOSE: In this minireview, recent insights in the pathophysiological mechanisms underlying POI and potential new therapeutic strategies are described.