Effect of surgery and endotoxin on metastatic tumor growth and regulation of VEGF expression and angiogenesis by endotoxin

TL;DRAbstract

The surgical removal of primary tumours has been associated with the subsequent growth of previously dormant metastases. This accelerated growth has previously been ascribed to the removal of the primary tumour and the anti-angiogenic factors they produce, such as angiostatin and endostatin. Endotoxin or lipopolysaccharide (LPS) is a cell wall constituent of gram negative bacteria, ubiquitously present in air and endogenous gut bacteria, that may be introduced during surgery. LPS has been shown to be angiogenic and vascular endothelial growth factor (VEGF) is the most potent angiogenic cytokine identified to date. The role of endotoxin in surgically induced metastatic tumour growth, the therapeutic use of anti-endotoxin agents in the perioperative period, the regulation of VEGF expression by endotoxin and the effect of VEGF and endotoxin on tumour cell survival was examined.\n\nA murine model of experimental metastasis was established where no primary tumour was present. This allowed t

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