Research ArticleWound Healing

Collagen degradation and MMP9 activation by Enterococcus faecalis contribute to intestinal anastomotic leak

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Science Translational Medicine  06 May 2015:
Vol. 7, Issue 286, pp. 286ra68
DOI: 10.1126/scitranslmed.3010658

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Can our gut microbes prevent wound healing?

In a new study, Shogan et al. examined whether the bacterium Enterococcus faecalis, normally present in the intestine, contributes to anastomotic leak, the most feared complication after intestinal surgery. They demonstrated that intestinal E. faecalis can produce a tissue-destroying enzyme that affects the normal healing process by breaking down collagen, a protein that is critical to fully seal the intestine after its removal and reconnection. E. faecalis also activates a host gut enzyme, MMP9, further contributing to anastomotic leak. Finally, the authors demonstrated that the most common antibiotic used in intestinal surgery does not eliminate E. faecalis and thus does not prevent anastomotic leak.