The impact of adipose fat tissue on pathogenesis of crypto-glandular anal fistula

Background: Cryptoglandular perianal fistula represents a prevalent benign anorectal condition, primarily addressed through surgical interventions, occasionally posing considerable therapeutic challenges. The associated decline in patient quality of life underscores the significance of effective management. However, the lack of a fully understood pathogenesis complicates the treatment approach. Recent research has proposed the involvement of adipose fat tissue in the inflammatory response and pathogenesis of cryptoglandular anal fistula.Methods: This study involved the characterization of serum levels of inflammatory cytokines and adipose tissue hormones. A total of 35 samples from both simple and complex cryptoglandular perianal fistula cases were collected during surgical procedures.Results: Serum levels of leptin, resistin, IL-1 and IL-8were significantly elevated in patients operated due to complex cryptoglandular perianal fistula when compared to patients with simple fistula. Adiponectin was significantly lowered in samples from complex perianal fistula in comparison to simple fistula. Conclusions: Complex perianal cryptoglandular fistula have a reduced level of antiinflammatory adipokines adiponectin and increase the level of proinflammatory resistin, leptin, IL-1 and IL-8.