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Differential alterations in intestinal permeability after trauma-hemorrhage
Joachim F Kuebler1, Balazs Toth, Loring W Rue
1Center for Surgical Research and Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
The Journal of Surgical Research
|July 31, 2003
Summary
Following trauma and hemorrhagic shock, mesenteric lymph plays a key role in clearing large molecules that leak through the gut barrier. This highlights the lymphatic system's importance in post-injury recovery.
Area of Science:
- Physiology
- Gastroenterology
- Trauma Research
Background:
- Trauma and hemorrhagic shock disrupt intestinal barrier function, allowing macromolecule translocation.
- Translocated molecules enter circulation via gut lymphatic tissue or directly.
- The relative contribution of these pathways to macromolecule clearance remains unclear.
Purpose of the Study:
- To investigate the role of mesenteric lymph in macromolecule clearance after trauma and hemorrhagic shock.
- To quantify the translocation of different sized molecules across the injured gut barrier.
Main Methods:
- Male Sprague-Dawley rats underwent laparotomy, hemorrhagic shock, and resuscitation.
- A jejunal blind loop was instilled with 51Cr-EDTA, FITC-dextran-4 kDa, and rhodamine B-dextran-40 kDa.
- Concentrations of marker molecules were measured in mesenteric lymph and blood post-resuscitation.
Main Results:
- Trauma-hemorrhage and resuscitation increased mesenteric lymph flow and mucosal permeability.
- No significant difference in 51Cr-EDTA concentrations between lymph and plasma.
- Higher concentrations of the high molecular weight marker (rhodamine B-dextran-40 kDa) were found in mesenteric lymph compared to plasma.
Conclusions:
- Macromolecule accumulation in mesenteric lymph indicates its significant role in altered gut barrier function post-trauma-hemorrhage.
- The lymphatic system is a crucial compartment for handling translocated molecules after severe injury.