Satyanarayan T Shanbhag1, Bernard Choong2, Maxim Petrov3, Brett Delahunt4, John A Windsor5, Anthony R J Phillips1. 1. Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand. 2. Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand. 3. Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 4. Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. 5. Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand. Electronic address: j.windsor@auckland.ac.nz.
Abstract
BACKGROUND: Critical illness including severe acute pancreatitis is associated with the multiple organ dysfunction syndrome. The "gut-lymph" hypothesis states that multiple organ dysfunction syndrome is due to release of toxic factors from the intestine into the mesenteric lymph. The aims of this study were to determine the effect of normotensive acute pancreatitis conditioned mesenteric lymph on cardiac function and whether external drainage of mesenteric lymph would protect the heart. METHODS: Groups of normal rats and those with normotensive taurocholate induced acute pancreatitis, had either no lymphatic intervention or thoracic duct ligation and external drainage of mesenteric lymph. After 6 hours, the hearts were removed for ex vivo functional measurements, including cardiac output, ventricular contractility (+dP/dt), and relaxation (-dP/dt). In a second experiment, mesenteric lymph from normal rats and those with established acute pancreatitis was infused into ex vivo perfused normal working rat hearts to assess impact on cardiac function. Heart and lung tissues were collected for assessment of edema. RESULTS: Significant cardiac dysfunction, denoted by decreased cardiac output (21%), contractility (37%), relaxability (23%), and increased cardiac tissue edema (2-fold), developed in rats with established acute pancreatitis and no lymphatic intervention compared with the control group (all P < .05). Strikingly this cardiac dysfunction and edema was normalized in acute pancreatitis rats that had undergone prior thoracic duct ligation and external drainage of mesenteric lymph. In the second experiment, infusion of acute pancreatitis conditioned mesenteric lymph resulted in an immediate and significant similar magnitude decrease in of cardiac output (17%), contractility (22%), and relaxation (27%) compared with the infusion of normal lymph (all P <.05). CONCLUSION: Mesenteric lymph from normotensive acute pancreatitis animals caused significant cardiac dysfunction which could be prevented by thoracic duct ligation and external drainage of mesenteric lymph.
BACKGROUND:Critical illness including severe acute pancreatitis is associated with the multiple organ dysfunction syndrome. The "gut-lymph" hypothesis states that multiple organ dysfunction syndrome is due to release of toxic factors from the intestine into the mesenteric lymph. The aims of this study were to determine the effect of normotensive acute pancreatitis conditioned mesenteric lymph on cardiac function and whether external drainage of mesenteric lymph would protect the heart. METHODS: Groups of normal rats and those with normotensive taurocholate induced acute pancreatitis, had either no lymphatic intervention or thoracic duct ligation and external drainage of mesenteric lymph. After 6 hours, the hearts were removed for ex vivo functional measurements, including cardiac output, ventricular contractility (+dP/dt), and relaxation (-dP/dt). In a second experiment, mesenteric lymph from normal rats and those with established acute pancreatitis was infused into ex vivo perfused normal working rat hearts to assess impact on cardiac function. Heart and lung tissues were collected for assessment of edema. RESULTS: Significant cardiac dysfunction, denoted by decreased cardiac output (21%), contractility (37%), relaxability (23%), and increased cardiac tissue edema (2-fold), developed in rats with established acute pancreatitis and no lymphatic intervention compared with the control group (all P < .05). Strikingly this cardiac dysfunction and edema was normalized in acute pancreatitisrats that had undergone prior thoracic duct ligation and external drainage of mesenteric lymph. In the second experiment, infusion of acute pancreatitis conditioned mesenteric lymph resulted in an immediate and significant similar magnitude decrease in of cardiac output (17%), contractility (22%), and relaxation (27%) compared with the infusion of normal lymph (all P <.05). CONCLUSION: Mesenteric lymph from normotensive acute pancreatitis animals caused significant cardiac dysfunction which could be prevented by thoracic duct ligation and external drainage of mesenteric lymph.
Authors: Lomani Archibald O'Hagan; John Albert Windsor; Anthony Ronald John Phillips; Maxim Itkin; Peter Spencer Russell; Seyed Ali Mirjalili Journal: J Anat Date: 2020-02-27 Impact factor: 2.921
Authors: Ziqi Lin; Chenlong Zhang; Xiaoxin Zhang; Na Shi; Yongjian Wen; Chengxia Han; Dan Du; Tingting Liu; Tao Jin; Lihui Deng; Kun Jiang; Xiaonan Yang; Jia Guo; Anthony Philips; Robert Sutton; John A Windsor; Wei Huang; Ping Xue; Qing Xia Journal: Evid Based Complement Alternat Med Date: 2020-02-10 Impact factor: 2.629