title: Mesenteric lymph duct ligation prevents shock-induced RBC deformability and shape changes.
abstract: OBJECTIVE
  The exact mechanisms that lead to RBC deformability and shape changes after trauma/hemorrhagic shock remain unknown. We hypothesize that RBC injury is caused in part by gut injury and is mediated by gut-derived factors carried in the intestinal lymph.
  
  
  METHODS
  RBC deformability was measured by a laser-assisted ektacytometer before and after trauma/hemorrhagic shock (T/HS) in 6 rats whose mesenteric lymph duct had been ligated and in 10 rats subjected to T/HS without duct ligation. In this assay a decrease in the elongation index is a marker of decreased RBC deformability. RBC shape was examined by scanning electron microscopy.
  
  
  RESULTS
  In the T/HS rats, the RBC elongation index decreased after T/HS from a preshock value of 0.064 +/- 0.011 to 0.052 +/- 0.009 (P < 0.01) and remained low (0.049 +/- 0.010) even at 3 h after resuscitation. In contrast, the elongation index did not decrease after T/HS in the lymph duct-ligated rats (0.062 +/- 0.004 vs. 0.056 +/- 0.005, P = NS). Likewise, the T/HS rats, but not the duct-ligated T/HS rats, had a significant increase in the percentage of abnormally shaped RBCs when studied by electron microscopy.
  
  
  CONCLUSIONS
  Interruption of lymph flow from the gut into the bloodstream by lymph duct ligation prevents T/HS-induced RBC damage. Because decreased RBC deformability contributes to impaired perfusion of the microcirculation, preservation of RBC deformability may decrease the incidence of T/HS-induced organ dysfunction.
authors.affiliation: Department of Surgery, VA New Jersey Healthcare System, East Orange, New Jersey, USA.
authors.forename: Sergey B
authors.initials: SB
authors.lastname: Zaets
authors.forename: Tamara L
authors.initials: TL
authors.lastname: Berezina
authors.forename: J
authors.initials: J
authors.lastname: Caruso
authors.forename: Da Zhong
authors.initials: DZ
authors.lastname: Xu
authors.forename: Edwin A
authors.initials: EA
authors.lastname: Deitch
authors.forename: George W
authors.initials: GW
authors.lastname: Machiedo
mesh_terms: D000818:Animals; D048429:Cell Size; D004907:Erythrocyte Deformability; D004912:Erythrocytes / Q000473:pathology*; D008026:Ligation; D008208:Lymphatic System / Q000601:surgery*; D008297:Male; D008643:Mesentery; D008855:Microscopy, Electron, Scanning; D051381:Rats; D017207:Rats, Sprague-Dawley; D012771:Shock, Hemorrhagic / Q000097:blood*; D014947:Wounds and Injuries