Differential alterations in intestinal permeability after trauma-hemorrhage.
BACKGROUND
Recent studies have shown that the intestinal barrier function is altered and macromolecules can translocate after trauma and hemorrhagic shock. The translocated molecules are absorbed from the lymphatic tissue or directly enter the circulation in the gut. However, it remains unknown to what degree these compartments contribute to the clearance of the macromolecules.


METHODS
Male Sprague-Dawley rats (350-400 g) underwent a 5-cm midline laparotomy (i.e., soft tissue injury), were bled to a mean arterial pressure of 35 mmHg and maintained for approximately 90 min, and then resuscitated with Ringer's lactate (4x the shed blood volume) over 60 min. At 2 h after resuscitation, a solution containing 51Cr-EDTA, FITC-dextran-4 kDa, and rhodamine B-dextran-40 kDa was instilled into a jejunal blind loop and their concentrations were determined in mesenteric lymph and blood samples harvested between 2 h and 4 h after resuscitation.


RESULTS
Trauma-hemorrhage and crystalloid resuscitation significantly increased mesenteric lymph flow and the mucosal permeability for the three marker molecules. There was no difference in the concentrations of 51Cr-EDTA between the blood and lymph compartment after trauma-hemorrhage. However, the high molecular weight marker (rhodamine-B-dextran-40 kDa) accumulated in significantly higher concentrations in the mesenteric lymph than in the plasma under such conditions.


CONCLUSIONS
The accumulation of macromolecules in the mesenteric lymph suggests that this compartment plays an important role in the altered gut barrier function after trauma-hemorrhage.
Kuebler
Joachim F
JF
Center for Surgical Research and Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
Toth
Balazs
B
Rue
Loring W
LW
Bland
Kirby I
KI
Chaudry
Irshad H
IH
D000818:Animals; D002614:Chelating Agents / Q000493:pharmacokinetics; D003911:Dextrans / Q000493:pharmacokinetics; D004492:Edetic Acid / Q000378:metabolism / Q000493:pharmacokinetics; D007413:Intestinal Mucosa / Q000378:metabolism*; D007422:Intestines / Q000187:drug effects; D008208:Lymphatic System / Q000502:physiology*; D008297:Male; D010539:Permeability; D051381:Rats; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology*; D014947:Wounds and Injuries / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology*
D002614:Chelating Agents; D003911:Dextrans; D004492:Edetic Acid