A study of the biologic activity of trauma-hemorrhagic shock mesenteric lymph over time and the relative role of cytokines.

Abstract

Gut-derived factors in intestinal lymph have been recently shown to cause lung injury, activate neutrophils, and injure endothelial cells in rats subjected to hemorrhagic shock (T/HS). However, the time course of the appearance and disappearance of these factors in intestinal lymph is unclear. Thus the goal of this study was to characterize the biologic activity of T/HS lymph collected at various times during and after shock. Male rats subjected to trauma (laparotomy) plus hemorrhagic shock (mean arterial pressure, 90 mm Hg x 90 min) (T/HS) or trauma plus sham shock (T/SS) had their mesenteric lymph duct catheterized. Mesenteric lymph collected before shock, during shock, and hourly for 6 hours after shock was assayed for cytokine levels (tumor necrosis factor, granulocyte-macrophage colony-stimulating factor, interleukin-1, and transforming growth factor-beta) as well as biologic activity on endothelial cells (cytotoxicity and permeability) and neutrophils (CD11b adhesion molecule expression and respiratory burst activity). T/HS, but not T/SS, lymph injured endothelial cells and activated neutrophils, although the cytokine levels did not differ between the T/HS and T/SS lymph samples. The biologic activity of T/HS lymph appeared during the shock (gut ischemic) period. The temporal pattern of activity varied on the basis of the biologic activity being tested, with the neutrophil-activating properties of the T/HS lymph persisting longest. These results suggest that gut ischemia itself is sufficient to induce the production of biologically active T/HS lymph and that the temporal pattern of biologic activity varies over time on the basis of the property being tested. Consequently, studies directed at identifying the active factors in T/HS lymph must take these temporal patterns of activity into account.