Lymphatic Pump Treatment Augments Lymphatic Flux of Lymphocytes in Rats

Abstract

Background: Lymphatic pump techniques (LPT) are used by osteopathic practitioners for the treatment of edema and infection; however, the mechanisms by which LPT enhances the lymphatic and immune systems are poorly understood. Methods and Results: To measure the effect of LPT on the rat, the cisterna chyli (CC) of 10 rats were cannulated and lymph was collected during 4 min of 1) pre-LPT baseline, 2) 4 min LPT, and 3) 10 min post-LPT recovery. LPT increased significantly (p < 0.05) lymph flow from a baseline of 24 AE 5 ml/min to 89 AE 30 ml/min. The baseline CC lymphocyte flux was 0.65 AE 0.21Â10 6 lymphocytes/min, and LPT increased CC lymphocyte flux to 6.10 AE 0.99Â10 6 lymphocytes/min (p < 0.01). LPT had no preferential effect on any lymphocyte population, since total lymphocytes, CD4+ T cells, CD8+ T cells, and B cell numbers were similarly increased. To determine if LPT mobilized gut-associated lymphocytes into the CC lymph, gut-associated lymphocytes in the CC lymph were identified by staining CC lymphocytes for the gut homing receptor integrin a4b7. LPT significantly increased (p < 0.01) the flux of a4b7 positive CC lymphocytes from a baseline of 0.70 AE 0.03Â10 5 lymphocytes/min to 6.50 AE 0.10Â10 5 lymphocytes/min during LPT. Finally, lymphocyte flux during recovery was similar to baseline, indicating the effects of LPT are transient. Conclusions: Collectively, these results suggest that LPT may enhance immune surveillance by increasing the numbers of lymphocytes released in to lymphatic circulation, especially from the gut associated lymphoid tissue. The rat provides a useful model to further investigate the effect of LPT on the lymphatic and immune systems.

Lymphatic Pump Treatment Repeatedly Enhances the Lymphatic and Immune Systems

“…5,12 Previously, we demonstrated that a single application of LPT increased lymph flow and leukocyte flux in both rats and dogs, and mobilized inflammatory mediators into lymph circulation. [13][14][15][16][17][18][19] These findings support the use of LPT to treat edema and to enhance immune function. Importantly, the effects of LPT on the lymphatic system were transient, suggesting this LPT-sensitive lymph reservoir is limited.…”

“…17 In addition, LPT increased lymph flow and the mobilization of gastrointestinal lymphoid tissue derived leukocyte counts of both dogs and rats. 15,17 The aim of the present study was to gain new information on replenishment of LPT-sensitive lymph reservoirs by repeating LPT after a 2 h resting interval. We found both LPT 1 and LPT 2 produced similar increases in TDL flow, TDL leukocyte concentration, and the lymphatic flux of leukocytes and immune mediators.…”

“…Importantly, the effects of LPT on the lymphatic system were transient, suggesting this LPT-sensitive lymph reservoir is limited. [13][14][15][16][17][18][19] The purpose of this study was to determine if a second application of LPT could also enhance lymph flow, the number of leukocytes, and the concentration of inflammatory mediators in thoracic duct lymph. Our results demonstrate that LPT can be repeatedly applied to enhance lymph flow, leukocyte numbers, and the flux of inflammatory mediators.…”

Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia

“…Lymphatic pump techniques have been shown to increase cytokines and chemokines in thoracic and intestinal lymph vessels 35 , while mechanical pressure to certain body regions distant from the location of lymph formation enhances flow into lymphatic systems 36 . In addition, it has been shown that lymphatic OMT augments leukocyte mobilization and flow in dogs and rats, primarily from gut-associated lymphoid tissue 37,38,39,40,41 .…”

Accruing Evidence for a Beneficial Role of Pneumatic Biocompression in Lymphedema

“…3 Two articles in the current issue of Lymphatic Research and Biology strive to address this need. Working in a rat model, Huff and colleagues 8 have attempted to objectively investigate the mechanisms whereby lymphatic pump techniques purportedly enhance lymphatic and immune function. The implications of their observations are that the pneumatic technique may enhance immune surveillance by increasing the numbers of lymphocytes released into the lymphatic circulation, in particular from the gut-associated lymphoid tissue.…”