Significance of disturbed lymph flow for the pathogenesis of pancreatitis

Müller, M.; Putzke, H P; Siegmund, E; Dummler, W

doi:10.1016/s0232-1513(88)80132-4

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…In AHNP animals, when thoracic lymphatic duct was ligated, the morbidity of rat was decreased in one study [6]. In another study, however, the same procedure induced pancreatic edema and pancreatitis in rat [7]. From those, how lymph-flow interruption effects AHNP remains a question.…”

Section: Introductionmentioning

confidence: 99%

Blocking abdominal lymphatic flow attenuates acute hemorrhagic necrotizing pancreatitis -associated lung injury in rats

Wang

Su-mei

et al. 2013

Journal of Inflammation

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BackgroundAcute hemorrhagic necrotizing pancreatitis (AHNP) is a severe acute inflammatory of pancreas that can lead to extrapancreatic organ disfunction. The lung and intestine is the most common involved organs, and abdominal lymphatic flow may contribute to AHNP- associated organ injury. In this study, we investigated the impact of thoracic duct ligation and drainage on lung and intestine injury in rats with AHNP.MethodsThirty-two male Wistar rats were randomly divided into 4 groups: sham operation group, AHNP group, AHNP + ligation group and AHNP + drainage group. Rat AHNP model was induced by retrograde injection of 3.5% sodium deoxycholate into the biliopancreatic duct, and the sham operation group was injected only with saline. In AHNP + ligation group and AHNP + drainage group, thoracic duct was ligated or drainaged before model induction. At 6 h after model induction, the bronchoalveolar lavage fluid (BALF) were collected for determination of tumor necrosis factor-alpha (TNF-alpha), and the tissues of lung, intestine and pancrease were harvested individually for pathohistological evaluation and the myeloperoxidase (MPO) activity determination. In addition, the activity of serum amylase and diamine oxidase (DAO) was determined in each group.ResultsThe pathohistological damage and MPO of lung, intestine and pancrease, TNF-alpha of BALF, serum amylase and DAO were all increased in AHNP group compared to those in sham operation group (P < 0.05). In AHNP + ligation group, the pathohistological damage and MPO of lung and TNF-alpha of BALF were reduced, but the pathohistological damage and MPO of intestine and pancrease were increased compared with AHNP group (P < 0.05), however the activity of serum amylase and DAO was no changed. In AHNP + drainage group, the pathohistological damage and MPO of lung, intestine and pancrease, TNF-alpha of BALF, serum amylase and DAO were all reduced compared to those in AHNP group (P < 0.05).ConclusionsOur finding suggest that thoracic duct ligation can reduce neutrophil infiltration and TNF-alpha release and then attenuates lung injury in rats with AHNP, but aggravates the injury of intestine and pancrease. While thoracic duct drainage attenuates the injury of lung, intestine and pancreaseat the same time in rats with AHNP.

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Section: Introductionmentioning

confidence: 99%

Blocking abdominal lymphatic flow attenuates acute hemorrhagic necrotizing pancreatitis -associated lung injury in rats

Wang

Su-mei

et al. 2013

Journal of Inflammation

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“…Ligation of the thoracic duct in rats induces edema and the accumulation of inflammatory cells in the exocrine parenchyma (18), demonstrating the importance of the lymphatic system in maintaining physiological levels of EIF volume and pressure in the exocrine pancreas. Notably, no comment was made concerning a similar edema in the islets (18). Disturbances in a tentative glymphatic transport system within the islets would have implications for the development of both T1D and T2D.…”

Section: Discussionmentioning

confidence: 99%

“…The extracellular volume in human islets has been estimated to be ;14% of the total islet volume (17). Ligation of the thoracic duct in rats induces edema and the accumulation of inflammatory cells in the exocrine parenchyma (18), demonstrating the importance of the lymphatic system in maintaining physiological levels of EIF volume and pressure in the exocrine pancreas. Notably, no comment was made concerning a similar edema in the islets (18).…”

Section: Discussionmentioning

confidence: 99%

An Apparent Deficiency of Lymphatic Capillaries in the Islets of Langerhans in the Human Pancreas

Korsgren

2016

Diabetes

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The lymphatic system is crucial for efficient immune surveillance and for the maintenance of a physiological pressure in the interstitial space. Even so, almost no information is available concerning the lymph drainage of the islets of Langerhans in the human pancreas. Immunohistochemical staining allowed us to distinguish lymphatic capillaries from blood capillaries. Almost no lymphatic capillaries were found within the islets in pancreatic biopsy specimens from subjects without diabetes or from subjects with type 1 or type 2 diabetes. Lymphatic capillaries were, however, found at the islet-exocrine interface, frequently located along blood capillaries and other fibrotic structures within or close to the islet capsule. Lymphatic capillaries were regularly found in the exocrine pancreas, with small lymphatic vessels located close to and around acini. Larger collecting lymphatic vessels were located in fibrotic septa between the exocrine lobules and adjacent to the ductal system of the pancreas. In summary, we report a pronounced deficiency of lymphatic capillaries in human islets, a finding with implications for immune surveillance and the regulation of interstitial fluid transport in the endocrine pancreas as well as for the pathophysiology of both type 1 and type 2 diabetes.

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“…However, the role of mesenteric lymph drainage in acute illness such as pancreatitis, burns and hemorrhagic shock is well established in experimental models [11]. The impact of thoracic duct ligation on the pancreas is known since 1958 by Papp et al and was more investigated by Müller et al in 1988 with thoracic duct ligation in rats [4, 12]. Their results demonstrated a long-lasting pancreatic edema.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there have been no abdominal complications reported or associated with ligation of the thoracic duct. In experimental models, some studies demonstrated that the sudden stop of lymphatic flow may induce intestinal and pancreatic edema with the presence of an inflammatory infiltrate [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

Acute pancreatitis after thoracic duct ligation for iatrogenic chylothorax. A case report

et al. 2017

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BackgroundTo report the association between thoracic duct ligation and acute pancreatitis. The association between sudden stop of lymphatic flow and pancreatitis has been established in experimental models.Case presentation A 57-year-old woman operated for thymoma presented a iatrogenic chylothorax. After thoracic duct ligation, she presented an acute pancreatitis which resolved after conservative treatment. The chylothorax disappeared within 4 days of thoracic duct ligation.ConclusionsThis is the first report of acute pancreatitis following thoracic duct ligation. The pancreas and digestive tract should be assessed in symptomatic patients after thoracic duct ligation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12893-017-0204-3) contains supplementary material, which is available to authorized users.

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Significance of disturbed lymph flow for the pathogenesis of pancreatitis

Cited by 6 publications

References 6 publications

Blocking abdominal lymphatic flow attenuates acute hemorrhagic necrotizing pancreatitis -associated lung injury in rats

Blocking abdominal lymphatic flow attenuates acute hemorrhagic necrotizing pancreatitis -associated lung injury in rats

An Apparent Deficiency of Lymphatic Capillaries in the Islets of Langerhans in the Human Pancreas

Acute pancreatitis after thoracic duct ligation for iatrogenic chylothorax. A case report

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