Document Detail


Gut lymph and lymphatics: a source of factors leading to organ injury and dysfunction.
MedLine Citation:
PMID:  20961300     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Major trauma, shock, sepsis, and other conditions can lead to the acute respiratory distress syndrome (ARDS), which may progress to the highly lethal multiple organ dysfunction syndrome (MODS). Although a number of therapeutic strategies have been initiated, their success has been limited largely due to an incomplete understanding of the biology of MODS. However, recent studies indicate that the intestinal lymphatics serve as the primary route for nonbacterial, tissue injurious gut-derived factors, which can induce acute ARDS and MODS. The gut lymph hypothesis of ARDS and MODS thus helps clarify several important issues. First, because the lung is the first organ exposed to mesenteric lymph and not the liver (i.e., mesenteric lymph enters the subclavian vein via the thoracic duct, which, in turn, empties directly into the heart and lungs), it would explain the clinical observation that the lung is generally the first organ to fail. Second, this hypothesis provides new pathophysiologic information, thereby providing a basis for novel therapies. Finally, by studying the composition of lymph, MODS-inducing factors can be isolated and identified.
Authors:
Edwin A Deitch
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1207 Suppl 1     ISSN:  1749-6632     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-21     Completed Date:  2010-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E103-11     Citation Subset:  IM    
Copyright Information:
© 2010 New York Academy of Sciences.
Affiliation:
Department of Surgery, University of Medicine and Dentistry New Jersey, Newark, New Jersey, USA. edeitch@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Humans
Intestines / physiopathology*
Lymphatic Vessels / physiopathology*
Grant Support
ID/Acronym/Agency:
GM 59841/GM/NIGMS NIH HHS; P50 GM 06979/GM/NIGMS NIH HHS

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