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Lymphatic Pump Technique Enhances Pulmonary Immunity and Facilitates the Clearance of Respiratory Infection With Streptococcus pneumoniae

Journal: The Journal of the American Osteopathic Association Date: 2012/08, 112(8):Pages: 533. doi: Subito , type of study: animal experiment

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2012.112.8.529/html)

Keywords:

animal experiment [60]
LPT [24]
lymphatic pump technique [41]
pneumonia [39]
streptococcus pneumoniae [3]

Abstract:

Background: Lymphatic pump technique (LPT) is thought to aid in the removal of built-up metabolic wastes, toxins, exudates, and cellular debris that occur during infection or edema. Furthermore, LPT has been reported to enhance immune function. Streptococcus pneumoniae is known to be a common cause of otitis media, meningitis, and respiratory infections. In addition, it is a major cause of pneumonia in older adults and infants. Clinical trials have shown LPT effective at decreasing hospital length of stay, decreasing the length of intravenous antibiotics, and lowering incidence of death when compared to only conventional care when treating patients with pneumonia. Few studies have explored the underlying mechanisms that exhibit the protective mechanism previously shown in clinical trials. Objective: To determine if LPT would enhance the clearance of S pneumoniae respiratory infection in a rat model, and explore the mechanisms associated with such clearance. Methods: Rats were nasally infected with ~1×108S pneumoniae CFUs. Rats were divided into control, sham, or LPT treatment groups. Rats then received (1) a daily sham treatment consisting of intravenous administration of 10 mg/kg propofol anesthesia followed by 4 minutes of light touch, (2) 4 minutes of LPT daily under anesthesia, or (3) no treatment or anesthesia (control). At different time points, lungs were collected and measured for S pneumoniae bacteria and the number of pulmonary leukocytes. In addition, blood and spleens were collected to measure the extrapulmonary immune response. Further, bronchoalveolar lavage fluid was collected at different time points and analyzed for inflammatory mediators. In vitro studies using isolated alveolar macrophages and in vivo depletion studies on alveolar macrophages were also performed. Results: Animals treated with LPT showed a statistically significant (P<.05) decrease in total CFUs/lung postinfection. In vitro studies showed an increase in macrophage nitric oxide production in animals treated with LPT, suggesting a pulmonary macrophage polarization effect towards the M1 phenotype. Analysis of bronchoalveolar lavage fluid showed a difference in the concentrations of pulmonary associated protein D and IL-6. Furthermore, preliminary results show that depleting alveolar macrophages will result in the loss of protective function, suggesting macrophages as major players in LPT-induced protection. Conclusion: We have shown that LPT enhances the clearance of pneumococcal bacteria in the lungs and have shown results, which suggest a mechanism for such a clearance. Our initial findings support the clinical use of LPT to treat patients with pneumonia.


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