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Lymphatic Pump Technique Enhances Immunity in a DSS Colitis Model

Journal: Journal of Osteopathic Medicine Date: 2018/11, 118(11):Pages: e142-e143. doi: Subito , type of study: animal experiment

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2018.163/html)

Keywords:

animal experiment [36]
IBD [3]
immune response [6]
inflammatory bowel disease [7]
LPT [3]
lymphatic pump technique [21]

Abstract:

Research Question: Inflammatory bowel disease (IBD), comprised of ulcerative colitis and Crohn disease, is known to have a multifactorial process involving the immune, lymphatic, and gastrointestinal systems. It is comprised of both genetic and environmental causes; however, the exact pathophysiology of IBD is unknown. In the gut, the lymphatics have shown to control tissue edema, leukocyte trafficking, and chemokine clearance. Therefore, lymph stasis is thought to be a major contributing factor to the disruption of the normal immune and wound healing response to the tissue damage seen in IBD. If the lymph flow can be restored, then lymphatic remodeling and the body's natural self-healing mechanisms can overcome the innate immune response. We hypothesize that osteopathic manipulative treatment (OMT), specifically lymphatic pumping techniques (LPT), can be used to increase immune cell mobilization, antigen, and cytokine clearance, while also promoting proper wound healing in an IBD mice model. Methods: In this study, we used C57BL6 mice treated with a 3% solution of dextran sulfate sodium (DSS). This method is a well-established model showing similar clinical features to IBD, with minimal risk of mortality. The mice were divided into 4 groups: control with normal water, control with 3% DSS, anesthesia with 3% DSS, and anesthesia with LPT and 3% DSS. All groups received the respective fluid intake for 4 days, with euthanasia and colon collection following on the fifth day. For the groups requiring treatment, the anesthesia and LPT were performed 24 hours after the initial start time, once daily for the first 4 days. The LPT group received daily treatment by contacting the abdomen and pumping at a rate of 1/sec for 4 minutes. Following euthanasia and colon collection, all samples were divided in half, then half homogenized and half fixed in formalin. Institutional Animal Care and Use Committee (IACUC) approval was given for the project. The homogenized colons were analyzed using flow cytometry, ELISA, and staining for multiple inflammatory markers including, but not limited to, TNF-α, IFN-γ, IL-12, and TGF-β. The fixed colons were stained using hematoxylin and eosin. Results: The histology showed significantly less inflammation and epithelial damage in the LPT group compared with the DSS groups without LPT (P<.01). Additionally, significantly lower levels of TNF-α and IFN-γ were found in the LPT group compared with the DSS groups without LPT (P<.01). Conclusion: These results provide valuable evidence for the potential use of OMT in patients with IBD and the need for human clinical trials. The results also show the importance of the lymphatics in the disease process helping us to better understand this illness. Future research should be aimed at using chronic model IBD mice and human trials.


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