Lymphatic pump treatment mobilizes leukocytes from the gut associated lymphoid tissue into lymph

Abstract

Background: Lymphatic pump techniques (LPT) are used clinically by osteopathic practitioners for the treatment of edema and infection; however, the mechanisms by which LPT enhances lymphatic circulation and provides protection during infection are not understood. Rhythmic compressions on the abdomen during LPT compress the abdominal area, including the gut-associated lymphoid tissues (GALT), which may facilitate the release of leukocytes from these tissues into the lymphatic circulation. This study is the first to document LPT-induced mobilization of leukocytes from the GALT into the lymphatic circulation.

Methods and results: Catheters were inserted into either the thoracic or mesenteric lymph ducts of dogs. To determine if LPT enhanced the release of leukocytes from the mesenteric lymph nodes (MLN) into lymph, the MLN were fluorescently labeled in situ. Lymph was collected during 4 min pre-LPT, 4 min LPT, and 10 min following cessation of LPT. LPT significantly increased lymph flow and leukocytes in both mesenteric and thoracic duct lymph. LPT had no preferential effect on any specific leukocyte population, since neutrophil, monocyte, CD4+ T cell, CD8+ T cell, IgG+B cell, and IgA+B cell numbers were similarly increased. In addition, LPT significantly increased the mobilization of leukocytes from the MLN into lymph. Lymph flow and leukocyte counts fell following LPT treatment, indicating that the effects of LPT are transient.

Conclusions: LPT mobilizes leukocytes from GALT, and these leukocytes are transported by the lymphatic circulation. This enhanced release of leukocytes from GALT may provide scientific rationale for the clinical use of LPT to improve immune function.

FIG. 1.

Thoracic duct lymph was collected at 0 (pre-injection) and at 1, 10, 20, 30, 45, and 60 min following intranodal injection of the MLN with CFSE. Lymph was assayed for the numbers of CFSE-labeled leukocytes per minute and the amount of free (unbound) CFSE.

FIG. 2.

Thoracic duct lymph was collected 1) pre-LPT, 2) during 4 min LPT, and 3) during 10 min post-LPT. Data are means × 10⁶ total leukocytes/minute ± SE or mean arterial blood pressure ± SE from 6 animals. *Greater than Pre-LPT and Post-LPT (P < 0.001).

FIG. 3.

Mesenteric duct lymph was collected 1) pre-LPT, 2) during 4 min LPT, and 3) during 10 min post-LPT. Data are means × 10⁶ total leukocytes/minute ± SE or mean arterial blood pressure ± SE from 6 animals. *Greater than Pre-LPT and Post-LPT (P < 0.01).

FIG. 4.

Sixty minutes after labeling the MLN in situ with CFSE, thoracic duct lymph was collected 1) pre-LPT, 2) during 4 min LPT, and 3) during 10 min post-LPT. Data are means × 10⁶ of CFSE labeled leukocytes/minute ± SE or mean arterial blood pressure ± SE from 5 animals. *Greater than Pre-LPT (P < 0.05).