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The Lymphatic Drainage of the Gut and the Pathogenesis of SIRS and MODS

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Sepsis

Abstract

The data accumulated so far from experimental animals, clinical observations, and clinical trials of gut-oriented interventions are considered by many acceptably good evidence for the role of the gut in septic states. In fact, the hypothesis that the systemic inflammatory response syndrome (SIRS) and associated organ dysfunctions are initiated, perpetuated, and/or exacerbated by microbiological and immunological phenomena that occur at the gut level has attracted the effort of many investigators over the last two decades. The changes of the gut microbial flora, bacterial translocation, and the functional and morphological abnormalities of the intestinal mucosa and the gut-associated lymphatic tissue (GALT) that occur in experimental as well as human septic states have been made responsible for the clinical syndromes of SIRS and multiple organ dysfunction syndrome (MODS). The potential pathways of an inflammatory signal from the gut to the systemic circulation and distant organ systems are the portal vein and the lymphatic drainage of the gut via the mesenteric lymph nodes and the thoracic duct. The present article reviews the current state of our knowledge of the lymphatic drainage of the gut that may provide the route of access to the systemic circulation for a gut-associated inflammatory signal.

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  1. Unidad de Cuidados Intensivos, Hospital Universitario Príncipe de Asturias, Madrid, Spain

    Miguel Sánchez García

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García, M.S. The Lymphatic Drainage of the Gut and the Pathogenesis of SIRS and MODS. Sepsis 3, 293–301 (1999). https://doi.org/10.1023/A:1009849326489

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