Vagal nerve stimulation modulates gut injury and lung permeability in trauma-hemorrhagic shock

Gal Levy, Jordan E. Fishman, Da Zhong Xu, Wei Dong, Dave Palange, Gergely Vida, Alicia Mohr, Luis Ulloa, Edwin A. Deitch

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

BACKGROUND: Hemorrhagic shock is known to disrupt the gut barrier leading to end-organ dysfunction. The vagus nerve can inhibit detrimental immune responses that contribute to organ damage in hemorrhagic shock. Therefore, we explored whether stimulation of the vagus nerve can protect the gut and recover lung permeability in trauma-hemorrhagic shock (THS). METHODS: Male Sprague-Dawley rats were subjected to left cervical vagus nerve stimulation at 5 V for 10 minutes. The right internal jugular and femoral artery were cannulated for blood withdrawal and blood pressure monitoring, respectively. Animals were then subjected to hemorrhagic shock to a mean arterial pressure between 30 mm Hg and 35 mm Hg for 90 minutes then reperfused with their own whole blood. After observation for 3 hours, gut permeability was assessed with fluorescein dextran 4 in vivo injections in a ligated portion of distal ileum followed by Evans blue dye injection to assess lung permeability. Pulmonary myeloperoxidase levels were measured and compared. RESULTS: Vagal nerve stimulation abrogated THS-induced lung injury (mean [SD], 8.46 [0.36] vs. 4.87 [0.78]; p < 0.05) and neutrophil sequestration (19.39 [1.01] vs. 12.83 [1.16]; p < 0.05). Likewise, THS gut permeability was reduced to sham levels. CONCLUSION: Neuromodulation decreases injury in the THS model as evidenced by decreased gut permeability as well as decreased lung permeability and pulmonary neutrophil sequestration in a rat model.

Original languageEnglish (US)
Pages (from-to)338-342
Number of pages5
JournalJournal of Trauma and Acute Care Surgery
Volume73
Issue number2
DOIs
StatePublished - Aug 1 2012
Externally publishedYes

Fingerprint

Vagus Nerve Stimulation
Hemorrhagic Shock
Lung Injury
Permeability
Wounds and Injuries
Lung
Neutrophils
Bronchopulmonary Sequestration
Evans Blue
Injections
Vagus Nerve
Adult Respiratory Distress Syndrome
Femoral Artery
Ileum
Peroxidase
Sprague Dawley Rats
Arterial Pressure
Coloring Agents
Neck
Observation

Keywords

  • gut barrier
  • lung permeability
  • Vagus

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Vagal nerve stimulation modulates gut injury and lung permeability in trauma-hemorrhagic shock. / Levy, Gal; Fishman, Jordan E.; Xu, Da Zhong; Dong, Wei; Palange, Dave; Vida, Gergely; Mohr, Alicia; Ulloa, Luis; Deitch, Edwin A.

In: Journal of Trauma and Acute Care Surgery, Vol. 73, No. 2, 01.08.2012, p. 338-342.

Research output: Contribution to journalArticle

Levy, G, Fishman, JE, Xu, DZ, Dong, W, Palange, D, Vida, G, Mohr, A, Ulloa, L & Deitch, EA 2012, 'Vagal nerve stimulation modulates gut injury and lung permeability in trauma-hemorrhagic shock', Journal of Trauma and Acute Care Surgery, vol. 73, no. 2, pp. 338-342. https://doi.org/10.1097/TA.0b013e31825debd3
Levy, Gal ; Fishman, Jordan E. ; Xu, Da Zhong ; Dong, Wei ; Palange, Dave ; Vida, Gergely ; Mohr, Alicia ; Ulloa, Luis ; Deitch, Edwin A. / Vagal nerve stimulation modulates gut injury and lung permeability in trauma-hemorrhagic shock. In: Journal of Trauma and Acute Care Surgery. 2012 ; Vol. 73, No. 2. pp. 338-342.
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N2 - BACKGROUND: Hemorrhagic shock is known to disrupt the gut barrier leading to end-organ dysfunction. The vagus nerve can inhibit detrimental immune responses that contribute to organ damage in hemorrhagic shock. Therefore, we explored whether stimulation of the vagus nerve can protect the gut and recover lung permeability in trauma-hemorrhagic shock (THS). METHODS: Male Sprague-Dawley rats were subjected to left cervical vagus nerve stimulation at 5 V for 10 minutes. The right internal jugular and femoral artery were cannulated for blood withdrawal and blood pressure monitoring, respectively. Animals were then subjected to hemorrhagic shock to a mean arterial pressure between 30 mm Hg and 35 mm Hg for 90 minutes then reperfused with their own whole blood. After observation for 3 hours, gut permeability was assessed with fluorescein dextran 4 in vivo injections in a ligated portion of distal ileum followed by Evans blue dye injection to assess lung permeability. Pulmonary myeloperoxidase levels were measured and compared. RESULTS: Vagal nerve stimulation abrogated THS-induced lung injury (mean [SD], 8.46 [0.36] vs. 4.87 [0.78]; p < 0.05) and neutrophil sequestration (19.39 [1.01] vs. 12.83 [1.16]; p < 0.05). Likewise, THS gut permeability was reduced to sham levels. CONCLUSION: Neuromodulation decreases injury in the THS model as evidenced by decreased gut permeability as well as decreased lung permeability and pulmonary neutrophil sequestration in a rat model.

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