101
|
Benveniste H, Heerdt PM, Fontes M, Rothman DL, Volkow ND. Glymphatic System Function in Relation to Anesthesia and Sleep States. Anesth Analg 2019; 128:747-758. [PMID: 30883420 DOI: 10.1213/ane.0000000000004069] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The brain is one of the most metabolically active organs in the body. The brain's high energy demand associated with wakefulness persists during rapid eye movement sleep, and even during non-rapid eye movement sleep, cerebral oxygen consumption is only reduced by 20%. The active bioenergetic state parallels metabolic waste production at a higher rate than in other organs, and the lack of lymphatic vasculature in brain parenchyma is therefore a conundrum. A common assumption has been that with a tight blood-brain barrier restricting solute and fluid movements, a lymphatic system is superfluous in the central nervous system. Cerebrospinal fluid (CSF) flow has long been thought to facilitate central nervous system tissue "detoxification" in place of lymphatics. Nonetheless, while CSF production and transport have been studied for decades, the exact processes involved in toxic waste clearance remain poorly understood. Over the past 5 years, emerging data have begun to shed new light on these processes in the form of the "glymphatic system," a novel brain-wide perivascular transit passageway dedicated to CSF transport and metabolic waste drainage from the brain. Here, we review the key anatomical components and operational drivers of the brain's glymphatic system, with a focus on its unique functional dependence on the state of arousal and anesthetic regimens. We also discuss evidence for why clinical exploration of this novel system may in the future provide valuable insight into new strategies for preventing delirium and cognitive dysfunction in perioperative and critical care settings.
Collapse
Affiliation(s)
| | | | | | - Douglas L Rothman
- Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Nora D Volkow
- Laboratory for Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| |
Collapse
|
102
|
Nelson TS, Nepiyushchikh Z, Hooks JST, Razavi MS, Lewis T, Clement CC, Thoresen M, Cribb MT, Ross MK, Gleason RL, Santambrogio L, Peroni JF, Dixon JB. Lymphatic remodelling in response to lymphatic injury in the hind limbs of sheep. Nat Biomed Eng 2019; 4:649-661. [PMID: 31873209 DOI: 10.1038/s41551-019-0493-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 11/15/2019] [Indexed: 02/06/2023]
Abstract
Contractile activity in the lymphatic vasculature is essential for maintaining fluid balance within organs and tissues. However, the mechanisms by which collecting lymphatics adapt to changes in fluid load and how these adaptations influence lymphatic contractile activity are unknown. Here we report a model of lymphatic injury based on the ligation of one of two parallel lymphatic vessels in the hind limb of sheep and the evaluation of structural and functional changes in the intact, remodelling lymphatic vessel over a 42-day period. We show that the remodelled lymphatic vessel displayed increasing intrinsic contractile frequency, force generation and vessel compliance, as well as decreasing flow-mediated contractile inhibition via the enzyme endothelial nitric oxide synthase. A computational model of a chain of lymphatic contractile segments incorporating these adaptations predicted increases in the flow-generation capacity of the remodelled vessel at the expense of normal mitochondrial function and elevated oxidative stress within the lymphatic muscle. Our findings may inform interventions for mitigating lymphatic muscle fatigue in patients with dysfunctional lymphatics.
Collapse
Affiliation(s)
- Tyler S Nelson
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Zhanna Nepiyushchikh
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Joshua S T Hooks
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Mohammad S Razavi
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Tristan Lewis
- College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Cristina C Clement
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Merrilee Thoresen
- College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Matthew T Cribb
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Mindy K Ross
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Rudolph L Gleason
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Laura Santambrogio
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - John F Peroni
- College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - J Brandon Dixon
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA. .,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA. .,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
| |
Collapse
|
103
|
O'Melia MJ, Lund AW, Thomas SN. The Biophysics of Lymphatic Transport: Engineering Tools and Immunological Consequences. iScience 2019; 22:28-43. [PMID: 31739172 PMCID: PMC6864335 DOI: 10.1016/j.isci.2019.11.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/25/2019] [Accepted: 11/01/2019] [Indexed: 12/17/2022] Open
Abstract
Lymphatic vessels mediate fluid flows that affect antigen distribution and delivery, lymph node stromal remodeling, and cell-cell interactions, to thus regulate immune activation. Here we review the functional role of lymphatic transport and lymph node biomechanics in immunity. We present experimental tools that enable quantitative analysis of lymphatic transport and lymph node dynamics in vitro and in vivo. Finally, we discuss the current understanding for how changes in lymphatic transport and lymph node biomechanics contribute to pathogenesis of conditions including cancer, aging, neurodegeneration, and infection.
Collapse
Affiliation(s)
- Meghan J O'Melia
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive NW, Atlanta, GA 30332, USA
| | - Amanda W Lund
- Departments of Cell Developmental Cancer Biology, Molecular Microbiology & Immunology, and Dermatology, Knight Cancer Institute, Oregon Health & Science University, 2720 SW Moody Avenue, KR-CDCB, Portland, OR 97239, USA.
| | - Susan N Thomas
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive NW, Atlanta, GA 30332, USA; Parker H. Petit Institute for Bioengineering and Bioscience, 315 Ferst Dr NW, Georgia Institute of Technology, Atlanta, GA 30332, USA; George W. Woodruff School of Mechanical Engineering, 801 Ferst Dr NW, Georgia Institute of Technology, Atlanta, GA 30332, USA; Winship Cancer Institute, 1365 Clifton Rd, Emory University, Atlanta, GA 30322, USA.
| |
Collapse
|
104
|
Patterson KC, Queval CJ, Gutierrez MG. Granulomatous Inflammation in Tuberculosis and Sarcoidosis: Does the Lymphatic System Contribute to Disease? Bioessays 2019; 41:e1900086. [PMID: 31588585 DOI: 10.1002/bies.201900086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/09/2019] [Indexed: 12/22/2022]
Abstract
A striking and unexplained feature of granulomatous inflammation is its anatomical association with the lymphatic system. Accumulating evidence suggests that lymphatic tracks and granulomas may alter the function of each other. The formation of new lymphatics, or lymphangiogenesis, is an adaptive response to tumor formation, infection, and wound healing. Granulomas also may induce lymphangiogenesis which, through a variety of mechanisms, could contribute to disease outcomes in tuberculosis and sarcoidosis. On the other hand, alterations in lymph node function and lymphatic draining may be primary events which attenuate the risk and severity of granulomatous inflammation. This review begins with an introduction of granulomatous inflammation and the lymphatic system. A role of the lymphatic system in tuberculosis and sarcoidosis is then hypothesized. With a focus on lymphangiogenesis in these diseases, and on the potential for this process to promote dissemination, parallels are established with the well-established role of lymphangiogenesis in tumor biology.
Collapse
Affiliation(s)
- Karen C Patterson
- Brighton and Sussex Medical School, 94N-SRd, Falmer, Brighton, BN1 9PX, UK.,Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Christophe J Queval
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Maximiliano G Gutierrez
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| |
Collapse
|
105
|
Solari E, Marcozzi C, Bartolini B, Viola M, Negrini D, Moriondo A. Acute Exposure of Collecting Lymphatic Vessels to Low-Density Lipoproteins Increases Both Contraction Frequency and Lymph Flow: An In Vivo Mechanical Insight. Lymphat Res Biol 2019; 18:146-155. [PMID: 31526222 DOI: 10.1089/lrb.2019.0040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Lymphatic vessels drain fluids and solutes from interstitial spaces and serosal cavities. Among the solutes, low-density lipoproteins (LDL) are drained and can be detected in peripheral lymph, where they have been reported to exert a modulatory action on lymphatic vessels intrinsic contraction rate. In the present work, we investigated lymphatic vessel mechanical properties (contraction frequency and amplitude) that may be modulated by LDL application and the consequence on lymph flow. Methods and Results: Human-derived LDL were resuspended in phosphate-buffered saline (PBS) and microinjected in the interstitial space surrounding spontaneously contracting lymphatic vessels of the rat diaphragm, in vivo. Vessels' contraction rate and diameter were measured in control conditions (PBS) and after LDL injection. Lymph flow (Jlymph) was computed from contraction rate and diameter change. In some animals, after the recording procedure, diaphragmatic tissue samples were excised and immunostained with antilymphatic muscle (LM) actin to investigate the correlation between LM signal level and contraction amplitude. Data indicate a positive, saturating correlation between the abundance of LM actin and contraction amplitude, and LDL microinjection caused an acute increase in contraction frequency (+126%), a reduction of contraction amplitude to 75% of that obtained after PBS injection, and a +63% increase in Jlymph. Conclusions: From our in vivo analysis of the mechanical parameters affected by LDL, Jlymph was increased by a predominant effect on the contraction rate rather than amplitude, suggesting that the still elusive messaging system might be linked to the pacemaker sites.
Collapse
Affiliation(s)
- Eleonora Solari
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Cristiana Marcozzi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Barbara Bartolini
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Manuela Viola
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Daniela Negrini
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Andrea Moriondo
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| |
Collapse
|
106
|
Jafarnejad M, Ismail AZ, Duarte D, Vyas C, Ghahramani A, Zawieja DC, Lo Celso C, Poologasundarampillai G, Moore JE. Quantification of the Whole Lymph Node Vasculature Based on Tomography of the Vessel Corrosion Casts. Sci Rep 2019; 9:13380. [PMID: 31527597 PMCID: PMC6746739 DOI: 10.1038/s41598-019-49055-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022] Open
Abstract
Lymph nodes (LN) are crucial for immune function, and comprise an important interface between the blood and lymphatic systems. Blood vessels (BV) in LN are highly specialized, featuring high endothelial venules across which most of the resident lymphocytes crossed. Previous measurements of overall lymph and BV flow rates demonstrated that fluid also crosses BV walls, and that this is important for immune function. However, the spatial distribution of the BV in LN has not been quantified to the degree necessary to analyse the distribution of transmural fluid movement. In this study, we seek to quantify the spatial localization of LNBV, and to predict fluid movement across BV walls. MicroCT imaging of murine popliteal LN showed that capillaries were responsible for approximately 75% of the BV wall surface area, and that this was mostly distributed around the periphery of the node. We then modelled blood flow through the BV to obtain spatially resolved hydrostatic pressures, which were then combined with Starling’s law to predict transmural flow. Much of the total 10 nL/min transmural flow (under normal conditions) was concentrated in the periphery, corresponding closely with surface area distribution. These results provide important insights into the inner workings of LN, and provide a basis for further exploration of the role of LN flow patterns in normal and pathological functions.
Collapse
Affiliation(s)
- M Jafarnejad
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - A Z Ismail
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - D Duarte
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK
| | - C Vyas
- The School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK
| | - A Ghahramani
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - D C Zawieja
- Department of Medical Physiology, Texas A&M Health Science Center, Temple, Texas, 76504, USA
| | - C Lo Celso
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK.,The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | | | - J E Moore
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK.
| |
Collapse
|
107
|
Stolarz AJ, Sarimollaoglu M, Marecki JC, Fletcher TW, Galanzha EI, Rhee SW, Zharov VP, Klimberg VS, Rusch NJ. Doxorubicin Activates Ryanodine Receptors in Rat Lymphatic Muscle Cells to Attenuate Rhythmic Contractions and Lymph Flow. J Pharmacol Exp Ther 2019; 371:278-289. [PMID: 31439806 DOI: 10.1124/jpet.119.257592] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 08/09/2019] [Indexed: 11/22/2022] Open
Abstract
Doxorubicin is a risk factor for secondary lymphedema in cancer patients exposed to surgery or radiation. The risk is presumed to relate to its cytotoxicity. However, the present study provides initial evidence that doxorubicin directly inhibits lymph flow and this action appears distinct from its cytotoxic activity. We used real-time edge detection to track diameter changes in isolated rat mesenteric lymph vessels. Doxorubicin (0.5-20 μmol/l) progressively constricted lymph vessels and inhibited rhythmic contractions, reducing flow to 24.2% ± 7.7% of baseline. The inhibition of rhythmic contractions by doxorubicin paralleled a tonic rise in cytosolic Ca2+ concentration in lymphatic muscle cells, which was prevented by pharmacological antagonism of ryanodine receptors. Washout of doxorubicin partially restored lymph vessel contractions, implying a pharmacological effect. Subsequently, high-speed optical imaging was used to assess the effect of doxorubicin on rat mesenteric lymph flow in vivo. Superfusion of doxorubicin (0.05-10 μmol/l) maximally reduced volumetric lymph flow to 34% ± 11.6% of baseline. Likewise, doxorubicin (10 mg/kg) administered intravenously to establish clinically achievable plasma concentrations also maximally reduced volumetric lymph flow to 40.3% ± 6.0% of initial values. Our findings reveal that doxorubicin at plasma concentrations achieved during chemotherapy opens ryanodine receptors to induce "calcium leak" from the sarcoplasmic reticulum in lymphatic muscle cells and reduces lymph flow, an event linked to lymph vessel damage and the development of lymphedema. These results infer that pharmacological block of ryanodine receptors in lymphatic smooth muscle cells may mitigate secondary lymphedema in cancer patients subjected to doxorubicin chemotherapy. SIGNIFICANCE STATEMENT: Doxorubicin directly inhibits the rhythmic contractions of collecting lymph vessels and reduces lymph flow as a possible mechanism of secondary lymphedema, which is associated with the administration of anthracycline-based chemotherapy. The inhibitory effects of doxorubicin on rhythmic contractions and flow in isolated lymph vessels were prevented by pharmacological block of ryanodine receptors, thereby identifying the ryanodine receptor family of proteins as potential therapeutic targets for the development of new antilymphedema medications.
Collapse
Affiliation(s)
- Amanda J Stolarz
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - Mustafa Sarimollaoglu
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - John C Marecki
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - Terry W Fletcher
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - Ekaterina I Galanzha
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - Sung W Rhee
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - Vladimir P Zharov
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - V Suzanne Klimberg
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| | - Nancy J Rusch
- Department of Pharmacology and Toxicology, College of Medicine (A.J.S., T.W.F., S.W.R., N.J.R.) and Department of Biochemistry and Molecular Biology, College of Medicine (J.C.M.), Arkansas Nanomedicine Center, College of Medicine (M.S., V.P.Z.), Department of Pharmaceutical Sciences, College of Pharmacy (A.J.S.), and Laboratory of Lymphatic Research, Diagnosis and Therapy (E.I.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and MD Anderson Cancer Center Houston, Texas (V.S.K.)
| |
Collapse
|
108
|
Mohanakumar S, Telinius N, Kelly B, Hjortdal V. Reduced Lymphatic Function Predisposes to Calcium Channel Blocker Edema: A Randomized Placebo-Controlled Clinical Trial. Lymphat Res Biol 2019; 18:156-165. [PMID: 31429625 DOI: 10.1089/lrb.2019.0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The current belief is that the calcium channel blocker (CCB)-induced edema is due to a preferential arterial over venous dilatation leading to increased fluid filtration. We challenged this conviction by measuring the lymphatic removal of interstitial fluid during chronic systemic treatment with the CCB, amlodipine. Lymphatic vessels could potentially be an off-target effect of the drugs and play a role in CCB edema. Methods and Results: Sixteen healthy postmenopausal women completed a 12-week double-blinded randomized placebo-controlled crossover trial. Lymphatic function was assessed by near-infrared fluorescence imaging. The lymphatic function during amlodipine treatment compared with placebo did not show any difference in pumping pressure (53.9 ± 13.9 mmHg vs. 54.7 ± 9.4 mmHg, p = 0.829), contraction frequency (0.4 ± 0.2/min vs. 0.4 ± 0.3/min, p = 0.932), refill time (440 ± 438 seconds vs. 442 ± 419 seconds, p = 0.990), or propagation velocity of lymph packets (18 ± 10 mm/s vs. 15 ± 7 mm/s, p = 0.124). However, the subjects who developed edema during CCB treatment had a 20% lower baseline lymphatic pumping pressure (48.9 ± 4.4 mmHg, n = 7) than the subjects not affected by treatment (59.1 ± 1.2 mmHg, n = 9, p = 0.025). Contraction frequency, refill time, and lymph packet velocity showed no differences in baseline values between the two groups. Conclusion: Our results suggest that CCB does not directly impair lymphatic function. However, our results show that a reduced lymphatic function predisposes to CCB edema, which may explain why some patients develop edema during treatment.
Collapse
Affiliation(s)
- Sheyanth Mohanakumar
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Niklas Telinius
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Benjamin Kelly
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Vibeke Hjortdal
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| |
Collapse
|
109
|
The effects of valve leaflet mechanics on lymphatic pumping assessed using numerical simulations. Sci Rep 2019; 9:10649. [PMID: 31337769 PMCID: PMC6650476 DOI: 10.1038/s41598-019-46669-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 06/20/2019] [Indexed: 01/04/2023] Open
Abstract
The lymphatic system contains intraluminal leaflet valves that function to bias lymph flow back towards the heart. These valves are present in the collecting lymphatic vessels, which generally have lymphatic muscle cells and can spontaneously pump fluid. Recent studies have shown that the valves are open at rest, can allow some backflow, and are a source of nitric oxide (NO). To investigate how these valves function as a mechanical valve and source of vasoactive species to optimize throughput, we developed a mathematical model that explicitly includes Ca2+ -modulated contractions, NO production and valve structures. The 2D lattice Boltzmann model includes an initial lymphatic vessel and a collecting lymphangion embedded in a porous tissue. The lymphangion segment has mechanically-active vessel walls and is flanked by deformable valves. Vessel wall motion is passively affected by fluid pressure, while active contractions are driven by intracellular Ca2+ fluxes. The model reproduces NO and Ca2+ dynamics, valve motion and fluid drainage from tissue. We find that valve structural properties have dramatic effects on performance, and that valves with a stiffer base and flexible tips produce more stable cycling. In agreement with experimental observations, the valves are a major source of NO. Once initiated, the contractions are spontaneous and self-sustained, and the system exhibits interesting non-linear dynamics. For example, increased fluid pressure in the tissue or decreased lymph pressure at the outlet of the system produces high shear stress and high levels of NO, which inhibits contractions. On the other hand, a high outlet pressure opposes the flow, increasing the luminal pressure and the radius of the vessel, which results in strong contractions in response to mechanical stretch of the wall. We also find that the location of contraction initiation is affected by the extent of backflow through the valves.
Collapse
|
110
|
Abstract
The ability to generate new microvessels in desired numbers and at desired locations has been a long-sought goal in vascular medicine, engineering, and biology. Historically, the need to revascularize ischemic tissues nonsurgically (so-called therapeutic vascularization) served as the main driving force for the development of new methods of vascular growth. More recently, vascularization of engineered tissues and the generation of vascularized microphysiological systems have provided additional targets for these methods, and have required adaptation of therapeutic vascularization to biomaterial scaffolds and to microscale devices. Three complementary strategies have been investigated to engineer microvasculature: angiogenesis (the sprouting of existing vessels), vasculogenesis (the coalescence of adult or progenitor cells into vessels), and microfluidics (the vascularization of scaffolds that possess the open geometry of microvascular networks). Over the past several decades, vascularization techniques have grown tremendously in sophistication, from the crude implantation of arteries into myocardial tunnels by Vineberg in the 1940s, to the current use of micropatterning techniques to control the exact shape and placement of vessels within a scaffold. This review provides a broad historical view of methods to engineer the microvasculature, and offers a common framework for organizing and analyzing the numerous studies in this area of tissue engineering and regenerative medicine. © 2019 American Physiological Society. Compr Physiol 9:1155-1212, 2019.
Collapse
Affiliation(s)
- Joe Tien
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
- Division of Materials Science and Engineering, Boston University, Brookline, Massachusetts, USA
| |
Collapse
|
111
|
Hu D, Li L, Li S, Wu M, Ge N, Cui Y, Lian Z, Song J, Chen H. Lymphatic system identification, pathophysiology and therapy in the cardiovascular diseases. J Mol Cell Cardiol 2019; 133:99-111. [PMID: 31181226 DOI: 10.1016/j.yjmcc.2019.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/02/2019] [Accepted: 06/05/2019] [Indexed: 12/20/2022]
Abstract
The mammalian circulatory system comprises both the cardiovascular system and the lymphatic system. In contrast to the closed, high-pressure and circular blood vascular circulation, the lymphatic system forms an open, low-pressure and unidirectional transit network from the extracellular space to the venous system. It plays a key role in regulating tissue fluid homeostasis, absorption of gastrointestinal lipids, and immune surveillance throughout the body. Despite the critical physiological functions of the lymphatic system, a complete understanding of the lymphatic vessels lags far behind that of the blood vasculatures due to the challenge of their visualization. During the last 20 years, discoveries of underlying genes responsible for lymphatic vessel biology, combined with state-of-the-art lymphatic function imaging and quantification techniques, have established the importance of the lymphatic vasculature in the pathogenesis of cardiovascular diseases including lymphedema, obesity and metabolic diseases, dyslipidemia, hypertension, inflammation, atherosclerosis and myocardial infraction. In this review, we highlight the most recent advances in the field of lymphatic vessel biology, with an emphasis on the new identification techniques of lymphatic system, pathophysiological mechanisms of atherosclerosis and myocardial infarction, and new therapeutic perspectives of lymphangiogenesis.
Collapse
Affiliation(s)
- Dan Hu
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Long Li
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Sufang Li
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Manyan Wu
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Nana Ge
- Department of Geriatrics, Beijing Renhe Hospital, Beijing, China
| | - Yuxia Cui
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Zheng Lian
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Junxian Song
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Hong Chen
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China.
| |
Collapse
|
112
|
Bertram CD, Macaskill C, Moore JE. Inhibition of contraction strength and frequency by wall shear stress in a single-lymphangion model. J Biomech Eng 2019; 141:2733771. [PMID: 31074761 DOI: 10.1115/1.4043724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Indexed: 12/29/2022]
Abstract
The phasic contractions of collecting lymphatic vessels are reduced in strength and occur at diminished frequency when the favourable pressure difference and the resulting antegrade flow create large fluid shear stresses at the luminal surface. This paper describes a minimal phenomenological model of this mechanism, that is applied to a previously validated numerical model of a phasically contracting lymphangion. The parameters of the inhibition model are quantitatively matched to observations in isolated segments of rat lymphatic vessel, first for mesenteric lymphatics then for thoracic duct, and outcomes from the numerical model are then qualitatively compared with recent observations in isolated segments of rat thoracic duct.
Collapse
Affiliation(s)
- C D Bertram
- School of Mathematics & Statistics, University of Sydney, New South Wales, Australia 2006
| | - Charles Macaskill
- School of Mathematics & Statistics, University of Sydney, New South Wales, Australia 2006
| | - James E Moore
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
| |
Collapse
|
113
|
Chang CW, Seibel AJ, Song JW. Application of microscale culture technologies for studying lymphatic vessel biology. Microcirculation 2019; 26:e12547. [PMID: 30946511 DOI: 10.1111/micc.12547] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 03/04/2019] [Accepted: 04/02/2019] [Indexed: 12/17/2022]
Abstract
Immense progress in microscale engineering technologies has significantly expanded the capabilities of in vitro cell culture systems for reconstituting physiological microenvironments that are mediated by biomolecular gradients, fluid transport, and mechanical forces. Here, we examine the innovative approaches based on microfabricated vessels for studying lymphatic biology. To help understand the necessary design requirements for microfluidic models, we first summarize lymphatic vessel structure and function. Next, we provide an overview of the molecular and biomechanical mediators of lymphatic vessel function. Then we discuss the past achievements and new opportunities for microfluidic culture models to a broad range of applications pertaining to lymphatic vessel physiology. We emphasize the unique attributes of microfluidic systems that enable the recapitulation of multiple physicochemical cues in vitro for studying lymphatic pathophysiology. Current challenges and future outlooks of microscale technology for studying lymphatics are also discussed. Collectively, we make the assertion that further progress in the development of microscale models will continue to enrich our mechanistic understanding of lymphatic biology and physiology to help realize the promise of the lymphatic vasculature as a therapeutic target for a broad spectrum of diseases.
Collapse
Affiliation(s)
- Chia-Wen Chang
- Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio
| | - Alex J Seibel
- Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio
| | - Jonathan W Song
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio.,The Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| |
Collapse
|
114
|
Mukherjee A, Hooks J, Nepiyushchikh Z, Dixon JB. Entrainment of Lymphatic Contraction to Oscillatory Flow. Sci Rep 2019; 9:5840. [PMID: 30967585 PMCID: PMC6456495 DOI: 10.1038/s41598-019-42142-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 03/26/2019] [Indexed: 12/28/2022] Open
Abstract
Lymphedema, a disfiguring condition characterized by an asymmetrical swelling of the limbs, is suspected to be caused by dysfunctions in the lymphatic system. A possible source of lymphatic dysfunction is the reduced mechanosensitivity of lymphangions, the spontaneously contracting units of the lymphatic system. In this study, the entrainment of lymphangions to an oscillatory wall shear stress (OWSS) is characterized in rat thoracic ducts in relation to their shear sensitivity. The critical shear stress above which the thoracic ducts show a substantial inhibition of contraction was found to be significantly negatively correlated to the diameter of the lymphangion. The entrainment of the lymphangion to an applied OWSS was found to be significantly dependent on the difference between the applied frequency and the intrinsic frequency of contraction of the lymphangion. The strength of the entrainment was also positively correlated to the applied shear stress when the applied shear was less than the critical shear stress of the vessel. The ejection fraction and fractional pump flow were also affected by the difference between the frequency of the applied OWSS and the vessel's intrinsic contraction frequency. The results suggest an adaptation of the lymphangion contractility to the existing oscillatory shear stress as a function of its intrinsic contractility and shear sensitivity. These adaptations might be crucial to ensure synchronized contraction of lymphangions through mechanosensitive means and might help explain the lymphatic dysfunctions that result from impaired mechanosensitivity.
Collapse
Affiliation(s)
- Anish Mukherjee
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, Georgia
| | - Joshua Hooks
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, Georgia
| | - Zhanna Nepiyushchikh
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, Georgia
| | - J Brandon Dixon
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, Georgia. .,Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, Georgia.
| |
Collapse
|
115
|
Reed HO, Wang L, Sonett J, Chen M, Yang J, Li L, Aradi P, Jakus Z, D'Armiento J, Hancock WW, Kahn ML. Lymphatic impairment leads to pulmonary tertiary lymphoid organ formation and alveolar damage. J Clin Invest 2019; 129:2514-2526. [PMID: 30946031 DOI: 10.1172/jci125044] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The lung is a specialized barrier organ that must tightly regulate interstitial fluid clearance and prevent infection in order to maintain effective gas exchange. Lymphatic vessels are important for these functions in other organs, but their roles in the lung have not been fully defined. In the present study, we addressed how the lymphatic vasculature participates in lung homeostasis. Studies using mice carrying a lymphatic reporter allele revealeded that, in contrast to other organs, lung lymphatic collecting vessels lack smooth muscle cells entirely, suggesting that forward lymph flow is highly dependent on movement and changes in pressure associated with respiration. Functional studies using CLEC2-deficient mice in which lymph flow is impaired due to loss of lympho-venous hemostasis or using inducible lung-specific ablation of lymphatic endothelial cells in a lung transplant model revealeded that loss of lymphatic function leads to an inflammatory state characterized by the formation of tertiary lymphoid organs (TLOs). In addition, impaired lymphatic flow in mice resulteds in hypoxia and features of lung injury that resemble emphysema. These findings reveal both a lung-specific mechanism of lymphatic physiology and a lung-specific consequence of lymphatic dysfunction that may contribute to chronic lung diseases that arise in association with TLO formation.
Collapse
Affiliation(s)
- Hasina Outtz Reed
- Department of Medicine and Division of Pulmonary and Critical Care.,Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Liqing Wang
- Department of Pathology and Laboratory Medicine, Division of Transplant Immunology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jarrod Sonett
- Department of Anesthesiology, Center for Molecular Pulmonary Disease, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Mei Chen
- Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jisheng Yang
- Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Larry Li
- Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Petra Aradi
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary.,MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - Zoltan Jakus
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary.,MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - Jeanine D'Armiento
- Department of Anesthesiology, Center for Molecular Pulmonary Disease, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Wayne W Hancock
- Department of Pathology and Laboratory Medicine, Division of Transplant Immunology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark L Kahn
- Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
116
|
Zawieja SD, Castorena JA, Gui P, Li M, Bulley SA, Jaggar JH, Rock JR, Davis MJ. Ano1 mediates pressure-sensitive contraction frequency changes in mouse lymphatic collecting vessels. J Gen Physiol 2019; 151:532-554. [PMID: 30862712 PMCID: PMC6445586 DOI: 10.1085/jgp.201812294] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/06/2019] [Indexed: 12/16/2022] Open
Abstract
Lymphatic collecting vessels exhibit spontaneous contractions with a pressure-dependent contraction frequency. The initiation of contraction has been proposed to be mediated by the activity of a Ca2+-activated Cl- channel (CaCC). Here, we show that the canonical CaCC Anoctamin 1 (Ano1, TMEM16a) plays an important role in lymphatic smooth muscle pacemaking. We find that isolated murine lymphatic muscle cells express Ano1, and demonstrate functional CaCC currents that can be inhibited by the Ano1 inhibitor benzbromarone. These currents are absent in lymphatic muscle cells from Cre transgenic mouse lines targeted for Ano1 genetic deletion in smooth muscle. We additionally show that loss of functional Ano1 in murine inguinal-axillary lymphatic vessels, whether through genetic manipulation or pharmacological inhibition, results in an impairment of the pressure-frequency relationship that is attributable to a hyperpolarized resting membrane potential and a significantly depressed diastolic depolarization rate preceding each action potential. These changes are accompanied by alterations in action potential shape and duration, and a reduced duration but increased amplitude of the action potential-induced global "Ca2+ flashes" that precede lymphatic contractions. These findings suggest that an excitatory Cl- current provided by Ano1 is critical for mediating the pressure-sensitive contractile response and is a major component of the murine lymphatic action potential.
Collapse
Affiliation(s)
- Scott D Zawieja
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO
| | - Jorge A Castorena
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO
| | - Peichun Gui
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO
| | - Min Li
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO
| | - Simon A Bulley
- Department of Physiology, University of Tennessee Health Science Center, Memphis, TN
| | - Jonathan H Jaggar
- Department of Physiology, University of Tennessee Health Science Center, Memphis, TN
| | - Jason R Rock
- Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Michael J Davis
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO
| |
Collapse
|
117
|
Moeller AL, Hjortdal VE, Boedtkjer DMB, Boedtkjer E. Acidosis inhibits rhythmic contractions of human thoracic ducts. Physiol Rep 2019; 7:e14074. [PMID: 31025551 PMCID: PMC6483936 DOI: 10.14814/phy2.14074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 11/24/2022] Open
Abstract
Lymph vessels counteract edema by transporting interstitial fluid from peripheral tissues to the large veins and serve as conduits for immune cells, cancer cells, and pathogens. Because edema during inflammation and malignancies is frequently associated with acidosis, we tested the hypothesis that acid-base disturbances affect human thoracic duct contractions. We studied, by isometric and isobaric myography, the contractile function of human thoracic duct segments harvested with written informed consent from patients undergoing esophageal cancer surgery. Human thoracic ducts produce complex contractile patterns consisting of tonic rises in tension (isometric myography) or decreases in diameter (isobaric myography) with superimposed phasic contractions. Active tone development decreases substantially (~90% at 30 vs. 7 mmHg) at elevated transmural pressure. Acidosis inhibits spontaneous as well as noradrenaline- and serotonin-induced phasic contractions of human thoracic ducts by 70-90% at extracellular pH 6.8 compared to 7.4 with less pronounced effects observed at pH 7.1. Mean tension responses to noradrenaline and serotonin - averaged over the entire period of agonist exposure - decrease by ~50% at extracellular pH 6.8. Elevating extracellular [K+ ] from the normal resting level around 4 mmol/L increases overall tension development but reduces phasic activity to a level that is no different between human thoracic duct segments investigated at normal and low extracellular pH. In conclusion, we show that extracellular acidosis inhibits human thoracic duct contractions with more pronounced effects on phasic than tonic contractions. We propose that reduced phasic activity of lymph vessels at low pH attenuates lymph propulsion and increases the risk of edema formation.
Collapse
Affiliation(s)
| | | | - Donna M. B. Boedtkjer
- Department of BiomedicineAarhus UniversityAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | | |
Collapse
|
118
|
Russell PS, Hong J, Windsor JA, Itkin M, Phillips ARJ. Renal Lymphatics: Anatomy, Physiology, and Clinical Implications. Front Physiol 2019; 10:251. [PMID: 30923503 PMCID: PMC6426795 DOI: 10.3389/fphys.2019.00251] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/25/2019] [Indexed: 12/30/2022] Open
Abstract
Renal lymphatics are abundant in the cortex of the normal kidney but have been largely neglected in discussions around renal diseases. They originate in the substance of the renal lobule as blind-ended initial capillaries, and can either follow the main arteries and veins toward the hilum, or penetrate the capsule to join capsular lymphatics. There are no valves present in interlobular lymphatics, which allows lymph formed in the cortex to exit the kidney in either direction. There are very few lymphatics present in the medulla. Lymph is formed from interstitial fluid in the cortex, and is largely composed of capillary filtrate, but also contains fluid reabsorbed from the tubules. The two main factors that contribute to renal lymph formation are interstitial fluid volume and intra-renal venous pressure. Renal lymphatic dysfunction, defined as a failure of renal lymphatics to adequately drain interstitial fluid, can occur by several mechanisms. Renal lymphatic inflow may be overwhelmed in the setting of raised venous pressure (e.g., cardiac failure) or increased capillary permeability (e.g., systemic inflammatory response syndrome). Similarly, renal lymphatic outflow, at the level of the terminal thoracic duct, may be impaired by raised central venous pressures. Renal lymphatic dysfunction, from any cause, results in renal interstitial edema. Beyond a certain point of edema, intra-renal collecting lymphatics may collapse, further impairing lymphatic drainage. Additionally, in an edematous, tense kidney, lymphatic vessels exiting the kidney via the capsule may become blocked at the exit point. The reciprocal negative influences between renal lymphatic dysfunction and renal interstitial edema are expected to decrease renal function due to pressure changes within the encapsulated kidney, and this mechanism may be important in several common renal conditions.
Collapse
Affiliation(s)
- Peter Spencer Russell
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jiwon Hong
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - John Albert Windsor
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Maxim Itkin
- Center for Lymphatic Disorders, Penn Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Anthony Ronald John Phillips
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|
119
|
Narayanan SA, Ford J, Zawieja DC. Impairment of lymphatic endothelial barrier function by X-ray irradiation. Int J Radiat Biol 2019; 95:562-570. [PMID: 30570385 DOI: 10.1080/09553002.2019.1562253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Although the microvascular system is a significant target for radiation-induced effects, the lymphatic response to radiation has not been extensively investigated. This is one of the first investigations characterizing the lymphatic endothelial response to ionizing radiation. MATERIALS AND METHODS Rat mesenteric lymphatic endothelial cells (RMLECs) were exposed to X-ray doses of 0, 0.5, 1, 1.5, and 2 Gy. RMLEC cellular response was assessed 24 and 72-h post-irradiation via measures of cellular morphometry and junctional adhesion markers. RMLEC functional response was characterized through permeability experiments. RESULTS Cell morphometry showed radiation sensitivity at all doses. Notably, there was a loss of cell-to-cell adhesion with irradiated cells increasing in size and cellular roundness. This was coupled with decreased β-catenin and VE-cadherin intensity and altered F-actin anisotropy, leading to a loss of intercellular contact. RMLEC monolayers demonstrated increased permeability at all doses 24 h post-irradiation and at 2-Gy 72 h post-irradiation. CONCLUSIONS In summary, lymphatics show radiation sensitivity in the context of these cell culture experiments. Our results may have functional implications of lymphatics in tissue, with endothelial barrier dysfunction due to loss of cell-cell adhesion leading to leaky vessels and lymphedema. These preliminary experiments will build the framework for future investigations towards lymphatic radiation exposure response.
Collapse
Affiliation(s)
- S Anand Narayanan
- a Department of Medical Physiology , Texas A&M University -- College of Medicine , Temple , TX , USA
| | - John Ford
- b Department of Nuclear Engineering , Texas A&M University College of Engineering , College Station , TX , USA
| | - David C Zawieja
- a Department of Medical Physiology , Texas A&M University -- College of Medicine , Temple , TX , USA
| |
Collapse
|
120
|
Blatter C, Meijer EF, Padera TP, Vakoc BJ. Simultaneous measurements of lymphatic vessel contraction, flow and valve dynamics in multiple lymphangions using optical coherence tomography. JOURNAL OF BIOPHOTONICS 2018; 11:e201700017. [PMID: 28700145 PMCID: PMC5766440 DOI: 10.1002/jbio.201700017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/16/2017] [Accepted: 05/19/2017] [Indexed: 05/29/2023]
Abstract
Lymphatic dysfunction is involved in many diseases including lymphedema, hypertension, autoimmune responses, graft rejection, atherosclerosis, microbial infections, cancer and cancer metastasis. Expanding our knowledge of lymphatic system function can lead to a better understanding of these disease processes and improve treatment options. Here, optical coherence tomography (OCT) methods were used to reveal intraluminal valve dynamics in 3 dimensions, and measure lymph flow and vessel contraction simultaneously in 3 neighboring lymphangions of the afferent collecting lymphatic vessels to the popliteal lymph node in mice. Flow measurements were based on Doppler OCT techniques in combination with exogenous lymph labeling by Intralipid. Through these imaging methods, it is possible to study lymphatic function and pumping more comprehensively. These capabilities can lead to a better understanding of the regulation and dysregulation of lymphatic vessels in health and disease. The image depicts the dynamic measurements of lymphatic valves, lymphatic vessels cross-sectional area and lymph velocity simultaneously measured in vivo with optical coherence tomography.
Collapse
Affiliation(s)
- Cedric Blatter
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Eelco F.J. Meijer
- Edwin L. Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Timothy P. Padera
- Edwin L. Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Benjamin J. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| |
Collapse
|
121
|
Contarino C, Toro EF. A one-dimensional mathematical model of collecting lymphatics coupled with an electro-fluid-mechanical contraction model and valve dynamics. Biomech Model Mechanobiol 2018; 17:1687-1714. [PMID: 30006745 DOI: 10.1007/s10237-018-1050-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
We propose a one-dimensional model for collecting lymphatics coupled with a novel Electro-Fluid-Mechanical Contraction (EFMC) model for dynamical contractions, based on a modified FitzHugh-Nagumo model for action potentials. The one-dimensional model for a deformable lymphatic vessel is a nonlinear system of hyperbolic Partial Differential Equations (PDEs). The EFMC model combines the electrical activity of lymphangions (action potentials) with fluid-mechanical feedback (circumferential stretch of the lymphatic wall and wall shear stress) and lymphatic vessel wall contractions. The EFMC model is governed by four Ordinary Differential Equations (ODEs) and phenomenologically relies on: (1) environmental calcium influx, (2) stretch-activated calcium influx, and (3) contraction inhibitions induced by wall shear stresses. We carried out a stability analysis of the stationary state of the EFMC model. Contractions turn out to be triggered by the instability of the stationary state. Overall, the EFMC model allows emulating the influence of pressure and wall shear stress on the frequency of contractions observed experimentally. Lymphatic valves are modelled by extending an existing lumped-parameter model for blood vessels. Modern numerical methods are employed for the one-dimensional model (PDEs), for the EFMC model and valve dynamics (ODEs). Adopting the geometrical structure of collecting lymphatics from rat mesentery, we apply the full mathematical model to a carefully selected suite of test problems inspired by experiments. We analysed several indices of a single lymphangion for a wide range of upstream and downstream pressure combinations which included both favourable and adverse pressure gradients. The most influential model parameters were identified by performing two sensitivity analyses for favourable and adverse pressure gradients.
Collapse
Affiliation(s)
| | - Eleuterio F Toro
- Laboratory of Applied Mathematics, DICAM, University of Trento, Trento, Italy
| |
Collapse
|
122
|
Naskar S, Panda AK, Kumaran V, Mehta B, Basu B. Controlled Shear Flow Directs Osteogenesis on UHMWPE-Based Hybrid Nanobiocomposites in a Custom-Designed PMMA Microfluidic Device. ACS APPLIED BIO MATERIALS 2018; 1:414-435. [DOI: 10.1021/acsabm.8b00147] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Sharmistha Naskar
- Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore 560012, India
- Department of Chemical Engineering, Indian Institute of Science, Bangalore 560012, India
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore 560012, India
| | - Asish Kumar Panda
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore 560012, India
| | - Viswanathan Kumaran
- Department of Chemical Engineering, Indian Institute of Science, Bangalore 560012, India
| | - Bhupesh Mehta
- Department of Biophysics, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Bikramjit Basu
- Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore 560012, India
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore 560012, India
| |
Collapse
|
123
|
Kilarski WW. Physiological Perspective on Therapies of Lymphatic Vessels. Adv Wound Care (New Rochelle) 2018; 7:189-208. [PMID: 29984111 PMCID: PMC6032671 DOI: 10.1089/wound.2017.0768] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/26/2018] [Indexed: 12/16/2022] Open
Abstract
Significance: Growth of distinctive blood vessels of granulation tissue is a central step in the post-developmental tissue remodeling. Even though lymphangiogenesis is a part of the regeneration process, the significance of the controlled restoration of lymphatic vessels has only recently been recognized. Recent Advances: Identification of lymphatic markers and growth factors paved the way for the exploration of the roles of lymphatic vessels in health and disease. Emerging pro-lymphangiogenic therapies use vascular endothelial growth factor (VEGF)-C to combat fluid retention disorders such as lymphedema and to enhance the local healing process. Critical Issues: The relevance of recently identified lymphatic functions awaits verification by their association with pathologic conditions. Further, despite a century of research, the complete etiology of secondary lymphedema, a fluid retention disorder directly linked to the lymphatic function, is not understood. Finally, the specificity of pro-lymphangiogenic therapy depends on VEGF-C transfection efficiency, dose exposure, and the age of the subject, factors that are difficult to standardize in a heterogeneous human population. Future Directions: Further research should reveal the role of lymphatic circulation in internal organs and connect its impairment with human diseases. Pro-lymphangiogenic therapies that aim at the acceleration of tissue healing should focus on the controlled administration of VEGF-C to increase their capillary specificity, whereas regeneration of collecting vessels might benefit from balanced maturation and differentiation of pre-existing lymphatics. Unique features of pre-nodal lymphatics, fault tolerance and functional hyperplasia of capillaries, may find applications outreaching traditional pro-lymphangiogenic therapies, such as immunomodulation or enhancement of subcutaneous grafting.
Collapse
Affiliation(s)
- Witold W. Kilarski
- Institute for Molecular Engineering, The University of Chicago, Chicago, Illinois
| |
Collapse
|
124
|
Balasubbramanian D, Lopez Gelston CA, Rutkowski JM, Mitchell BM. Immune cell trafficking, lymphatics and hypertension. Br J Pharmacol 2018; 176:1978-1988. [PMID: 29797446 DOI: 10.1111/bph.14370] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/10/2018] [Accepted: 05/15/2018] [Indexed: 12/11/2022] Open
Abstract
Activated immune cell infiltration into organs contributes to the development and maintenance of hypertension. Studies targeting specific immune cell populations or reducing their inflammatory signalling have demonstrated a reduction in BP. Lymphatic vessels play a key role in immune cell trafficking and in resolving inflammation, but little is known about their role in hypertension. Studies from our laboratory and others suggest that inflammation-associated or induction of lymphangiogenesis is organ protective and anti-hypertensive. This review provides the basis for hypertension as a disease of chronic inflammation in various tissues and highlights how renal lymphangiogenesis is a novel regulator of kidney health and BP. LINKED ARTICLES: This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc.
Collapse
Affiliation(s)
| | | | - Joseph M Rutkowski
- Department of Medical Physiology, Texas A&M College of Medicine, College Station, TX, USA
| | - Brett M Mitchell
- Department of Medical Physiology, Texas A&M College of Medicine, College Station, TX, USA
| |
Collapse
|
125
|
Contraction of collecting lymphatics: organization of pressure-dependent rate for multiple lymphangions. Biomech Model Mechanobiol 2018; 17:1513-1532. [PMID: 29948540 DOI: 10.1007/s10237-018-1042-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/28/2018] [Indexed: 02/07/2023]
Abstract
The paper describes the extension of a previously developed model of pressure-dependent contraction rate to the case of multiple lymphangions. Mechanical factors are key modulators of active lymphatic pumping. As part of the evolution of our lumped-parameter model to match experimental findings, we have designed an algorithm whereby the time until the next contraction depends on lymphangion transmural pressure in the contraction just completed. The functional dependence of frequency on pressure is quantitatively matched to isobaric contraction experiments on isolated lymphatic segments. When each of several lymphangions is given this ability, a scheme for their coordination must be instituted to match the observed synchronization. Accordingly, and in line with an experiment on an isolated lymphatic vessel segment in which we measured contraction sequence and conduction delay, we took the fundamental principle to be that local timing can be overridden by signals to initiate contraction that start in adjacent lymphangions, conducted with a short delay. The scheme leads to retrograde conduction when the lymphangion chain is pumping against an adverse pressure difference, but antegrade conduction when contractions occur with no or a favourable pressure difference. Abolition of these conducted signals leads to chaotic variation of cycle-mean flow-rate from the chain, diastolic duration in each lymphangion, and inter-lymphangion delays. Chaotic rhythm is also seen under other circumstances. Because the model responds to increasing adverse pressure difference by increasing the repetition rate of contractions, it maintains time-average output flow-rate better than one with fixed repetition rate.
Collapse
|
126
|
Abstract
PURPOSE OF REVIEW The essential role of the lymphatic system in fluid homeostasis, nutrient transport, and immune trafficking is well recognized; however, there is limited understanding of the mechanisms that regulate lymphatic function, particularly in the setting of critical illness. The lymphatics likely affect disease severity and progression in every condition, from severe systemic inflammatory states to respiratory failure. Here, we review structural and functional disorders of the lymphatic system, both congenital and acquired, as they relate to care of the pediatric patient in the intensive care setting, including novel areas of research into medical and procedural therapeutic interventions. RECENT FINDINGS The mainstay of current therapies for congenital and acquired lymphatic abnormalities has involved nonspecific medical management or surgical procedures to obstruct or divert lymphatic flow. With the development of dynamic contrast-enhanced magnetic resonance lymphangiography, image-directed percutaneous intervention may largely replace surgery. Because of new insights into the mechanisms that regulate lymphatic biology, pharmacologic inhibitors of mTOR and leukotriene B4 signaling are each in Phase II clinical trials to treat abnormal lymphatic structure and function, respectively. SUMMARY As our understanding of normal lymphatic biology continues to advance, we will be able to develop novel strategies to support and augment lymphatic function during critical illness and through convalescence.
Collapse
|
127
|
Probing the effect of morphology on lymphatic valve dynamic function. Biomech Model Mechanobiol 2018; 17:1343-1356. [DOI: 10.1007/s10237-018-1030-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 05/10/2018] [Indexed: 12/19/2022]
|
128
|
Narayanan SA, Metzger CE, Bloomfield SA, Zawieja DC. Inflammation-induced lymphatic architecture and bone turnover changes are ameliorated by irisin treatment in chronic inflammatory bowel disease. FASEB J 2018; 32:4848-4861. [PMID: 29596023 DOI: 10.1096/fj.201800178r] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Inflammatory bowel disease (IBD) is a chronic disease with gastrointestinal dysfunction as well as comorbidities such as inflammation-induced bone loss and impaired immune response. Current treatments for IBD all have negative, potentially severe side effects. We aimed to test whether exogenous treatment with irisin, a novel immunomodulatory adipomyokine, could ameliorate IBD-induced lymphatic and bone alterations. Irisin treatment improved both gut and bone outcomes by mitigating inflammation and restoring structure. In the gut, IBD caused colonic lymphatic hyperproliferation into the mucosal and submucosal compartments. This proliferation in the rodent model is akin to what is observed in IBD patient case studies. In bone, IBD increased osteoclast surface and decreased bone formation. Both gut and osteocytes in bone exhibited elevated levels of TNF-α and receptor activator of NF-κB ligand (RANKL) protein expression. Exogenous irisin treatment restored normal colonic lymphatic architecture and increased bone formation rate concurrent with decreased osteoclast surfaces. After irisin treatment, gut and osteocyte TNF-α and RANKL protein expression levels were no different from vehicle controls. Our data indicate that the systemic immunologic changes that occur in IBD are initiated by damage in the gut and likely linked through the lymphatic system. Additionally, irisin is a potential novel intervention mitigating both local inflammatory changes in the gut and distant changes in bone.-Narayanan, S. A., Metzger, C. E., Bloomfield, S. A., Zawieja, D. C. Inflammation-induced lymphatic architecture and bone turnover changes are ameliorated by irisin treatment in chronic inflammatory bowel disease.
Collapse
Affiliation(s)
- S Anand Narayanan
- Department of Medical Physiology, Texas A&M University Health Science Center, Temple, Texas, USA; and
| | - Corinne E Metzger
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Susan A Bloomfield
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
| | - David C Zawieja
- Department of Medical Physiology, Texas A&M University Health Science Center, Temple, Texas, USA; and
| |
Collapse
|
129
|
Cromer WE, Zawieja SD, Doersch KM, Stagg H, Hunter F, Tharakan B, Childs E, Zawieja DC. Burn Injury-Associated MHCII + Immune Cell Accumulation Around Lymphatic Vessels of the Mesentery and Increased Lymphatic Endothelial Permeability Are Blocked by Doxycycline Treatment. Lymphat Res Biol 2018; 16:56-64. [PMID: 29359999 DOI: 10.1089/lrb.2017.0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
It is theorized that toxic agents are transported from the hyperpermeable gut of burn victims through the lymph, to the systemic circulation, causing global injury. We believe that immune cells respond to leakage of "toxic lymph" following trauma causing the attraction of these cells to the perilymphatic space. To test this, we utilized a model of burn on rats to examine changes in a single immune cell population associated with mesenteric lymphatic dysfunction. We examined the ability of serum from these animals to increase permeability in lymphatic endothelial monolayers and disrupt cellular junctions. We also treated burn animals with doxycycline, an inhibitor of microvascular permeability, and observed the effects on immune cell populations, morphometry, and lymphatic endothelial permeability. Burn injury increased the number of MHCII+ immune cells along the vessel (>50%). The size and shape of these cells also changed significantly following burn injury. Serum from burn animals increased lymphatic endothelial permeability (∼1.5-fold) and induced breaks in VE-cadherin staining. Doxycycline treatment blocked the accumulation of immune cells along the vessel, whereas serum from doxycycline-treated animals failed to increase lymphatic endothelial permeability. The size of cells along the vessel in doxycycline-treated burn animals was not affected, suggesting that the cells already present on the lymphatic vessels still respond to substances in the lymph. These findings suggest that factors produced during burn can induce lymphatic endothelial barrier disruption and lymph produced during traumatic injury can influence the attraction and morphology of immune cell populations along the vessel.
Collapse
Affiliation(s)
- Walter E Cromer
- 1 Department of Medical Physiology, Texas A&M University Health Science Center , Temple, Texas
| | - Scott D Zawieja
- 2 Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine , Columbia, South Carolina
| | - Karen M Doersch
- 1 Department of Medical Physiology, Texas A&M University Health Science Center , Temple, Texas
| | - Hayden Stagg
- 3 Department of Surgery, Scott & White Hospital , Temple, Texas
| | - Felicia Hunter
- 3 Department of Surgery, Scott & White Hospital , Temple, Texas.,4 Department of Surgery, Morehouse Medical College , Atlanta, Georgia
| | - Binu Tharakan
- 3 Department of Surgery, Scott & White Hospital , Temple, Texas
| | - Ed Childs
- 3 Department of Surgery, Scott & White Hospital , Temple, Texas.,4 Department of Surgery, Morehouse Medical College , Atlanta, Georgia
| | - David C Zawieja
- 1 Department of Medical Physiology, Texas A&M University Health Science Center , Temple, Texas
| |
Collapse
|
130
|
Jones D, Meijer EFJ, Blatter C, Liao S, Pereira ER, Bouta EM, Jung K, Chin SM, Huang P, Munn LL, Vakoc BJ, Otto M, Padera TP. Methicillin-resistant Staphylococcus aureus causes sustained collecting lymphatic vessel dysfunction. Sci Transl Med 2018; 10:eaam7964. [PMID: 29343625 PMCID: PMC5953194 DOI: 10.1126/scitranslmed.aam7964] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 07/20/2017] [Accepted: 11/20/2017] [Indexed: 12/13/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of morbidity and mortality worldwide and is a frequent cause of skin and soft tissue infections (SSTIs). Lymphedema-fluid accumulation in tissue caused by impaired lymphatic vessel function-is a strong risk factor for SSTIs. SSTIs also frequently recur in patients and sometimes lead to acquired lymphedema. However, the mechanism of how SSTIs can be both the consequence and the cause of lymphatic vessel dysfunction is not known. Intravital imaging in mice revealed an acute reduction in both lymphatic vessel contractility and lymph flow after localized MRSA infection. Moreover, chronic lymphatic impairment is observed long after MRSA is cleared and inflammation is resolved. Associated with decreased collecting lymphatic vessel function was the loss and disorganization of lymphatic muscle cells (LMCs), which are critical for lymphatic contraction. In vitro, incubation with MRSA-conditioned supernatant led to LMC death. Proteomic analysis identified several accessory gene regulator (agr)-controlled MRSA exotoxins that contribute to LMC death. Infection with agr mutant MRSA resulted in sustained lymphatic function compared to animals infected with wild-type MRSA. Our findings suggest that agr is a promising target to preserve lymphatic vessel function and promote immunity during SSTIs.
Collapse
Affiliation(s)
- Dennis Jones
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Eelco F J Meijer
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Cedric Blatter
- Harvard Medical School, Boston, MA 02115, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Shan Liao
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
| | - Ethel R Pereira
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Echoe M Bouta
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Keehoon Jung
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Shan Min Chin
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Peigen Huang
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Lance L Munn
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Benjamin J Vakoc
- Harvard Medical School, Boston, MA 02115, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Michael Otto
- Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
| | - Timothy P Padera
- Edwin L. Steele Laboratory, Department of Radiation Oncology, MGH Cancer Center, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA.
- Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
131
|
Ekinci Ö, Öğüt B, Çelik B, Dursun A. Compared With Elastin Stains, h-Caldesmon and Desmin Offer Superior Detection of Vessel Invasion in Gastric, Pancreatic, and Colorectal Adenocarcinomas. Int J Surg Pathol 2018; 26:318-326. [PMID: 29325463 DOI: 10.1177/1066896917752442] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The presence of vessel invasion is considered indicative of a poor prognosis in many malignant tumors. We aimed to compare the sensitivity of elastin stains (van Gieson's and orcein methods) with 2 smooth muscle markers (h-caldesmon and desmin) in gastric, pancreatic, and colorectal adenocarcinoma specimens. MATERIALS AND METHODS We used 27 (29.3%) gastric, 35 (38.0%) pancreatic, and 30 (32.6%) colorectal resection specimens. We applied a provisional classification of vessel invasion patterns: type A, a focus with a nearby artery unaccompanied by a vein; type T, a focus at the invasive front without an unaccompanied artery; and type X, foci that only appeared by any of the 4 stains used. RESULTS There were 369 foci. The smooth muscle markers were more sensitive than the elastin stains, and h-caldesmon more sensitive than desmin, in all types. Among the 139 type A foci, 33 (23.7%) were positive by desmin and h-caldesmon, whereas the elastin stains were not ( P = .001). h-Caldesmon was the only positive marker in 11 (7.9%; P = .011). Among the 78 type T foci, 21 (26.9%) were positive by desmin and h-caldesmon, when both elastin stains were negative ( P = .000). In 16 (20.5%) foci, h-caldesmon was the only positive marker ( P = .002). Among 152 type X foci, 91 (59.9%) were positive by all markers, 26 (17.1%) by both desmin and h-caldesmon, and 9 (5.9%) by only the 2 elastin stains ( P = .001). CONCLUSION We recommend these stains for suspect foci in gastric, pancreatic, and colorectal adenocarcinoma specimens. They might highlight both predictable and unpredictable foci.
Collapse
|
132
|
Abstract
The supply of oxygen and nutrients to tissues is performed by the blood system, and involves a net leakage of fluid outward at the capillary level. One of the principal functions of the lymphatic system is to gather this fluid and return it to the blood system to maintain overall fluid balance. Fluid in the interstitial spaces is often at subatmospheric pressure, and the return points into the venous system are at pressures of approximately 20 cmH2O. This adverse pressure difference is overcome by the active pumping of collecting lymphatic vessels, which feature closely spaced one-way valves and contractile muscle cells in their walls. Passive vessel squeezing causes further pumping. The dynamics of lymphatic pumping have been investigated experimentally and mathematically, revealing complex behaviours indicating that the system performance is robust against minor perturbations in pressure and flow. More serious disruptions can lead to incurable swelling of tissues called lymphœdema.
Collapse
Affiliation(s)
- James E Moore
- Department of Bioengineering, Imperial College London
| | | |
Collapse
|
133
|
Abstract
The supply of oxygen and nutrients to tissues is performed by the blood system, and involves a net leakage of fluid outward at the capillary level. One of the principal functions of the lymphatic system is to gather this fluid and return it to the blood system to maintain overall fluid balance. Fluid in the interstitial spaces is often at subatmospheric pressure, and the return points into the venous system are at pressures of approximately 20 cmH2O. This adverse pressure difference is overcome by the active pumping of collecting lymphatic vessels, which feature closely spaced one-way valves and contractile muscle cells in their walls. Passive vessel squeezing causes further pumping. The dynamics of lymphatic pumping have been investigated experimentally and mathematically, revealing complex behaviours indicating that the system performance is robust against minor perturbations in pressure and flow. More serious disruptions can lead to incurable swelling of tissues called lymphœdema.
Collapse
Affiliation(s)
- James E Moore
- Department of Bioengineering, Imperial College London
| | | |
Collapse
|
134
|
Sabine A, Davis MJ, Bovay E, Petrova TV. Characterization of Mouse Mesenteric Lymphatic Valve Structure and Function. Methods Mol Biol 2018; 1846:97-129. [PMID: 30242755 DOI: 10.1007/978-1-4939-8712-2_7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intraluminal valves of collecting lymphatic vessels ensure unidirectional lymph transport against hydrostatic pressure gradient. Mouse mesentery harbors up to 800 valves and represents a convenient model for lymphatic valve quantification, high resolution imaging of different stages of valve development as well as for analysis of valve function. The protocol describes embryonic and postnatal mesenteric lymphatic vessel preparation for whole-mount immunofluorescent staining and visualization of valve organization, quantification of main morphological parameters such as valve size and leaflet length, and the quantitative assessment of functional properties of adult valves using back-leak and closure tests.
Collapse
Affiliation(s)
- Amélie Sabine
- Department of Oncology, Division of Experimental Pathology, CHUV, Ludwig Institute for Cancer Research, University of Lausanne, Epalinges, Switzerland.
| | - Michael J Davis
- Medical Pharmacology & Physiology, University of Missouri, Columbia, MO, USA
| | - Esther Bovay
- Department of Oncology, Division of Experimental Pathology, CHUV, Ludwig Institute for Cancer Research, University of Lausanne, Epalinges, Switzerland
| | - Tatiana V Petrova
- Department of Oncology, Division of Experimental Pathology, CHUV, Ludwig Institute for Cancer Research, University of Lausanne, Epalinges, Switzerland.
- Swiss Institute for Cancer Research, EPFL, Lausanne, Switzerland.
| |
Collapse
|
135
|
Unt DV, Lobov GI. Inhibitory Effect of Interferons on Contractive Activity of Bovine Mesenteric Lymphatic Vessels and Nodes. Bull Exp Biol Med 2017; 164:123-126. [DOI: 10.1007/s10517-017-3939-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Indexed: 11/27/2022]
|
136
|
Kinking and Torsion Can Significantly Improve the Efficiency of Valveless Pumping in Periodically Compressed Tubular Conduits. Implications for Understanding of the Form-Function Relationship of Embryonic Heart Tubes. J Cardiovasc Dev Dis 2017; 4:jcdd4040019. [PMID: 29367548 PMCID: PMC5753120 DOI: 10.3390/jcdd4040019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/14/2017] [Accepted: 11/15/2017] [Indexed: 01/01/2023] Open
Abstract
Valveless pumping phenomena (peristalsis, Liebau-effect) can generate unidirectional fluid flow in periodically compressed tubular conduits. Early embryonic hearts are tubular conduits acting as valveless pumps. It is unclear whether such hearts work as peristaltic or Liebau-effect pumps. During the initial phase of its pumping activity, the originally straight embryonic heart is subjected to deforming forces that produce bending, twisting, kinking, and coiling. This deformation process is called cardiac looping. Its function is traditionally seen as generating a configuration needed for establishment of correct alignments of pulmonary and systemic flow pathways in the mature heart of lung-breathing vertebrates. This idea conflicts with the fact that cardiac looping occurs in all vertebrates, including gill-breathing fishes. We speculate that looping morphogenesis may improve the efficiency of valveless pumping. To test the physical plausibility of this hypothesis, we analyzed the pumping performance of a Liebau-effect pump in straight and looped (kinked) configurations. Compared to the straight configuration, the looped configuration significantly improved the pumping performance of our pump. This shows that looping can improve the efficiency of valveless pumping driven by the Liebau-effect. Further studies are needed to clarify whether this finding may have implications for understanding of the form-function relationship of embryonic hearts.
Collapse
|
137
|
Urner S, Kelly-Goss M, Peirce SM, Lammert E. Mechanotransduction in Blood and Lymphatic Vascular Development and Disease. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2017; 81:155-208. [PMID: 29310798 DOI: 10.1016/bs.apha.2017.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The blood and lymphatic vasculatures are hierarchical networks of vessels, which constantly transport fluids and, therefore, are exposed to a variety of mechanical forces. Considering the role of mechanotransduction is key for fully understanding how these vascular systems develop, function, and how vascular pathologies evolve. During embryonic development, for example, initiation of blood flow is essential for early vascular remodeling, and increased interstitial fluid pressure as well as initiation of lymph flow is needed for proper development and maturation of the lymphatic vasculature. In this review, we introduce specific mechanical forces that affect both the blood and lymphatic vasculatures, including longitudinal and circumferential stretch, as well as shear stress. In addition, we provide an overview of the role of mechanotransduction during atherosclerosis and secondary lymphedema, which both trigger tissue fibrosis.
Collapse
Affiliation(s)
- Sofia Urner
- Institute of Metabolic Physiology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Molly Kelly-Goss
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Shayn M Peirce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Eckhard Lammert
- Institute of Metabolic Physiology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute for Beta Cell Biology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.
| |
Collapse
|
138
|
Thompson RL, Margolis EA, Ryan TJ, Coisman BJ, Price GM, Wong KHK, Tien J. Design principles for lymphatic drainage of fluid and solutes from collagen scaffolds. J Biomed Mater Res A 2017; 106:106-114. [PMID: 28879690 DOI: 10.1002/jbm.a.36211] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/04/2017] [Accepted: 08/24/2017] [Indexed: 12/30/2022]
Abstract
In vivo, tissues are drained of excess fluid and macromolecules by the lymphatic vascular system. How to engineer artificial lymphatics that can provide equivalent drainage in biomaterials remains an open question. This study elucidates design principles for engineered lymphatics, by comparing the rates of removal of fluid and solute through type I collagen gels that contain lymphatic vessels or unseeded channels, or through gels without channels. Surprisingly, no difference was found between the fluid drainage rates for gels that contained vessels or bare channels. Moreover, solute drainage rates were greater in collagen gels that contained lymphatic vessels than in those that had bare channels. The enhancement of solute drainage by lymphatic endothelium was more pronounced in longer scaffolds and with smaller solutes. Whole-scaffold imaging revealed that endothelialization aided in solute drainage by impeding solute reflux into the gel without hindering solute entry into the vessel lumen. These results were reproduced by computational models of drainage with a flow-dependent endothelial hydraulic conductivity. This study shows that endothelialization of bare channels does not impede the drainage of fluid from collagen gels and can increase the drainage of macromolecules by preventing solute transport back into the scaffold. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 106-114, 2018.
Collapse
Affiliation(s)
- Rebecca L Thompson
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215
| | - Emily A Margolis
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215
| | - Tyler J Ryan
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215
| | - Brent J Coisman
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215
| | - Gavrielle M Price
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215
| | - Keith H K Wong
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215
| | - Joe Tien
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215.,Division of Materials Science and Engineering, Boston University, 15 St. Mary's Street, Brookline, Massachusetts, 02446
| |
Collapse
|
139
|
Demonstration and Analysis of the Suction Effect for Pumping Lymph from Tissue Beds at Subatmospheric Pressure. Sci Rep 2017; 7:12080. [PMID: 28935890 PMCID: PMC5608746 DOI: 10.1038/s41598-017-11599-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/25/2017] [Indexed: 12/11/2022] Open
Abstract
Many tissues exhibit subatmospheric interstitial pressures under normal physiologic conditions. The mechanisms by which the lymphatic system extracts fluid from these tissues against the overall pressure gradient are unknown. We address this important physiologic issue by combining experimental measurements of contractile function and pressure generation with a previously validated mathematical model. We provide definitive evidence for the existence of 'suction pressure' in collecting lymphatic vessels, which manifests as a transient drop in pressure downstream of the inlet valve following contraction. This suction opens the inlet valve and is required for filling in the presence of low upstream pressure. Positive transmural pressure is required for this suction, providing the energy required to reopen the vessel. Alternatively, external vessel tethering can serve the same purpose when the transmural pressure is negative. Suction is transmitted upstream, allowing fluid to be drawn in through initial lymphatics. Because suction plays a major role in fluid entry to the lymphatics and is affected by interstitial pressure, our results introduce the phenomenon as another important factor to consider in the study of lymphoedema and its treatment.
Collapse
|
140
|
Wheatley CM, Baker SE, Taylor BJ, Keller-Ross ML, Chase SC, Carlson AR, Wentz RJ, Snyder EM, Johnson BD. Influence of Inhaled Amiloride on Lung Fluid Clearance in Response to Normobaric Hypoxia in Healthy Individuals. High Alt Med Biol 2017; 18:343-354. [PMID: 28876128 DOI: 10.1089/ham.2017.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Wheatley, Courtney M., Sarah E. Baker, Bryan J. Taylor, Manda L. Keller-Ross, Steven C. Chase, Alex R. Carlson, Robert J. Wentz, Eric M. Snyder, and Bruce D. Johnson. Influence of inhaled amiloride on lung fluid clearance in response to normobaric hypoxia in healthy individuals. High Alt Med Biol 18:343-354, 2017. AIM To investigate the role of epithelial sodium channels (ENaC) on lung fluid clearance in response to normobaric hypoxia, 20 healthy subjects were exposed to 15 hours of hypoxia (fraction of inspired oxygen [FiO2] = 12.5%) on two randomized occasions: (1) inhaled amiloride (A) (1.5 mg/5 mL saline); and (2) inhaled saline placebo (P). Changes in lung fluid were assessed through chest computed tomography (CT) for lung tissue volume (TV), and the diffusion capacity of the lungs for carbon monoxide (DLCO) and nitric oxide (DLNO) for pulmonary capillary blood volume (VC). Extravascular lung water (EVLW) was derived as TV-VC and changes in the CT attenuation distribution histograms were reviewed. RESULTS Normobaric hypoxia caused (1) a reduction in EVLW (change from baseline for A vs. P, -8.5% ± 3.8% vs. -7.9% ± 5.2%, p < 0.05), (2) an increase in VC (53.6% ± 28.9% vs. 53.9% ± 52.3%, p < 0.05), (3) a small increase in DLCO (9.6% ± 29.3% vs. 9.9% ± 23.9%, p > 0.05), and (4) CT attenuation distribution became more negative, leftward skewed, and kurtotic (p < 0.05). CONCLUSION Acute normobaric hypoxia caused a reduction in lung fluid that was unaffected by ENaC inhibition through inhaled amiloride. Although possible amiloride-sensitive ENaC may not be necessary to maintain lung fluid balance in response to hypoxia, it is more probable that normobaric hypoxia promotes lung fluid clearance rather than accumulation for the majority of healthy individuals. The observed reduction in interstitial lung fluid means alveolar fluid clearance may not have been challenged.
Collapse
Affiliation(s)
- Courtney M Wheatley
- 1 Department of Pharmaceutical Science, University of Arizona , Tucson, Arizona
| | - Sarah E Baker
- 1 Department of Pharmaceutical Science, University of Arizona , Tucson, Arizona
| | - Bryan J Taylor
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | | | - Steven C Chase
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Alex R Carlson
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Robert J Wentz
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Eric M Snyder
- 1 Department of Pharmaceutical Science, University of Arizona , Tucson, Arizona
| | - Bruce D Johnson
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| |
Collapse
|
141
|
Nathan AA, Dixit M, Babu S, Balakrishnan AS. Comparison and functional characterisation of peripheral blood mononuclear cells isolated from filarial lymphoedema and endemic normals of a South Indian population. Trop Med Int Health 2017; 22:1414-1427. [PMID: 28869696 DOI: 10.1111/tmi.12969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The underlying problem in lymphatic filariasis is irreversible swelling of the limbs (lymphoedema), which is a unique feature of lymphatic insufficiency. It is still unclear whether the natural ability of lymphatics to form functional lymphatic vasculature is achieved or attenuated in the lymphoedemal pathology. Clinical studies have clearly shown that circulating lymphatic progenitors (CLPs), a subset of bone marrow-derived mononuclear cells (PBMCs), contribute to post-natal lymph vasculogenesis. CLP-based revascularisation could be a promising strategy to bypass the endothelial disruption and damage incurred by the filarial parasites. Thus our aim was to compare and characterise the functional prowess of PBMCs in physiological and lymphoedemal pathology. METHODS PBMCs were isolated from venous blood sample from drug-naive endemic normals (EN) and drug-deprived filarial lymphoedema (FL) individuals using density gradient centrifugation. Adhesion, transwell migration and in vitro matrigel assays were employed to characterise the lymphvasculogenic potential of PBMCs. CLPs were phenotypically characterised using flow cytometry; expression levels of lymphatic markers and inflammatory cytokines were quantified using qRT-PCR and ELISA, respectively. RESULTS PBMCs from FL group display poor adherence to fibronectin (P = 0.040), reduced migration towards SDF-1α (P = 0.035), impaired tubular network (P = 0.004) and branching point (P = 0.048) formation. The PBMC mRNA expression of VEGFR3 (P = 0.039) and podoplanin (P = 0.050) was elevated, whereas integrin α9 (P = 0.046) was inhibited in FL individuals; additionally, the surface expression of CD34 (P = 0.048) was significantly reduced in the FL group compared to the EN group. CONCLUSION PBMCs from filarial lymphoedema show defective and dysregulated lymphvasculogenic function compared to endemic normals.
Collapse
Affiliation(s)
- Abel Arul Nathan
- Department of Genetic Engineering, School of Biotechnology, Madurai Kamaraj University, Madurai, India
| | - Madhulika Dixit
- Laboratory of Vascular Biology, Department of Biotechnology, Bhupat Joyti Metha School of Biosciences and Bioengineering, Indian Institute of Technology Madras, Chennai, India
| | - Subash Babu
- NIH-ICER, National Institute for Research in Tuberculosis, Chennai, India
| | - Anand Setty Balakrishnan
- Department of Genetic Engineering, School of Biotechnology, Madurai Kamaraj University, Madurai, India
| |
Collapse
|
142
|
Bernier-Latmani J, Petrova TV. Intestinal lymphatic vasculature: structure, mechanisms and functions. Nat Rev Gastroenterol Hepatol 2017; 14:510-526. [PMID: 28655884 DOI: 10.1038/nrgastro.2017.79] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The mammalian intestine is richly supplied with lymphatic vasculature, which has functions ranging from maintenance of interstitial fluid balance to transport of antigens, antigen-presenting cells, dietary lipids and fat-soluble vitamins. In this Review, we provide in-depth information concerning the organization and structure of intestinal lymphatics, the current view of their developmental origins, as well as molecular mechanisms of intestinal lymphatic patterning and maintenance. We will also discuss physiological aspects of intestinal lymph flow regulation and the known and emerging roles of intestinal lymphatic vessels in human diseases, such as IBD, infection and cancer.
Collapse
Affiliation(s)
- Jeremiah Bernier-Latmani
- Department of Fundamental Oncology, Ludwig Institute for Cancer Research and Institute of Pathology, Centre Hospitalier Universitaire Vaudois and University of Lausanne (UNIL), Chemin des Boveresses 155, Epalinges, Switzerland
| | - Tatiana V Petrova
- Department of Fundamental Oncology, Ludwig Institute for Cancer Research and Institute of Pathology, Centre Hospitalier Universitaire Vaudois and University of Lausanne (UNIL), Chemin des Boveresses 155, Epalinges, Switzerland.,Swiss Institute for Experimental Cancer Research, School of Life Sciences, Swiss Federal Institute of Technology Lausanne, Route Cantonale 1015, Lausanne, Switzerland
| |
Collapse
|
143
|
Wang Y, Jin Y, Mäe MA, Zhang Y, Ortsäter H, Betsholtz C, Mäkinen T, Jakobsson L. Smooth muscle cell recruitment to lymphatic vessels requires PDGFB and impacts vessel size but not identity. Development 2017; 144:3590-3601. [PMID: 28851707 PMCID: PMC5665477 DOI: 10.1242/dev.147967] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 08/21/2017] [Indexed: 12/13/2022]
Abstract
Tissue fluid drains through blind-ended lymphatic capillaries, via smooth muscle cell (SMC)-covered collecting vessels into venous circulation. Both defective SMC recruitment to collecting vessels and ectopic recruitment to lymphatic capillaries are thought to contribute to vessel failure, leading to lymphedema. However, mechanisms controlling lymphatic SMC recruitment and its role in vessel maturation are unknown. Here, we demonstrate that platelet-derived growth factor B (PDGFB) regulates lymphatic SMC recruitment in multiple vascular beds. PDGFB is selectively expressed by lymphatic endothelial cells (LECs) of collecting vessels. LEC-specific deletion of Pdgfb prevented SMC recruitment causing dilation and failure of pulsatile contraction of collecting vessels. However, vessel remodelling and identity were unaffected. Unexpectedly, Pdgfb overexpression in LECs did not induce SMC recruitment to capillaries. This was explained by the demonstrated requirement of PDGFB extracellular matrix (ECM) retention for lymphatic SMC recruitment, and the low presence of PDGFB-binding ECM components around lymphatic capillaries. These results demonstrate the requirement of LEC-autonomous PDGFB expression and retention for SMC recruitment to lymphatic vessels, and suggest an ECM-controlled checkpoint that prevents SMC investment of capillaries, which is a common feature in lymphedematous skin. Summary:Pdgfb mutant mice provide insight into the recruitment and function of smooth muscle cells in the lymphatic vasculature, and shed new light on mechanisms of lymph vessel-associated diseases.
Collapse
Affiliation(s)
- Yixin Wang
- Karolinska Institutet, Department of Medical Biochemistry and Biophysics, Division of Vascular Biology, Scheeles Väg 2, SE171 77 Stockholm, Sweden
| | - Yi Jin
- Karolinska Institutet, Department of Medical Biochemistry and Biophysics, Division of Vascular Biology, Scheeles Väg 2, SE171 77 Stockholm, Sweden
| | - Maarja Andaloussi Mäe
- Uppsala University, Dept. Immunology, Genetics and Pathology, Rudbeck Laboratory, Dag Hammarskjölds väg 20, SE751 85 Uppsala, Sweden
| | - Yang Zhang
- Uppsala University, Dept. Immunology, Genetics and Pathology, Rudbeck Laboratory, Dag Hammarskjölds väg 20, SE751 85 Uppsala, Sweden
| | - Henrik Ortsäter
- Uppsala University, Dept. Immunology, Genetics and Pathology, Rudbeck Laboratory, Dag Hammarskjölds väg 20, SE751 85 Uppsala, Sweden
| | - Christer Betsholtz
- Uppsala University, Dept. Immunology, Genetics and Pathology, Rudbeck Laboratory, Dag Hammarskjölds väg 20, SE751 85 Uppsala, Sweden.,Integrated Cardio Metabolic Centre (ICMC), Karolinska Institutet, Novum, Blickagången 6, SE14157 Huddinge, Sweden
| | - Taija Mäkinen
- Uppsala University, Dept. Immunology, Genetics and Pathology, Rudbeck Laboratory, Dag Hammarskjölds väg 20, SE751 85 Uppsala, Sweden
| | - Lars Jakobsson
- Karolinska Institutet, Department of Medical Biochemistry and Biophysics, Division of Vascular Biology, Scheeles Väg 2, SE171 77 Stockholm, Sweden
| |
Collapse
|
144
|
Solari E, Marcozzi C, Negrini D, Moriondo A. Temperature-dependent modulation of regional lymphatic contraction frequency and flow. Am J Physiol Heart Circ Physiol 2017; 313:H879-H889. [PMID: 28778912 DOI: 10.1152/ajpheart.00267.2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/21/2017] [Accepted: 08/02/2017] [Indexed: 11/22/2022]
Abstract
Lymph drainage and propulsion are sustained by an extrinsic mechanism, based on mechanical forces acting from the surrounding tissues against the wall of lymphatic vessels, and by an intrinsic mechanism attributable to active spontaneous contractions of the lymphatic vessel muscle. Despite being heterogeneous, the mechanisms underlying the generation of spontaneous contractions share a common biochemical nature and are thus modulated by temperature. In this study, we challenged excised tissues from rat diaphragm and hindpaw, endowed with spontaneously contracting lymphatic vessels, to temperatures from 24°C (hindpaw) or 33°C (diaphragmatic vessels) to 40°C while measuring lymphatic contraction frequency (fc) and amplitude. Both vessel populations displayed a sigmoidal relationship between fc and temperature, each centered around the average temperature of surrounding tissue (36.7 diaphragmatic and 32.1 hindpaw lymphatics). Although the slope factor of the sigmoidal fit to the fc change of hindpaw vessels was 2.3°C·cycles-1·min-1, a value within the normal range displayed by simple biochemical reactions, the slope factor of the diaphragmatic lymphatics was 0.62°C·cycles-1·min-1, suggesting the added involvement of temperature-sensing mechanisms. Lymph flow calculated as a function of temperature confirmed the relationship observed on fc data alone and showed that none of the two lymphatic vessel populations would be able to adapt to the optimal working temperature of the other tissue district. This poses a novel question whether lymphatic vessels might not adapt their function to accommodate the change if exposed to a surrounding temperature, which is different from their normal condition.NEW & NOTEWORTHY This study demonstrates to what extent lymphatic vessel intrinsic contractility and lymph flow are modulated by temperature and that this modulation is dependent on the body district that the vessels belong to, suggesting a possible functional misbehavior should lymphatic vessels be exposed to a chronically different temperature.
Collapse
Affiliation(s)
- Eleonora Solari
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Cristiana Marcozzi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Daniela Negrini
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Andrea Moriondo
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| |
Collapse
|
145
|
Razavi MS, Nelson TS, Nepiyushchikh Z, Gleason RL, Dixon JB. The relationship between lymphangion chain length and maximum pressure generation established through in vivo imaging and computational modeling. Am J Physiol Heart Circ Physiol 2017; 313:H1249-H1260. [PMID: 28778909 DOI: 10.1152/ajpheart.00003.2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The intrinsic contraction of collecting lymphatic vessels serves as a pumping system to propel lymph against hydrostatic pressure gradients as it returns interstitial fluid to the venous circulation. In the present study, we proposed and validated that the maximum opposing outflow pressure along a chain of lymphangions at which flow can be achieved increases with the length of chain. Using minimally invasive near-infrared imaging to measure the effective pumping pressure at various locations in the rat tail, we demonstrated increases in pumping pressure along the length of the tail. Computational simulations based on a microstructurally motivated model of a chain of lymphangions informed from biaxial testing of isolated vessels was used to provide insights into the pumping mechanisms responsible for the pressure increases observed in vivo. These models suggest that the number of lymphangions in the chain and smooth muscle cell force generation play a significant role in determining the maximum outflow pressure, whereas the frequency of contraction has no effect. In vivo administration of nitric oxide attenuated lymphatic contraction, subsequently lowering the effective pumping pressure. Computational simulations suggest that the reduction in contractile strength of smooth muscle cells in the presence of nitric oxide can account for the reductions in outflow pressure observed along the lymphangion chain in vivo. Thus, combining modeling with multiple measurements of lymphatic pumping pressure provides a method for approximating intrinsic lymphatic muscle activity noninvasively in vivo while also providing insights into factors that determine the extent that a lymphangion chain can transport fluid against an adverse pressure gradient. NEW & NOTEWORTHY Here, we report the first minimally invasive in vivo measurements of the relationship between lymphangion chain length and lymphatic pumping pressure. We also provide the first in vivo validation of lumped parameter models of lymphangion chains previously developed through data obtained from isolated vessel testing.
Collapse
Affiliation(s)
- Mohammad S Razavi
- The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology , Atlanta, Georgia.,The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology , Atlanta, Georgia
| | - Tyler S Nelson
- The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology , Atlanta, Georgia.,The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology , Atlanta, Georgia
| | - Zhanna Nepiyushchikh
- The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology , Atlanta, Georgia.,The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology , Atlanta, Georgia
| | - Rudolph L Gleason
- The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology , Atlanta, Georgia.,The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology , Atlanta, Georgia.,The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology , Atlanta, Georgia
| | - J Brandon Dixon
- The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology , Atlanta, Georgia.,The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology , Atlanta, Georgia.,The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology , Atlanta, Georgia
| |
Collapse
|
146
|
Morley ST, Walsh MT, Newport DT. Opportunities for Studying the Hydrodynamic Context for Breast Cancer Cell Spread Through Lymph Flow. Lymphat Res Biol 2017; 15:204-219. [PMID: 28749743 DOI: 10.1089/lrb.2017.0005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The lymphatic system serves as the primary route for the metastatic spread of breast cancer cells (BCCs). A scarcity of information exists with regard to the advection of BCCs in lymph flow and a fundamental understanding of the response of BCCs to the forces in the lymphatics needs to be established. This review summarizes the flow environment metastatic BCCs are exposed to in the lymphatics. Special attention is paid to the behavior of cells/particles in microflows in an attempt to elucidate the behavior of BCCs under lymph flow conditions (Reynolds number <1).
Collapse
Affiliation(s)
- Sinéad T Morley
- 1 Faculty of Science & Engineering, School of Engineering, Bernal Institute, University of Limerick , Limerick, Ireland
| | - Michael T Walsh
- 1 Faculty of Science & Engineering, School of Engineering, Bernal Institute, University of Limerick , Limerick, Ireland .,2 Health Research Institute, University of Limerick , Limerick, Ireland
| | - David T Newport
- 1 Faculty of Science & Engineering, School of Engineering, Bernal Institute, University of Limerick , Limerick, Ireland
| |
Collapse
|
147
|
Meens MJ, Kutkut I, Rochemont V, Dubrot J, Kaladji FR, Sabine A, Lyons O, Hendrikx S, Bernier-Latmani J, Kiefer F, Smith A, Hugues S, Petrova TV, Kwak BR. Cx47 fine-tunes the handling of serum lipids but is dispensable for lymphatic vascular function. PLoS One 2017; 12:e0181476. [PMID: 28732089 PMCID: PMC5521787 DOI: 10.1371/journal.pone.0181476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/30/2017] [Indexed: 12/04/2022] Open
Abstract
Mutations in the gap junction protein connexin47 (Cx47) are associated with lymphedema. However, the role of Cx47 in lymphatic pathophysiology is unknown. We demonstrate that Cx47 is expressed in lymphatic endothelial cells by whole-mount immunostaining and qPCR. To determine if Cx47 plays a role in lymphatic vessel function we analysed Cx47-/- mice. Cx47-deficiency did not affect lymphatic contractility (contractile amplitude or frequency) or lymphatic morphology (vessel diameter or number of valves). Interstitial fluid drainage or dendritic cell migration through lymphatic vessels was also not affected by Cx47-deficiency. Cx47 is dispensable for long-chain fatty acid absorption from the gut but rather promotes serum lipid handling as prolonged elevated triglyceride levels were observed in Cx47-deficient mice after oral lipid tolerance tests. When crossed with Apolipoprotein E-deficient (Apoe-/-) mice, LDL-cholesterol was decreased in young Cx47-/-Apoe-/- adults as compared to Apoe-/- mice, which was inverted later in life. Finally, advanced atherosclerotic plaques in thoracic-abdominal aortas of 15 months-old mice tended to be larger in Cx47-/-Apoe-/- mice. These plaques contained fewer macrophages but similar amounts of T lymphocytes, collagen and lipids than plaques of Apoe-/- mice. In conclusion, Cx47 is expressed in lymphatic endothelium and seems modestly implicated in multiple aspects of lymphatic pathophysiology.
Collapse
Affiliation(s)
- Merlijn J. Meens
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Issa Kutkut
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Viviane Rochemont
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Juan Dubrot
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Fouad R. Kaladji
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Amélie Sabine
- Department of Fundamental Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
- Division of Experimental Pathology, Institute of Pathology, CHUV, Lausanne, Switzerland
| | - Oliver Lyons
- Academic Department of Vascular Surgery, Cardiovascular Division, King's College London, BHF Centre of Research Excellence & NIHR Biomedical Research Centre at King's Health Partners, St Thomas' Hospital, London, United Kingdom
| | - Stefanie Hendrikx
- Department of Fundamental Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
- Division of Experimental Pathology, Institute of Pathology, CHUV, Lausanne, Switzerland
| | - Jeremiah Bernier-Latmani
- Department of Fundamental Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
- Division of Experimental Pathology, Institute of Pathology, CHUV, Lausanne, Switzerland
| | - Friedemann Kiefer
- Mammalian Cell Signalling Laboratory, Department of Vascular Cell Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - Alberto Smith
- Academic Department of Vascular Surgery, Cardiovascular Division, King's College London, BHF Centre of Research Excellence & NIHR Biomedical Research Centre at King's Health Partners, St Thomas' Hospital, London, United Kingdom
| | - Stéphanie Hugues
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Tatiana V. Petrova
- Department of Fundamental Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
- Division of Experimental Pathology, Institute of Pathology, CHUV, Lausanne, Switzerland
- Swiss Institute for Experimental Cancer Research, School of Life Sciences, Swiss Federal Institute of Technology Lausanne, Lausanne, Switzerland
| | - Brenda R. Kwak
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
- Department of Medical Specialties – Cardiology, University of Geneva, Geneva, Switzerland
| |
Collapse
|
148
|
Al-Kofahi M, Yun JW, Minagar A, Alexander JS. Anatomy and roles of lymphatics in inflammatory diseases. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/cen3.12400] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Mahmoud Al-Kofahi
- Department of Experimental and Clinical Pharmacology; College of Pharmacy; University of Minnesota; Minneapolis MN USA
| | - J. Winny Yun
- Department of Molecular and Cellular Physiology; Louisiana State University Health Sciences Center Shreveport; Shreveport LA USA
| | - Alireza Minagar
- Department of Neurology; Louisiana State University Health Sciences Center Shreveport; Shreveport LA USA
| | - J. Steven Alexander
- Department of Molecular and Cellular Physiology; Louisiana State University Health Sciences Center Shreveport; Shreveport LA USA
- Department of Neurology; Louisiana State University Health Sciences Center Shreveport; Shreveport LA USA
| |
Collapse
|
149
|
Friedland-Little JM, Gajarski RJ, Schumacher KR. Dopamine as a potential rescue therapy for refractory protein-losing enteropathy in Fontan-palliated patients. Pediatr Transplant 2017; 21. [PMID: 28370952 DOI: 10.1111/petr.12925] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2017] [Indexed: 12/18/2022]
Abstract
PLE is an important cause of morbidity and mortality in patients who have undergone Fontan palliation. While multiple PLE therapies have been reported, none has proved consistently effective. Patients who do not respond to "standard" PLE therapies face poor long-term outcomes. We report here a significant response to dopamine infusion in three patients with chronic, refractory PLE. We hypothesize that this response may be at least partially due to a dopamine effect on lymphatic receptors rather than to an augmentation of cardiac output.
Collapse
Affiliation(s)
- Joshua M Friedland-Little
- Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Robert J Gajarski
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA
| | - Kurt R Schumacher
- Division of Pediatric Cardiology, Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
150
|
Nizamutdinova IT, Maejima D, Nagai T, Meininger CJ, Gashev AA. Histamine as an Endothelium-Derived Relaxing Factor in Aged Mesenteric Lymphatic Vessels. Lymphat Res Biol 2017; 15:136-145. [PMID: 28453392 PMCID: PMC5488315 DOI: 10.1089/lrb.2016.0062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Knowledge of the mechanisms by which aging affects contracting lymphatic vessels remains incomplete; therefore, the functional role of histamine in the reaction of aged lymphatic vessels to increases in flow remains unknown. METHODS AND RESULTS We measured and analyzed parameters of lymphatic contractility in isolated and pressurized rat mesenteric lymphatic vessels (MLVs) obtained from 9- and 24-month Fischer-344 rats under control conditions and after pharmacological blockade of nitric oxide (NO) by Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME, 100 μM) or/and blockade of histamine production by α-methyl-DL-histidine dihydrochloride (α-MHD, 10 μM). We also quantitatively compared results of immunohistochemical labeling of the histamine-producing enzyme, histidine decarboxylase (HDC) in adult and aged MLVs. Our data provide the first demonstration of an increased functional role of histamine as an endothelial-derived relaxing factor in aged MLVs, which appears in parallel with the abolished role of NO in the reactions of these lymph vessels to increases in flow. In addition, we found an increased expression of HDC in endothelium of aged MLVs. CONCLUSIONS Our findings provide the basis for better understanding of the processes of aging in lymphatic vessels and for setting new important directions for investigations of the aging-associated disturbances in lymph flow and the immune response.
Collapse
Affiliation(s)
- Irina Tsoy Nizamutdinova
- Department of Medical Physiology, College of Medicine, Texas A&M University Health Science Center, Temple, Texas
| | - Daisuke Maejima
- Department of Medical Physiology, College of Medicine, Texas A&M University Health Science Center, Temple, Texas
- Department of Physiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Nagai
- Department of Medical Physiology, College of Medicine, Texas A&M University Health Science Center, Temple, Texas
- Department of Physiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Cynthia J. Meininger
- Department of Medical Physiology, College of Medicine, Texas A&M University Health Science Center, Temple, Texas
| | - Anatoliy A. Gashev
- Department of Medical Physiology, College of Medicine, Texas A&M University Health Science Center, Temple, Texas
| |
Collapse
|