Distribution of diaphragmatic lymphatic lacunae

Negrini, Daniela; Fabbro, Massimo Del; Gonano, C.; Mukenge, Sylvain; Miserocchi, Giuseppe

doi:10.1152/jappl.1992.72.3.1166

Cited by 37 publications

(29 citation statements)

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“…This difference might be compatible with a greater distribution of the peritoneal lymphatic network and/or a higher driving pressure gradients promoting lymph formation. The present data in fact describe a more developed initial lymphatic network, at least in terms of vessel density and area lacunae -to-area tissue ratio, over the peritoneal compared with the pleural side of the diaphragm (Table 1), confirming the previous observation on the distribution of diaphragmatic lacunae (14) and stomata (18) in normal rabbits. Concerning the pressure gradients arising between the peritoneal cavity and the diaphragmatic lumen, at this state of the art one may only comment that because P abd Ͼ P pl during the whole respiratory cycle (see RESULTS), P abd Ϫ P lymph might also be greater than P pl Ϫ P lymph provided that P lymph is similar on the two sides of the diaphragm.…”

Section: Discussionsupporting

confidence: 91%

Functional arrangement of rat diaphragmatic initial lymphatic network

Grimaldi¹,

Moriondo²,

Sciacca³

et al. 2006

American Journal of Physiology-Heart and Circulatory Physiology

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Fluid and solute flux between the pleural and peritoneal cavities, although never documented under physiological conditions, might play a relevant role in pathological conditions associated with the development of ascitis and pleural effusion and/or in the processes of tumor dissemination. To verify whether a pleuroperitoneal flux might take place through the diaphragmatic lymphatic network, the transdiaphragmatic pressure gradient (⌬P TD) was measured in five spontaneously breathing anesthetized rats. ⌬PTD was Ϫ1.93 cmH2O (SD 0.59) and Ϫ3.1 cmH2O (SD 0.82) at end expiration and at end inspiration, respectively, indicating the existence of a pressure gradient directed from the abdominal to the pleural cavity. Morphometrical analysis of the diaphragmatic lymphatic network was performed in the excised diaphragm of three additional rats euthanized with an anesthesia overdose. Optical and electron microscopy revealed that lymphatic submesothelial lacunae and lymphatic capillaries among the skeletal muscles fibers show the ultrastructural features of the socalled initial lymphatic vessels, namely, a discontinuous basal lamina and anchoring filaments linking the outer surface of the endothelial cells to connective tissue or to muscle fibers. Primary unidirectional valves in the wall of the initial lymphatics allow entrance of serosal fluid into the lymphatic network preventing fluid backflow, while unidirectional intraluminar valves in the transverse vessels convey lymph centripetally toward central collecting ducts. The complexity and anatomical arrangement of the two valves system suggests that, despite the existence of a favorable ⌬P TD, in the physiological condition no fluid bulk flow takes place between the pleural and peritoneal cavity through the diaphragmatic lymphatic network. intraluminar lymphatic pressure; serosal fluid pressure; tissue fluid homeostasis THE DRAINAGE OF FLUID, solutes of large molecular weight, and even cells from the pleural and the peritoneal cavity mainly occurs through the lymphatic system located in the parietal mesothelial and submesothelial tissues covering the thoracic and abdominal walls and both surfaces of the diaphragm (10,12,15,19). The ability of the diaphragmatic lymphatic system to drain fluid from both the pleural and peritoneal cavity has been assessed in normal healthy animals (10, 12) by using experimental approaches that were meant to respect the physiological condition as much as possible. The results from these studies, whereas demonstrating the importance of the diaphragmatic lymphatics in maintaining the serosal fluid volume, failed to reveal or suggest the occurrence of fluid transfer between the pleural and peritoneal cavities through the diaphragm itself. However, the existence of direct transdiaphragmatic lymphatic pathways often has been proposed (4, 25) to explain clinical observations like the development of hydrothoraces secondary to peritoneal dialysis or ascitis. At present it is not clear whether the recruitment of a direct transdiaphragmatic pathway wi...

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Section: Discussionsupporting

confidence: 91%

Functional arrangement of rat diaphragmatic initial lymphatic network

Grimaldi¹,

Moriondo²,

Sciacca³

et al. 2006

American Journal of Physiology-Heart and Circulatory Physiology

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“…The regional distribution of microspheres in the diaphragmatic pleura was most concentrated in the central region (i.e., the tendinous pleura rather than in the peripheral muscular pleura) consistent with published results [17]. Fig.…”

Section: Diaphragmatic Pleural Absorptionsupporting

confidence: 90%

Regional Pleural Filtration and Absorption Measured by Fluorescent Tracers in Rabbits

Wang

Lai-Fook

1999

Lung

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In prone anesthetized rabbits, we used Evans blue-dyed albumin (EBA) to study regional pleural filtration and FITC dextran to study regional pleural absorption. Evans blue was injected intravenously, and the animals were ventilated for 6 h at either of two levels of ventilation. Postmortem the right rib cage was frozen and thawed before study. EBA fluorescence emitted from the rib cage surface was measured along the cranial-caudal axis near the mid chest with fluorescence videomicroscopy. Fluorescent light intensity increased from the third to the eighth rib in a cyclic fashion, with peaks at the ribs and troughs at the intercostal spaces. This increase was greater at the higher ventilation. Fluorescent images of cross sections of a frozen rib cage verified a cranial-caudal gradient in filtration. Fluorescent images of FITC dextran absorbed from the pleural space into the rib cage surface indicated major areas of absorption at the ventral, caudal, and cranial regions adjacent to the lung margins and areas of absorption scattered in the intercostal spaces. Simultaneous measurements of EBA filtration and FITC absorption showed sites of maximal filtration that were different from sites of maximal absorption. Pleural uptake of fluorescent microspheres (2-microm diameter) located lymphatic stomata distributed randomly within clusters in the intercostal spaces and channels of lymphatic lacunae parallel to blood vessels. Diaphragmatic uptake of microspheres was confined mainly to the ventral surface of the central tendon. Visceral pleural absorption was minimal.

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“…The extension of the lymphatic REVIEW: VOLUME CONTROL MECHANISMS G. MISEROCCHI network is mostly developed on the diaphragmatic surface where the density of stomata reaches the considerable value of 8,000?cm -2 , and on the mediastinal side where the density of stomata is so high that one speaks of a ''cribriform membrane''; the mesothelial openings connect to an extended network of submesothelial lacunae [11]. In physiological conditions, lymphatic flow amounts to 3 mL?min…”

Section: Pleural Fluid Steady State Pleural Fluid Dynamicsmentioning

confidence: 99%

Mechanisms controlling the volume of pleural fluid and extravascular lung water

Miserocchi

2009

Eur Respir Rev

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Pleural and interstitial lung fluid volumes are strictly controlled and maintained at the minimum thanks to the ability of lymphatics to match the increase in filtration rate. In the pleural cavity, fluid accumulation is easily accommodated by retraction of lung and chest wall (high compliance of the pleural space); the increase of lymph flow per unit increase in pleural fluid volume is high due to the great extension of the parietal lymphatic. However, for the lung interstitium, the increase in lymph flow to match increased filtration does not need to be so great. In fact, increased filtration only causes a minor increase in extravascular water volume (,10%) due to a marked increase in interstitial pulmonary pressure (low compliance of the extracellular matrix) which, in turn, buffers further filtration. Accordingly, a less extended lymphatic network is needed. The efficiency of lymphatic control is achieved through a high lymphatic conductance in the pleural fluid and through a low interstitial compliance for the lung interstitium. Fluid volume in both compartments is so strictly controlled that it is difficult to detect initial deviations from the physiological state; thus, a great physiological advantage turns to be a disadvantage on a clinical basis as it prevents an early diagnosis of developing disease.

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Distribution of diaphragmatic lymphatic lacunae

Cited by 37 publications

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Functional arrangement of rat diaphragmatic initial lymphatic network

Functional arrangement of rat diaphragmatic initial lymphatic network

Regional Pleural Filtration and Absorption Measured by Fluorescent Tracers in Rabbits

Mechanisms controlling the volume of pleural fluid and extravascular lung water

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