ResultsEvidence collected allows us to propose the following working model. Compromised lymph drainage, reported in IBD, leads to oedema, lymphangiogenesis, impaired immune cell trafficking and lymph leakage. Lymph factor(s) stimulate adipose tissue to proliferate and produce cytokines, which affect immune cell functions and exacerbate inflammation.
ConclusionsUnderstanding the lymphatic system's role in immune cell trafficking and immune responses, contribution to fat transport, distribution, metabolism and implication in the pathogenesis of chronic intestinal inflammation may provide the basis for new therapeutic strategies and improved quality-oflife. Alimentary Pharmacology and Therapeutics
Aliment Pharmacol Ther
INTRODUCTIONThe lymphatic system is a frequently overlooked yet vitally important system in the body. In addition to maintaining tissue fluid homoeostasis, it plays critical roles in immune defence and in metabolic maintenance. Indeed, it functions as an interface between our body and the environment. It is a pre-eminent player in the body's response to pathogens and acts as the physical basis of the immune system by providing conduits and lymph nodes for the presentation of potentially harmful antigens from the environment to immune cells, leading to recognition and initiation of an immune response. It is important for energy storage and metabolic functions, most notably by supplying a route for ingested lipids to be absorbed, stored and metabolized. Finally, it serves as a collective 'garbage dump', where dead cells, bacteria, poisons, toxins and excess fluids are deposited from bodily tissues. Subsequently, it indirectly delivers these substances via the blood to the organs of detoxification including the liver, kidneys, skin, lungs and large colon for eventual elimination.
LYMPHATIC SYSTEM, LYMPHATIC PUMPING AND LYMPH FLOWThe lymphatic system is composed of numerous vessels connecting the interstitial tissue space to blood circulation and to lymphoid organs such as lymph nodes, the spleen and other lymphoid structures (e.g. Peyer's patches in the small intestine). The lymphatic vessels, or lymphatics, are widely distributed throughout the body and are organized into a very dense and extensive network. Unlike the cardiovascular system, which is a closed-circuit relying on a central pump to move blood, lymphatic vessels form a one-way system that collects lymph from the extremities by the initial lymphatics, propels it via the pumping action of the collecting lymphatics and empties its contents into the venous circulation. Any deficiencies in this process lead to fluid accumulation in the interstitium, oedema and insurmountable osmotic imbalance.1 Initial lymphatics are blind-ended tubes comprising endothelial cells (e.g. lacteals in intestinal villi), which lie in close proximity to the blood capillaries, picking up fluid and proteins that leave the cardiovascular system to maintain tissue fluid balance. The collecting lymphatic vessels differ from the initial lymphatics in that most have smooth ...