Microradiographic demonstration of human intrarenal microlymphatic pathways

Cuttino, John T.; Clark, Richard L.; Jennette, J. Charles

doi:10.1007/bf02926482

Cited by 26 publications

(29 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, neolymphangiogenesis could be detrimental if the immune process is perpetuated and augmented in the inflammed tissues, but it may be beneficial if cytotoxic cells are removed more efficiently. In kidney grafts, the newly formed lymphatics reach deep into the tubulointerstitial space, unlike in normal kidneys (Cuttino et al, 1989), and are associated with nodular infiltrates that can be found in 10%-15% of transplant biopsies. As apoptosis can only partially remove infiltrates at a rate similar to the one in the thymus, lymph vessels could be responsible for the residual evacuation (Paavonen et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…This ''second circulation'' network is also present in the kidney, where the lymph vessels are confined to the area around largeand middle-sized arteries (McIntosh and Morris, 1971) in the cortex, but do not appear in the peritubular space (Kerjaschki et al, 2004). The medulla of a healthy person rarely possesses any lymphatics (Cuttino et al, 1989). Just a few years ago, the Kerjaschki group showed that neolymphangiogenesis occurs in allograft kidney transplants, a finding confirmed by another report 3 years later (Adair et al, 2007;Stuht et al, 2007).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Lymphangiogenesis Is Upregulated in Kidneys of Patients With Multiple Myeloma

Zimmer

Dahdal

Mühlfeld

et al. 2010

The Anatomical Record

View full text Add to dashboard Cite

Neolymphangiogenesis has recently been demonstrated in transplanted kidneys as well as in chronic interstitial nephritis and IgA nephropathy. However, its significance in kidney disease remains to be defined and a systematic study of renal lymphangiogenesis is warranted. We investigated patients with multiple myeloma (MM) presenting in the great majority with acute renal insufficiency. Controls were allograft kidney donors and patients with renal insufficiency due to acute renal failure (ARF). Lymph vessel length density (LVD) was quantified immunohistochemically by means of antipodoplanin staining followed by computer-assisted stereology. The mean LVD in kidneys of patients with MM (23.19 mm À2 ) was higher when compared with allograft donors (7.42 mm À2 , P ¼ 0.0003) and patients with ARF (6.78 mm À2 , P ¼ 0.0002). The higher LVD was significantly associated with interstitial inflammation, and the newly formed lymph vessels were accompanied by diffuse and nodular interstitial infiltrates composed mainly of CD20 þ B cells and CD27 þ plasma cells. The infiltrates in patients with MM also displayed a higher expression of the B-cell chemoattractant CXCL13. These results demonstrate for the first time that lymphangiogenesis is a prominent feature in MM kidneys and that it is associated with a significant accumulation of macrophages, CD20 þ and CD27 þ B lymphocytes. Further studies should clarify whether these changes represent a beneficial or detrimental factor in the progression of the myeloma-related kidney damage. Anat Rec, 293:1497Rec, 293: -1505

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Lymphangiogenesis Is Upregulated in Kidneys of Patients With Multiple Myeloma

Zimmer

Dahdal

Mühlfeld

et al. 2010

The Anatomical Record

View full text Add to dashboard Cite

show abstract

“…Hydraulic permeability (L p ) relates the total flux of solvent (water) plus solute through a membrane (volume flux, J v ) to the difference in hydrostatic pressure between the two sides of the membrane (⌬P). L p equals (J v /⌬P), when the transmembrane dif- 14 C]urea permeability (PU, ordinate) vs. 22 Na permeability (PNa, abscissa) is shown for outer medullary DVR (OMDVR) isolated from Sprague-Dawley rats and perfused in vitro and inner medullary DVR and AVR (IMDVR, IMAVR) perfused on the surface of the exposed papilla of MunichWistar rats in vivo. Dashed line represents identity.…”

Section: Transport Properties-general Definitionsmentioning

confidence: 99%

“…Evidence for a shared pathway conducting diffusion of hydrophilic solutes through the walls of DVR comes from measurements of the correlations between the diffusional permeabilities of these microvessels to 22 Na (P Na ) and to tritiated water (P D ), (90). The simplest interpretation of correlated variations in diffusional permeability to hydrophilic solutes is that they arise from variations in a shared aqueous (porous) pathway.…”

Section: Transport Of Water Through the Dvr Wallmentioning

confidence: 99%

See 1 more Smart Citation

Countercurrent exchange in the renal medulla

Pallone

Turner

Edwards

et al. 2003

American Journal of Physiology-Regulatory, Integrative and Comp

139

102

View full text Add to dashboard Cite

Pallone, Thomas L., Malcolm R. Turner, Auré lie Edwards, and Rex L. Jamison. Countercurrent exchange in the renal medulla. Am J Physiol Regul Integr Comp Physiol 284: R1153-R1175, 2003 10.1152/ ajpregu.00657.2002The microcirculation of the renal medulla traps NaCl and urea deposited to the interstitium by the loops of Henle and collecting ducts. Theories have predicted that countercurrent exchanger efficiency is favored by high permeability to solute. In contrast to the conceptualization of vasa recta as simple "U-tube" diffusive exchangers, many findings have revealed surprising complexity. Tubular-vascular relationships in the outer and inner medulla differ markedly. The wall structure and transport properties of descending vasa recta (DVR) and ascending vasa recta (AVR) are very different. The recent discoveries of aquaporin-1 (AQP1) water channels and the facilitated urea carrier UTB in DVR endothelia show that transcellular as well as paracellular pathways are involved in equilibration of DVR plasma with the interstitium. Efflux of water across AQP1 excludes NaCl and urea, leading to the conclusion that both water abstraction and diffusion contribute to transmural equilibration. Recent theory predicts that loss of water from DVR to the interstitium favors optimization of urinary concentration by shunting water to AVR, secondarily lowering blood flow to the inner medulla. Finally, DVR are vasoactive, arteriolar microvessels that are anatomically positioned to regulate total and regional blood flow to the outer and inner medulla. In this review, we provide historical perspective, describe the current state of knowledge, and suggest areas that are in need of further exploration. vasa recta; microperfusion; microcirculation; water channel; urinary concentration; permeability SINCE THE EXPERIMENTAL FINDINGS of Wirz et al. (147) led to the countercurrent theory of the urinary concentrating mechanism, as described by Hargitay and Kuhn (31), most subsequent research has focused on the countercurrent multiplier function of the loops of Henle. According to the theory, a small difference in osmotic pressure (the single effect) is multiplied by countercurrent flow in adjacent channels of the limbs of Henle's loop to produce a large axial difference in osmotic pressure between the renal cortex and the tip of the renal papilla; that is, the multiplier generates a hypertonic renal medulla. Less attention has been paid to countercurrent exchange, which is thought to preserve medullary hypertonicity rather than create it. It is generally accepted that the microcirculation of the renal medulla functions as a countercurrent exchanger that traps NaCl and urea deposited to the interstitium by the loops of Henle and collecting ducts, respectively. Early hypothetical descriptions of this process envisioned a system in which descending vasa recta (DVR) and ascending vasa recta (AVR) are parallel tubes that equilibrate by diffusion. According to that notion, blood flowing from the corticomedullary junction toward the papillary t...

show abstract

Kidney Lymphatics

Russell

Itkin

Windsor

et al. 2023

Comprehensive Physiology

View full text Add to dashboard Cite

Following significant advances in lymphatic biology, the important role of kidney lymphatics in kidney function and dysfunction is now being more fully appreciated. Kidney lymphatics begin in the cortex as blind-ended lymphatic capillaries and then coalesce into larger lymphatics that follow the main blood vessels out through the kidney hilum. Their function in draining interstitial fluid, macromolecules, and cells underpins their important role in kidney fluid and immune homeostasis. This article provides a comprehensive overview of recent and more established research findings on kidney lymphatics and the implications of these findings for kidney function and disease. The use of lymphatic molecular markers has greatly expanded our knowledge of the development, anatomy, and pathophysiology of kidney lymphatics. Significant recent discoveries include the diverse embryological source of kidney lymphatics, the hybrid nature of the ascending vasa recta, and the effects of lymphangiogenesis on kidney diseases such as acute kidney injury and renal fibrosis. On the basis of these recent advances, there is now an opportunity to link information from across multiple research disciplines to drive a new era of lymphatic-targeted therapies for kidney disease.

show abstract

Microradiographic demonstration of human intrarenal microlymphatic pathways

Cited by 26 publications

References 10 publications

Lymphangiogenesis Is Upregulated in Kidneys of Patients With Multiple Myeloma

Lymphangiogenesis Is Upregulated in Kidneys of Patients With Multiple Myeloma

Countercurrent exchange in the renal medulla

Kidney Lymphatics

Contact Info

Product

Resources

About