Lymph

Last updated

Lymph
Illu lymph capillary.png
Diagram showing the formation of lymph from interstitial fluid (labeled here as "Tissue fluid"). Note how the tissue fluid is entering the blind ends of lymph capillaries (shown as deep green arrows)
Details
System Lymphatic system
SourceFormed from interstitial fluid
Identifiers
Latin lympha
MeSH D008196
TA98 A12.0.00.043
TA2 3893
FMA 9671
Anatomical terminology

Lymph (from Latin lympha  'water') [1] is the fluid that flows through the lymphatic system, a system composed of lymph vessels (channels) and intervening lymph nodes whose function, like the venous system, is to return fluid from the tissues to be recirculated. At the origin of the fluid-return process, interstitial fluid—the fluid between the cells in all body tissues [2] —enters the lymph capillaries. This lymphatic fluid is then transported via progressively larger lymphatic vessels through lymph nodes, where substances are removed by tissue lymphocytes and circulating lymphocytes are added to the fluid, before emptying ultimately into the right or the left subclavian vein, where it mixes with central venous blood.

Contents

Because it is derived from interstitial fluid, with which blood and surrounding cells continually exchange substances, lymph undergoes continual change in composition. It is generally similar to blood plasma, which is the fluid component of blood. Lymph returns proteins and excess interstitial fluid to the bloodstream. Lymph also transports fats from the digestive system (beginning in the lacteals) to the blood via chylomicrons.

Bacteria may enter the lymph channels and be transported to lymph nodes, where the bacteria are destroyed. Metastatic cancer cells can also be transported via lymph.

Etymology

The word lymph is derived from the name of the ancient Roman deity of fresh water, Lympha.

Structure

Human lymph, obtained after a thoracic duct injury Homa limfo 001.jpg
Human lymph, obtained after a thoracic duct injury

Lymph has a composition similar but not identical to that of blood plasma. Lymph that leaves a lymph node is richer in lymphocytes than blood plasma is. The lymph formed in the human digestive system called chyle is rich in triglycerides (fat), and looks milky white because of its lipid content.

Development

Formation of interstitial fluid from blood. Starling forces are labelled: the hydrostatic pressure is higher proximally, driving fluid out; oncotic forces are higher distally, pulling fluid in. Capillary Microcirculation.svg
Formation of interstitial fluid from blood. Starling forces are labelled: the hydrostatic pressure is higher proximally, driving fluid out; oncotic forces are higher distally, pulling fluid in.

Blood supplies nutrients and important metabolites to the cells of a tissue and collects back the waste products they produce, which requires exchange of respective constituents between the blood and tissue cells. This exchange is not direct, but instead occurs through an intermediary called interstitial fluid, which occupies the spaces between cells. As the blood and the surrounding cells continually add and remove substances from the interstitial fluid, its composition continually changes. Water and solutes can pass between the interstitial fluid and blood via diffusion across gaps in capillary walls called intercellular clefts; thus, the blood and interstitial fluid are in dynamic equilibrium with each other. [3]

Interstitial fluid forms at the arterial (coming from the heart) end of capillaries because of the higher pressure of blood compared to veins, and most of it returns to its venous ends and venules; the rest (up to 10%) enters the lymph capillaries as lymph. [4] (Prior to entry, this fluid is referred to as the lymph obligatory load, or LOL, as the lymphatic system is effectively "obliged" to return it to the cardiovascular network. [5] ) The lymph when formed is a watery clear liquid with the same composition as the interstitial fluid. However, as it flows through the lymph nodes it comes in contact with blood, and tends to accumulate more cells (particularly, lymphocytes) and proteins. [6]

Functions

Components

Lymph returns proteins and excess interstitial fluid to the bloodstream. Lymph may pick up bacteria and transport them to lymph nodes, where the bacteria are destroyed. Metastatic cancer cells can also be transported via lymph. Lymph also transports fats from the digestive system (beginning in the lacteals) to the blood via chylomicrons.

Circulation

Tubular vessels transport lymph back to the blood, ultimately replacing the volume lost during the formation of the interstitial fluid. These channels are the lymphatic channels, or simply lymphatics. [7]

Unlike the cardiovascular system, the lymphatic system is not closed. In some amphibian and reptilian species, the lymphatic system has central pumps, called lymph hearts, which typically exist in pairs, [8] [9] but humans and other mammals do not have a central lymph pump. Lymph transport is slow and sporadic. [8] Despite low pressure, lymph movement occurs due to peristalsis (propulsion of the lymph due to alternate contraction and relaxation of smooth muscle tissue), valves, and compression during contraction of adjacent skeletal muscle and arterial pulsation. [10]

Lymph that enters the lymph vessels from the interstitial spaces usually does not flow backwards along the vessels because of the presence of valves. If excessive hydrostatic pressure develops within the lymph vessels, though, some fluid can leak back into the interstitial spaces and contribute to formation of edema.

The flow of lymph in the thoracic duct in an average resting person usually approximates 100ml per hour. Accompanied by another ~25ml per hour in other lymph vessels, the total lymph flow in the body is about 4 to 5 litres per day. This can be elevated several fold while exercising. It is estimated that without lymphatic flow, the average resting person would die within 24 hours. [11]

Clinical significance

Histopathological examination of the lymph system is used as a screening tool for immune system analysis in conjunction with pathological changes in other organ systems and clinical pathology to assess disease status. [12] Although histological assessment of the lymph system does not directly measure immune function, it can be combined with identification of chemical biomarkers to determine underlying changes in the diseased immune system. [13]

As a growth medium

In 1907 the zoologist Ross Granville Harrison demonstrated the growth of frog nerve cell processes in a medium of clotted lymph. It is made up of lymph nodes and vessels.

In 1913, E. Steinhardt, C. Israeli, and R. A. Lambert grew vaccinia virus in fragments of tissue culture from guinea pig cornea grown in lymph. [14]

After death

Decomposing corpses release lymph if the dead body is not preserved properly. A Thai religious cult attracted widespread disgust in 2022 for the unusual practices of its adherents, which included washing their faces in lymph that drained out of holes drilled into the coffins of dead followers. [15]

Related Research Articles

<span class="mw-page-title-main">Human body</span> Entire structure of a human being

The human body is the entire structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organs and then organ systems. They ensure homeostasis and the viability of the human body.

<span class="mw-page-title-main">Capillary</span> Smallest type of blood vessel

A capillary is a small blood vessel, from 5 to 10 micrometres in diameter, and is part of the microcirculation system. Capillaries are microvessels and the smallest blood vessels in the body. They are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the site of the exchange of many substances from the surrounding interstitial fluid, and they convey blood from the smallest branches of the arteries (arterioles) to those of the veins (venules). Other substances which cross capillaries include water, oxygen, carbon dioxide, urea, glucose, uric acid, lactic acid and creatinine. Lymph capillaries connect with larger lymph vessels to drain lymphatic fluid collected in microcirculation.

<span class="mw-page-title-main">Circulatory system</span> Organ system for circulating blood in animals

The circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, that consists of the heart and blood vessels. The circulatory system has two divisions, a systemic circulation or circuit, and a pulmonary circulation or circuit. Some sources use the terms cardiovascular system and vascular system interchangeably with circulatory system.

<span class="mw-page-title-main">Edema</span> Accumulation of excess fluid in body tissue

Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area may feel heavy, and joint stiffness. Other symptoms depend on the underlying cause.

<span class="mw-page-title-main">Lymphatic system</span> Organ system in vertebrates complementary to the circulatory system

The lymphatic system, or lymphoid system, is an organ system in vertebrates that is part of the immune system, and complementary to the circulatory system. It consists of a large network of lymphatic vessels, lymph nodes, lymphoid organs, lymphoid tissues and lymph. Lymph is a clear fluid carried by the lymphatic vessels back to the heart for re-circulation. The Latin word for lymph, lympha, refers to the deity of fresh water, "Lympha".

<span class="mw-page-title-main">Lymph node</span> Organ of the lymphatic system

A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that include B and T cells. Lymph nodes are important for the proper functioning of the immune system, acting as filters for foreign particles including cancer cells, but have no detoxification function.

<span class="mw-page-title-main">Microcirculation</span> Circulation of the blood in the smallest blood vessels

The microcirculation is the circulation of the blood in the smallest blood vessels, the microvessels of the microvasculature present within organ tissues. The microvessels include terminal arterioles, metarterioles, capillaries, and venules. Arterioles carry oxygenated blood to the capillaries, and blood flows out of the capillaries through venules into veins.

<span class="mw-page-title-main">Pia mater</span> Delicate innermost layer of the meninges, the membranes surrounding the brain and spinal cord

Pia mater, often referred to as simply the pia, is the delicate innermost layer of the meninges, the membranes surrounding the brain and spinal cord. Pia mater is medieval Latin meaning "tender mother". The other two meningeal membranes are the dura mater and the arachnoid mater. Both the pia and arachnoid mater are derivatives of the neural crest while the dura is derived from embryonic mesoderm. The pia mater is a thin fibrous tissue that is permeable to water and small solutes. The pia mater allows blood vessels to pass through and nourish the brain. The perivascular space between blood vessels and pia mater is proposed to be part of a pseudolymphatic system for the brain. When the pia mater becomes irritated and inflamed the result is meningitis.

<span class="mw-page-title-main">Extracellular fluid</span> Body fluid outside the cells of a multicellular organism

In cell biology, extracellular fluid (ECF) denotes all body fluid outside the cells of any multicellular organism. Total body water in healthy adults is about 50–60% of total body weight; women and the obese typically have a lower percentage than lean men. Extracellular fluid makes up about one-third of body fluid, the remaining two-thirds is intracellular fluid within cells. The main component of the extracellular fluid is the interstitial fluid that surrounds cells.

<span class="mw-page-title-main">Lymphatic vessel</span> Tubular vessels that are involved in the transport of lymph and lymphocytes

The lymphatic vessels are thin-walled vessels (tubes), structured like blood vessels, that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessels are lined by endothelial cells, and have a thin layer of smooth muscle, and adventitia that binds the lymph vessels to the surrounding tissue. Lymph vessels are devoted to the propulsion of the lymph from the lymph capillaries, which are mainly concerned with the absorption of interstitial fluid from the tissues. Lymph capillaries are slightly bigger than their counterpart capillaries of the vascular system. Lymph vessels that carry lymph to a lymph node are called afferent lymph vessels, and those that carry it from a lymph node are called efferent lymph vessels, from where the lymph may travel to another lymph node, may be returned to a vein, or may travel to a larger lymph duct. Lymph ducts drain the lymph into one of the subclavian veins and thus return it to general circulation.

The Starling principle holds that extracellular fluid movements between blood and tissues are determined by differences in hydrostatic pressure and colloid osmotic (oncotic) pressure between plasma inside microvessels and interstitial fluid outside them. The Starling Equation, proposed many years after the death of Starling, describes that relationship in mathematical form and can be applied to many biological and non-biological semipermeable membranes. The classic Starling principle and the equation that describes it have in recent years been revised and extended.

<span class="mw-page-title-main">Lacteal</span> Lymphatic capillary

A lacteal is a lymphatic capillary that absorbs dietary fats in the villi of the small intestine.

<span class="mw-page-title-main">Loose connective tissue</span> Type of connective tissue in animals

Loose connective tissue, also known as areolar tissue, is a cellular connective tissue with thin and relatively sparse collagen fibers. They have a semi-fluid matrix with lesser proportions of fibers. Its ground substance occupies more volume than the fibers do. It has a viscous to gel-like consistency and plays an important role in the diffusion of oxygen and nutrients from the capillaries that course through this connective tissue as well as in the diffusion of carbon dioxide and metabolic wastes back to the vessels. Moreover, loose connective tissue is primarily located beneath the epithelia that cover the body surfaces and line the internal surfaces of the body. It is also associated with the epithelium of glands and surrounds the smallest blood vessels. This tissue is thus the initial site where pathogenic agents, such as bacteria that have breached an epithelial surface, are challenged and destroyed by cells of the immune system.

The interstitium is a contiguous fluid-filled space existing between a structural barrier, such as a cell membrane or the skin, and internal structures, such as organs, including muscles and the circulatory system. The fluid in this space is called interstitial fluid, comprises water and solutes, and drains into the lymph system. The interstitial compartment is composed of connective and supporting tissues within the body – called the extracellular matrix – that are situated outside the blood and lymphatic vessels and the parenchyma of organs.

<span class="mw-page-title-main">Lymphangitis</span> Medical condition

Lymphangitis is an inflammation or an infection of the lymphatic channels that occurs as a result of infection at a site distal to the channel. It may present as long red streaks spreading away from the site of infection. It is a possible medical emergency as involvement of the lymphatic system allows for an infection to spread rapidly. The most common cause of lymphangitis in humans is bacteria, in which case sepsis and death could result within hours if left untreated. The most commonly involved bacteria include Streptococcus pyogenes and hemolytic streptococci. In some cases, it can be caused by viruses such as mononucleosis or cytomegalovirus, as well as specific conditions such as tuberculosis or syphilis, and the fungus Sporothrix schenckii. Lymphangitis is sometimes mistakenly called "blood poisoning". In reality, "blood poisoning" is synonymous with sepsis.

<span class="mw-page-title-main">Lymph capillary</span> Microvessel serving to drain and process extracellular fluid

Lymph capillaries or lymphatic capillaries are tiny, thin-walled microvessels located in the spaces between cells which serve to drain and process extracellular fluid. Upon entering the lumen of a lymphatic capillary, the collected fluid is known as lymph. Each lymphatic capillary carries lymph into a lymphatic vessel, which in turn connects to a lymph node, a small bean-shaped gland that filters and monitors the lymphatic fluid for infections. Lymph is ultimately returned to the venous circulation.

The lymphatic endothelium refers to a specialized subset of endothelial cells located in the sinus systems of draining lymph nodes. Specifically, these endothelial cells line the branched sinus systems formed by afferent lymphatic vessels, forming a single-cell layer which functions in a variety of critical physiological processes. These lymphatic endothelial cells contribute directly to immune function and response modulation, provide transport selectivity, and demonstrate orchestration of bidirectional signaling cascades. Additionally, lymphatic endothelial cells may be implicated in downstream immune cell development as well as lymphatic organogenesis. Until recently, lymphatic endothelial cells have not been characterized to their optimal potential. This system is very important in the function of continuous removal of interstitial fluid and proteins, while also having a significant function of entry for leukocytes and tumor cells. This leads to further research that is being developed on the relationship between lymphatic endothelium and metastasis of tumor cells . The lymphatic capillaries are described to be blind ended vessels, and they are made up of a single non-fenestrated layer of endothelial cells; The lymph capillaries function to aid in the uptake of fluids, macromolecules, and cells. Although they are generally similar to blood capillaries, the lymph capillaries have distinct structural differences. Lymph capillaries consist of a more wide and irregular lumen, and the endothelium in lymph capillaries is much thinner as well. Their origin has been speculated to vary based on them being dependent on specific tissue environments, and powered by organ-specific signals.(L. Gutierrez-Miranda, K. Yaniv, 2020). A lymph capillary endothelial cell is distinct from other endothelial cells in that collagen fibers are directly attached to its plasma membrane.

<span class="mw-page-title-main">Glymphatic system</span> System for waste clearance in the central nervous system of vertebrates

The glymphatic system is a system for waste clearance in the central nervous system (CNS) of vertebrates. According to this model, cerebrospinal fluid (CSF) flows into the paravascular space around cerebral arteries, combining with interstitial fluid (ISF) and parenchymal solutes, and exiting down venous paravascular spaces. The pathway consists of a para-arterial influx route for CSF to enter the brain parenchyma, coupled to a clearance mechanism for the removal of interstitial fluid (ISF) and extracellular solutes from the interstitial compartments of the brain and spinal cord. Exchange of solutes between CSF and ISF is driven primarily by arterial pulsation and regulated during sleep by the expansion and contraction of brain extracellular space. Clearance of soluble proteins, waste products, and excess extracellular fluid is accomplished through convective bulk flow of ISF, facilitated by astrocytic aquaporin 4 (AQP4) water channels.

Lymph node stromal cells are essential to the structure and function of the lymph node whose functions include: creating an internal tissue scaffold for the support of hematopoietic cells; the release of small molecule chemical messengers that facilitate interactions between hematopoietic cells; the facilitation of the migration of hematopoietic cells; the presentation of antigens to immune cells at the initiation of the adaptive immune system; and the homeostasis of lymphocyte numbers. Stromal cells originate from multipotent mesenchymal stem cells.

<span class="mw-page-title-main">Meningeal lymphatic vessels</span>

The meningeal lymphatic vessels are a network of conventional lymphatic vessels located parallel to the dural venous sinuses and middle meningeal arteries of the mammalian central nervous system (CNS). As a part of the lymphatic system, the meningeal lymphatics are responsible for draining immune cells, small molecules, and excess fluid from the CNS into the deep cervical lymph nodes. Cerebrospinal fluid, and interstitial fluid are exchanged, and drained by the meningeal lymphatic vessels.

References

  1. "lymph". Merriam-Webster.com Dictionary . Retrieved 29 May 2010.
  2. Fluid Physiology: 2.1 Fluid Compartments
  3. "The Lymphatic System". Human Anatomy (Gray's Anatomy). Retrieved 12 October 2012.
  4. Warwick, Roger; Peter L. Williams (1973) [1858]. "Angiology (Chapter 6)". Gray's anatomy. illustrated by Richard E. M. Moore (Thirty-fifth ed.). London: Longman. pp. 588–785.
  5. Archer, Pat; Nelson, Lisa A. (2012). Applied Anatomy & Physiology for Manual Therapists. Wolters Kluwer Health. p. 604. ISBN   9781451179705.
  6. Sloop, Charles H.; Ladislav Dory; Paul S. Roheim (March 1987). "Interstitial fluid lipoproteins" (PDF). Journal of Lipid Research. 28 (3): 225–237. doi: 10.1016/S0022-2275(20)38701-0 . PMID   3553402 . Retrieved 7 July 2008.
  7. "Definition of lymphatics". Webster's New World Medical Dictionary. MedicineNet.com. Retrieved 6 July 2008.
  8. 1 2 Hedrick, Michael S.; Hillman, Stanley S.; Drewes, Robert C.; Withers, Philip C. (1 July 2013). "Lymphatic regulation in nonmammalian vertebrates". Journal of Applied Physiology. 115 (3): 297–308. doi:10.1152/japplphysiol.00201.2013. ISSN   8750-7587. PMID   23640588.
  9. Banda, Chihena H.; Shiraishi, Makoto; Mitsui, Kohei; Okada, Yoshimoto; Danno, Kanako; Ishiura, Ryohei; Maemura, Kaho; Chiba, Chikafumi; Mizoguchi, Akira; Imanaka-Yoshida, Kyoko; Maruyama, Kazuaki; Narushima, Mitsunaga (27 April 2023). "Structural and functional analysis of the newt lymphatic system". Scientific Reports. 13 (1). doi: 10.1038/s41598-023-34169-w . ISSN   2045-2322. PMC   10140069 . PMID   37106059.
  10. Shayan, Ramin; Achen, Marc G.; Stacker, Steven A. (2006). "Lymphatic vessels in cancer metastasis: bridging the gaps". Carcinogenesis. 27 (9): 1729–38. doi: 10.1093/carcin/bgl031 . PMID   16597644.
  11. Guyton and Hall Textbook of Medical Physiology. Saunders. 2010. pp. 186, 187. ISBN   978-1416045748.
  12. Elmore, Susan A. (16 November 2011). "Enhanced histopathology of the immune system". Toxicologic Pathology. 40 (2): 148–156. doi:10.1177/0192623311427571. ISSN   0192-6233. PMC   3465566 . PMID   22089843.
  13. Elmore, Susan A. (2018). "Enhanced Histopathology Evaluation of Lymphoid Organs". Immunotoxicity Testing. Methods in Molecular Biology. Vol. 1803. pp. 147–168. doi:10.1007/978-1-4939-8549-4_10. ISBN   978-1-4939-8548-7. ISSN   1064-3745. PMID   29882138.
  14. Steinhardt, E; Israeli, C; and Lambert, R.A. (1913) "Studies on the cultivation of the virus of vaccinia" J. Inf Dis. 13, 294–300
  15. "Disturbing Details Keep Emerging About This Bizarre Poop-Eating Cult".