Grimaldi Annalisa, Moriondo Andrea, Sciacca Laura, Guidali Maria Luisa, Tettamanti Gianluca, Negrini Daniela
Dipartimento di Biologia Strutturale e Funzionale, Università degli Studi dell'Insubria, Via J.H. Dunant 5, 21100 Varese, Italy.
Am J Physiol Heart Circ Physiol. 2006 Aug;291(2):H876-85. doi: 10.1152/ajpheart.01276.2005. Epub 2006 Feb 17.
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 (Delta P(TD)) was measured in five spontaneously breathing anesthetized rats. Delta P(TD) was -1.93 cmH2O (SD 0.59) and -3.1 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 so-called 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 Delta P(TD), in the physiological condition no fluid bulk flow takes place between the pleural and peritoneal cavity through the diaphragmatic lymphatic network.
胸膜腔与腹膜腔之间的液体和溶质通量,尽管在生理条件下从未被记录过,但可能在与腹水和胸腔积液发展相关的病理状况以及/或肿瘤播散过程中发挥重要作用。为了验证胸膜腹膜通量是否可能通过膈淋巴管网络发生,在五只自主呼吸的麻醉大鼠中测量了跨膈压力梯度(ΔP(TD))。呼气末和吸气末的ΔP(TD)分别为 -1.93 cmH₂O(标准差0.59)和 -3.1 cmH₂O(标准差0.82),表明存在从腹腔指向胸腔的压力梯度。对另外三只因过量麻醉而安乐死的大鼠的离体膈肌进行了膈淋巴管网络的形态计量学分析。光学显微镜和电子显微镜显示,骨骼肌纤维之间的淋巴管下间皮腔隙和淋巴管毛细血管具有所谓初始淋巴管的超微结构特征,即不连续的基膜和将内皮细胞外表面连接到结缔组织或肌肉纤维的锚定丝。初始淋巴管壁中的初级单向瓣膜允许浆液进入淋巴管网络,防止液体回流,而横向血管中的管腔内单向瓣膜将淋巴向心输送至中央集合管。这两个瓣膜系统的复杂性和解剖学排列表明,尽管存在有利的ΔP(TD),但在生理条件下,胸膜腔与腹膜腔之间不会通过膈淋巴管网络发生大量液体流动。