Inflammation Research Network and Smooth Muscle Research Group, Snyder Institute of Infection, Immunity and Inflammation, Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
Curr Opin Gastroenterol. 2011 Jul;27(4):335-41. doi: 10.1097/MOG.0b013e3283476e8f.
Intestinal lymph containing interstitial fluid, proteins, immune cells, and digested lipids is actively transported back to the blood stream thanks to rhythmical contractions of the mesenteric lymphatic vessels. During this process, lymph flows through several lymph nodes, allowing antigens to be sampled by the immune system. Abnormalities in lymphatic drainage have been noted in the original descriptions of Crohn's disease, but essentially ignored since. The lymphatic system is re-emerging as a critical player in inflammatory and immune processes and the purpose of this review is to present and discuss new concepts related to the involvement of the lymphatic system in the development of inflammatory bowel diseases (IBDs) and more specifically Crohn's disease.
Recent studies reporting lymphangitis, lymphangiogenesis, bacterial infiltration and lymph node infection, immune cell trafficking, and fat-wrapping in Crohn's disease suggest altered lymph drainage and lymphatic pumping, implicating the lymphatic system as a likely player in inflammatory disorders and IBDs.
Improved knowledge and appreciation of the roles that the lymphatic system plays in immune cell trafficking, infection, fat transport, distribution and metabolism and, of course, edema resolution is necessary to better understand the pathogenesis of chronic inflammatory conditions such as Crohn's disease and may provide the basis for new therapeutic strategies.
肠道淋巴液包含间质液、蛋白质、免疫细胞和消化后的脂质，这些成分通过肠系膜淋巴管的有节奏收缩被主动回收到血液中。在这个过程中，淋巴液流经几个淋巴结，使免疫系统能够对抗原进行取样。在克罗恩病的最初描述中已经注意到了淋巴引流的异常，但此后基本上被忽视了。淋巴系统作为炎症和免疫过程中的关键参与者重新出现，本综述的目的是介绍和讨论与淋巴系统参与炎症性肠病（IBD）发展，特别是克罗恩病相关的新概念。
最近的研究报告显示，在克罗恩病中存在淋巴管炎、淋巴管生成、细菌渗透和淋巴结感染、免疫细胞迁移以及脂肪包裹等现象，这表明淋巴引流和淋巴泵功能发生改变，提示淋巴系统可能是炎症性疾病和 IBD 的一个重要参与者。
为了更好地理解克罗恩病等慢性炎症性疾病的发病机制，并可能为新的治疗策略提供基础，有必要更好地了解淋巴系统在免疫细胞迁移、感染、脂肪运输、分布和代谢以及当然还有水肿消退中的作用。
