Scallan Joshua P, Zawieja Scott D, Castorena-Gonzalez Jorge A, Davis Michael J
Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA.
J Physiol. 2016 Oct 15;594(20):5749-5768. doi: 10.1113/JP272088. Epub 2016 Aug 2.
A combination of extrinsic (passive) and intrinsic (active) forces move lymph against a hydrostatic pressure gradient in most regions of the body. The effectiveness of the lymph pump system impacts not only interstitial fluid balance but other aspects of overall homeostasis. This review focuses on the mechanisms that regulate the intrinsic, active contractions of collecting lymphatic vessels in relation to their ability to actively transport lymph. Lymph propulsion requires not only robust contractions of lymphatic muscle cells, but contraction waves that are synchronized over the length of a lymphangion as well as properly functioning intraluminal valves. Normal lymphatic pump function is determined by the intrinsic properties of lymphatic muscle and the regulation of pumping by lymphatic preload, afterload, spontaneous contraction rate, contractility and neural influences. Lymphatic contractile dysfunction, barrier dysfunction and valve defects are common themes among pathologies that directly involve the lymphatic system, such as inherited and acquired forms of lymphoedema, and pathologies that indirectly involve the lymphatic system, such as inflammation, obesity and metabolic syndrome, and inflammatory bowel disease.
在身体的大多数部位，外在（被动）力和内在（主动）力共同作用，促使淋巴液逆着静水压力梯度流动。淋巴泵系统的效能不仅影响组织液平衡，还影响整体内环境稳定的其他方面。本综述聚焦于调节集合淋巴管内在主动收缩的机制及其主动运输淋巴的能力。淋巴液的推进不仅需要淋巴管平滑肌细胞有力收缩，还需要在一个淋巴管节段长度上同步的收缩波以及功能正常的腔内瓣膜。正常的淋巴泵功能取决于淋巴管平滑肌的内在特性以及淋巴预负荷、后负荷、自发收缩频率、收缩性和神经影响对泵功能的调节。淋巴收缩功能障碍、屏障功能障碍和瓣膜缺陷是直接累及淋巴系统的疾病（如遗传性和获得性淋巴水肿）以及间接累及淋巴系统的疾病（如炎症、肥胖和代谢综合征、炎症性肠病）的常见病理特征。
