Maeda Taku, Yamamoto Yuhei, Iwasaki Daisuke, Hayashi Toshihiko, Funayama Emi, Oyama Akihiko, Murao Naoki, Furukawa Hiroshi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS) , Sapporo City, Hokkaido, Japan .
Lymphat Res Biol. 2018 Apr;16(2):165-173. doi: 10.1089/lrb.2016.0070. Epub 2017 Sep 28.
Lymph node transplantation is being increasingly recognized as a method of reconstruction of the lymphatic system for the treatment of lymphedema. However, the mechanisms regulating the connections between the lymphatic vessels and the lymph nodes remain poorly understood. The objective of this study was to examine whether removal of a popliteal lymph node (PLN) could result in rerouting of lymph flow and whether a single transplanted nonvascularized lymph node could reconnect with a lymphatic vessel and restore lymph flow.
Thirty-six mice were allocated to undergo resection of a PLN alone (group 1) or a transplanted lymph node after resection of a PLN (group 2). Changes in lymph flow were observed using indocyanine green dye. The ability of the transplanted lymph node to reconnect with the lymphatic vessels was examined by fluorescein isothiocyanate (FITC)-dextran and immunohistochemical staining. In group 1, the flow of lymph was redirected to an inguinal lymph node (ILN) in 8 of 18 mice and continued to drain to the PLN in 10 mice. In group 2, the lymph continued to drain normally after removal of the PLN, and was also directed to an ILN in two mice. FITC-dextran demonstrated continuity of the transplanted PLN and the lymphatic vessels. Immunohistochemical staining showed that T cell and B cell populations in the transplanted lymph node were preserved.
Lymphatic flow was rerouted after lymph node resection. A transplanted lymph node can be made viable with normal lymph flow by reconnecting the transplanted lymph node to a lymphatic vessel.
淋巴结移植作为重建淋巴系统以治疗淋巴水肿的一种方法，正日益受到认可。然而，调节淋巴管与淋巴结之间连接的机制仍知之甚少。本研究的目的是探讨切除腘淋巴结（PLN）是否会导致淋巴引流改道，以及单个移植的无血管淋巴结能否与淋巴管重新连接并恢复淋巴引流。
36只小鼠被分配接受单独切除PLN（第1组）或切除PLN后进行淋巴结移植（第2组）。使用吲哚菁绿染料观察淋巴引流的变化。通过异硫氰酸荧光素（FITC）-葡聚糖和免疫组织化学染色检查移植淋巴结与淋巴管重新连接的能力。在第1组中，18只小鼠中有8只的淋巴引流改向腹股沟淋巴结（ILN），10只小鼠的淋巴继续引流至PLN。在第2组中，切除PLN后淋巴继续正常引流，两只小鼠的淋巴也改向ILN。FITC-葡聚糖显示移植的PLN与淋巴管连续。免疫组织化学染色显示移植淋巴结中的T细胞和B细胞群体得以保留。
淋巴结切除后淋巴引流改道。通过将移植的淋巴结与淋巴管重新连接，可使移植的淋巴结存活并具有正常的淋巴引流。
