Zhong Jianyong, Liu Jing, Mutchler Ashley L, Yang Haichun, Kirabo Annet, Shelton Elaine L, Kon Valentina
Department of Pediatrics, Division of Pediatric Nephrology, Vanderbilt University Medical Center, Medical Center North C-4204, 1161 21st Avenue South, Nashville, TN, 37232-2584, USA.
Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA.
Pediatr Nephrol. 2025 Feb 3. doi: 10.1007/s00467-025-06692-7.
The development of lymphatic-specific markers has enabled detailed visualization of the lymphatic vascular network that has greatly enhanced our ability to explore this often-overlooked system. Lymphatics remove fluid, solutes, macromolecules, and cells from the interstitium and return them to circulation. The kidneys have lymphatics. As in other organs, the kidney lymphatic vessels are highly sensitive to changes in the local microenvironment. The sensitivity to its milieu may be especially relevant in kidneys because they are central in regulating fluid homeostasis and clearance of metabolites delivered into and eliminated from the renal interstitial compartment. Numerous physiologic conditions and diseases modify the renal interstitial volume, pressure, and composition that can, in turn, influence the growth and function of the renal lymphatics. The impact of the renal microenvironment is further heightened by the fact that kidneys are encapsulated. This review considers the development, structure, and function of the renal lymphatic vessels and explores how factors within the kidney interstitial compartment modify their structure and functionality. Moreover, although currently there are no pharmaceutical agents that specifically target the lymphatic network, we highlight several medications currently used in children with kidney disease and hypertension that have significant but underappreciated effects on lymphatics.
淋巴管特异性标志物的发展使得淋巴管网络得以详细可视化，这极大地增强了我们探索这个常被忽视系统的能力。淋巴管从间质中清除液体、溶质、大分子和细胞，并将它们送回循环系统。肾脏有淋巴管。与其他器官一样，肾淋巴管对局部微环境的变化高度敏感。在肾脏中，这种对其微环境的敏感性可能尤为重要，因为肾脏在调节液体稳态以及清除进入肾间质和从肾间质清除的代谢产物方面起着核心作用。许多生理状况和疾病会改变肾间质的体积、压力和成分，进而影响肾淋巴管的生长和功能。肾脏被包裹这一事实进一步加剧了肾脏微环境的影响。本综述考虑了肾淋巴管的发育、结构和功能，并探讨了肾间质隔室内的因素如何改变其结构和功能。此外，尽管目前尚无专门针对淋巴管网络的药物，但我们强调了目前用于治疗肾病和高血压儿童的几种药物，这些药物对淋巴管有显著但未得到充分认识的作用。
