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Published on: March 6, 2015
Intestinal Lymphatic Dysfunction in Kidney Disease
Jianyong Zhong1,2, Annet Kirabo3,4, Hai-Chun Yang1,2
1Department of Pediatrics (J.Z., H.-C.Y., A.B.F., E.L.S., V.K.), Vanderbilt University Medical Center, Nashville, TN.
Abstract:
Kidney disease is associated with adverse consequences in many organs beyond the kidney, including the heart, lungs, brain, and intestines. The kidney-intestinal cross talk involves intestinal epithelial damage, dysbiosis, and generation of uremic toxins. Recent studies reveal that kidney injury expands the intestinal lymphatics, increases lymphatic flow, and alters the composition of mesenteric lymph. The intestinal lymphatics, like blood vessels, are a route for transporting potentially harmful substances generated by the intestines. The lymphatic architecture and actions are uniquely suited to take up and transport large macromolecules, functions that differentiate them from blood vessels, allowing them to play a distinct role in a variety of physiological and pathological processes. Here, we focus on the mechanisms by which kidney diseases result in deleterious changes in intestinal lymphatics and consider a novel paradigm of a vicious cycle of detrimental organ cross talk. This concept involves kidney injury-induced modulation of intestinal lymphatics that promotes production and distribution of harmful factors, which in turn contributes to disease progression in distant organ systems.
Insights
Kidney disease harms distant organs by altering intestinal lymphatics. This creates a vicious cycle where kidney injury promotes harmful substances, worsening overall health.
Area of Science:
- Nephrology
- Gastroenterology
- Lymphatic Biology
Background:
- Kidney disease impacts multiple organs, including the intestines.
- Kidney-intestinal interactions involve epithelial damage, gut bacteria imbalance, and uremic toxin production.
- Kidney injury affects intestinal lymphatic function and lymph composition.
Purpose of the Study:
- To investigate mechanisms linking kidney disease to detrimental changes in intestinal lymphatics.
- To propose a novel paradigm of a vicious cycle involving kidney-intestinal lymphatic cross talk.
Main Methods:
- Review of recent studies on kidney injury and intestinal lymphatics.
- Analysis of lymphatic transport of macromolecules.
- Conceptual framework development for organ cross talk.
Main Results:
- Kidney injury leads to expansion of intestinal lymphatics and increased lymphatic flow.
- Altered mesenteric lymph composition is observed in kidney disease.
- Intestinal lymphatics are a pathway for harmful substances from the gut.
Conclusions:
- Kidney disease induces changes in intestinal lymphatics, promoting harmful factor production and distribution.
- This kidney-intestinal lymphatic axis contributes to disease progression in distant organs.
- A vicious cycle of detrimental organ cross talk is implicated in kidney disease progression.
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