Morphometric analysis of intralobular, interlobular and pleural lymphatics in normal human lung
Morphometric analysis of intralobular, interlobular and pleural lymphatics in normal human lung
复制标题
正常人肺小叶内、小叶间和胸膜淋巴管的形态分析
作者：
F. Sozio;A. Rossi;E. Weber;D. Abraham;A. Nicholson;A. Wells;E. Renzoni;P. Sestini
尽管它们被认为与维持肺泡间隔液体稳态有关，但人类肺淋巴的解剖学知识仍然不完整。最近发现的可靠的淋巴内皮特异性标记导致观察到，与先前的假设相反，人类淋巴管延伸到肺小叶深处，与细支气管、小叶内小动脉或小肺静脉相关。本研究的目的是提供人肺周围淋巴管的形态计量学特征。用淋巴标记物D2‐40对人肺切片进行免疫标记，然后用血管性血液病因子对血管进行染色。淋巴管分为：小叶内（包括与支气管血管束、血管周围、细支气管周围和肺泡间）、胸膜（在内脏胸膜结缔组织中）和小叶间（在小叶间隔中）。淋巴腔在小叶间隔和胸膜下空间所占的面积比小叶大得多。大多数小叶内淋巴管与血管紧密接触，单独或在支气管血管束内，而7%与细支气管相关，< 1%不与血管或细支气管（肺泡间）相连。从支气管血管到细支气管周围、血管周围和肺泡间淋巴管，小叶内淋巴管的大小逐渐减小。与支气管维管束相关的淋巴管具有与胸膜淋巴管和小叶间淋巴管相似的形态学特征。不同淋巴群的形状因素相似，除了细支气管周围淋巴的圆度和圆形度略微增加，表明由于填充增加而形状更规则，而小叶间淋巴的延伸率更大，因为纵向切割的传导淋巴管比例更大。无监督聚类分析证实了组内和组间淋巴管的明显异质性，在肺泡间质内的血管周围和肺泡间的淋巴管中有一簇较小的血管。我们的数据表明，小叶内淋巴管是一个异质性的群体，包括支气管维管束周围的血管，类似于胸膜和小叶间隔中的传导血管，许多小的血管周围淋巴管负责维持肺泡间质中的液体平衡，以及少数中间淋巴管引流周围气道。这些淋巴细胞群可能不同地参与疾病的发病机制，优先涉及不同的肺室。
In spite of their presumed relevance in maintaining interalveolar septal fluid homeostasis, the knowledge of the anatomy of human lung lymphatics is still incomplete. The recent discovery of reliable markers specific for lymphatic endothelium has led to the observation that, contrary to previous assumptions, human lymphatic vessels extend deep inside the pulmonary lobule in association with bronchioles, intralobular arterioles or small pulmonary veins. The aim of this study was to provide a morphometric characterization of lymphatic vessels in the periphery of the human lung. Human lung sections were immunolabelled with the lymphatic marker D2‐40, followed by blood vessel staining with von Willebrand Factor. Lymphatic vessels were classified into: intralobular (including those associated with bronchovascular bundles, perivascular, peribronchiolar and interalveolar), pleural (in the connective tissue of the visceral pleura), and interlobular (in interlobular septa). The percentage area occupied by the lymphatic lumen was much greater in the interlobular septa and in the subpleural space than in the lobule. Most of the intralobular lymphatic vessels were in close contact with a blood vessel, either alone or within a bronchovascular bundle, whereas 7% were associated with a bronchiole and < 1% were not connected to blood vessels or bronchioles (interalveolar). Intralobular lymphatic size progressively decreased from bronchovascular through to peribronchiolar, perivascular and interalveolar lymphatics. Lymphatics associated with bronchovascular bundles had similar morphometric characteristics to pleural and interlobular lymphatics. Shape factors were similar across lymphatic populations, except that peribronchiolar lymphatics had a marginally increased roundness and circularity, suggesting a more regular shape due to increased filling, and interlobular lymphatics had greater elongation, due to a greater proportion of conducting lymphatics cut longitudinally. Unsupervised cluster analysis confirmed a marked heterogeneity of lymphatic vessels both within and between groups, with a cluster of smaller vessels specifically represented in perivascular and interalveolar lymphatics within the alveolar interstitium. Our data indicate that intralobular lymphatics are a heterogeneous population, including vessels surrounding the bronchovascular bundle analogous to the conducting vessels present in the pleural and interlobular septa, many small perivascular lymphatics responsible for maintaining fluid balance in the alveolar interstitium, and a minority of intermediate lymphatics draining the peripheral airways. These lymphatic populations could be differentially involved in the pathogenesis of diseases preferentially involving distinct lung compartments.
影响因子：
6
作者：
Hirakawa, S;Hong, YK;Detmar, M
通讯作者：
Detmar, M