FETAL LYMPH FLOW DYNAMICS AND CONTROL

拟议研究的长期目标有两个方面：1) 了解胎儿和胎儿淋巴流动的动态和控制 2)了解淋巴流量对液体容量的贡献 胎儿体内的动态平衡。到目前为止产生的数据表明， 胎儿的淋巴系统与胎儿的淋巴系统有独特的不同。 成人的淋巴流率和淋巴蛋白流量是 相对于体重，胎儿的体重要高出好几倍。因此， 淋巴系统将在液体容量中发挥更大的作用。 与成人相比，胎儿的调节作用。建议数 研究将通过长期置入左侧导管来进行 不同条件下胸腔淋巴管及淋巴流量的测量 条件。更具体地说，这些研究旨在 确定胎儿淋巴流量随孕期变化的程度 年龄和确定自主神经系统是否 导致较高的基础流量和/或其广泛 短期变化性。潜在的内分泌调节作用 胎儿淋巴系统的研究将通过确定 精氨酸加压素的特定激动剂或拮抗剂， 去甲肾上腺素或血管紧张素II受体改变淋巴泵功能 从而改变淋巴流动功能切割器( 淋巴流量和流出压力之间的关系)。在……里面 此外，增加胎儿水合对淋巴的影响 将探索抽水能力。总体而言，这些研究不会 仅提供有关动态和控制的重要信息 正常胎儿的全身淋巴流动，但他们也会 为了解胎儿血流量提供洞察力 调节，胎儿液体平衡和临床问题，如非 免疫性水肿会引起胎儿(即胎儿水肿)。

The long-term objectives of the proposed studies are two fold: 1) understand the dynamics and control of lymph flow in the fetus and 2) to understand the contribution of lymph flow to fluid volume homeostasis in the fetus. Data generated thus far show that the lymphatic system in the fetus is uniquely different from that in the adult in that lymph flow rates and lymph protein fluxes are several times higher in the fetus relative to body weight. Thus the lymphatic system will play a much greater role in fluid volume regulation in the fetus as compared to the adult. The proposed studies will be performed by chronically catheterizing the left thoracic lymph duct and measuring lymph flow under various conditions. More specifically, the studies are desinged to determine to what extent fetal lymph flows vary with gestational age and to determine whether the autonomic nervous system contributes to either the high basal flow rate and/or its extensive short-term variability. Potential endocrine modulation of the fetal lymphatic system will be explored by determining whether specific agonists or antagonists to arginine vasopressin, norepinephrine or angiotensin II receptors alter lymphatic pumping ability and thereby alter the lymph flow function cutve (the relationship between lymph flow and outflow pressure). In addition, the effects of increasing fetal hydration on lymphatic pumping ability will be explored. Overall, these studies will not only provide important information about the dynamics and control of whole-body lymph flow in the normal fetus but they will also provide insights into the understanding of fetal blood volume regulation, fetal fluid balance, and clinical problems such as non- immune hydrops fetalis (ie, fetal edema).