FETAL LYMPH FLOW DYNAMICS AND CONTROL

拟议研究的长远目标有两个：1） 了解胎儿淋巴液流动的动力学和控制， 2)了解淋巴液流量对体液容量的贡献 胎儿的体内平衡 迄今为止生成的数据显示， 胎儿的淋巴系统与胎儿的淋巴系统有着独特的不同。 成虫淋巴液流速和淋巴蛋白通量 相对于体重，胎儿的体重要高出几倍。 因此 淋巴系统将在液体体积中发挥更大的作用 与成人相比，胎儿的调节。 拟议 研究将通过对左心室进行长期导管插入 胸淋巴管和测量淋巴流量在不同情况下 条件 更具体地说，这些研究旨在 确定胎儿淋巴液流量在多大程度上随妊娠 年龄，并确定自主神经系统是否 有助于高基础流速和/或其广泛的 短期可变性。 潜在的内分泌调节 胎儿淋巴系统将通过确定是否 精氨酸加压素的特异性激动剂或拮抗剂， 去甲肾上腺素或血管紧张素II受体改变淋巴泵 能力，从而改变淋巴流动功能切割（ 淋巴流量和流出压力之间的关系）。 在 此外，增加胎儿水化对淋巴细胞的影响， 将探索泵送能力。 总的来说，这些研究不会 只提供有关动力学和控制的重要信息 正常胎儿全身淋巴液的流动，但他们也将 提供对胎儿血容量理解的见解 调节，胎儿液体平衡，和临床问题，如非- 免疫性胎儿水肿（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).