Intestinal Lymphatic Dysfunction in Kidney Disease

Author:

Zhong Jianyong12ORCID,Kirabo Annet34ORCID,Yang Hai-Chun12,Fogo Agnes B.125,Shelton Elaine L.1ORCID,Kon Valentina1

Affiliation:

1. Department of Pediatrics (J.Z., H.-C.Y., A.B.F., E.L.S., V.K.), Vanderbilt University Medical Center, Nashville, TN.

2. Department of Pathology, Microbiology and Immunology (J.Z., H.-C.Y., A.B.F.), Vanderbilt University Medical Center, Nashville, TN.

3. Department of Molecular Physiology and Biophysics (A.K.), Vanderbilt University Medical Center, Nashville, TN.

4. Division of Clinical Pharmacology, Vanderbilt University, Nashville, TN (A.K.).

5. Department of Medicine (A.B.F.), 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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine,Physiology

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