1 Center for Clinical Research, The Faculty of Medicine, Aalborg University, VBN2 Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, VBN3 The Faculty of Medicine, Aalborg University, VBN4 Aarhus University5 HNPCC-Register, Department of Gastroenterology and Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.6 Department of Cardiothoracic Surgery, Gentofte Hospital, University of Copenhagen Hellerup7 Aarhus University
Lymphatic vessels from animals have been shown to be innervated. While morphological studies have confirmed human lymphatic vessels are innervated, functional studies supporting this are lacking. The present study demonstrates a functional innervation of the human thoracic duct (TD) that is predominantly adrenergic. TDs harvested from 51 patients undergoing esophageal and cardia cancer surgery were either fixed for structural investigations or maintained in vitro for the functional assessment of innervation by isometric force measurements and electrical field stimulation (EFS). Electron microscopy and immunohistochemistry suggested scarce diffuse distribution of nerves in the entire vessel wall, but nerve-mediated contractions could be induced with EFS and were sensitive to the muscarinic receptor blocker atropine and the α-adrenoceptor blocker phentolamine. The combination of phentolamine and atropine resulted in a near-complete abolishment of EFS-induced contractions. The presence of sympathetic nerves was further confirmed by contractions induced by the sympathomimetic and catecholamine-releasing agent tyramine. Reactivity to the neurotransmitters norepinephrine, substance P, neuropeptide Y, acetylcholine, and methacholine was demonstrated by exogenous application to human TD ring segments. Norepinephrine provided the most consistent responses, whereas responses to the other agonists varied. We conclude that the human TD is functionally innervated with both cholinergic and adrenergic components, with the latter of the two dominating.
American Journal of Physiology: Heart and Circulatory Physiology, 2014, Vol 306, Issue 2
Human lymphatic vessels; Isolated vessel; Lymphatic innervation; Morphology; Myograph