From Big Medical Encyclopedia

LYMPH (Latin. lympha pure water, moisture) — the liquid body tissue which is contained in absorbent vessels and nodes of high-organized vertebrata and the person.

L. it is formed as a result of a resorption of intersticial liquid in limf, vessels. From L. it is necessary to distinguish a hydra a lymph — the liquid circulating in channels of enterovascular system of nek-ry coelenterates animals (jellyfishes, comb jellies) and which is directly reported with fluid medium of dwelling of these animals and also a hemolymph — the liquid which is in vessels and intercellular spaces at the animals who do not have a loop system of blood circulation (arthropods, mollusks). The highest animals between a bone of an inner ear and a webby labyrinth have a small space filled with special liquid — a feather a lymph; liquid contents of a webby labyrinth are called an endolymph.

Main functions L. are: maintenance of constancy of structure and volume of intersticial liquid; ensuring humoral communication between intersticial liquid (environment) of all bodies and fabrics, the lymphoid device and blood; absorption and transport of decomposition products of feedstuffs from a gleam of intestines in venous system; participation in immunol, reactions of an organism by transportation from lymphoid bodies of cells of a plasmatic row, macrophages, immune lymphocytes and antibodies and other substances; participation in a stress reaction of an organism on extraordinary irritants by transportation in marrow and to the place of damage of the lymphocytes migrating from lymphoid bodies, plasmocytes and products of their disintegration etc. Therefore biochemical, features (proteinaceous, fermental and electrolytic structure) regional L. more precisely, than composition of blood, reflect productive function of appropriate authority, the nature of permeability, rezorbtsionny ability of gistolimfogematichesky barriers. In a lymph, but not in blood the formed in cells in the conditions of norm and pathology of a squirrel, many hormones, enzymes rezorbirutsya. Various useful and harmful metabolites of the proteinaceous nature are controlled on an autoantigennost and toxicity in lymph nodes (see) where they are in case of need neutralized, then are brought in blood and to all bodies and fabrics, promoting thereby a normal metabolism in an organism.

Idea of identity of L. and intersticial liquid not precisely. It is necessary to understand the liquid which is in the connected state in the form of so-called connective tissue or intra fibrillar water, liquid of serous cavities, eyes and also cerebrospinal liquid as intersticial liquid. The cavities covered by serous covers (pleural, peritoneal, etc.) contain liquid, to-ruyu sometimes call a hydrolymph. It differs from blood serum in smaller ion concentration To and Ca, and from L. smaller content of proteins. Direct anatomic bonds absorbent vessels (see) with these cavities is not present, but, as shown D. A. Zhdanov (1952), not true openings on the surfaces of serous covers covered with a mesothelial layer create communication between the listed above cavities and limf, capillaries. The circulation of plasma proteins in an organism is caused by their diffundirovaniye from blood in band liquids and intersticial spaces and the return resorption from them — hl. obr. in vascular L.

Kolichestvo L. in an organism, calculated experimentally by I. A. Potapov (1977), approximately makes 50 ml/kg and represents depot of liquid, mobilization a cut if necessary promotes increase in volume of plasma and volume of the circulating blood. I. Rusnyak (1954) considers that the person in limf, vessels has 1 — 2 l of a lymph. At a dog weighing 10 kg per day through a chest channel 500 — 600 ml of a lymph, at the person weighing 60 kg through a chest channel at rest for the same time of 1,2 — 1,5 l proceed. However it must be kept in mind that L. comes to blood not only through a chest channel, but also through the right limf, a channel, right and left jugular and subclavial limf, trunks.

For formation of L. the condition of a vascular wall, it is important permeability (see), and also physical. - chemical features and fiziol, activity connecting fabric (see), through to-ruyu there is a metabolism between blood, a parenchyma of body and a lymph. In these processes the condition of function of body plays a role.

L. — it is transparent or poorly opalescent liquid of salty taste, alkali reaction (pH 7,35 — 9,0). Ud. weight of L. from different areas from 1,017 to 1,026 fluctuates. Conductivity of L. above, than blood plasma (125,6*10 - 4 return ohms). Low protein content in L. causes its smaller viscosity in comparison with blood plasma and lower colloid osmotic pressure. L. is in a condition of diffusion balance with intersticial liquid and plasma blood (see) therefore they differ generally on the content of proteins. The lymph received from a chest channel of the person contains 2,9 — 7,3 g of % of protein (apprx. 60% on average of concentration of protein in a blood plasma). Albumine in L. it is slightly more, than globulin. L., flowing from various bodies, contains unequal amount of protein. The greatest number of proteins (80% of contents them in a blood plasma) is revealed in L. liver. The most low concentration of proteins in L. extremities, about 20% in relation to proteins of a blood plasma.

Cellular structure L., flowing from bodies, and L., passed through limf. nodes, it is not identical. In this regard allocate peripheral L., not passed through one limf, a node, intermediate (tranzitorny), passed through one-two limf, a node, and central L., being in chest channel (see) or others limf, the trunks falling into large veins of a neck.

In peripheral L. various cells get from intersticial space, at their rest it is not enough. The main part of the leukocytes which are present in peripheral L., make lymphocytes (to 90%). At damage of circulatory capillaries number of cellular elements in L. sharply increases. So, in animal experiments it is shown that after their radiation the maintenance of erythrocytes in L. reaches 2 000 000 in 1 mkl (it is normal of them apprx. 1000), and the number of lymphocytes sharply decreases. Nek-ry authors are inclined to explain these post-beam anemia (see. Radial illness ). In intermediate L. the quantity of leukocytes increases several times generally at the expense of average lymphocytes that indicates their origin in limf, nodes. Small lymphocytes seldom exceed 10% of total quantity, big make 1 — 2%, plasmocytes of 2 — 3%. Single neutrophils, eosinophils, erythrocytes, the low-differentiated trunk and tranzitorny forms of cells are sometimes observed. In 1 mkl central L. at cats 12 000 lymphocytes, at rabbits 32 600, monkeys 20 400, the person from 2000 to 20 000 contain. Small lymphocytes of a chest channel, a thymus, limf, nodes and marrow are of great importance in exchange of populations of lymphocytes of an adenoid tissue. Leukocytic formula L. a chest channel at dogs, across Raus (P. Rous, 1908), is as follows: lymphocytes 9206 in 1 mkl (or 87,6%); big mononuklear 544 (5,2%); transitional forms 41 (0,40%); polymorphonuclear neutrophils 126 (1,2%); eosinophils 278 (2,6%); uncertain 316 (3,0%).

Quantity and composition of proteins L. are defined by permeability of circulatory capillaries and therefore are various for L. different bodies. Only immunoelektroforetichesk managed to be revealed in an organ lymph (hepatic) other proteinaceous components, than in blood and L. chest channel. Detection in L., the concentration of gamma-globulins and properdin flowing from limf, nodes, increased is the direct proof of their education in adenoid tissue (see). Albuminoglobulinovy indicator of L. above, than a blood plasma, also depends on the place of its education.

L. contains fibrinogen and a prothrombin therefore she curls up in a glass test tube in 10 — 15 min. (i.e. longer, than blood). Slow coagulation of L. (in Bazaron's device on the surface of paraffin) it is caused rather not by a lack of factors of XII and XI, and a lack of thrombocytes, the phospholipidic component to-rykh is necessary for formation of thromboplastin.

L. plays a crucial role in absorption and transport of fats and fat-soluble substances from intestines. The general concentration of lipids in L. below, than in blood, but in a post-absorbing condition of L. takes a form of milk due to accumulation of the chylomicrons passing from cells of a mucous membrane of intestines into a lacteal sine of fibers through interendothelial connections.

Amylases, acid and alkaline phosphatases, maltase, protease, a lipase, catalase and other enzymes contain in central L. in more low concentration, than in blood, however organ L. may support them in bigger quantity. In particular, it is richest with enzymes L., flowing from kidneys and intestines that indicates a big role of L. in their delivery in a blood stream, especially in the conditions of pathology. Intestinal L. transfers gastrin and enterogormona to blood; renal L. contains pressor substances, and L. a chest channel — a lactate dehydrogenase. Their concentration increases at a renal artery stenosis. Splenic L. has considerable hemolitic activity. Concentration of hormones of ovaries, adrenal glands and a thyroid gland in L. it is close to their concentration in blood. Concentration of corticosterone in L. a chest channel higher, than in plasma.

In regulation of proteinaceous structure of L. neurotransmitters, glucocorticoids, mediators of an inflammation take part. So, the cortisone significantly influences proteinaceous structure central L., increasing the content of gamma-globulins; removal of marrow of adrenal glands increases the content of albumine and alpha globulins. Structure of L. changes at a resorption in limf, vessels from an interstitium of hormones, antineoplastic and immunodepressive himiopreparat, antibiotics.

Transition of liquid and the substances dissolved in it from blood and cells of fabrics in intersticial liquid, their distribution in it and the subsequent resorption in limf, capillaries, i.e. process of a lymphopoiesis, depend on a ratio of hydrostatic and kolloidnoosmotichesky pressure of blood, rheological properties of blood, existence and a ratio of factors of permeability (a histamine, bradikinin, serotonin) etc.

Structure and physical. - chemical properties fabric L. reflect features of the metabolism happening in this or that body also pathologies are normal. At pancreatitis, e.g., fermental shifts in L. are clearer, than in blood; at hron, pancreatitis (after stimulation by secretin) in L. a chest channel the content of amylase increases; at cirrhosis the level of proteins of L. changes two-stage: in the beginning raises, then falls. On the level of proteins in central L. it is possible to judge the nature of disturbances of outflow from a liver.

Because of low concentration of protective proteins L. can be the environment of reproduction and distribution of the most dangerous contagiums, napr, a malignant anthrax. Bacteria, foreign proteins, viruses and tumor cells first of all get into a lymph, but not into blood.

Extreme influences (bone injuries, massive blood losses, burns of the II—III degree etc.) are followed by decrease in contents in flowing L. and blood of properdin, albumine, sometimes N-atsetilneyraminovoy to - you that indicates their delay in the damaged fabrics. At the same time intensity of a lymphopoiesis increases, offsetting loss by blood of liquid and proteins, and the crucial role in it is played by catecholamines, to-rye are allocated at various damages. Catecholamines (see) increase pressure in venules and capillaries that, strengthening transudation of liquid in intersticial space and complicating its absorption in blood, leads as a result to increase in products of L. and to acceleration of a lymph drainage. In these conditions only treatment by lymphotropic means since absorption of gematotropny substances is slowed down can be pathogenetic.

Methods of a research

Methods of a research L. are labor-consuming because of complexity of stay and catheterization limf, vessels. Grudnoy Canal catheterize in the place of a confluence it in the left venous corner — merge of the left jugular and subclavial veins (see. Catheterization of a chest channel ). In experiments on animals catheterize the himusovy tank (the tank of a chest channel, T.) — behind an aorta, at the I—II level of lumbar vertebrae, and hepatolienal limf, a trunk — at a root of a mesentery to the right of the lower vena cava. In a wedge, conditions big prospects of use were shown limfosorbtion (see), a method of stimulation of a lymphopoiesis and a lymph drainage at patients with a catheter chest limf, a channel as a way of desintoxication of an organism in cases of acute pancreatitis, hepatonephric insufficiency etc. At the same time the greatest effect was reached at intravenous infusion of osmoaktivny substances in combination with liquid loading and influence of the pharmaceuticals normalizing microcirculator processes.

The increasing application is found by a method of endolymphatic therapy by antibiotics, antineoplastic substances. Good to lay down. the effect at a number of diseases gives parenteral administration to L. by Tselishchev's method (1961).

See also Lymphatic system .

Bibliogr.: Bulekbayeva L. E. A role of cortical structures of a brain and cerebellum in regulation of a lymphokinesis, Alma-Ata, 1974; It is given about in D. A. General anatomy and physiology of lymphatic system, L., 1952; Zedgenidzeg. And. and Cibas A. T. Clinical limfografiya, M., 1977; Zerbinod. D. General pathology of lymphatic system, Kiev, 1974; Whitebait of the Item. Questions of a pathophysiology of lymphatic system, the lane from Czeches., Prague, 1963; Rusnyak I., Fyoldi M. and D. Fiziologiya's Sabot and pathology of a lymphokinesis, the lane with Wenger., Budapest, 1957, bibliogr.; With and-p and M. R., Yurin N. A. N. and L. E Ethyne-gene. Lymph node (structure and functions). M, 1978, bibliogr.; Transport function of a lymph in an animal organism, under the editorship of X. X. Aynsoya, page 5, Tallinn, 1973; With about IS of t ice F. Page of Lymph and plasma proteins, barriers to their movement throughout the extracellular fluid, Lymphology, v. 4, p. 9, 1971, bibliogr.; Yoffey J. M. a. Courtice F. C. Lymphatics, lypmh and the lymphomyeloid complex, L. — N. Y., 1970.

V. I. Kurochkin.