title: Mechanics of interstitial-lymphatic fluid transport: theoretical foundation and experimental validation.
abstract: Interstitial fluid movement is intrinsically linked to lymphatic drainage. However, their relationship is poorly understood, and associated pathologies are mostly untreatable. In this work we test the hypothesis that bulk tissue fluid movement can be evaluated in situ and described by a linear biphasic theory which integrates the regulatory function of the lymphatics with the mechanical stresses of the tissue. To accomplish this, we develop a novel experimental and theoretical model using the skin of the mouse tail. We then use the model to demonstrate how interstitial-lymphatic fluid movement depends on a balance between the elasticity, hydraulic conductivity, and lymphatic conductance as well as to demonstrate how chronic swelling (edema) alters the equipoise between tissue fluid balance parameters. Specifically, tissue fluid equilibrium is perturbed with a continuous interstitial infusion of saline into the tip of the tail. The resulting gradients in tissue stress are measured in terms of interstitial fluid pressure using a servo-null system. These measurements are then fit to the theory to provide in vivo estimates of the tissue hydraulic conductivity, elastic modulus, and overall resistance to lymphatic drainage. Additional experiments are performed on edematous tails to show that although chronic swelling causes an increase in the hydraulic conductivity, its greatly increased distensibility (due to matrix remodeling) dampens the driving forces for fluid movement and leads to fluid stagnation. This model is useful for examining potential treatments for edema and lymphatic disorders as well as substances which may alter tissue fluid balance and/or lymphatic drainage.
authors.affiliation: Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Swartz
authors.forename: A
authors.initials: A
authors.lastname: Kaipainen
authors.forename: P A
authors.initials: PA
authors.lastname: Netti
authors.forename: C
authors.initials: C
authors.lastname: Brekken
authors.forename: Y
authors.initials: Y
authors.lastname: Boucher
authors.forename: A J
authors.initials: AJ
authors.lastname: Grodzinsky
authors.forename: R K
authors.initials: RK
authors.lastname: Jain
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D003911:Dextrans; D004487:Edema / Q000503:physiopathology; D004548:Elasticity; D005110:Extracellular Space / Q000502:physiology*; D005260:Female; D016650:Fluorescein-5-isothiocyanate / Q000031:analogs & derivatives; D066298:In Vitro Techniques; D008196:Lymph / Q000502:physiology*; D008208:Lymphatic System / Q000033:anatomy & histology / Q000502:physiology; D051379:Mice; D008819:Mice, Nude; D008856:Microscopy, Fluorescence; D008954:Models, Biological; D011312:Pressure; D012867:Skin / Q000033:anatomy & histology; D012879:Skin Physiological Phenomena; D013623:Tail; D014882:Water-Electrolyte Balance / Q000502:physiology*
chemical_list: D003911:Dextrans; C015219:fluorescein isothiocyanate dextran; D016650:Fluorescein-5-isothiocyanate