title: Lymphatic pumping: mechanics, mechanisms and malfunction.
abstract: A combination of extrinsic (passive) and intrinsic (active) forces move lymph against a hydrostatic pressure gradient in most regions of the body. The effectiveness of the lymph pump system impacts not only interstitial fluid balance but other aspects of overall homeostasis. This review focuses on the mechanisms that regulate the intrinsic, active contractions of collecting lymphatic vessels in relation to their ability to actively transport lymph. Lymph propulsion requires not only robust contractions of lymphatic muscle cells, but contraction waves that are synchronized over the length of a lymphangion as well as properly functioning intraluminal valves. Normal lymphatic pump function is determined by the intrinsic properties of lymphatic muscle and the regulation of pumping by lymphatic preload, afterload, spontaneous contraction rate, contractility and neural influences. Lymphatic contractile dysfunction, barrier dysfunction and valve defects are common themes among pathologies that directly involve the lymphatic system, such as inherited and acquired forms of lymphoedema, and pathologies that indirectly involve the lymphatic system, such as inflammation, obesity and metabolic syndrome, and inflammatory bowel disease.
authors.affiliation: Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Scallan
authors.affiliation: Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Zawieja
authors.affiliation: Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Castorena-Gonzalez
authors.affiliation: Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA. davismj@missouri.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Davis
mesh_terms: D000818:Animals; D006801:Humans; D008196:Lymph / Q000502:physiology*; D008208:Lymphatic System / Q000502:physiology*; D042601:Lymphatic Vessels / Q000502:physiology*; D009119:Muscle Contraction / Q000502:physiology; D009130:Muscle, Smooth / Q000502:physiology; D011312:Pressure
keywords: lymphatic; lymphedema; muscle contraction