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Chronic hypertension impairs lymphatic drainage in deep cervical lymph nodes
Kaiming Xu, Ankita Bhardwaj, Sunil Koundal, Qin Ren, Chenyu You, Xenophon Papademetris, Helene Benveniste, Tryphon T. Georgiou
Kaiming Xu, Ankita Bhardwaj, Sunil Koundal, Qin Ren, Chenyu You, Xenophon Papademetris, Helene Benveniste, Tryphon T. Georgiou
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Research Article Aging Immunology

Chronic hypertension impairs lymphatic drainage in deep cervical lymph nodes

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Abstract

The glymphatic-meningeal pathway, important for brain homeostasis, depends on the drainage function of the cervical lymphatic system. Although new therapies aim to modulate this pathway, a lack of methods for quantifying lymphatic drainage function hinders our ability to understand how targeting the cervical lymph nodes may benefit brain health. To address this, we developed and applied a fluid transport model to dynamic contrast-enhanced MRI (DCE-MRI) data to visualize and quantify tracer-tagged lymph through the deep cervical lymph nodes (dcLNs). The model incorporated physical principles of solute transport to provide a biologically interpretable framework for analyzing microflows in real time. We applied this model to investigate the effects of chronic hypertension on dcLN drainage by comparing normotensive Wistar-Kyoto rats with spontaneously hypertensive stroke-prone (SHRSP) rats. In normal rats, the model revealed complex and tortuous lymph streams of a 200 kDa tracer transported through the sinus system of the dcLNs. In contrast, SHRSP rats exhibited significantly altered fluid dynamics, characterized by simpler stream patterns and reduced flow through the dcLNs. These findings demonstrated that untreated chronic hypertension adversely affects lymph node drainage function. This study provides potentially new insight into impaired lymphatic drainage as a mechanism linking systemic disease to brain health.

Authors

Kaiming Xu, Ankita Bhardwaj, Sunil Koundal, Qin Ren, Chenyu You, Xenophon Papademetris, Helene Benveniste, Tryphon T. Georgiou

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Figure 1

Reduced tracer transport in the dcLNs of hypertensive rats.

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Reduced tracer transport in the dcLNs of hypertensive rats.
(A) MIP of a...
(A) MIP of a dcLN from a WKY rat, with the location of the dcLN highlighted by a dashed circle. (B) Higher magnification of the dcLN. (C and D) Anatomical subcompartments, including the subcapsular (Sub) and medullary (Ms) sinuses. (E and F) Representative DCE-MRI time series from a WKY (E) and SHRSP (F) rat. (G) Mean TSCs for WKY (n = 6, 12 dcLNs) and SHRSP (n = 5, 10 dcLNs) rats, shown with 95% CI. (H) WCSS elbow curve for dcLN K-means cluster analysis. (I and J) Cluster analysis demonstrating the location of the subcapsular sinus (cluster 1, blue), paracortical sinus (cluster 2, green), and medullary sinus (cluster 3, red) in WKY and SHRSP dcLNs. (K and L) Cluster-specific TSCs from a WKY (K) and SHRSP (L) rat. (M) Volume fraction of the 3 clusters across both groups. Aff, afferent lymphatic vessel; Cca, common carotid artery; Eff, efferent lymphatic vessel. Scale bars: 2 mm (A–F), 1.5 mm (I and J). Data in M are presented as mean ± SD with individual data points shown. A linear mixed-effects model with FDR correction was used to assess group differences in TSCs (G), with the P value for time × group interaction indicated. A Mann-Whitney U test with FDR correction was used for the fractional volume analysis (M). ns, not significant; **P < 0.01.

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