Reticuloendothelial System: Vascular, Nonvascular, and Oncologic

The reticuloendothelial system is the portion of the immune system consisting of phagocytic cells found in reticular connective tissue in the spleen, liver, lungs, bone marrow, and lymph nodes. For the purposes of this chapter, the discussion will be limited to interventions within the spleen and the lymphatic system. Splenic arterial interventions are performed to treat a variety of clinical conditions, including abdominal trauma, hypersplenism, splenic arterial aneurysm/pseudoaneurysm, portal hypertension, and splenic neoplasm, and they provide an alternative to open surgery. Although not commonly performed, percutaneous splenic biopsy and drainage are relatively safe and efficacious procedures. Lymphangiography is a therapeutic option for patients with chylothorax, chylous ascites, and lymphatic fistula. Percutaneous thoracic duct embolization (TDE) is an alternative to surgical ligation of the thoracic duct (TD).

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Splenic Mechanisms of Thrombocytopenia

Blood ◽

10.1182/blood.v130.suppl_1.sci-33.sci-33 ◽

2017 ◽

Vol 130 (Suppl_1) ◽

pp. SCI-33-SCI-33

Author(s):

John W. Semple

Keyword(s):

Immune Responses ◽

Reticuloendothelial System ◽

Lymphoid Organ ◽

The Body ◽

White Pulp ◽

Cellular Mechanisms ◽

Venous Circulation ◽

Destructive Processes ◽

Clinical Conditions ◽

Red Pulp

The spleen is the largest secondary lymphoid organ in the body and contains up to 25 percent of the body's lymphocyte populations. It is not only responsible for initiating immune responses against a multitude of infectious antigens within its white pulp, it also has the exquisite ability to filter the blood and remove, for example, senescent erythrocytes and platelets. This natural process is carried out within the red pulp of the spleen which is composed monocyte-rich connective tissue cords of Billroth intertwined with sinus cavities lined by parallel-oriented endothelial cells that have interendothelial slits which allow for the mechanical sorting of "old" cells. This occurs because of the inability of the senescent cells to properly migrate through the endothelial fenestrae into the venous circulation allowing them to be identified by cells of the reticuloendothelial system (RES) and quickly destroyed by phagocytosis. This process also allows for the efficient recycling of iron from destroyed erythrocyte hemoglobin molecules. There are a wide variety of clinical conditions that can significantly alter the ability of the RES to destroy blood cells including hereditary blood cell defects, inflammation, cancer and abnormal immune responses. This lecture will focus on the central role that the spleen plays in not only generating immune responses against platelets but also in primarily causing the destruction of both senescent and antibody-opsonized platelets leading to thrombocytopenia. It will discuss the soluble and cellular mechanisms of splenic sequestration, destruction and the ability of the spleen to modulate anti-platelet immunity. Mechanisms involving complement activation, Fc Receptor-mediated phagocytosis, antibody dependent cellular cytotoxicity and platelet self-destruction will be addressed. It will compare the spleen's platelet destructive capabilities with other organs, particularly the liver and will detail how immune responses generated in the white pulp can modulate platelet destructive processes in the red pulp. Disclosures Semple: Amgen: Consultancy, Honoraria, Speakers Bureau; Rigel: Consultancy, Honoraria; UCB: Consultancy, Honoraria.

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Pills or Sleep Deprivation? Sleep-Deprivation as a Therapeutic Option Intervention in Psychiatry

Interactive science ◽

10.21661/r-551967 ◽

2020 ◽

pp. 16-32

Author(s):

Andrey Viktorovich Antsyborov ◽

Irina Vladimirovna Dubatova ◽

Anna Valerievna Kalinchuk

Keyword(s):

Sleep Deprivation ◽

Therapeutic Option ◽

Brain Regions ◽

Clinical Effects ◽

Data Set ◽

Close Supervision ◽

The Status ◽

Clinical Conditions ◽

Traditional Approaches

In recent decades, sleep deprivation has evolved from a single experimental data set to the status of an effective and affordable therapeutic intervention used in daily clinical practice. The mechanism of action of this method is aimed at the same neurotransmitter systems and brain regions as antidepressants. As in the case of pharmacotherapy for sleep deprivation, it should be used under close supervision of a physician. Clinical effects with sleep deprivation are achieved much faster than with psychopharmacotherapy, but they are not long-term in nature. It is possible to improve the results using a combination of pharmacotherapy and sleep deprivation. The use of sleep deprivation in clinical conditions is aimed primarily at preventing depression and its recurrence, as well as in cases resistant to pharmacotherapy. In modern conditions, the method of sleep deprivation is a significant alternative to traditional approaches to therapy of depression.

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STUDIES ON TUBERCULIN FEVER

Journal of Experimental Medicine ◽

10.1084/jem.131.3.483 ◽

1970 ◽

Vol 131 (3) ◽

pp. 483-498 ◽

Cited By ~ 6

Author(s):

William J. Hall ◽

Lorraine Francis ◽

Elisha Atkins

Keyword(s):

Mononuclear Cells ◽

Reticuloendothelial System ◽

Passive Transfer ◽

Host Cells ◽

Endogenous Pyrogen ◽

Phagocytic Cells ◽

Lymph Node Cells ◽

Intermediate Substance

Utilizing techniques of passive transfer, we have investigated the factors responsible for production of fever when tuberculin is given intravenously to specifically sensitized rabbits. The ability to develop a febrile response to tuberculin could be passively transferred to normal recipients with viable mononuclear cells from peritoneal exudates, spleen, or lymph nodes of donor rabbits sensitized with BCG. Sensitivity was usually apparent 48 hr after transfer, maximal at 7 to 14 days, and rapidly declined thereafter. Granulocytes and nonviable, sonicated, mononuclear cells from similarly sensitized donors were unable to transfer this form of reactivity. Passive transfer of reactivity was also effected with plasma and serum, suggesting that the reaction of antibody with antigen contained in tuberculin is one of the initial steps by which the host cells are activated to release the endogenous pyrogen (EP) that mediates this form of hypersensitivity fever. An intravenous infusion of granulocytes, as well as of several types of mononuclear cells from sensitized donors, made most recipients responsive to the pyrogenic effect of old tuberculin (OT) given 2 hr later. Some of these passively transferred cells, such as the granulocyte and alveolar macrophage, may be activated in vivo by OT, as they are in vitro. However, in the case of splenic and lymph node cells that cannot be activated by OT to produce EP in vitro, it seems likely that an intravenous injection of OT causes these transferred, sensitized cells to liberate an intermediate substance that either directly, or in association with antigen, activates the host's normal cells to produce EP. In support of previous suggestions that leukocytes of several types, as well as phagocytic cells of the reticuloendothelial system, serve as potential sources of EP in tuberculin-induced fever, evidence was presented that OT also activates both granulocytes and mononuclear cells from sterile exudates of BCG-sensitized donors to produce EP in vitro.

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Natural Antibody Contributes to Host Defense against an Attenuated Brucella abortus virB Mutant

Infection and Immunity ◽

10.1128/iai.01114-08 ◽

2009 ◽

Vol 77 (7) ◽

pp. 3004-3013 ◽

Cited By ~ 25

Author(s):

Hortensia G. Rolán ◽

Mariana N. Xavier ◽

Renato L. Santos ◽

Renée M. Tsolis

Keyword(s):

Knockout Mice ◽

Brucella Abortus ◽

Reticuloendothelial System ◽

Type Iv Secretion ◽

Natural Antibody ◽

Immune Functions ◽

Phagocytic Cells ◽

Type Iv ◽

Early Expression

ABSTRACT Brucella abortus is an intracellular pathogen that persists within phagocytic cells of the reticuloendothelial system. To identify in vivo interactions between B. abortus and the host that lead to persistent infection, we studied the persistence of B. abortus and an isogenic virB mutant deficient in the VirB type IV secretion system (T4SS) in knockout mice. In contrast to control mice, mice lacking B cells (Igh6 −/−) were permissive for infection with the attenuated virB mutant. To determine the basis for this phenotype, we characterized immune functions of Igh6 −/− mice in the context of B. abortus infection. Igh6 −/− mice had greater numbers of extracellular bacteria in the spleen and increased early expression of proinflammatory cytokines during B. abortus infection. Further, a virB mutant, despite its wild-type level of survival, failed to elicit microgranuloma formation in the spleens of Igh6 −/− mice, suggesting a requirement for the T4SS to elicit this pathological change. Passive transfer of immunoglobulin G from naïve mice restored the ability of Igh6 −/− mice to control the persistence of the virB mutant by a complement-independent mechanism. Further, adoptive transfer of CD11b+ cells from C57BL/6 mice to Igh6 −/− mice restored the ability of the knockout mice to limit the replication of the virB mutant in the spleen, suggesting that the Igh6 − / − mutation affects phagocyte function and that phagocyte function can be restored by natural antibody.

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THE ROLE OF OPSONINS IN THE CLEARANCE OF LIVING AND INERT PARTICLES BY CELLS OF THE RETICULOENDOTHELIAL SYSTEM

Journal of Experimental Medicine ◽

10.1084/jem.114.3.363 ◽

1961 ◽

Vol 114 (3) ◽

pp. 363-374 ◽

Cited By ~ 74

Author(s):

Charles R. Jenkin ◽

Derrick Rowley

Keyword(s):

Large Dose ◽

Reticuloendothelial System ◽

Blood Stream ◽

Phagocytic Cells ◽

Serum Factors ◽

Inert Particles ◽

Reduced Rate ◽

Living Bacteria

An investigation of the clearance of bacteria and colloids from the blood stream of mice has shown that both living and inert particles require serum factors (opsonins) in order that they may be phagocytosed by the macrophages of the reticuloendothelial system. It has been demonstrated that after the injection of a large dose of colloid there is a depletion of these serum opsonins which appears to account for the reduced rate of clearance of a second dose of colloid or living bacteria, since replacement of these factors leads to normal clearance. The significance of these results is discussed and it is suggested that in "blockaded" animals there is a depletion of serum opsonins rather than a saturation of phagocytic cells.

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First successful case of percutaneous transabdominal thoracic duct embolization (PTTDE) for chylous ascites resulting from laparoscopic gastric cancer surgery

International Cancer Conference Journal ◽

10.1007/s13691-021-00468-0 ◽

2021 ◽

Author(s):

Hideyuki Yokokawa ◽

Takao Katsube ◽

Miki Miyazawa ◽

Ryohei Nishiguchi ◽

Shinichi Asaka ◽

...

Keyword(s):

Gastric Cancer ◽

Thoracic Duct ◽

Distal Gastrectomy ◽

Oral Intake ◽

Chylous Ascites ◽

Albumin Concentration ◽

Serum Albumin Concentration ◽

Node Dissection ◽

Gastric Cancer Surgery ◽

Successful Case

AbstractA 61-year-old woman underwent laparoscopy-assisted distal gastrectomy (LADG) with extragastric lymph node dissection (D2). Two months later, she was readmitted to hospital to be treated for chylous ascites. Oral intake was discontinued and total parenteral nutrition started, but increasing body weight and decreasing serum albumin concentration was not controllable. Percutaneous transabdominal thoracic duct embolization (PTTDE) was performed on the 8th day after the readmission. Five days after PTTDE, oral intake was resumed. Seventeen days after PTTDE, the patient was discharged without recurrence of ascites. She has remained asymptomatic. We describe here the first patient with chylous ascites two months after LADG with D2 dissection for early gastric cancer who was successfully treated by PTTDE.

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Chylous Ascites: A Rare Complication of Thoracic Duct Embolization for Chylothorax

CardioVascular and Interventional Radiology ◽

10.1007/s00270-010-9900-4 ◽

2010 ◽

Vol 34 (S2) ◽

pp. 245-249 ◽

Cited By ~ 12

Author(s):

Ron C. Gaba ◽

Charles A. Owens ◽

James T. Bui ◽

Tami C. Carrillo ◽

M. Grace Knuttinen

Keyword(s):

Thoracic Duct ◽

Rare Complication ◽

Chylous Ascites

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Surgical Management of Lymphatic Leakage

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i56b33958 ◽

2021 ◽

pp. 317-323

Author(s):

Hashem Bark Awadh Abood ◽

Atheer Hamad Alatawi ◽

Abdulaziz Ali ALMohammed ◽

Mutasim Hassan Alhasani ◽

Saleh Amir Almutairi ◽

...

Keyword(s):

Lymphatic System ◽

Interventional Procedure ◽

Chylous Ascites ◽

The Body ◽

Waste Products ◽

Surgical Closure ◽

Pharmacological Manipulation ◽

Lymphatic Fistula ◽

Underlying Illness ◽

Flow Through

Lymphatics are found in almost every organ in the body, and they produce a variety of waste products that must be eliminated. lymphatic leakage is a typical occurrence. It can cause immunodeficiency as well as nutritional issues. Furthermore, it has a significant morbidity and death rate, depending on the existence of an underlying illness. Lymphatic leakage can be congenital, traumatic, or cancerous, and occurs when the lymphatic system is disrupted. It might take the following forms: Chylothorax, Lymphatic Fistula, Chylous Ascites. treatment of lymph leaks includes: reduction of lymphatic flow through physiological or pharmacological manipulation; replacement of fluid and electrolytes, as well as interventional procedure and/or direct surgical closure. In this review we’ll be discussing lymphatic system anatomy, its leakage and its management.

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