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OBJECTIVE: To observe the changes of thoracic duct lymph volume and the contents of histamine (HA), 5-hydroxytryptamine (5-HT), etc. in the lymph after acupuncture or thermal acupuncture interventions, in order to investigate the effect of lymphatic system in transmitting acupuncture and moxibustion signals. METHODS: A total of 45 male Wistar rats were randomly divided into control group, acupuncture group, and thermal acupuncture (acupuncture with the needle warmed by burning moxa) group (n = 15/group). The rat thoracic duct lymphatic fistula model was replicated. Acupuncture or thermal acupuncture was applied to "Zusanli" (ST 36), and the changes of thoracic duct lymph volume and the concentrations of HA, 5-HT in the lymph were observed. RESULTS: Compared with the control group, the thoracic duct lymph volume in acupuncture group and thermal acupuncture group were obviously increased (P < 0.05), while the concentrations of lymph HA and 5-HT in both acupuncture and thermal acupuncture groups had no significant changes (P > 0.05). CONCLUSION: Both acupuncture and thermal acupuncture interventions can increase the thoracic duct lymph volume, but have no effects on lymph HA and 5-HT contents in normal rats.

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Somatostatin and its analog octreotide have been used successfully to treat postoperative chylothorax, and it has been shown that octreotide binds with high affinity to somatostatin receptor (SSTR) subtypes 2 and 5. Therefore, we investigated expression of SSTR2 and SSTR5 in the human thoracic duct by immunohistochemistry. Normal rat pancreas was used as a positive control for antibodies against SSTR2 and SSTR5, and Factor VIII-related antigen, SMA, actin, elastin, or collagen type II, III, IV or V antibodies were used to identify cell types and structures within the human thoracic duct. The antibodies against SSTR2 and SSTR5 worked well and yielded positive staining in control rat islets. In the human thoracic duct, SSTR2 was present in smooth muscle cells and some scattered structures which were stained by antibodies against Factor VIII-related antigen, SMA, actin, elastin or collagen type II, III, IV or V. SSTR5 was also present in smooth muscle cells. The presence of SSTR2 and SSTR5 in the human thoracic duct sheds light on the mechanism of somatostatin and octreotide use in the successful treatment of chylothorax and offers new molecular pathways to explore for potential future therapies.

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To elucidate compositional changes of the thoracic duct with aging, the authors investigated age-related changes of elements in the thoracic ducts in comparison with the azygos veins. The subjects consisted of 22 men and 1 woman, ranging in age from 65 to 95 yr. After ordinary dissection, the thoracic ducts and azygos veins were resected from the subjects and element contents were determined by inductively coupled plasma-atomic emission spectrometry. It was found that calcium appeared to increase in the thoracic duct with aging, but the other elements, such as phosphorus, sulfur, magnesium, iron, zinc, and sodium, did not change significantly with aging. In the azygos vein, both calcium and sulfur increased significantly with aging. Regarding the relationship among elements, extremely significant direct correlations were found among calcium, phosphorus, sulfur, and magnesium in the thoracic ducts, except for phosphorus and magnesium contents with a very significant direct correlation. In the azygos veins, significant direct correlations were found between calcium and sulfur contents and between sulfur and magnesium contents. However, no significant correlations were found among calcium, phosphorus, and magnesium in the azygos veins. These results revealed that with regard to the relationship among calcium, phosphorus, and magnesium, the thoracic duct was similar to the arteries, but not to the azygos vein.

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The existence of lymphatic vessels in dental pulp has been a matter of continuing controversy because of the difficulty of discriminating them in ordinary stained tissue sections. Recently, we have succeeded in establishing a new identification method for lymphatic vessels in human frozen sections by using a commercial monoclonal antibody specific for the human thoracic duct and anti-human laminin antiserum. The present study aimed to examine the lymphatic vessels in human dental pulp using the new immunostaining method, and compared the results with those in human small intestine. The study clearly demonstrated the distribution of lymphatic vessels in human dental pulp. Large lymphatic vessels are located in the central part of the pulp and there are small lymphatic vessels in the periphery of the pulp. This suggests that lymphatic drainage of the human dental pulp starts from the periphery of the pulp and collects in the central part of the pulp. A notable difference between the small intestine and dental pulp was found in the immunoreactivity of lymphatic vessels to anti-human laminin anti-serum. In small intestine, immunoreactivity was significantly weaker than that of the blood vessels, whereas in dental pulp, that of lymphatic vessels was almost the same as blood vessels, except for some lymphatic vessels showing very weak reactivity. These findings suggest that the development of the basement membrane in both the lymphatic and blood vessels of human dental pulp is not as marked as in other tissue.

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Light microscopic identification of lymphatic vessels of the human small intestine was studied immuno-histochemically with a monoclonal antibody specific for human thoracic duct (mAb-D) and rabbit anti-human laminin antibody (anti-L). Two types of vessels were observed with anti-L; one strongly reacted with regularly outlined vessels and the other weakly reacted with irregularly outlined vessels and thin walls. Immunoreactivity to mAb-D was strong in the weakly reacting vessels, and the strongly reacting vessels did not react to mAb-D. Immunoreactivity of lymphatic vessels to anti-L has been reported to be weaker than that of the blood vessels; only irregularly outlined vessels which were weakly immunostained with anti-L reacted to mAb-D and no cross-reaction to mAb-D was observed in the regularly outlined vessels. This indicates that the vessels strongly reacting with anti-L are blood vessels and the vessels immunostained with mAb-D must be lymphatics. The study shows that it is possible to identify lymphatic vessels light microscopically by mAb-D. This method will be useful in studying the fine distribution of lymphatic vessels in normal tissue and also in pathological tissue such as metastasis of malignant tumors.

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The macroscopic arrangement of the termination of the thoracic duct (TD) was examined in detail in Japanese cadavers, and the distribution of various types of collagen, tenascin, laminin, and fibronectin in the framework of the wall of the thoracic duct termination was demonstrated. We identified several branching patterns and pathways of the TD (i.e., those terminating 1) at the venous angle (Type A); 2) at the end of the internal jugular vein (Type B); 3) at the the external jugular vein (Type C); or 4) in a complex with various branches (Type D). The TD often divided into two or three trunks before or after passing beneath the left brachiocephalic vein. Compared with the main trunk of the TD, fewer muscle fibers, elastic fibers, specific compounds of the extracellular matrices, and valvular connective tissues were found near the termination of the TD and the valves of the TD and veins. Smooth muscle cells were arranged irregularly in each region of the TD.

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