Dr. Ralf Oettmeier, Alpstein Clinic AG, Gais, Switzerland, www.alpstein-clinic.ch
Although its importance and presence, our lymphatic system is neglected by conventional medicine. It not only forms the drainage and evacuation system, but together with the immune cells and primary and secondary lymphatic organs it is the main carrier of our immunocompetence. In the context of milieu medicine, the understanding of lymphatic disease is of great practical relevance. After targeted diagnostics, it is important to develop an individualized treatment that paves the way for the organism's ability to regulate and heal itself.
The main components of our lymphatic system
The Latin word "lympha" means "clear water" and describes the plasma-like appearance of the lymph fluid. The protein content is between 1-5% depending on the region. Around 2 liters of new lymph are formed every day. About 25% of our body water is in the lymph. Figure 1 shows the main components of the lymphatic system.
Figure 1: Main components of the lymphatic system
1. Webinar as part of the SANUM conference 2020
The lymph accumulates within the periphery of the organs and tissue in very permeable lymph capillaries, which are approximately 100 µm in diameter and have a wall thickness of only 0.1 µm. These flow into so-called lymph collectors, which are thicker and, similar to the leg veins, also have valves. In the abdominal cavity, the lymph is collected in the cisterna chyli and then flows upwards over large lymphatic trunks (ducts) to finally open into the large vena cava behind the collarbones. Thus there is a direct integration of the lymph into the blood vessel system. The cycle is open and thus also transports a large amount of metabolic products that have to be excreted into the blood (which we can possibly see in vital blood microscopy).
Figure 2: Reticulated interaction of the lymph capillaries (Source: lumenlearning.com)
While the flow in the large lymphatic vessels is transported to the center by the suction effect of the large vena cava, in the periphery, this depends on the build-up of colloid osmotic pressure. This flow depends crucially on the supply of electrolytes and protein. For example, if there is a lack of protein, the absorption of lymph becomes slow, which can lead to massive edema.
Between 600 and 700 lymph nodes with a size of 2 to 20 mm are placed between the lymphatic channels. They form the home and maturation site of the lymph cells and are particularly concentrated on the trunk of the body. The most important lymph nodes that are accessible for an examination are located on the side of the neck and above the collarbones (= upper lymphatic belt), in the armpits and in the inguinal region (= lower lymphatic belt).
Figure 3: Structure and histology of a lymph node (Source: lumenlearning.com)
The most important lymph cells are those of the B and T series. The B lymphocytes are the main component of the adaptive immune system and, as activated plasma cells, produce various types of antibodies. These immunoglobulins are the product of an antigen-antibody reaction against foreign particles and pathogens of all kinds. The germinal centers of the B cells are lymph nodes, spleen and intestinal wall. 15% of the immunoglobulins (Ig) produced are of type A and are located on the surface of the mucous membrane (IgA). In fresh infections, IgM appear after 1-2 weeks, which disappear again after an average of 6 weeks and are replaced by IgG, which represent about 75% of the serum antibodies, beginning with the third week after a new infection. Immunoglobulins are used in serological diagnosis of pathogens. The term "T-lymphocyte" refers to the thymus as its center of maturation. These immune cells organize the cell-mediated or cellular immune defense and have a number of subgroups. In the laboratory test "lymphocyte subpopulation determination", for example, one can differentiate into T helper cells, T regulator cells (formerly suppressor cells), natural killer cells (NK cells) or cytotoxic T cells. All processes are controlled by immunological messenger substances, so-called lymphokines or cytokines. The process of a specific immune defense against viruses, parasites, fungi, cancer cells and special bacteria (Borellia, Lues, leprosy) is highly complex and is shown in Figure 4. The