The lymphatic system

The lymphatic system is part of the circulatory system and a vital part of the immune
system, comprising a network of lymphatic vessels that carry a clear fluid called lymph.
Lymph is very similar to blood: it contains lymphocytes and other white blood cells. It also
contains waste products and cellular debris together with bacteria and proteins. Lymphocytes
are concentrated in the lymph nodes.

The lymphatic system of the body consists of the main lymphoid organs a conducting
network of lymphatic vessels, and the circulating lymph together with a network of smaller
concentrations of lymphoid tissue called lymph nodes.
The spleen, thymus and bone marrow are lymphoid organs of the immune system.
The tonsils are lymphoid organs that are also associated with the digestive system (trap and
destroy bacteria).

Primary Lymphoid Organs consist of the thymus and the bone marrow involved in
the production and early clonal selection of lymphocyte tissues. Bone marrow is responsible
for both the creation of T cells and the production and maturation of B cells.

— From the bone marrow, B cells immediately join the circulatory system and travel to
secondary lymphoid organs in search of pathogens. T cells, on the other hand, travel from the
bone marrow to the thymus, where they develop further. Mature T cells join B cells in search
of pathogens.
— Secondary Or Peripheral Lymphoid Organs which include lymph nodes and the
spleen, maintain mature lymphocytes. The peripheral lymphoid organs are the sites of
lymphocyte activation by antigens. Activation leads to clonal expansion and affinity
maturation. Mature lymphocytes recirculate between the blood and the peripheral lymphoid
organs until they encounter their specific antigen. Secondary lymphoid tissue provides the
environment for the antigens to interact with the lymphocytes.
— The Tertiary Lymphoid Tissue typically contains far fewer lymphocytes, and
assumes an immune role only when challenged with antigens that result in inflammation. It
achieves this by importing the lymphocytes from blood and lymph.
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The lymphatic system:

1. Bone marrow:
Is the flexible tissue in the interior of bones. In humans blood cells are produced by
bone marrow in a process known as hematopoiesis. The hematopoietic component of bone
marrow produces approximately 500 billion blood cells per day. Bone marrow is also a key
component of the lymphatic system, producing the lymphocytes that support the
body's immune system
2. Thymus:
The thymus is a primary lymphoid organ and the site of maturation for T cells, the
lymphocytes of the adaptive immune system. The thymus increases in size from birth in
response to postnatal antigen stimulation, then to puberty and regresses thereafter. The loss
or lack of the thymus results in severe immunodeficiency and subsequent high susceptibility
to infection. In most species, the thymus consists of lobules divided.
3. Spleen:
Largest lymphatic organ Located between the stomach & diaphragm. Structure is
similar to a node Capsule present But no afferent vessels or sinuses.
Histology: Red pulp contains all the components of circulating blood. White pulp is
similar to lymphatic nodules.
The main functions of the spleen are:

1. To produce immune response against antigens

2. To remove particulate matter and aged blood cells, mainly erythrocytes
3. To produce blood cells during fetal life
4. Site for immune surveillance and response
5. Removes debris, foreign matter, toxins, bacteria, viruses, old blood cells
6. Readily subject to rupture from mechanical trauma
The spleen retains the ability to produce lymphocytes. The spleen stores red blood
cells and lymphocytes. It can store enough blood cells to help in an emergency. Up to 25% of
lymphocytes can be stored at any one time.
4. Lymph nodes:
— The lymph nodes are found at branches of the lymphatic vessels and are present in
clusters in Neck, Axillae, Groin, Mediastinum And the Abdominal cavity.

A lymph node is an organized collection of lymphoid tissue, through which the lymph
passes on its way back to the blood. Lymph nodes are located at intervals along the
lymphatic system. There are between five and six hundred lymph nodes in the human body,
many of which are grouped in clusters in different regions as in the underarm and abdominal
areas. Lymph node clusters are commonly found at the base of limbs (groin, armpits) and in
the neck, where lymph is collected from regions of the body likely to sustain pathogen
contamination from injuries.
 The substance of a lymph node consists of lymphoid follicles in an outer portion called
the cortex. The inner portion of the node is called the medulla, which is surrounded by the
cortex on all sides except for a portion known as the hilum. The hilum presents as a
depression on the surface of the lymph node, causing the otherwise spherical lymph node to
be bean-shaped or ovoid. The efferent lymph vessel directly emerges from the lymph node at
the hilum. The arteries and veins supplying the lymph node with blood enter and exit through
the hilum.
A lymph follicle is a dense collection of lymphocytes, the number, size and
configuration of which change in accordance with the functional state of the lymph node. For
example, the follicles expand significantly when encountering a foreign antigen.
In summary, Typically a lymph node consists of three main regions: The cortex (B cell
area), The paracortex (T cell area) and The medulla which contains cords of lymphoid tissue.
Lymph nodes function by filtering antigen from the lymphatic ducts and presenting IT
to the lymphoid cells (acting as filters for foreign particles and cancer cells). Lymph nodes
do not deal with toxicity.

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5. Tonsils
Multiple groups of large lymphatic nodules. Location; mucous membrane of the oral
and pharyngeal cavities
1. Palatine tonsils
Posterior-lateral walls of the oropharynx
2. Pharyngeal tonsil
Posterior wall of nasopharynx
3. Lingual tonsils
Base of tongue
Function of the Lymphatic System:
a. Defense against harmful organisms and chemicals
b. 2 types of defense
i. Nonspecific
ii. Specific
c. Specific defense = immunity
i. Humoral immunity involves B cells that become plasma cells which
produce antibodies that bind with specific antigens.
ii. Cell-mediated immunity involves T cells that directly destroy foreign
cells

Derivation and Distribution of Lymphocytes:

Hemocytoblast divisions produce lymphocytic stem cells with two different fates. One
group remains in the bone marrow, producing B cells and NK cells. The second group
migrates to the thymus, producing T cells. All three types circulate in the bloodstream

Immune function
The lymphatic system plays a major role in body's immune system, as the primary site
for cells relating to adaptive immune system including T-cells and B-cells. Cells in the
lymphatic system react to antigens presented or found by the cells directly or by
other dendritic cells. When an antigen is recognised, and immunological cascade begins
involving activation and recruitment of more and more cells, production
of antibodies and cytokines and recruitment of other immunological cells such
as macrophages.
Some Lymphatic disease:
The study of lymphatic drainage of various organs is important in diagnosis, prognosis,
and treatment of cancer.
The lymph nodes can trap the cancer cells. If they are not successful in destroying the
cancer cells the nodes may become sites of secondary tumors.
1. Lymphadenopathy
Lymphadenopathy refers to one or more enlarged lymph nodes. Small groups or
individually enlarged lymph nodes are generally reactive in response to infection or
inflammation. This is called local lymphadenopathy. When many lymph nodes in different
areas of the body are involved, this is called generalized lymphadenopathy. Generalized
lymphadenopathy may be caused by infections such as tuberculosis and HIV, rheumatoid
arthritis, and cancers.
2. Lymphedema
Lymphedema is the swelling caused by the accumulation of lymph, which may occur if
the lymphatic system is damaged or has malformations. It usually affects limbs, though the
face, neck and abdomen may also be affected. The edema progresses to the extent that the
skin becomes thick with an appearance similar to the skin on elephant limbs. Causes are
unknown in most cases, but sometimes there is a previous history of severe infection, usually
caused by a parasitic disease, such as lymphatic filariasis. Lymphedema can also occur after
surgical removal of cancerous lymph nodes in the armpit (causing the arm to swell due to
poor lymphatic drainage) or groin (causing swelling of the leg). Treatment is by massage,
and is not permanent.
3. Cancer:
Lymphoma refers to cancer that arises from lymphatic tissue. Lymphangiosarcoma is a
malignant soft tissue tumor.
Mucosal Immunology:
Mucosal immunity protects internal epithelial surfaces. Components of the mucosal
immune system include lymphoid elements associated with internal surfaces of the body (GI,
respiratory, urogenital) and exocrine secretory glands linked to these organs, such as the
salivary, lachrymal, pancreas, and mammary glands.
Protection at mucosal surfaces and the mucosa-lymphoid tissue (MALT)

The mucosa-lymphoid tissue is a diffuse system of small concentrations of lymphoid

tissue found in various mucosal sites of the body, such as the gastrointestinal
tract, thyroid, breast, lung, salivary glands, eye, and skin.

The mucosal surfaces of the body are secretory in nature and have their own immune
system (MALT). MALT is mucosa-associated lymphatic tissue. It includes Peyer's patches,
the appendix, and the tonsils in the digestive tract, lymphoid follicles in the walls of the
bronchi, and genitourinary tract. Collectively, MALT protects passages open to the exterior
from foreign matter entering them. MALT is one of the major secondary lymphoid organs,
along with the lymph nodes and spleen. Plays an important immunological role.

MALT is populated by lymphocytes such as T cells and B cells, as well as plasma

cells and macrophages, each of which is well situated to encounter antigens passing through
the mucosal epithelium. T cells constitute a large percentage of gut-associated lymphocytes
and almost all of the intraepithelial lymphocytes are T cells

The main mucosal surfaces are :

1. The gastrointestinal tract (including oral mucosa and the salivary glands)
2. The genitourinary tract
3. The respiratory tract.

The secretion of the mammary glands is also part of the MALT. Protection at mucosal
surfaces and the MALT BY Antigen travels through specialized epithelium (M cells) to the
subepithelial lymphoid tissue. The main antibody produced at these sites is secretory IgA.
Localization to mammary gland is an important mechanism for maternal transfer of IgA via
milk
 Antigen presentation and induction of T and B cell responses occurs in MALT in a
fashion similar to other sites. MALT is well-equipped with professional APCs such as
dendritic cells.

MALT is equipped with T cells preferentially supporting B cell class switch to IgA

IgA is the predominant antibody class of the mucosal immune system. Distribution of
dimeric IgA is similar to the distribution of mucosal-associated lymphoid tissues.

Unique features of IgA immunity:

In the human, IgA is found in both monomeric and dimeric forms. Monomeric IgA is
produced mostly in bone marrow and found mainly in blood. Dimeric IgA is produced
mostly in lamina propria of mucosal tissues and found mainly in external secretions.
Monomeric IgA is structurally similar to monomers of other immunoglobulin classes.

Role of IgA in host defense against viruses. It can either block entry into epithelium, or
directly inactivate virus.

IgA and mucosal host defense against bacteria. IgA can act to prevent bacterial
adhesion to epithelium, a key first step in infection.
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