Intestinal lymphatic dysfunction: a new pathway mediating gut–kidney crosstalk in kidney disease

The importance of kidney-gut crosstalk in driving kidney disease complications is increasingly being realized. However, little attention has been given to intestinal lymphatic changes in kidney disease. Zhong et al. report striking changes to intestinal lymphatic composition, structure, and function in proteinuric kidney injury models, including increased lymphangiogenesis, lymph flow, and transport of lipoproteins and proinflammatory mediators. These changes appear to be stimulated by isolevuglandin (IsoLG)-modified apolipoprotein AI (ApoAI). This intestinal lymphatic response may regulate systemic complications. The importance of kidney-gut crosstalk in driving kidney disease complications is increasingly being realized. However, little attention has been given to intestinal lymphatic changes in kidney disease. Zhong et al. report striking changes to intestinal lymphatic composition, structure, and function in proteinuric kidney injury models, including increased lymphangiogenesis, lymph flow, and transport of lipoproteins and proinflammatory mediators. These changes appear to be stimulated by isolevuglandin (IsoLG)-modified apolipoprotein AI (ApoAI). This intestinal lymphatic response may regulate systemic complications. Kidney injury-mediated disruption of intestinal lymphatics involves dicarbonyl-modified lipoproteinsKidney InternationalVol. 100Issue 3PreviewKidney disease affects intestinal structure and function. Although intestinal lymphatics are central in absorption and remodeling of dietary and synthesized lipids/lipoproteins, little is known about how kidney injury impacts the intestinal lymphatic network, or lipoproteins transported therein. To study this, we used puromycin aminoglycoside-treated rats and NEP25 transgenic mice to show that proteinuric injury expanded the intestinal lymphatic network, activated lymphatic endothelial cells and increased mesenteric lymph flow. Full-Text PDF