Research in autoimmunity tends to focus on the immune cells mediating disease and not structural aspects of involved tissues. However, a recent review article published in the journal Frontiers in Immunology highlights the role of a bodily structure associated with the immune system, known as the lymphatic system, in the pathophysiology of rheumatic autoimmune diseases such as Lupus, Scleroderma, Dermatomyositis, and Rheumatoid Arthritis. This network of vessels connects the extracellular matrix of many tissues to lymph nodes and eventually the bloodstream, is necessary for clearing immune cells and fluid from sites of inflammation, and has increasingly recognized roles in mediating immunological tolerance.
Rheumatic autoimmune diseases are associated with dysfunction of lymphatic vessels that limits the flow of fluid and cells from tissues to the bloodstream. Current therapies such as Tumor Necrosis Factor (TNF) inhibitors may contribute to combatting autoimmune disease by restoring proper lymphatic vessel function.
In addition, alternative medicines known for hundreds of years to remedy rheumatic diseases, such as lymphatic-directed massage techniques and acupuncture, may soon be recognized by researchers as grounded in modern medical science.
Peristaltic pulse dynamic compression devices (PPDC), a type of massage therapy technology, have been demonstrated to induce the expression of anti-inflammatory genes and may contribute to restoring lymphatic system functionality.
Acupuncture may stimulate nerves and other cell types to support the activity of lymphatic vessels, and acupoints, the sites of needle insertion during acupuncture, interestingly co-localize with lymphatic and blood vessels, nerves, and niches of an immune cell type that contributes to the regulation of fluid flow through tissues.
The scientific basis for the efficacy of these therapies will likely be explored in greater detail within the next decade and may contribute to expanding their use by patients with rheumatic diseases.
Schwartz N, Chalasani MLS, Li TM, et al. (2019), Lymphatic Function in Autoimmune Diseases. Frontiers in Immunology, https://doi.org/10.3389/fimmu.2019.00519
“Magnetic resonance images of lumbar and lower thoracic spine: psoriatic arthritis. (a) T1-weighted and (b) short tau inversion recovery (STIR) magnetic resonance images of the lumbar and lower thoracic spine. Signs of active inflammation are seen at several levels (arrows). In particular, anterior spondylitis is seen at level L1/L2 and an inflammatory Andersson lesion at the upper vertebral endplate of L3.”
Source: “Magnetic resonance imaging in psoriatic arthritis: a review of the literature.” Fiona McQueen, Marissa Lassere and Mikkel Østergaard. Arthritis Research & Therapy 2006, 8:207. doi:10.1186/ar1934