Lymphatics in intestinal transport of nutrients and gastrointestinal hormones

The lymph fistula rat has been used for studying intestinal absorption of nutrients, especially lipids. Lipid absorption begins with the digestion of triacylglycerol (TAG) to form 2-monoacylglycerol (2-MAG) and fatty acids (FA), which are then incorporated in bile salt-mixed micelles. The mixed micelles deliver these digestion products to enterocytes for uptake. There, 2-MAG and FA are re-esterified to form TAG, which is then incorporated into chylomicrons (CMs) to be carried by the lymphatic system. Coincident with CMs' secretion into lymph, the small intestine also secretes incretin hormones. Advantages of the lymph fistula model in studying CMs and incretin secretion include the following: (1) the animal being conscious, (2) much less dilution of CMs and incretins than in portal blood, and (3) fewer degrading enzymes than portal blood, e.g., dipeptidyl peptidase-IV. Examples of the lymph fistula model being used for studying CMs' transport in normal and pathophysiologic states are presented. Recently, the lymph fistula rat has also been used for studying the secretion of incretins by the small intestine.