Regulation of immune function by the lymphatic system in lymphedema Review


Authors: Kataru, R. P.; Baik, J. E.; Park, H. J.; Wiser, I.; Rehal, S.; Shin, J. Y.; Mehrara, B. J.
Review Title: Regulation of immune function by the lymphatic system in lymphedema
Abstract: The lymphatic vasculature has traditionally been thought to play a passive role in the regulation of immune responses by transporting antigen presenting cells and soluble antigens to regional lymph nodes. However, more recent studies have shown that lymphatic endothelial cells regulate immune responses more directly by modulating entry of immune cells into lymphatic capillaries, presenting antigens on major histocompatibility complex proteins, and modulating antigen presenting cells. Secondary lymphedema is a disease that develops when the lymphatic system is injured during surgical treatment of cancers or is damaged by infections. We have used mouse models of lymphedema in order to understand the effects of chronic lymphatic injury on immune responses and have shown that lymphedema results in a mixed T helper cell and T regulatory cell (Treg) inflammatory response. Prolonged T helper 2 biased immune responses in lymphedema regulate the pathology of this disease by promoting tissue fibrosis, inhibiting formation of collateral lymphatics, decreasing lymphatic vessel pumping capacity, and increasing lymphatic leakiness. Treg infiltration following lymphatic injury results from proliferation of natural Tregs and suppresses innate and adaptive immune responses. These studies have broad clinical relevance since understanding how lymphatic injury in lymphedema can modulate immune responses may provide a template with which we can study more subtle forms of lymphatic injury that may occur in physiologic conditions such as aging, obesity, metabolic tumors, and in the tumor microenvironment.
Keywords: inflammation; fibrosis; lymphatic vessels; immune function; th2 type t cells
Journal Title: Frontiers in Immunology
Volume: 10
ISSN: 1664-3224
Publisher: Frontiers Media S.A.  
Date Published: 2019-03-18
Start Page: 470
Language: English
DOI: 10.3389/fimmu.2019.00470
PUBMED: 30936872
PROVIDER: scopus
PMCID: PMC6431610
DOI/URL:
Notes: Review -- Export Date: 1 May 2019 -- Source: Scopus
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MSK Authors
  1. Babak Mehrara
    448 Mehrara
  2. Raghu Prasad Kataru
    60 Kataru
  3. Sonia Rehal
    5 Rehal
  4. Jungeun Baik
    13 Baik
  5. Hyeung Ju Park
    20 Park
  6. Itay Wiser
    6 Wiser
  7. Jinyeon Shin
    22 Shin