Lymphatics Are in My Veins

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Science  09 Aug 2013:
Vol. 341, Issue 6146, pp. 622-624
DOI: 10.1126/science.1243452

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The lymphatic system is generally underappreciated until something goes wrong. It controls fluid balance, dietary lipid absorption, and immune surveillance (1). When disrupted in adults, the consequences can be lethal, arising from inflammation, infection, and fibrosis. Impaired lymphatic vessel development causes fluid and protein accumulation in tissues, resulting in lymphedema, a disfiguring and disabling swelling of the extremities and other parts of the body. Moreover, lymphedema and chronic inflammation are aggravating factors in cardiovascular disease. Therapeutic agents that can promote lymphatic vessel formation (lymphangiogenesis) should prevent lymphedema and benefit individuals with cardiovascular pathologies. Both blood-vascular and lymphatic circulatory systems are closely intermingled and share many molecular signaling mechanisms for their development (2). At a recent meeting (3), advances in our understanding of these mechanisms indicate that selectively targeting lymphatic vessels without affecting blood vessels remains a challenge.