title: The lymphatics and the inflammatory response: lessons learned from human lymphedema.
abstract: In lymphedema, there is a profound predisposition to infection with bacterial pathogens. It therefore seems appropriate to reconsider our unique functional definition of the lymphatic structures within a circulatory construct. While the lymphatics unquestionably fulfill a vital circulatory function, it seems more appropriate to view this complex network, comprised both of endothelial-lined vessels and of lymphoid tissue, as the nexus between the circulatory and immune systems. Viewed in this fashion, it becomes evident that the complex biology of regional lymphatic disruption is a manifestation of the interplay between these two vital bodily functions. Experimental lymph stasis in murine model has been utilized to effectively demonstrate the pathological attributes of human lymphedema, namely, inflammation, fat deposition, and fibrosis. Large-scale transcriptional corroborates the role of inflammatory mechanisms. The murine studies have set the stage for subsequent translational investigation of human lymphedema. Many of the gene expression pathways invoked by lymphedema are relevant to the inflammatory response and have provided a pragmatic approach to the successful identification of potentially relevant circulating biomarkers for human lymphedema.
authors.affiliation: Stanford University School of Medicine , Stanford, California.
authors.forename: Stanley G
authors.initials: SG
authors.lastname: Rockson
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D053263:Gene Regulatory Networks; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D007249:Inflammation / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D008208:Lymphatic System / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D008209:Lymphedema / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D051379:Mice; D020411:Oligonucleotide Array Sequence Analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D059467:Transcriptome
references.citation: Plast Reconstr Surg. 2012 Apr;129(4):825-834
references.pmid: 22456354
references.citation: Vasc Med. 2010 Jun;15(3):223-31
references.pmid: 20483987
references.citation: PLoS Med. 2006 Jul;3(7):e254
references.pmid: 16834456
references.citation: Lymphat Res Biol. 2009;7(2):97-100
references.pmid: 19522679
references.citation: Lymphat Res Biol. 2009 Dec;7(4):181
references.pmid: 20143915
references.citation: Am J Physiol Cell Physiol. 2011 May;300(5):C1107-21
references.pmid: 21248077
references.citation: PLoS Med. 2006 Jul;3(7):e264
references.pmid: 16842020
references.citation: Am J Pathol. 2010 Dec;177(6):3202-14
references.pmid: 21056998
references.citation: Plast Reconstr Surg. 2012 Apr;129(4):838-847
references.pmid: 22456356
references.citation: Ann N Y Acad Sci. 2010 Oct;1207 Suppl 1:E2-6
references.pmid: 20961302
references.citation: Lymphat Res Biol. 2006;4(4):199-210
references.pmid: 17394403
references.citation: PLoS One. 2012;7(12):e52021
references.pmid: 23272198