The cardiac lymphatic system

Loukas, Marios; Abel, Nicole; Tubbs, R. Shane; Grabska, Joanna; Birungi, Judith; Anderson, Robert H.

doi:10.1002/ca.21104

Cited by 32 publications

(22 citation statements)

References 31 publications

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“…The second vessel collects lymph from the left ventricle and runs on the surface of the coronary sinus towards the upper mediastinum. Recently published review articles [1, 4, 54] and the monographic edition by Karunamuni [10] summarize normal anatomy and structure of lymphatics, point to the newest techniques for studying cardiac lymphatics, the importance of the lymphatic system in tumor progression and metastasis, and describe the mechanisms of lymphangiogenesis in prenatal development and in various cardiovascular disorders.…”

Section: Resultsmentioning

confidence: 99%

Comparative and Developmental Anatomy of Cardiac Lymphatics

Ratajska

Gula

Flaht-Zabost

et al. 2014

The Scientific World Journal

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The role of the cardiac lymphatic system has been recently appreciated since lymphatic disturbances take part in various heart pathologies. This review presents the current knowledge about normal anatomy and structure of lymphatics and their prenatal development for a better understanding of the proper functioning of this system in relation to coronary circulation. Lymphatics of the heart consist of terminal capillaries of various diameters, capillary plexuses that drain continuously subendocardial, myocardial, and subepicardial areas, and draining (collecting) vessels that lead the lymph out of the heart. There are interspecies differences in the distribution of lymphatic capillaries, especially near the valves, as well as differences in the routes and number of draining vessels. In some species, subendocardial areas contain fewer lymphatic capillaries as compared to subepicardial parts of the heart. In all species there is at least one collector vessel draining lymph from the subepicardial plexuses and running along the anterior interventricular septum under the left auricle and further along the pulmonary trunk outside the heart and terminating in the right venous angle. The second collector assumes a different route in various species. In most mammalian species the collectors run along major branches of coronary arteries, have valves and a discontinuous layer of smooth muscle cells.

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Section: Resultsmentioning

confidence: 99%

Comparative and Developmental Anatomy of Cardiac Lymphatics

Ratajska

Gula

Flaht-Zabost

et al. 2014

The Scientific World Journal

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“…Based on the hitherto reported data, the adult cardiac lymphatic vasculature consists of a network of sub-epicardial and sub-endocardial vessels and a plexus of myocardial capillaries of various diameters and variable concentrations in the different regions of the heart [2–4, 10, 11]. By employing immunohistochemical labeling of proteins preferentially expressed in lymphatic endothelial cells, such as lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), membrane glycoprotein podoplanin, prospero homeobox-1 (Prox-1) transcription factor, or vascular endothelial growth factor-3 (VEGFR-3), it was established that the localization and morphology of CLVs are substantially altered in pathological conditions [7–9, 11–15].…”

Section: Introductionmentioning

confidence: 99%

Phenotypically heterogeneous podoplanin-expressing cell populations are associated with the lymphatic vessel growth and fibrogenic responses in the acutely and chronically infarcted myocardium

et al. 2017

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Cardiac lymphatic vasculature undergoes substantial expansion in response to myocardial infarction (MI). However, there is limited information on the cellular mechanisms mediating post-MI lymphangiogenesis and accompanying fibrosis in the infarcted adult heart. Using a mouse model of permanent coronary artery ligation, we examined spatiotemporal changes in the expression of lymphendothelial and mesenchymal markers in the acutely and chronically infarcted myocardium. We found that at the time of wound granulation, a three-fold increase in the frequency of podoplanin-labeled cells occurred in the infarcted hearts compared to non-operated and sham-operated counterparts. Podoplanin immunoreactivity detected LYVE-1-positive lymphatic vessels, as well as masses of LYVE-1-negative cells dispersed between myocytes, predominantly in the vicinity of the infarcted region. Podoplanin-carrying populations displayed a mesenchymal progenitor marker PDGFRα, and intermittently expressed Prox-1, a master regulator of the lymphatic endothelial fate. At the stages of scar formation and maturation, concomitantly with the enlargement of lymphatic network in the injured myocardium, the podoplanin-rich LYVE-1-negative multicellular assemblies were apparent in the fibrotic area, aligned with extracellular matrix deposits, or located in immediate proximity to activated blood vessels with high VEGFR-2 content. Of note, these podoplanin-containing cells acquired the expression of PDGFRβ or a hematoendothelial epitope CD34. Although Prox-1 labeling was abundant in the area affected by MI, the podoplanin-presenting cells were not consistently Prox-1-positive. The concordance of podoplanin with VEGFR-3 similarly varied. Thus, our data reveal previously unknown phenotypic and structural heterogeneity within the podoplanin-positive cell compartment in the infarcted heart, and suggest an alternate ability of podoplanin-presenting cardiac cells to generate lymphatic endothelium and pro-fibrotic cells, contributing to scar development.

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“…Although the lymphatic vasculature is a key player in the immune response, its role in the acute phase of MI remains to be elucidated. Remodeling of the lymphatic system has been recently proposed to participate in edema and tissue fibrosis in MI (2,36). We provide evidence that the lymphangiogenic process occurs in the periphery of the ischemic zone 2 weeks after MI and extends to the right ventricle 6 weeks after MI.…”

Section: Discussionmentioning

confidence: 51%