Lymphatics Keep Flowing Along . . .

by Lowell A. Goldsmith, MD, MPH

Lymphatics were a challenge to me and my fellow  medical students during  our gross anatomy class a half century ago. We could find arteries and veins galore, but where were the elusive lymphatics? Even the two larger connections between the venous and  lymphatic systems were elusive.

Lymphatic biology has progressed  exponentially since then. For two days in May, 2013  the world’s  lymphatic gurus gathered at Yale to fete the rich molecular biology and physiology of the lymphatics, as  summarized recently in Science (Simons and Eichmann, 2013). As of August 17, 2013, lymphedema was  a feature  of almost 70 genetic diseases and syndromes in OMIM, and many common conditions are transmitted  by — or alter — lymphatics.  Vascular endothelial growth factors and their receptors are major players in lymphatic development, and  an RNA binding protein antigen, R(huR), and other molecules are important VEGF modulators.  Lymphatics continue to be the subject of  many narratives, with  implications for cutaneous biology and cutaneous diseases, both inflammatory and neoplastic.  The key role of lymphatic endothelial cells during the transit of dendritic cells from the periphery to lymph nodes is highlighted in the  September issue of JID, underscoring  the importance of lymphatics in cutaneous inflammatory biology.  (Teijeira et al, 2013)

I started with history and end on a historical theme. Dermatology and Yale have a rich history in lymphatic and vascular biology, and Irwin Braverman, currently  a Professor of Dermatology at Yale, published a masterful review in 1983 on the role of blood vessels and lymphatics in skin diseases containing many of his seminal original studies.(Braverman, 1983)   I suspect he is  pleased that skin and lymphatics are still closely intertwined and that Yale was the setting for this vascular biology meeting.



Braverman IM   (1983) The role of blood vessels and lymphatics in cutaneous inflammatory processes: an overview.  Br J Dermatol.  109 Suppl 25:89-98

Simons M and Eichmann A (2013)  Lymphatics are in my veins  Science 341: 622-4

Teijeira A, Garasa S, Palaez R, et al (2013) Lymphatic Endothelium Forms Integrin-Engaging 3D Structures during DC Transit across Inflamed Lymphatic Vessels. J Invest Dermatol 133:2276-85



This image is from Wikipedia, and it is in the public domain.


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