Emerging roles of lymphatics in inflammatory bowel disease

JS Alexander, GV Chaitanya… - Annals of the New …, 2010 - Wiley Online Library
JS Alexander, GV Chaitanya, MB Grisham, M Boktor
Annals of the New York Academy of Sciences, 2010Wiley Online Library
The mobilization and recruitment of blood and lymphatic vasculatures are widely described
in inflammatory bowel diseases (IBDs). Although angiogenesis contributes to intense gut
inflammation, it remains unclear whether and when lymphangiogenesis amplifies or protects
in IBD. The prolonged maintenance of lymphatic (over blood vessels) in inflammation
indicates that lymphatic–blood vessel interactions may regulate IBD pathogenesis and
restitution. Although lymphatic expansion helps to restore fluid balance and clear cytokines …
The mobilization and recruitment of blood and lymphatic vasculatures are widely described in inflammatory bowel diseases (IBDs). Although angiogenesis contributes to intense gut inflammation, it remains unclear whether and when lymphangiogenesis amplifies or protects in IBD. The prolonged maintenance of lymphatic (over blood vessels) in inflammation indicates that lymphatic–blood vessel interactions may regulate IBD pathogenesis and restitution. Although lymphatic expansion helps to restore fluid balance and clear cytokines and immune cells, lymphatic failure results in accumulation of these factors and exacerbates IBD. Lymphatic obstruction and remodeling may impair lymphatic pumping, leading to repeated rounds of lymphangiogenesis. Early descriptions of Crohn's disease and ulcerative colitis describe colon lymphatic congestion, remodeling, expansion, and many other features that are recapitulated in experimental IBD and also by intestinal lymphatic obstruction, supporting lymphangitis as a cause and consequence of IBD. Growth factors, cytokines, gut flora, Toll receptors, and leukocytes all regulate inflammation and gut lymphatic remodeling in IBD. This review summarizes the importance of lymphatics and lymphangiogenesis in IBD etiology that may be useful in diagnosis and therapy of gut inflammation.
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