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Publication : CD4<sup>+</sup> T cells are activated in regional lymph nodes and migrate to skin to initiate lymphedema.

First Author  García Nores GD Year  2018
Journal  Nat Commun Volume  9
Issue  1 Pages  1970
PubMed ID  29773802 Mgi Jnum  J:262909
Mgi Id  MGI:6161156 Doi  10.1038/s41467-018-04418-y
Citation  Garcia Nores GD, et al. (2018) CD4(+) T cells are activated in regional lymph nodes and migrate to skin to initiate lymphedema. Nat Commun 9(1):1970
abstractText  T cell-mediated responses have been implicated in the development of fibrosis, impaired lymphangiogenesis, and lymphatic dysfunction in secondary lymphedema. Here we show that CD4(+) T cells are necessary for lymphedema pathogenesis by utilizing adoptive transfer techniques in CD4 knockout mice that have undergone tail skin and lymphatic excision or popliteal lymph node dissection. We also demonstrate that T cell activation following lymphatic injury occurs in regional skin-draining lymph nodes after interaction with antigen-presenting cells such as dendritic cells. CD4(+) T cell activation is associated with differentiation into a mixed T helper type 1 and 2 phenotype, as well as upregulation of adhesion molecules and chemokines that promote migration to the skin. Most importantly, we find that blocking T cell release from lymph nodes using a sphingosine-1-phosphate receptor modulator prevents lymphedema, suggesting that this approach may have clinical utility.
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