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Myocardial infarction (MI) arising from obstruction of the coronary circulation engenders massive cardiomyocyte loss and replacement by non-contractile scar tissue, leading to pathological remodeling, dysfunction, and ultimately heart failure. This is presently a global health problem for which there is no effective cure. Following MI, the innate immune system directs the phagocytosis of dead cell debris in an effort to stimulate cell repopulation and tissue renewal. In the mammalian adult heart, however, the persistent influx of immune cells, coupled with the lack of an inherent regenerative capacity, results in cardiac fibrosis. Here, we reveal that stimulation of cardiac lymphangiogenesis with VEGF-C improves clearance of the acute inflammatory response after MI by trafficking immune cells to draining mediastinal lymph nodes (MLNs) in a process dependent on lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1). Deletion of Lyve1 in mice, preventing docking and transit of leukocytes through the lymphatic endothelium, results in exacerbation of chronic inflammation and long-term deterioration of cardiac function. Our findings support targeting of the lymphatic/immune cell axis as a therapeutic paradigm to promote immune modulation and heart repair.

Original publication

DOI

10.1172/JCI97192

Type

Journal article

Journal

J Clin Invest

Publication Date

01/08/2018

Volume

128

Pages

3402 - 3412

Keywords

Cardiovascular disease, Inflammation, Vascular Biology, Animals, Cell Movement, Heart Failure, Inflammation, Leukocytes, Lymphangiogenesis, Lymphatic System, Mice, Mice, Knockout, Myocardial Infarction, Myocytes, Cardiac, Vascular Endothelial Growth Factor C, Vesicular Transport Proteins