Key Points• BMP9 is required for lymphatic valve formation.• Mice deficient in Bmp9 exhibit reduction in lymphatic draining efficiency.Lymphatic vessels are critical for the maintenance of tissue fluid homeostasis and their dysfunction contributes to several human diseases. The activin receptor-like kinase 1 (ALK1) is a transforming growth factor-b family type 1 receptor that is expressed on both blood and lymphatic endothelial cells (LECs). Its high-affinity ligand, bone morphogenetic protein 9 (BMP9), has been shown to be critical for retinal angiogenesis. The aim of this work was to investigate whether BMP9 could play a role in lymphatic development. We found that Bmp9 deficiency in mice causes abnormal lymphatic development. Bmp9-knockout (KO) pups presented hyperplastic mesenteric collecting vessels that maintained LYVE-1 expression. In accordance with this result, we found that BMP9 inhibited LYVE-1 expression in LECs in an ALK1-dependent manner. Bmp9-KO pups also presented a significant reduction in the number and in the maturation of mesenteric lymphatic valves at embryonic day 18.5 and at postnatal days 0 and 4. Interestingly, the expression of several genes known to be involved in valve formation (Foxc2, Connexin37, EphrinB2, and Neuropilin1) was upregulated by BMP9 in LECS. Finally, we demonstrated that Bmp9-KO neonates and adult mice had decreased lymphatic draining efficiency. These data identify BMP9 as an important extracellular regulator in the maturation of the lymphatic vascular network affecting valve development and lymphatic vessel function. (Blood. 2013;122(4):598-607)
IntroductionThe lymphatic vasculature is essential for the maintenance of normal fluid balance and for the immune response. It consists of a network of vessels that drain protein-rich lymph from the extracellular space back to the blood circulation, which absorbs dietary fatty acids and is involved in the traffic of immune cells.1 Lymphatic vessels may also serve as a conduit to lymph nodes and thereby participate in systemic metastasis of cancer cells. Hypoplasia, disruption or dysfunction of the lymphatic vessels, impair the ability of the lymphatic vasculature to collect and transport fluids and lead to lymphedema.
1,2The mammalian lymphatic system has been shown to originate from embryonic veins. Lymphatic vessel development starts at embryonic days (E) 9.5 to 10.5 in mice. After formation of the primary lymph sacs, further expansion leads to the formation of a primary lymphatic vascular plexus that, through subsequent remodeling and maturation, will provide a hierarchical network of lymphatic capillaries and lymphatic collecting vessels.1,3 During this vessel specification, maturation of collecting vessels is accompanied by the downregulation of lymphatic marker molecules such as LYVE-1, the acquisition of partial smooth muscle cell coverage, and the formation of intraluminal valves. [4][5][6] Lymphatic valves are essential components that ensure unidirectional lymph flow. They develop from E15.5 to early postnatal d...