The ambivalent nature of the relationship between lymphatics and cancer

Lymphatic malformation:Classification, Pathogenesis and Therapeutic Strategies

Lymphatic malformation is a lymphatic system tumor caused by abnormal development during the embryonic period, which leads to structural defects in the lymphatic vessels. It originates from lymphatic endothelial cells and is prone to occur in the lymphatic vessels of the head, neck and axilla. It is characterized by abnormal proliferation and cystic expansion of lymphatic endothelial cells. In the current study of the molecular mechanism of lymphatic malformation, phosphatidylinositol-4,5-bisphosphate3-kinase catalytic subunit alpha and phosphoinositide-3-kinase regulatory subunit 3 gene mutations lead to abnormal activation of PI3K/AKT/mTOR signaling pathway, promoting lymphatic malformation lymphatic endothelial cells proliferation and lymphangiogenesis; vascular endothelial growth factor C binds to vascular endothelial growth factor receptor 3 to promote the survival, proliferation and migration of lymphatic endothelial cells. Overexpression of vascular endothelial growth factor C is involved in the formation of lymphatic malformation subtype gorham-stout disease; in the Wnt/β-catenin signaling pathway, wingless-type MMTV integration site family member 5A loss leads to the occurrence of lymphatic malformation; asparaginyl-tRNA synthetase mutations activate extracellular signal-regulated kinase phosphorylation, driving the occurrence of lymphatic malformation subtypes generalized lymphatic abnormality and kaposiform lymphangiomatosis. Clinically, treatment strategies are symptom-oriented and individualized according to the location and clinical manifestations of the disease. In recent years, mTOR inhibitor silomus and vascular endothelial growth factor receptor 3 inhibitors are effective in the treatment of lymphatic malformation. This review aims to explore the latest progress of clinical manifestations, pathogenesis and treatment methods of lymphatic malformation.

Combination of Anti-Angiogenics and Immunotherapies in Renal Cell Carcinoma Show Their Limits: Targeting Fibrosis to Break through the Glass Ceiling?

This review explores treating metastatic clear cell renal cell carcinoma (ccRCC) through current therapeutic modalities-anti-angiogenic therapies and immunotherapies. While these approaches represent the forefront, their limitations and variable patient responses highlight the need to comprehend underlying resistance mechanisms. We specifically investigate the role of fibrosis, prevalent in chronic kidney disease, influencing tumour growth and treatment resistance. Our focus extends to unravelling the intricate interplay between fibrosis, immunotherapy resistance, and the tumour microenvironment for effective therapy development. The analysis centres on connective tissue growth factor (CTGF), revealing its multifaceted role in ccRCC-promoting fibrosis, angiogenesis, and cancer progression. We discuss the potential of targeting CTGF to address the problem of fibrosis in ccRCC. Emphasising the crucial relationship between fibrosis and the immune system in ccRCC, we propose that targeting CTGF holds promise for overcoming obstacles to cancer treatment. However, we recognise that an in-depth understanding of the mechanisms and potential limitations is imperative and, therefore, advocate for further research. This is an essential prerequisite for the successful integration of CTGF-targeted therapies into the clinical landscape.

Immunomodulatory properties of the lymphatic endothelium in the tumor microenvironment

The tumor microenvironment (TME) is an intricate complex and dynamic structure composed of various cell types, including tumor, stromal and immune cells. Within this complex network, lymphatic endothelial cells (LECs) play a crucial role in regulating immune responses and influencing tumor progression and metastatic dissemination to lymph node and distant organs. Interestingly, LECs possess unique immunomodulatory properties that can either promote or inhibit anti-tumor immune responses. In fact, tumor-associated lymphangiogenesis can facilitate tumor cell dissemination and metastasis supporting immunoevasion, but also, different molecular mechanisms involved in LEC-mediated anti-tumor immunity have been already described. In this context, the crosstalk between cancer cells, LECs and immune cells and how this communication can shape the immune landscape in the TME is gaining increased interest in recent years. In this review, we present a comprehensive and updated report about the immunomodulatory properties of the lymphatic endothelium within the TME, with special focus on primary tumors and tumor-draining lymph nodes. Furthermore, we outline emerging research investigating the potential therapeutic strategies targeting the lymphatic endothelium to enhance anti-tumor immune responses. Understanding the intricate mechanisms involved in LEC-mediated immune modulation in the TME opens up new possibilities for the development of innovative approaches to fight cancer.

ANRIL promotes the regulation of colorectal cancer on lymphatic endothelial cells via VEGF-C and is the key target for Pien Tze Huang to inhibit cancer metastasis

lncRNA ANRIL is an oncogene, however the role of ANRIL in the regulation of colorectal cancer on human lymphatic endothelial cells (HLECs) is remain elusive. Pien Tze Huang (PZH, PTH) a Tradition Chinese Medicine (TCM) as an adjunctive medication could inhibit the cancer metastasis, however the mechanism still uncovering. We used network pharmacology, subcutaneous and orthotopic transplanted colorectal tumors models to determine the effect of PZH on tumor metastasis. Differential expressions of ANRIL in colorectal cancer cells, and stimulating the regulation of cancer cells on HLECs by culturing HLECs with cancer cells' supernatants. Network pharmacology, transcriptomics, and rescue experiments were carried out to verify key targets of PZH. We found PZH interfered with 32.2% of disease genes and 76.7% of pathways, and inhibited the growth of colorectal tumors, liver metastasis, and the expression of ANRIL. The overexpression of ANRIL promoted the regulation of cancer cells on HLECs, leading to lymphangiogenesis, via upregulated VEGF-C secretion, and alleviated the effect of PZH on inhibiting the regulation of cancer cells on HLECs. Transcriptomic, network pharmacology and rescue experiments show that PI3K/AKT pathway is the most important pathway for PZH to affect tumor metastasis via ANRIL. In conclusion, PZH inhibits the regulation of colorectal cancer on HLECs to alleviate tumor lymphangiogenesis and metastasis by downregulating ANRIL dependent PI3K/AKT/VEGF-C pathway.